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GP Week 1 Flashcards

Exam Prep

1
Q

Presenting symptoms of breast cancer?

A
  1. New breast lump (most common)
  2. Thickening or ridge
  3. Breast or nipple asymmetry
  4. Skin changes (dimpling, redness)
  5. Nipple changes
  6. Nipple discharge
  7. Unilateral breast pain
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2
Q

The triple test refers to what three diagnostic components?

A
  1. Medical history and breast examination.
  2. Imaging; mammography and/ or ultrasound
  3. Non-excisional biopsy; core biopsy and/ or fine needle aspiration cytology
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3
Q

Risk factors of endometrial cancer.

A
  1. History of chronic anovulation.
  2. Exposure to unopposed oestrogen.
  3. PCOS
  4. Exposure to tamoxifen.
  5. Family Hx Lynch syndrome
  6. Nulliparity
  7. Obesity
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4
Q

Investigations for abnormal PV bleeding.

A
  1. Pelvic examination
  2. Bloods, and hormones
  3. Transvaginal ultrasound
  4. Endometrial biopsy
  5. Diagnostic hysteroscopy
  6. D&C
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5
Q

Treatment options for erectile dysfunction.

A

1st Line:
Alter modifiable risks and causes.
Facilitate sexual health.
2nd Line:
Oral PDE5 inhibitors.
Counselling and education.
Vacuum devices/ rings.
3rd Line:
Itracavernous vasoactive drug injection.
4th Line:
Surgical treatment ? implant.

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6
Q

Oral PDE5 Inhibitors for erectile dysfunction.

A
  1. Tadalafil (Cialis)
  2. Vardenafil (Levitra)
  3. Sildenafil (Viagra)
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7
Q

Types of lower urinary tract symptoms in men.

A
  1. Voiding (obstructive symptoms)
  2. Storage symptoms
  3. Complex symptoms.
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8
Q

Voiding or obstructive LUT symptoms in men.

A
  1. Hesitancy
  2. Poor stream.
  3. Intermittent flow.
  4. Incomplete emptying.
  5. Post-void dribbling.
  6. Overflow incontinence.
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9
Q

Storage LUT symptoms in men.

A
  1. Frequency.
  2. Nocturia.
  3. Urgency.
  4. Urgency incontinence.
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10
Q

Complex LUT symptoms in men.

A
  1. Haematuria.
  2. Recurrent UTI
  3. Acute or chronic urinary retention.
  4. Urinary incontinence.
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11
Q

Common causes of Storage LUT symptoms in men.

A
  1. UTI
  2. Bladder calculi
  3. Urothelial carcinoma
  4. Overactive bladder
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12
Q

Common causes of Voiding (obstructive) LUT symptoms in men.

A
  1. Benign prostatic enlargement
  2. Bladder neck stenosis
  3. Urethral stricture
  4. Poor detrusor contractility
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13
Q

Management options of LUTS in older men.

A
  1. Watchful waiting.
  2. Medical management.
  3. Surgical management.
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14
Q

Medical pharmoacotherapy for LUTS in men.

A
  1. Alpha blockers
  2. Antimuscarinics
  3. 5 alpha reductase inhibitors
  4. Combination therapy.
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15
Q

Role of alpha blockers to treat LUTS in men.

A
  1. Used to treat voiding/ obstructive symptoms.

2. Block alpha 1A adrenoreceptors to promote prostatic smooth muscle and bladder neck relaxation.

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16
Q

Role of antimuscarinics to treat LUTS in men.

A
  1. Used to treat storage symptoms.

2. Inhibits acetylcholines effect on muscarinic M3 receptors and hence reducing detrusor muscle contractions.

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17
Q

Role of 5 alpha reductase inhibitors to treat LUTS in men.

A
  1. Use to treat obstructive symptoms.
  2. They inhibit the enzyme 5 alpha reductase to block the conversion of testosterone into the more potent DHT form.
  3. This induces prostatic cell apoptosis and thus reduces prostate size.
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18
Q

Surgical treatments for LUTS.

A
  1. Ablative - needle ablation, or microwave therapy

2. Cavitating - TURP or laser

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19
Q

Symptoms of prostatitis.

A
  1. Dysuria
  2. Urgent need to urinate.
  3. Frequent urinating.
  4. Painful ejaculation.
  5. Pain, lower back and perineum
  6. Chills/ fevers
  7. Muscular pain
  8. General lack of energy
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20
Q

Investigation in prostatitis.

A
  1. DRE
  2. PSA
  3. Urinalysis, 1st pass for chlamydia and midstream for M/C/S
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21
Q

1st line treatments for bacterial vaginosis.

A
  1. Metronidazole
22
Q

Usual testing method for suspected bacterial vaginosis.

A
  1. Microscopy of vaginal smear.
23
Q

1st line treatments for candidiasis STI.

A
  1. Imidazole
24
Q

Usual testing method for suspected candidiasis STI.

A
  1. Microscopy or culture of vaginal swab.
25
Q

1st line treatment for first time genital herpes.

A
  1. Valaciclovir or aciclovir orally for 5-10 days
26
Q

1st line treatment for recurrent genital herpes.

A
  1. Valaciclovir or aciclovir 3 -5 days, potentially daily for supressive treatment .
27
Q

Usual testing method for suspected genital herpes.

A
  1. Swab lesion for HSV/ syphyilis NAAT
28
Q

1st line treatment for genital warts.

A
  1. Non - pregnant; podophyllotoxin paint or imiquimod

2. Pregnant; cryotherapy

29
Q

1st line treatment for trichomoniasis.

A
  1. Metronidazole, single dose
30
Q

1st line treatment for chlamydia.

A
  1. Azithromycin
31
Q

1st line treatment of gonorrhoea.

A
  1. Ceftriaxone and azithromycin.
32
Q

1st line treatment of donovanosis.

A
  1. Azithromycin.
33
Q

1st line treatment for syphilis.

A
  1. Penicillin.

2. Doxycycline if allergic to penicillin.

34
Q

Usual testing method for suspected syphilis.

A
  1. Serology.

2. Ulcer swab.

35
Q

1st line treatment for chancroid STI.

A
  1. Azithromycin.
36
Q

1st line treatment for Viral Hepatitis A STI.

A
  1. No antiviral therapy available.
  2. Post exposure prophylaxis within 2 weeks of sexual exposure.
  3. Normal human immunoglobulin with 2 weeks of sexual exposure.
37
Q

1st line treatment for Viral Hepatitis B STI.

A
  1. Acute infection doesn’t require treatment.

2. Post exposure prophylaxis - Hep B immunoglobulin IM with 72 hours.

38
Q

1st line treatment for Viral Hepatitis C.

A
  1. Interferon and ribavirin.
39
Q

1st line treatment of pelvic inflammatory disease.

A
  1. rule out pregnancy.
  2. NSAID for pain.
  3. Intial: Azithromycin oral plus ceftriaxone IM
  4. Outpatient: Doxycycline or azithromycin plus metronidazole
40
Q

Contact tracing period for chlamydia.

A
  1. 6 months
41
Q

Contact tracing period for gonorrhoea.

A
  1. 2 months
42
Q

Contact tracing period for syphilis.

A
  1. Primary - 3 months plus duration of symptoms.
  2. Secondary - 6 months plus duration of symptoms.
  3. Early latent - 12 months
43
Q

Contact tracing period for HIV.

A
  1. Start with recent sexual or injecting partners.
44
Q

Contact tracing period for HBV and HCV.

A
  1. 6 months prior to onset of acute symptoms.

2. Contact public health unit for newly acquired case.

45
Q

Usual testing methods for gonorrhoea.

A
  1. Vaginal swab
  2. First pass urine
  3. Throat swabs for sex workers and homosexual males
  4. Endocervical swabs for sex workers
  5. Rectal swabs for homosexual males
46
Q

Usual testing methods for chlamydia.

A
  1. Vaginal swab
  2. First pass urine
  3. Endocervical swab
  4. Throat swab for homosexual males
  5. Rectal swab for homosexual males
47
Q

Usual testing methods for HBV.

A
  1. HBsAg
  2. Anti - HBc
  3. Anti - HBs
48
Q

Usual testing method for HCV.

A
  1. HCV Ab
49
Q

Usual testing method for HIV.

A
  1. HIV Ab/Ag
50
Q

Usual testing method for HAV.

A
  1. Anti - HAV Ig total

GP (7 decks)

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