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GP > GP Week 5 > Flashcards

GP Week 5 Flashcards

1
Q

An approach for testing for coeliac disease: If not eating gluten.

A
  1. Gluten challenge
  2. 2 slices of bread for 2-8 weeks
  3. Coeliac serology
  4. If negative at 2 weeks continue and recheck at 8 weeks
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2
Q

An approach for testing for coeliac diaease: If EATING gluten.

A
  1. Coeliac serology
    a) IgA - tTG
    b) IgA - EMA
    c) IgA - DGP
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3
Q

Next step if patient returns positive coeliac serology.

A
  1. Refer for duodenal biopsy.
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4
Q

Management of coeliac patient at time of diagnosis.

A
  1. Refer to dietitian.
  2. Investigate and treat micro-nutrient deficiencies.
  3. Review for co-morbidity.
  4. Review immunisation status.
  5. Encourage support group engagement.
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5
Q

Management of coeliac patient at 3-6 month review.

A
  1. Assess response to diet.

2. Recommend screening of first degree relatives.

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6
Q

What gene is tested for in detection of coeliac disease?

A
  1. HLA DQ2/ DQ8
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7
Q

Assessments to be made in dementia.

A
  1. Clinical history + collateral
  2. Physical examination
  3. Review activities of daily living.
  4. Geriatric depression scale
  5. Medication review.
  6. Cognitive screen/ MMSE
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8
Q

Routine tests for dementia.

A
  1. FBC
  2. ESR
  3. LFTs
  4. Calcium
  5. TFTs
  6. B12, folate
  7. CT brain w/o contrast
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9
Q

Other tests (not routine) for consideration in dementia.

A
  1. CXR
  2. BGL
  3. Lipids
  4. Homocysteine level
  5. ECG
  6. MSU
  7. HIV serology, syphilis screen
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10
Q

Special investigations for dementia.

A
  1. EEG
  2. MRI
  3. PET Scan
  4. Apolipoprotein E (increase = increased risk)
  5. Neuropsychological assessment
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11
Q

Pain Assessment 4 P’s

A
  1. Pain
  2. Pathologies/ past medical history
  3. Performance
  4. Psychological/ psychiatric
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12
Q

Management strategies regarding pains 4 P’s

A
  1. Physical
  2. Psychological
  3. Pharmacological
  4. Procedural
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13
Q

Follow up of 6 A’s in regards to pain assessment and management.

A
  1. Activities
  2. Analgesia
  3. Adverse effects
  4. Aberrant behaviours
  5. Affect
  6. Adequate documentation.
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14
Q

Symptoms of lactose intolerance.

A
  1. Abdominal discomfort.
  2. Bloating.
  3. Wind.
  4. Diarrhoea.
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15
Q

Summary of irritable bowel syndrome/ intolerance management,

A
  1. Investigate diet and potential intolerance.
  2. Consider FODMAP’s, caffeine and lactose as co-contributors.
  3. Consider coeliac serology
  4. Consider lactose hydrogen breath test.
  5. Look for red flags: anaemia, bleeding, weight loss.
  6. Colonoscopy after age 40
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16
Q

First line drug therapies to consider for diabetic polyneuropathy.

A
  1. Duloxetine
  2. Gabapentin
  3. Pregabalin
  4. TCA
  5. Venlafaxine
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17
Q

First line drug therapies to consider for?

  1. Duloxetine
  2. Gabapentin
  3. Pregabalin
  4. TCA
  5. Venlafaxine
A
  1. Diabetic polyneuropathy.
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18
Q

First line drug therapies to consider for postherpetic neuralgia.

A
  1. TCA
  2. Gabapentin
  3. Pregabalin
  4. 5% lignocaine patch
19
Q

First line drug therapies to consider for?

  1. TCA
  2. Gabapentin
  3. Pregabalin
  4. 5% lignocaine patch
A
  1. Postherpetic neuralgia.
20
Q

First line drug therapies to consider for trigeminal neuralgia.

A
  1. Carbamazepine.

2. Oxycarbazepine.

21
Q

First line drug therapies to consider for?

  1. Carbamazepine.
  2. Oxycarbazepine.
A
  1. Trigeminal neuralgia.
22
Q

Drug therapies to consider for chronic regional pain syndrome.

A
  1. Oral prednisone.
  2. Bisphosphonates.
  3. Gabapentin.
  4. Opioids.
  5. NSAIDs
  6. Topical capsaicin.
  7. IV lignocaine.
23
Q

Drug therapies to consider for?

  1. Oral prednisone.
  2. Bisphosphonates.
  3. Gabapentin.
  4. Opioids.
  5. NSAIDs
  6. Topical capsaicin.
  7. IV lignocaine.
A
  1. Chronic regional pain syndrome.
24
Q

Diagnostic indications for PPI use.

A
  1. GORD
  2. Functional dyspepsia
  3. Barrett’s oesophagus
  4. Peptic ulcer disease (H.pylori)
  5. Peptic ulcer disease (NSAID)
25
Q

Potential harms associated with long term PPI use.

A
  1. Bone fractures
  2. Pneumonia
  3. Enteric infections
  4. Vitamin and mineral deficiencies
  5. Acute interstitial nephritis
26
Q

Current PPIs for GP prescription.

A
  1. Esomeprazole
  2. Lansoprazole
  3. Omeprazole
  4. Pantoprazole
  5. Rabeprazole
27
Q
  1. Esomeprazole
  2. Lansoprazole
  3. Omeprazole
  4. Pantoprazole
  5. Rabeprazole
A
  1. Current PPIs for GP prescription.
28
Q

Red flag symptoms in GORD patient requiring urgent endoscopy.

A
  1. Dysphagia.
  2. Odynophagia.
  3. Unexplained weight loss
  4. Persistent vomiting.
  5. Haematemesis or Melaena.
  6. Signs of anaemia.
29
Q

Lifestyle interventions for patients with GORD.

A
  1. Avoid foods or drinks that trigger symptoms.
  2. Avoid late or large meals, and lying down immediately following meal.
  3. Raise the head of the bed.
  4. Lose weight.
  5. Reduce alcohol intake.
  6. Smoking cessation.
30
Q

Questions to ponder in the pre-treatment evaluation of Hepatitis C Virus infection.

A
  1. HCV genotype? (1-6)
  2. Evidence of cirrhosis?
  3. Is the patient treatment naive or treatment experienced?
  4. Is there any priority co-morbidity?
  5. Medication interactions?
  6. Is a specialist referral required?
31
Q

Direct acting antiviral (DAA) treatment for HCV: Genotype 1

A
  1. Ledipasvir
    plus
  2. Sofosbuvir
32
Q

Direct acting antiviral (DAA) treatment for HCV: Genotype 2

A
  1. Sofosbuvir
    pluse
  2. Ribavirin
33
Q

Direct acting antiviral (DAA) treatment for HCV: Genotype 3

A
  1. Daclatasvir
    plus
  2. Sofosbuvir
34
Q

Direct acting antiviral (DAA) treatment for HCV: Genotype 4-6.

A 
1. Sofosbuvir
plus
2. PEG-IFN (peginterferon alpha 2a)
plus
3. Ribavirin
35
Q

The following drugs are used for?

  1. Sofosbuvir
  2. Ledipasvir
  3. Ribavirin
  4. Daclatasvir
  5. PEG-IFN (peginterferon alpha 2a)
A
  1. Direct acting antivirals (DAA) for Hepatitis C.
36
Q

Likely diagnosis for anorectal pain: Pain alone.

A
  1. Anal fissure.
  2. Anal herpes.
  3. Ulcerative proctitis.
  4. Proctalgia fugax.
37
Q

Likely diagnosis of anorectal pain: Pain and bleeding.

A
  1. Anal fissure.

2. Proctitis.

38
Q

Likely diagnosis of anorectal pain: Pain, lump, and bleeding.

A
  1. Second degree haemorrhoid. (lump spontaneously reduces)
  2. Third degree haemorrhoid. (Lump prolapse but reducible)
  3. Fourth degree haemorrhoid.
  4. Ulcerated perianal haematoma (blood on underwear)
39
Q

Likely diagnosis of anorectal complaint: Lump alone (no pain)

A
  1. Skin tag.
  2. Perianal wart
  3. Anal carcinoma.
40
Q

Likely diagnosis of anorectal complaint: Lump with bleeding (no pain)

A
  1. Second degree haemorrhoid.

2. Anal carcinoma.

41
Q

Likely diagnosis of anorectal complaint: Bleeding alone (no pain, no lump)

A
  1. Internal haemorrhoids (blood on and separate to faeces)
  2. Colorectal polyps (blood mixed with faeces)
  3. Colorectal carcinoma (blood mixed with faeces)
  4. Anal carcinoma
42
Q

Likely diagnosis of anorectal pain: Pain with Lump

A
  1. Perianal haematoma
  2. Strangulated internal haemorrhoid
  3. Abscess
  4. Pilonidal sinus
43
Q

Step-wise haemorrhoid treatment.

A
  1. High fibre diet.
  2. Sclerosant injection
  3. Rubber band ligation.
  4. Referral for surgical haemorrhoidectomy.
44
Q

Step-wise anal fissure treatment.

A
  1. Avoid constipation: high fibre diet
  2. Topical anaesthesia
  3. Topical GTN
  4. Botulinim toxin.
  5. Referral for subcutaneous sphincterotomy

GP (7 decks)

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