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Clinical Methods > GP From another persons deck > Flashcards

GP From another persons deck Flashcards

1
Q

Name the common differentials for TATT

A
  • VITAMIN DCE
  • Anaemia
  • Hypothyroidism
  • Diabetes
  • Depression
  • Stress
  • Post-viral
  • Neoplasm
  • Chronic inflammatory conditions
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2
Q

Describe the different types of headache and the main symptoms

A
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3
Q

Name some signs of iron deficiency anaemia

A
  • Pallor
  • Atrophic glossitis
  • Angular cheilosis (ulceration in corners of mouth)
  • Nail changes
    • Longitudinal ridging
    • Koilonychia (spoon shaped)
  • Tachycardia, murmurs, cardiomegaly, heart failure if severe
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4
Q

Name the categories of anaemia and some examples for each

A

Microcytic = TAILS

  • Thalassaemia
  • Iron deficiency
  • Sideroblastic anaemia

Macrocytic = FAT RBC

  • Folate
  • Alcoholism
  • B12
  • Myelodysplastic syndromes
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5
Q

Which antibiotic for bacterial tonsilitis?

A

Penicillin / erythromycin (7 days)

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6
Q

Which antibiotic for lower respiratory tract infection?

A

Amoxicillin or doxycycline (5 days)

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7
Q

Which antibiotic for uncomplicated UTI?

A

Trimethoprim or nitrofurantoin (3 days)

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8
Q

Which antibiotic for complicated UTI?

A

Trimethoprim or nitrofurantoin (5 days)

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9
Q

Which antibiotic for UTI in pregnancy?

A

Nitrofurantoin or Trimethoprim (7 days)

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10
Q

Which antibiotic for cellulitis?

A

Flucloxacillin (7 days)

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11
Q

Which antibiotic for meningitis?

A
  • Refer to A&E immediately
  • IV penicillin before
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12
Q

Describe the appearance and protein content of transudates and exudates

A

Transudate:

  • Clear/pale yellow
  • Protein < 30g/L

Exudate:

  • Turbid/bloody
  • Protein > 30g/L
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13
Q

Name some examples of transudate and exudate

A

Transudate = failure syndromes

  • Heart failure
  • Cirrhosis
  • Nephrotic syndrome
  • Hypothyroidism
  • Meig’s

Exudate:

  • Infection
  • RA/SLE
  • Malignancy
  • Pancreatitis
  • PE
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14
Q

Name some tumour markers in the blood

A
  • Colorectal = CEA
  • Ovarian = CA-125
  • Pancreatic/bile duct = CA19-9
  • Liver/germ cell = AFP
  • Prostate = PSA
  • Breast = CA27.29 / CA-125
  • Germ cell = B-HCG
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15
Q

Name some classes of antibiotics and their mechanism of action

A
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16
Q

Name some enzyme inducers and inhibitors

A
17
Q

Name the cranial nerves

A
18
Q

Antibiotic for pyelonephritis?

A

Co-amoxiclav 14 days

19
Q

What is a migraine?

A

Neurovascular disorder in a genetically predisposed (trigeminal network) characterised by episodic unilateral throbbing headache lasting 4-72 hours

  • More common in young women
  • May be preceded by visual aura
  • Increase in serotonin
20
Q

What are the clinical features of migraine?

A
  • Nausea/vomiting
  • Photophobia/Phonophobia/Osmophobia (smell)
  • Unilateral (2/3) or bilateral (1/3)
    • Behind or along inner angle of eye
    • Radiates to occiput or neck
    • Dull to throbbing
  • May be preceded by focal neurological symptoms
  • Aura
    • Visual
    • Parasthesia
    • Hemiparesis
21
Q

Describe the IHS criteria for migraine

A

Without aura:

  • 4 hours - 3 days
  • Nausea/vomiting/photophobia
  • 2 of
    • Unilateral
    • Moderate/severe pain
    • Aggravation by physical activity
    • Pulsating

With aura (At least 3 of):

  • Reversible brainstem/cortical dysfunction
  • Aura > 4 mins or 2 auras in succession
  • Aura lasts > 60 mins
  • Headache < 60 mins after aura
22
Q

How is acute migraine managed?

A
  • Analgesia with antiemetics (aspirin 1g and metoclopramide 10mg)
  • Triptans (sumatriptan/zolmitriptan) = serotonin agonists
    • Avoid MAOI, propanolol, SSRI = serotonin syndrome
  • Ergotamine tartrate if intolerant to 5-HT agonist
23
Q

What is the prophylaxis management of migraines?

A

If at least 2 attacks per month or affecting lifestyle

  • Avoid triggers - stress, lack of sleep, hypohylcaemia, exercise, heat etc
  • If OCP/HRT - stop if migraine with aura
  • Drugs
    • Beta blockers
    • Amitriptyline
    • Verapamil
    • Sodium valproate
    • Topiramate
    • Pizotifen
24
Q

What are the features of tension headache?

A

Diffue ‘band-like’ dull headache

  • May be accompanied by scalp tenderness
  • May be aggravated by noise or light
  • Lasts hours to days
  • No physcial signs (vomiting, photophobia, throbbing etc)
  • Can be exacerbated by analgesic overuse
25
Q

How is tension headache managed?

A

If episodic (<15 days a month)

  • Physical treatments (massage)
  • Simple analgesics (paracetemol, aspirin, NSAIDs)

If chronic (>15 days)

  • Amitriptyline
  • Avoid chronic analgesics
26
Q

What are the features of cluster headache?

A

Severe unilateral orbital/supraorbital/temporal pain lasting 15 mins-3 hours

  • Abrupt onset and cessation
  • Associated autonomic features (ipsilateral)
    • Lacrimation
    • Nasal congestion
    • Rhinorrhoea
    • Facial sweating
    • Miosis
    • Ptosis
    • Eyelid oedema
27
Q

What is the acute management of cluster headache?

A
  • SC sumatriptan 6mg
  • 100% O2 7-12L/min for 20 mins via non-rebreathe
  • Topical lidocaine intranasally
  • Prednisolone for 5 days
  • Methysergide (serotonin antagonist) for 6 months
  • Ergotamine 1-2mg PO 1 hour prior to attack
28
Q

What is the long term management of cluster headaches?

A
  • Verapamil
    • Baseline ECG
  • Lithium 300mg BD
    • Renal and liver function tests
29
Q

What are the signs of raised intracranial pressure?

A
  • Generalised ache
  • Aggravated by bending, coughing, straining
  • Worse in morning
  • Accompanied by
    • Vomiting
    • Visual obscurations
    • Focal neurological signs
    • Papilloedema
  • Risk of herniation = coning
30
Q

What are the features of trigeminal neuralgia?

A

Sudden and severe unilateral paroxysms of electric shock-like/shooting pain usually in V2/V3 distributions of the trigeminal nerve

  • Usual onset after 40
  • Attacks last a few seconds, can be several times/min
  • Triggers - washing, shaving, cold wind, eating, talking
  • Not associated with physical signs
31
Q

How is trigeminal neuralgia managed?

A
  • Drugs
    • Carbamazepine
    • Baclofen
  • Surgical if intolerable side effects or unresponsive to drugs
    • Alcohol injection
    • Microvascular depression
    • Cryotherapy
32
Q

What is Idiopathic Intracranial Hypertension (IIH)?

A

Raised intracranial pressure without hydrocephalus or mass lesion

  • Most common in young, overweight women
  • Normal CT/MRI
33
Q

What is infectious mononucleosis? How does it present

A

EBV infection, usually in children and young adults

  • Fever
  • Sore throat
  • Cervical lymphadenopathy
  • Tonsil swelling
  • Membranous exudate (greyish)

NB: Diffuse rash with amoxicillin

34
Q

How is infectious mononucleosis investigated and managed?

A
  • FBC (high lymphocytes)
  • Blood film (atypical lymphocytes)
  • Monospot/Paul Bunnell test positive (heterophile antibody)

Treat if severe with high dose steroids

35
Q

Causes and features of malaria

A

Plasmodium falciparum/vivax/malariae

  • Malaise and fatigue
  • Fever
  • Headache
  • Rigors
  • Sweating
  • Jaundice
  • Splenomegaly
36
Q

How is malaria investigated?

A
  • Blood film (thin and thick)
  • FBC
  • Glucose
  • U&E
  • Urine dip (Blood0
37
Q

How is malaria managed?

A
  • Advice from infectious disease specialist
  • Quinine
  • Doxycycline

Clinical Methods (21 decks)

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