GP Week 3 Flashcards

Exam Prep

1
Q

Medical conditions that can be associated with anxiety.

A
  1. Hypoglycaemia
  2. Hyper/ hypothyroidism
  3. Cardiac disorders
  4. Chronic respiratory disease
  5. Withdrawal from benzodiazepines
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2
Q

SSRIs used in the GP setting for treatment of anxiety disorders.

A
  1. Escitalopram
  2. Fluoxetine
  3. Fluvoxamine
  4. Paroxetine
  5. Sertraline
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3
Q

Common broad causes of insomnia.

A
  1. Psycho-social, physical, and environmental stressors
  2. Medical conditions
  3. Psychiatric disorders
  4. Poor sleep hygiene/ practices
  5. Substance use
  6. Medications.
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4
Q

6 psycho-social, physical, and environmental stressors associated with insomnia.

A
  1. Grief and loss
  2. Changing time zones (jet lag)
  3. Light
  4. Noise
  5. Temperature
  6. Stress
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5
Q

5 poor sleep practices leading/ contributing to insomnia.

A
  1. Daytime napping
  2. Use of bed for other activities other than sex and sleep.
  3. Heavy meals.
  4. Exercise near bed time
  5. Variable sleep/ wake times.
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6
Q

4 types of substances that attribute to insomnia.

A
  1. Alcohol
  2. Caffeine
  3. Nicotine
  4. Recreational drugs
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7
Q

Cognitive and behavioural therapies for insomnia.

A
  1. CBT
  2. Stimulus control
  3. Sleep restriction
  4. Relaxation training
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8
Q

GP approach to gradual dose reduction of benzodiazepines for insomnia.

A
  1. Tailor reductions according to patients response.
  2. Allow at least several days to stabilise between dose reductions.
  3. If multiple drugs are being used, decrease the dose of one drug at a time, or switch to diazepam by summing dose equivalents.
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9
Q

4 common factor categories associated with fatigue.

A
  1. Physical
  2. Psychological
  3. Lifestyle
  4. Social
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10
Q

5 lifestyle factors that contribute to fatigue.

A
  1. Drug and alcohol abuse.
  2. Sleep deprivation.
  3. Overworked.
  4. Sedentary lifestyle.
  5. Inappropriate diet.
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11
Q

4 social factors that contribute to fatigue.

A
  1. Family and relationship problems
  2. Bereavement
  3. Occupational stress including bullying
  4. Unemployment.
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12
Q

4 psychological factors that contribute to fatigue.

A
  1. Anxiety
  2. Depression
  3. PTSD
  4. Sleep disorders
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13
Q

8 medical/physical factors that contribute to fatigue.

A
  1. Age/ gender
  2. Medications
  3. Endocrine/ metabolic disorders
  4. Cardiac conditions
  5. Malignancy
  6. Respiratory conditions
  7. Infections
  8. Anaemia
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14
Q

When to investigate/ types of patients to organise sleep studies in suspected OSA.

A
  1. Loud noisy snoring.
  2. Neurocognitive impairment from sleepiness
  3. CVD patients
  4. Patients with pharmacotherapies that reduce respiratory drive or motor tone
  5. Obese
  6. Unstable general medical condition
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15
Q

The clinical examination of a patient with possible OSA should include:

A
  1. Estimates of sleep duration
  2. Epworth Sleepiness Scale
  3. Nasal patency and sinus disease
  4. Mallampati score
  5. Neck circumference
  6. Blood pressure
  7. Medications review
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16
Q

Neck circumferences that increase the risk of OSA.

A
  1. > 42 cm in males

2. > 39 cm in females

17
Q

Lifestyle indications and causes of OSA: Children.

A
  1. Anatomical
18
Q

Lifestyle indications and causes of OSA: Middle aged patients.

A
  1. Lifestyle/ weight
19
Q

Lifestyle indications and causes of OSA: Older patients

A
  1. Drugs
  2. Medical conditions
  3. Lifestyle/ weight
20
Q

Best treatment for OSA: Children

A
  1. Surgical
21
Q

Best treatment for OSA: Middle aged patients.

A
  1. Lifestyle changes.
  2. Weight loss.
  3. Mandibular advancement splints.
  4. CPAP.
  5. Surgery.
22
Q

Best treatment for OSA: Older patients.

A
  1. Rationalise drugs if possible.
  2. Treat underlying condition.
  3. Lifestyle changes/ weight loss
  4. CPAP.
  5. Mandibular advancement splints.
  6. Surgery.
23
Q

Initial lifestyle management should include:

A
  1. Caution of alcohol intake (<7 per week)
  2. Smoking cessation advice
  3. Avoidance of sleep deprivation
  4. Nasal steroid trial for 4 weeks
  5. Positional therapy in bed. (add pillow or raise head end of bed)
  6. Weight loss program.
24
Q

Complications of CPAP.

A
  1. Pump breakdown/ equipment failure
  2. Acute rhinitis
  3. Pressure sores
25
Q

The 3 clinical tests for syndesmosis injury.

A
  1. External rotation stress test
  2. Squeeze test
  3. Interosseous membrane tenderness length.
26
Q

Management summary of mild to moderate ankle ligament complex sprain.

A
  1. Treatable with early mobilisation and guided proprioceptive and strengthening rehab program.
27
Q

Management summary of severe ankle lateral ligament complex sprain.

A
  1. Immobilisation for a period of days in a cast or cam walker (boot) followed by guided proprioceptive and strengthening rehab program.
28
Q

Management summary for ankle fracture/ dislocation or unstable syndesmotic injury.

A
  1. Orthopaedic surgeon referral.