GP Peer teaching Flashcards
What is the difference between the hypertension threshholds if measuring at home vs in clinic?
The threshhold is 5mmHg lower for home monitoring
What lifestyle advice would you give to someone with hypertension?
Reduce salt <6g but <3g ideally
Reduce caffeine intake
Stop smoking, lose weight etc
What is the first line treatment for hypertension in under 55s? Class and drug example
ACE inhibitor e.g. ramipril
What is the first line treatment for hypertension in over 55s or people of Afro-Carribean origin?
Calcium Channel Blockers e.g. Amlodipine
What is the 2nd line treatment for hypertension?
CCB + ACEi
What is the 3rd line treatment for hypertension?
Add a thiazide diuretic (to CCB and ACEi)
Which thiazide diuretic can be used as the 3rd line hypertension treatment?
Clorthalidone
What is the treatment for resistant hypertension if potassium is <4.5mmol?
Spironolactone
What is the treatment for resistant hypertension if potassium is >4.5mmol?
Higher dose thiazide diuretic
What is the target BP for someone over 80?`
150/90
What is the target BP for someone under 80?
140/90
What investigations need to be done when an ACEi is started?
Urea and electrolytes
What are indications for specialist referral in hypertension?
BP >180/110
Papilloedema
Headache
Which guidelines are used to determine if someone under 16 should receive contraception?
Fraser guidelines
At what age can children never consent?
Under 13
What is the long acting contraception of choice in young people, why?
Implant
because depo shot may reduce bone mineral density
What is the PHQ-9?
Patient Health Questionnaire for depression
What are 3 aspects of diet advice for controlling T2DM?
Low fat dairy products Oily fish High fibre sources of carbs Reduce saturated fats and trans fats 5-10% weightloss
When should metformin be offered?
When HbA1c rises to 48mmol on lifestyle treatment
Give examples of add-on drugs in T2DM management.
sulfonylurea
gliptin
What should be offered if glucose is inadequately controlled on metformin + add-on?
Triple therapy
Consider insulin therapy
What is the cut-off for add-on therapy on someone who is on highest dose metformin? What do you do if they are over that?
58mmol/mol
Add on e.g. sulfonylurea
What is the target blood pressure for a diabetic?
140/80
When should you offer a statin?
When someone’s QRisk is >10%
What is the Qrisk score?
10 year risk of cardiovascular disease
