GP formative Flashcards
A 10 year old boy has just played sports and is limping, complaining of pain in his left knee. It is worse going up stairs. 2 days later he has the same symptoms and is in discomfort if he weight bears on the affected side.
What is the single most important action for the GP?
Exclude irritable hip (also known as transient/toxic synovitis).
Irritable hip is a common childhood condition that can occur following viral infection or minor trauma.
May require X rays and blood tests to exclude more serious hip conditions like septic arthritis and Perthes disease.
What is a pGALS assessment?
paediatric Gait Arms and Legs and Spine assessment
Starts with 3 screening questions:
“Do you have any pain or stiffness in your muscles, joints or back?”
“Do you have any difficulty getting yourself dressed without any help?”
“Do you have any problem going up and down the stairs?”
Gait assessment includes heel and tiptoe walking
A patient asks for a repeat prescription of a high dose antidepressant as they are running out today. What is the most important action to take?
Prescribe and organise a time to review their medication
An elderly patient has just been released from hospital with an indwelling catheter. Name one medication that should be stopped using STOPP START in this circumstance
Oxybutinin - for an overactive bladder
- no longer required and has a high anticholinergic burden
A teenage boy presents with severe acne, causing him to be withdrawn and teary. He has lost weight. What is the most important next step?
Referral to CAMHS
An elderly man presents struggling to cope after the sudden death of his wife. He states that he sometimes sees her in her old armchair and sits and talks to her, although he is aware that what he is seeing is not real. What is the most likely explanation?
Normal grief reaction
Can you catch chicken pox from somebody with shingles?
Yes if you have not had it before, but you cannot catch shingles from them
At what age do children usually start walking independently?
18 months
Single most appropriate medication to prescribe a child with a fever and chickenpox?
Paracetamol to bring down temp
What tests are used in baby examinations for developmental dysplasia of the hip?
Barlow and Ortolani tests
What is the most appropriate action to take if a patient presents to GP with signs of upper GI bleeding and are haemodynamically unstable?
Call the surgical registrar on call and arrange for the patient to go to ED in an ambulance
What should you do if a parent says they are concerned about their child being vaccinated because they noted irritability and mild erythema around the injection site after their last set of routine immunisations?
Reassure the parent and continue with the planned immunisations
Differentials for erythematous flexural rash in a baby?
Infantile seborrheic dermatitis
Candidiasis - lesions are discrete and often accompanied by oral thrush (creamy plaques visible in mouth)
How should you tx impetigo?
Topical Fusidic acid cream
