GP Clinic Flashcards
Raised WCC and dysuria with no UTI Sx. Dx?
Bladder cancer
Tonsillitis treated with amoxicillin. Comes back 2 days later with widespread maculopapular rash. Dx?
EBV (glandular fever)
List signs of glandular fever
Splenomegaly
Axillary lymphadenopathy
What are Ix for glandular fever?
Monospot test
FBC
Blood film
What would an EBV blood film show?
Atypical activated lymphocytes
What would FBC show in EBV?
Lymphocytosis, low platelets, anaemia
45y/o with RUQ stabbing pain + nausea. Happens after eating. DDx?
Gallstones Biliary colic Cholecystitis Peptic ulcer R lower love pneumonia Hepatitis
Ix for biliary colic?
BLOODS: FBC, U&E, LFT, CRP, amylase
Abdo USS
Cramps in legs when walking, stops when rests. DDx?
PAD
Intermittent claudication
Spinal stenosis
Ix for ?intermittent claudication
Peripheral vascular exam inc pulses, skin changes
Buergers test
ABPI
How does intermittent claudication differ from acute limb ischaemia?
IC = pain on walking, ABPI <0.9 ALI = 6 Ps, severely impaired blood flow
What is critical limb ischaemia?
Rest pain >2 weeks +/- tissue loss
ABPI <0.5
Burning sensation for 3 months after eating. Sometimes a nasty taste in the mouth. Qs to ask?
Other Sx eg cough or dysphagia
Worse when lying down?
Smoking? Alcohol? obese?
Burning sensation for 3 months after eating. Sometimes a nasty taste in the mouth. DDx?
GORD
Peptic ulcer
Ix for ?GORD
4 week PPI trial
H.Pylori trial
If H.Pylori test is +’ve, what is Tx?
Triple therapy
7 day course of PPI (twice a day), 2 ABx - clarithromycin/amoxicillin/metronidazole
L sided facial drop. Arms&legs fine. DDx?
Bells palsy
MN lesion
Stroke
L sided facial drop. Arms&legs fine. Ix?
CN exam
Upper & lower limb exam
Scalp, parotids, ears, mastoids, mouth inspection
Differentiate between UMN and LMN lesions in the face
U = forehead spared L = forehead not spared
What is Bells palsy?
Idiopathic facial nerve palsy
Diagnosis of exclusion
What is Mx of Bells palsy?
Reassurance - not stroke
Eye care - esp when sleeping
High dose steroids if PC <72hrs
