GP rotation Flashcards
do we give amoxycillin for a patient with swollen oedematous tonsils?
No! bc it may be EBV virus and giving amoxycillin and augmentin may bring out a rash
what criteria do we use for a child with possible strep pharyngitis?
FACEL (centor criteria) F- fever A- age less than 14 C- cough absent E- exudate on tonsils L- lymphadenopathy
what criteria do we use for headscanning post head injury?
SLAV5
Seizure, LOC, amnesia, vomiting greater than 5 times ( for children)
how do we surgically manage an ingrown toenail?
wedge resection
what are murtagh’s 7 masquerades?
depression, diabetes, drugs, anaemia, thyroid, UTI, referred pain from spine
Impaired fasting glucose means?
IFG is when you have impaired fasting glucose (higher than 6 mmols/L) but the glucose levels do NOT abnormally rise with 75g of glucose drink (OGTT)
Impaired glucose tolerance means?
IGT is when the blood glucose levels at 2hrs in the OGTT is higher than normal, but not high enough to be classified as diabetes
a 35 yr old patient first presents with reflux symptoms. What is your first line of action? when is endoscopy indicated?
First line- trial of PPI for 1 month. If it improves with PPI then this is good enough for a diagnosis of reflux.
If reflux continues post PPI for 1 month, or there are other red flag symptoms such as dysphagia, LOW, iron deficiency anaemia etc then order a gastroscope
what are the aus cardio risk cut offs for high/med/low risk?
high greater than 15, med greater 10, low less than 10%
who do we consider to be automatically at high risk of a CVD event in the next 5 years?
· Familial hypercholesterolemia · Diabetes + >60 · Diabetes + microalbuminuria · Mod-severe CKD · BP > 180 or >110 · Total cholesterol >7.5 Existing CVD (previous event, symptomatic CVD), stroke,TIAs or CKD
when do we start cardiovascular risk assessments and how often do we do them?
at age 45 and every 2 years or at 35 year old for aboriginal patients
how do we manage patients with high cvd risk scores?
intensive lifestyle advice SNAP
+
Commence cholesterol lowering therapy simultaneously with antihypertensives
how do we manage patients with moderate CVD risk scores
Intensive lifestyle advice SNAP
Lipids specific:
Consider pharmacotherapy if not reaching target after 6 months or if FHx of premature CVD or from Aboriginal/South Asian descent.
BP specific:
Consider meds if not reaching target 140/90 or 130/80 (CKD), 125/75 (diabetes/proteinuria) after 3-6 months.
Or if always greater than 160/100, FHx etc.
how do we manage low risk CVD score patients
Lifestyle advice
SNAP
what sort of lifestyle advice would you provide for nutrition?
dietary salt restriction ≤4 g/day, don't add any to cooking reduce fats, cheese, meats, portions trim off excess fats, use olive oil Avoid takeaway food Avoid processed foods (Give pamphlet)
what are some standard lifestyle advice for alcohol consumption
limit alcohol intake to ≤2 standard drinks per day for males and ≤1 standard drink per day for females
with at least 2 alcohol free days
what can we advise for the amount of physical activity done per day for a patient we are counselling about CVD risk?
at least 30 minutes of moderate-intensity physical activity on most, if not all, days
what are the normal waist circumferences for females and men
waist measurement less than 94cm for men
waist measurement less than 80cm for women
what do we prescribe for sore throat that fits the centor criteria?
phenoxymethylpenicillin 500mg for 10 days every 12 hours or cephalexin
a patient comes in with a hx of sore throat and voice change. what do you think of?
abscess e.g. quinsey abscess
what are the pathogens that cause acute otitis media and their incidence?
- viruses 25%
- strep pneumoniae 35%
- haemophillis 25%
- moraxella cataralis 15%
what are some sequelae of acute otitis media?
- mastoiditis
- facial nerve paralysis
- intracranial abscess
- meningitis
how might we manage chronic suppurative otitis media?
ciprofloxacin ear drops
first line treatment for allergic rhinitis?
intranasal corticosteroids