LOs

Question 1

RAPRIOP for mx

Answer 1

Shared underst
Advice eg smok, infec control, meds incl OTC, work, fluids/paracetamol/rest, NAT HX ie how long will last, driving.
Prescription
Referral
Investigation
Obs/safety netting- 3 red flags
Health promotion eg lifestyle and prevention.

Question 2

Triple diagnosis

Answer 2

Bio
Psycho
Social

Question 3

Surgical seive

Answer 3

VITAMIN-
Vascular
Infec/inflamm
Trauma
AI
Metabolic
Iatrogenic/idiopathic
Neoplastic

Question 4

Muscle strain and ST sprain

Answer 4

PRICE- protect eg support. Rest 48-72hr. Ice 15 mins every 2-3hr for first 2-3d. Compression. elevation until swell controlled.
Paracetamol or topical NSAID first line.
Codeine add on if req.
oral NSAID after 48hr if req.
HARM 1st 72hr acoid all of- heat, alc, running, massage.
Physio if severe strain only.
Immobilisation if req.
seek help in 5-7d if not improving or worsening. Maybe ortho rev.
If sev sprain with large or complete tear may need immobil up to 6wk.

Question 5

Dyspepsia

Answer 5

dysphagia, mass, wl, haematemesis, high pl etc means 2wk endosc.
If none of these- rev meds, lifestyle advise, trial full dose PPI 1 mnth OR Hp test ans treat.
Hp test- C13 urea breath test or stool Ag test, or lab based serology. Then test for cure with C13.

Question 6

GORD oesophagitis

Answer 6

Trial PPI 1mnth.
Reduce if works.
Double dose if not work.

Question 7

GORD no oesophagitis

Answer 7

PPI 1 mnth
Lower dose if works
H2RA or prokinetic for 1 mtnh if not work.

Question 8

GORD complics

Answer 8

Oesophagitis
Ulcer
Anaemia
Stricture
Barretts
Oes carcinoma.