GP Handbook Flashcards
In the context of preventative health, what is SNAP?
Smoking, nutrition, alcohol and physical activity
Describe the tactics you might employ to help a person quit smoking
- Quit plan
- Quit date
- Reasons to quit
- Trigger avoidance (places, people, circumstances)
- Distract, discuss, delay, drink water, deep breaths
- Diet
- Medication (nicotine replacement therapy > 8/52, champix/varenicline [blocks partial nicotinic agonist, care in renal failure], bupropion [CI - seizures, SSRIs, pregnancy])
What are the guidelines for regular physical activity in adults?
- 2.5 hours mod-intensity per week (brisk walk) OR
- 1.5 hours high-intensity per week (run)
- More for children
How often should adults have their lipid levels monitored?
- 5-yearly
- 2-yearly if >45 and moderate CVS risk
- 1-yearly if high risk
Which patients fit into the category 1 (low risk) group for bowel cancer screening. How should they be managed?
- No personal or family history of bowel cancer OR
- One FDR/SDR > 55 with bowel cancer
- FOBT 2-yearly from 50
- Flexible sigmoidoscopy 5-yearly
Which patients fit into the category 2 (medium risk) group for bowel cancer screening. How should they be managed?
- One FDR
- Two FDR or an FDR + SDR with bowel cancer at any age
- Colonoscopy 5-yearly from 50 or 10 years earlier than familial diagnosis
- Flexible sigmoidoscopy + barium enema/CT colonography if above contraindicated
- FOBT in intervening years
Which patients fit into the category 3 (very high risk) group for bowel cancer screening? How should they be managed?
- Three or more FDRs or FDR/SDRs on the same side of the family with bowel cancer
- Two or more FDR/SDRs on the same side of the family with any:
- Multiple bowel cancers in the one person
- Bowel cancer before 50 y/o
- HNPCC-related cancers - endometrial/ovarian/stomach/SI/renal/biliary/brain
- One FDR/SDR with multiple adenomas (?FAP)
- Genetic mutation with high susceptibility in family member
- Referral to genetic counsellor
- FAP
- Flexible sigmoidoscopy yearly/2-yearly from 12-15 until polyposis, then prophylactic surgery
- HNPCC
- Colonoscopy 2-yearly from 25 or 5y earlier than familial diagnosis
How often should the asymptomatic population be screened for diabetes?
- 3-yearly over 40 (fasting BGLs)
- OGTT if borderline
How often should the asymptomatic female population undergo mammography? At what age?
- 2-yearly from 50-74
Describe the symptoms of depression using an acronym
- S - sleep problems
- A - appetite or weight change
- D - dysphoria or bad mood
- F - fatigue
- A - agitation/psychomotor retardation
- C - concentration problems
- E - esteem problems
- S - suicidal thoughts
What are the criteria for anorexia nervosa?
- Weight < 85% predicted for height gender and ethnicity OR BMI < 17.5
- Fear of weight gain even when underweight - dieting, vomiting or excessive exercise
- Feeling fat when objectively thin
- Amenorrhoea (except OCP)
What are the criteria for bulimia nervosa?
- Regular binge eating episodes
- Preoccupation with weight
- Regular actions to offset binges - starvation, vomiting, laxatives, excessive exercise
- Weight in normal or overweight range
What are the criteria for diagnosis of schizophrenia?
- 2+ of for a significant portion of 1 month
- delusions
- hallucinations
- disorganised speech
- disorganised behaviour or catatonia
- negative symptoms
- Socio-occupational dysfunction
- Continuous disturbance for 6+ months
What are the likely side-effects of first-gen antipsychotics?
- Extrapyramidal movement disorders
- Dystonia, akathisia, parkisonism, tardive dyskinesia
- Anticholinergic effects
- Hyperprolactinaemia
- Hyperglycaemia
- Sedation
- Weight gain
What preventative and screening measures should be undertaken with patients on second-gen antipsychotics?
- Metabolic syndrome more likely
- Diet and exercise advice
- BMI
- BP
- BGL
- Lipids
- Medication review
