Lectures: GP Flashcards
What is the dose of adrenaline given as soon as anaphylaxis is recognised?
adrenaline 0.5mg IM
What dose of adrenaline is given in cardiac arrest?
IV adrenaline 1mg
Definition of anaphylaxis
Severe life threatening systemic hypersensitivity reaction that can affect people of all ages.
Involving 1 or both
- respiratory difficulty
- hypotension (fainting, collapse, LOC)
What type of hypersensitivity reaction is anaphylaxis?
Type 1
Type 1 = IgE mediated, anaphylaxis
Type 2 = IgG or IgM, hours to days, haemolytic anaemia
Type 3 = Immune complex, SLE
Type 4 = T cell medicated, rash, SJS
ANAPHYLAXIS
What forms part of the ongoing management plan once the patient is stable?
- admit and observe (6-12 hrs)
- biphasic reactions can occur iN up to 20%
- mast cell tryptase at baseline and 2 hrs later
- Follow up in allergy clinic
How many epi-pens are patients given at discharge?
2 ! can give second dose if they feel like they are not improving
The appearance of a retracted membrane on otoscopy indicated what:
Eustachian tube dysfunction
Key features associated with anterior uveitis?
- abnormal shaped pupil (posterior synechiae)
- hypopyon
- ciliary flush
The uveal tract is made up of what three key parts?
- Iris
- Ciliary body
- Choroid (covers eye like a coat)
Inflammation of all layers of uvea is what type of uveitis?
Pan-uveitis
Hospital management of anterior uveitis?
1. Corticosteroids
- reduce inflammation
- prevent adhesions in eye
2. Cycloplegic-mydriatic drugs
- given to paralyse ciliary body
- relieves pain and prevents adhesions between iris and lens
What is the name given to these adhesions between the iris and lens that distort the pupil?
SYNECHAE
Treatment for corneal abrasion?
- Remove foreign body
-
Chloramphenicol
- to prevent infection
- prevent corneal ulcer development
- eye patch - Usually heals within 2-3 days
Symptoms of hyperthyroidism
- weight loss
- intolerance heat
- palpitations / anxiety
- skin , hair, bowel changes
- neck swelling
What is Tamsulosin?
- blocker of alpha 1a and alpha 1d adrenoreceptors
- blockage of these receptors allows smooth muscle in prostate to relax
- urinary flow improved
Recap NICE 2WW for colorectal cancer
40 and over –> unexplained weight loss + abdominal pain
50 and over –> unexplained rectal bleeding
60 and over –> iron deficiency anaemia or changes in bowel habit or blood in faeces
CONTRACEPTION
How to manage missed COCP pill?
If 1 pill missed then taken when you remember.
If 2 pills are missed:
- take last pill
- rest of the packet as normal
- condoms next 7 days
Where in the cycle pills are missed:
Pills 1-7
- consider EC if UPSI
- then finish packet and have usual pill free interval
Pills 8-14
- no need for EC if last 7 pills taken correctly
- finish packet
- do pill free interval
Pills 15-21
- next pack of pills should be started without break
What criteria is used to assess contraception based on certain medical conditions?
UKMEC criteria
Only condition which is UKMEC 4 for POP
breast cancer
How to take POP
- taken continuously , no hormone free interval
- should be taken same time each day (3 hours of time)
- can be used during breast feeding
- can be used during surgery
Which POP has a longer window?
Desogestrel
How long is implant licensed for?
3 years
How long is the IUS licensed for?
5 years
In what situations may you given ABx for acute otitis media?
- If under 2 years with bilateral infection
- otorrhea
What might be prescribed if giving an delayed ABx prescription for acute otitis media?
1st line = AMOXICILLIN (5-7 days)
If pen allergic –> clarithromycin
Cholesteatoma complications:
- facial nerve palsy
- vertigo
- intracranial abscess
- meningitis
