GP Clinic

Question 1

Haematuria differentials

Answer 1

Renal colic - Stones  
Pyelonephritis
UTI
Trauma
BPH
Malignancy

Question 2

Investigations/next steps for renal stones

Answer 2

Pain management and CTKUB - check whether there’s an infection/obstruction

Question 3

What increases the risk for AKI with renal stones?

Answer 3

Bilateral renal stones

One kidney

Question 4

Safety netting

Answer 4

Vomiting

Fever

Question 5

Painless haematuria

Answer 5

LUTS
FH
Risk factors for urologic malignancies e.g. smoke/aromatic amines e.g. dye

Question 6

Painless haematuria questions to ask

Answer 6

LUTS
FH
Risk factors for urologic malignancies e.g. smoke/aromatic amines e.g. dye

Question 7

Microscopic haematuria differentials

Answer 7

UTI
Pyelonephritis
BPH
Vigorous exercise
Sex

Question 8

What is persistent haematuria?

Answer 8

2/3 positive dips between a few weeks

Question 9

When do you refer for 2WW for bladder malignancy?

Answer 9

Over 45 with unexplained VISIBLE haematuria

Above 60 with unexplained non -visible haematuria and raised WCC or dysuria

Question 10

What is dysuria?

Answer 10

Painful urination

Question 11

Causes of tonsillitis - what scoring system would you use to differentiate?

Answer 11

Viral >bacterial

Centor criteria - age, exudate or tonsil swelling, tender swollen anterior cervical lymph noes, temp, cough

If above 3, bacterial

Question 12

Treatment for tonsillitis

Answer 12

Pencillin

Erythromycin 3 day course

Question 13

Other signs of glandular fever/EBV

Answer 13

SPlenomegaly

Axillary lymphadenopathy

Question 14

EBV diagnosis

Answer 14

Monospot/heterophile test (looks for antibodies)

Question 15

EBV diagnosis

Answer 15

Monospot/heterophile test (looks for antibodies)

Question 16

What would you see on a blood test with glandular fever?

Answer 16

Haemolytic anaemia
Transient thrombocytopenia
Reactive lymphocytosis

Question 17

Advice for someone with glandular fever

Answer 17

Avoid contact sports (as risk of splenic rupture)

Avoid close contact

Question 18

Dfx for RUQ after eating

Answer 18

Right lower lobe pneumonia
Biliary colic
Peptic ulcer
Cholecystitis
Hepatitis

Question 19

What is cholecystitis?

Answer 19

Gall stone stuck in cystic duct and inflammation
tenderness in area
Fever

Question 20

Investigations for biliary colic

Answer 20

FBC
U and E
LFT
CRP
Amylase 
Abdo USS

Question 21

Who would you refer gall stones to and why?

Answer 21

Referral to upper GI surgery

Laparoscopic cholecystectomy

Question 22

When do you not refer gall stones?

Answer 22

Asymptomatic and small stones within gall bladder

Question 23

Dfx for calf pain

Answer 23

Intermittent claudication
PVD

Diabetic neuropathy
Spinal stenosis

Question 24

What relieves spinal stenosis?

Answer 24

Fetal position relieves spinal stenosis

Question 25

Investigations for calf pain

Answer 25

``` Cap refill Hair loss 6Ps of acute limb ischemia Buerger's test ABPI ankle brachial pressure indx ```

Question 26

Differentiate between intermittent claudication, critical limb ischemia and acute limb ischemia

Answer 26

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

Question 27

How long do you give omeprazole for in gord

Answer 27

4 week trial of omeprazole or hpylori test

Question 28

Treatment for h pylori

Answer 28

7 day course of triple hterapy: PPI BD Metronidazole Amoxicillin Clarithromycin

Question 29

What else would you examine if someone has facial weakness

Answer 29

Scalp, ears, mastoid, parotid, glands, oral cavity

Question 30

Treatment

Answer 30

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

Question 31

LMN facial palsy causes

Answer 31

Idiopathic - HZV - ramsay hunt syndromeNeoplastic - acoustic neuroma o rparotid malignancy Traumatic Otitis media, lyme diseaes,

Question 32

LMN facial palsy causes

Answer 32

Idiopathic - HZV - ramsay hunt syndrome Neoplastic - acoustic neuroma or parotid malignancy Traumatic Otitis media, lyme diseaes,