GP VOPPS Flashcards
Contraindications of breast feeding.
- HIV when alternative feeding is suitable.
- Human T-cell leukaemia virus.
- Active TB while mother is still infectious.
- Illicit drug use.
- Some medications.
- Galactosaemia.
- HIV when alternative feeding is suitable.
- Human T-cell leukaemia virus.
- Active TB while mother is still infectious.
- Illicit drug use.
- Some medications.
- Galactosaemia.
- Contraindications of breast feeding.
Predisposing factors for mastitis.
- Cracked nipples
- Milk stasis.
- Sources of staph infection
- Past history of mastitis
- Depressed immune system
Treatment for mastitis.
- Keep the breast drained
- Antibiotics
- Analgesia/ anti-inflammatory agents
Antibiotic options/ regimes for mastitis.
- Dicloxicillin 500 mg QID
- Cephalexin 500 mg QID
- Clindamycin 450 mg QID
NHMRC - Infant feeding guidelines.
- Exclusive breastfeeding for around 6 months.
- Continued breastfeeding with solids for 12 months
- Continue breastfeeding for as long as mother and infant desire.
Murtagh’s diagnostic strategy for Acute Abdominal Pain: Diagnostic Probability in Adults.
- Acute gastroenteritis.
- Acute appendicitis.
- Mittleschmirtz/ dysmenorrhoea
- IBS
- Biliary colic/ renal colic
Murtagh’s diagnostic strategy for Acute Abdominal Pain: Diagnostic Probability in Children.
- Gastroenteritis.
- Infant colic.
- Mesenteric adentitis.
Murtagh’s diagnostic strategy for Acute Abdominal Pain: RED FLAG CONDITIONS in Children.
- Intussusception
- Acute appendicitis
- Bowel obstruction.
Whats the rash?
Rash features:
- Pale pink
- Maculopapular rash, usually confined to the trunk.
- Often fades within 48 hours.
- Viral exantha (fourth disease)
Whats the rash?
Rash features:
- Starts as bright macular rash on face with circumoral pallor.
- Then becomes maculopapular rash on limbs.
- Prodromal symptoms 2 - 5 days prior to rash onset.
- Erythema infectiousum (slapped cheek disease, or fifth disease)
Whats the rash?
Rash features:
- Sudden high fever, falling after 3 days.
- Rash after fever falls.
- Blanching erythematous rash on trunk and limbs.
- Roseola (sixth disease)
Whats the rash?
Rash features:
- Fever, headache, malaise, and sore throat 1 - 2 days prior to onset of rash.
- Macules that progress to vesicles.
- Present on palms, soles, and buccal mucosa.
- May appear on limbs, buttocks, and genitalia.
- Hand, foot, and mouth disease.
Whats the rash?
Rash features:
- Pruritic erythematous maculopapular rash with centripetal distribution.
- “Cropping” of vesicle, papules, and crusting lesions.
- Chickenpox.
Whats the rash?
Rash features:
- Blotchy erythematous maculopapular rash.
- Rash starts behind ears, spreading to face, then trunk, then limbs.
- Koplick spots (white spots on buccal mucosa)
- 3 C’s; coryza, conjunctivtis, and cough
- Measles
Whats the rash?
Rash features:
- Pale pink maculopapular rash, worse on sun exposed areas.
- Rash starts at face and neck, and spreads to extremities.
- Brief duration, with mild systemic symptoms.
- Rubella
Whats the rash?
Rash features:
- Gingivostomatitis
- May have vesicular lesion on face and conjunctivae
- Herpes simplex virus
Rash causative agent: Viral exantha (fourth disease)
- Various, especially enteroviruses.
Rash causative agent: Erythema infectiousum (slapped cheek disease, fifth disease)
- Parvovirus B19
Rash causative agent: Roseola (sixth disease)
- Human herpes virus 6
Rash causative agent: Hand, foot, and mouth disease.
- Enterovirus, usually coxsackie virus.
Rash causative agent: Chickenpox
- Varicella zoster virus
Rash causative agent: Measles
- RNA paramyxovirus
Rash causative agent: Rubella
- Togavirus
Rash causative agent: Herpes simplex virus
- Herpes simplex virus.
Whats the rash?
Rash Features:
1. Vesicopustular crusted lesions or bullous lesions.
- Impetigo
Whats the rash?
Rash Features:
- Prodrome: malaise, sore throat, fever, vomiting.
- Punctate erythematous blancing rash (boiled lobster)
- Texture of sandpaper
- Starts on neck, rapidly becomes generalised.
- Prominent in skin folds.
- Absent/ sparse on face, palms, and soles.
- Scarlet fever.
Whats the rash?
Rash features:
1. Non-blanching petechial/ purpuric rash.
- Meningococcal septicaemia
Whats the rash?
Rash Features:
1. Fever lasting 5 days or more plus at least 4 of the following:
a) polymorphous rash
b) bilateral conjunctivae injection
c) mucus membrane changes (strawberry
tongue)
d) palm/ sole erythema, desquamation or
oedema
e) cervical lymphadenopathy
- Kawasaki disease
Rash causative agent: Impetigo
- Staph aereus
2. Strep pyogenes
Rash causative agent: Scarlet fever
- Group A Strep
Rash causative agent: Meningococcal septicaemia
- Neisseria meningitidis
Rash causative agent: Kawasaki disease
- Systemic vasculitis
National Immunisation Schedule: Birth
- HBV
2. TB (ATSI)
National Immunisation Schedule: 2 and 4 months
- Diptheria
- Tetanus
- Pertussis
- HBV
- Poliomylitis
- Hib
- Pneumococcal
- Rotavirus
National Immunisation Schedule: 12 months
- Measles, mumps, rubella
- Meningococcal
- Pneumococcal
- HAV (ATSI)
National Immunisation Schedule: 18 months
- Measles, mumps, rubella, varicella
- Diphtheria, tetanus, pertussis
- Hib
- HAV (ATSI)
National Immunisation Schedule: 4 years
- Diphtheria, tetanus, pertussis
- Poliomyelitis
- Pneumococcal (Medically at risk)
National Immunisation Schedule: 6 months
- Diphtheria
- Tetanus
- Pertussis
- HBV
- Poliomyelitis
- Hib
- Pneumococcal (ATSI)
National Immunisation Schedule: 12 - 13 years.
- HPV
2. Diphtheria, tetanus, pertussis
National Immunisation Schedule: 14 - 16 years.
- Meningococcal
National Immunisation Schedule: Pregnant women
- Pertussis
2. Influenza
National Immunisation Schedule: 70 - 79 years
- Shingles - herpes zoster
National Immunisation Schedule: Adult Pneumococcal
- 15 - 49 year old ATSI with medical risks
- 50 years and over ATSI
- 65 years and over general population
Red Flags for NEW ONSET headache.
- Seizure but not epileptic
- Pregnant or post-partum
- Anticoagulants
- Amphetamine or cocaine use
- > 50 years
- Young and obese
- History of cancer or immunodeficiency
General Red Flags for headache.
- Head injury
- Woken from sleep
- Neurovegtative symptoms
- Fever or vomiting
- Neck stiffness
- Worsened by cough/ physical activity.
- Abrupt onset
- Progressive worsening
What’s the PV discharge?
Features:
- Offensive odour
- Dysuria
- Vulval itch with erythema
- Copious bubbly discharge
- Strawberry cervix
- Trichomoniasis.
What’s the PV discharge?
Features:
- Thick, white, ‘cottage cheese’
- Non-offensive odour
- Vulval itch, oedema, erythema
- Skin fissures, satellite lesions
- Terminal dysuria
- Superficial dyspareunia
- Candidiasis
What’s the PV discharge?
Features:
- Thin, grey/ white watery discharge.
- Fishy odour
- Discharge coats vestibule/ vagina
- Bacterial Vaginosis
GP Management of Trichomoniasis.
- High vaginal swab for PCR
- Either: Metronidazole or Tinidazole
- No sexual contact for 7 days after treatment
- Current sexual partner requires treatment.
GP Management of Bacterial Vaginosis.
- High vaginal swab for M/C/S
- No treatment if asymptomatic.
- Metronidazole or clindamycin before gynaecological procedures or if symptomatic.
GP Management of Candidiasis.
- No treatment if asymptomatic (may be normal flora)
2. If symptomatic; clotrimazole or fluconazole creams
Non pharmacological management of menopause.
- Diet
- Exercise
- Relaxation
- Reduce smoking
- Reduce caffeine
- Reduce alcohol
- Pelvic floor exercises.
HRT oestrogen only option.
- Recommended in women post-hysterectomy
- No history of endometriosis
- Must be taken continuously
HRT combined oestrogen and progesterone option.
- Given to women with a uterus.
1. Either continuously or cyclic
Alternative options to HRT.
- Lifestyle changes.
- Tibolone
- Testosterone (in very low libido)
- SSRI and venlafaxine
- Complementary (naturals)
First choice antibiotics for UTI.
- Trimethoprim
2. Cephalexin
Combined oral contraceptives: MOA.
- Inhibits ovulation.
- Reduces receptivity of endometrium to implantation.
- Thickens cervical mucus to form barrier to sperm.
Combined oral contraceptives: Protection from pregnancy.
- Best started on 1st day of period.
- Protected immediately if commenced on any of the first 5 ‘active’ days of the cycle.
- Otherwise protected following 7 active pills.
Progesterone only contraceptives: MOA
- Acts on hypothalamus and suppresses pituitary LH surge.
- May inhibit ovulation.
- Thickens cervical mucus to form barrier to sperm.
- Reduces receptivity of endometrium to implantation.
First choice antibiotics for TYPICAL community acquired pneumonia.
Either:
1. Amoxycillin
OR
2. Doxycycline
First choice antibiotic for otitis media.
- Amoxycillin
Adhesive capsultitis (frozen shoulder).
- Second most common shoulder disorder.
- Characterised by pain in 3 phases.
a) Painful phase
b) Stiffening phase
c) Resolution - Loss of motion in all planes to variable degrees
Rotator cuff tear.
- Most common shoulder disorder.
2. Decreased ROM with relative full passive ROM.
Laboratory tests for diagnosis of diabetes.
- FBG
- RBG
- OGTT
- HbA1c
Diagnosis identified by screening: FBG or RBG
- FBG > 7.0
- RBG > 11.1
- Confirmed if same the next day.
Diagnosis identified by screening: HbA1c
- > 6.5% on 2 x separate occasions