GP Clinic Flashcards
Haematuria differentials
Renal colic - Stones Pyelonephritis UTI Trauma BPH Malignancy
Investigations/next steps for renal stones
Pain management and CTKUB - check whether there’s an infection/obstruction
What increases the risk for AKI with renal stones?
Bilateral renal stones
One kidney
Safety netting
Vomiting
Fever
Painless haematuria
LUTS
FH
Risk factors for urologic malignancies e.g. smoke/aromatic amines e.g. dye
Painless haematuria questions to ask
LUTS
FH
Risk factors for urologic malignancies e.g. smoke/aromatic amines e.g. dye
Microscopic haematuria differentials
UTI Pyelonephritis BPH Vigorous exercise Sex
What is persistent haematuria?
2/3 positive dips between a few weeks
When do you refer for 2WW for bladder malignancy?
Over 45 with unexplained VISIBLE haematuria
Above 60 with unexplained non -visible haematuria and raised WCC or dysuria
What is dysuria?
Painful urination
Causes of tonsillitis - what scoring system would you use to differentiate?
Viral >bacterial
Centor criteria - age, exudate or tonsil swelling, tender swollen anterior cervical lymph noes, temp, cough
If above 3, bacterial
Treatment for tonsillitis
Pencillin
Erythromycin 3 day course
Other signs of glandular fever/EBV
SPlenomegaly
Axillary lymphadenopathy
EBV diagnosis
Monospot/heterophile test (looks for antibodies)
EBV diagnosis
Monospot/heterophile test (looks for antibodies)
What would you see on a blood test with glandular fever?
Haemolytic anaemia
Transient thrombocytopenia
Reactive lymphocytosis
Advice for someone with glandular fever
Avoid contact sports (as risk of splenic rupture)
Avoid close contact
Dfx for RUQ after eating
Right lower lobe pneumonia Biliary colic Peptic ulcer Cholecystitis Hepatitis
What is cholecystitis?
Gall stone stuck in cystic duct and inflammation
tenderness in area
Fever
Investigations for biliary colic
FBC U and E LFT CRP Amylase Abdo USS
Who would you refer gall stones to and why?
Referral to upper GI surgery
Laparoscopic cholecystectomy
When do you not refer gall stones?
Asymptomatic and small stones within gall bladder
Dfx for calf pain
Intermittent claudication
PVD
Diabetic neuropathy
Spinal stenosis
What relieves spinal stenosis?
Fetal position relieves spinal stenosis
Investigations for calf pain
Cap refill Hair loss 6Ps of acute limb ischemia Buerger's test ABPI ankle brachial pressure indx
Differentiate between intermittent claudication, critical limb ischemia and acute limb ischemia
Intermittent claudication - pain on walking - conservative and medical treatment needed
Rest pain for more than 2 weeks with ulcers - critical limb ischemia - bypass needed
6Ps - acute limb ischemia, sudden onset due to blockage - embolectomy needed
How long do you give omeprazole for in gord
4 week trial of omeprazole
or hpylori test
Treatment for h pylori
7 day course of triple hterapy:
PPI BD
Metronidazole
Amoxicillin
Clarithromycin
What else would you examine if someone has facial weakness
Scalp, ears, mastoid, parotid, glands, oral cavity
Treatment
Reassure
careful of eye as might not close
Eye lubricant
Tape eye shut overnight
Any eye symptoms - refer to ophthalmology
Prednisolone 50mg 10 days
Neuro referral if you don’t recover within 3-4 months
LMN facial palsy causes
Idiopathic -
HZV - ramsay hunt syndromeNeoplastic - acoustic neuroma o rparotid malignancy
Traumatic
Otitis media, lyme diseaes,
LMN facial palsy causes
Idiopathic -
HZV - ramsay hunt syndrome
Neoplastic - acoustic neuroma or parotid malignancy
Traumatic
Otitis media, lyme diseaes,
