Miscellaneous Flashcards
What is primary focal hyperhidrosis and what are the diagnostic criteria?
It is excessive sweating of a benign cause, sometimes running in families.
Diagnostic criteria:
Typically symmetrical, bilateral sweating
Sweating eases off at night and there is no focal nocturnal sweating
Age of onset < 25 years
Affecting ADLs
Frequency of at least 1x episode per week
Features that suggest alternative cause are onset > 25, night sweats and uniliateral.
In which circumstances should urine MCS be sent from GP if suspecting a UTI?
Treat on clinical suspicion / positive dip generally
Ensure send MCS if
> 65
Visible OR non-visible haematuria
Pregnant women symptomatic of UTI (always treat for 7/7, even if asymptomatic bacteruria in pregnancy due to risk of ascending infection, send repeat urine MCS after completing abx for test of cure)
Men with suspected UTI (also treated for 7/7)
What is the Widowed Partner’s Allowance?
This is a payout from the government to someone who’s spouse or civil partner has died and they have dependent children.
They are eligible until their oldest child leaves full time education or they reach retirement age or they REMARRY whichever is sooner
The payout is dependent on the deceased having made sufficient national insurance contributions while alive
What is the funeral payment?
This is a ONE-OFF payment to the partner or parents of the deceased if they are ON BENEFITS to help pay for a funeral
What is the bereavement support payment?
This is a lumpsum and then 18 monthly payments that you are eligible for if you are under the state pension age when your partner dies.
This is dependent on sufficient national insurance contributions
The amount given changes depending on whether you are also on benefits
True or false - beta blockers can reduce hypoglycaemic awareness in diabetics / those on insulin?
TRUE
Beta blockers can block the adrenergic mediated response to hypoglycaemia and so diabetics should be cautioned re this
According to the GMC, what is the most common monitoring error in prescribing?
Failing to order the appropriate monitoring test
What is the FRAMEs model of communication and for what can it be used for?
FRAMES is a brief intervention / motivational interview approach that can be used e.g for those with drug abuse.
Feedback, Recommendations, Advice, Menu of Options, Empathy and Self-efficacy
How do you calculate the number of units in an alcoholic drink?
The volume (ml) x the ABV (alcohol by volume e.g 9%) divided by a 1,000
What associated medical conditions have an increased prevalence in Down’s syndrome?
Hypothyroidism
Type I DM (no ^ risk of Type 2 DM in Down’s!)
Congenital heart disease
Congenital GIT abnormalities
Atlanto-axial instability
Alzheimer’s
Leukaemia
Cataracts
Deafness
What is the standard recommended dose of vitamin D recommended for adults in the UK?
400 IU / 10 mcg per day for everyone aged over 1 years including during pregnancy and breast feeding
What age range is faecal calprotectin recommended for use as a screening tool in primary care for IBD?
18 - 60
Not recommended > 60. If fit negative, then refer if concerns
True or false - paternity testing can be offered on the NHS?
FALSE
GPs should direct patients requesting paternity testing to private providers. NOT provided on the NHS
What is the most common cause of vitamin B12 deficiency in adult, especially elderly adults?
Food-cobalamin malabsorption
Food-cobalamin malabsorption is the inability to absorb vit B12 from food despite adequate oral intake. It is very common in the elderly. It is mainly caused by atrophic gastritis which can be caused by multiple factors including long-term PPI use, metformin, H.pylori infection or age-related gastric atrophy.
It does respond to high dose oral Cobalamin so can save them needing IM B12 like in pernicious anaemia
What are the criteria for an URGENT referral for obstructive sleep apnoea?
Drive for a living or a job for which vigilance is essential
Pregnant
Undergoing preoperative major surgery
Unstable cardiovascular disease (uncontrolled HTN, uncontrolled arrhythmia or nocturnal angina)
Non-arteritic anterior ischaemic optic neuropathy
What is the definition of obesity class I, II and III
Class I = BMI 30-35
Class II = BMI 35-40
Class III = BMI > 40
(Overweight = BMI 25 and over)
What is the minimum amount of moderate and vigorous activity that an adult should do each week?
Should do at least 150 minutes of moderate intensity activity (brisk walking or cycling) OR 75 minutes of vigorous intensity activity
What does the MUST screening tool screen for?
Malnutrition Universal Screening Tool
Screens for those that are malnourished, at risk of malnourishment or obese
What IQ levels define mild, moderate, severe and profound learning disability respectively?
Mild = 50-70
Moderate - 35 - 50
Severe - 20 - 35
Profound - < 20
Which cancers does Epstein Barr infection confer a greater risk of ?
Nasopharyngeal cancer
Lymphoma
What are the age-related doses for IM BenPen in suspected meningococcal meningitis?
< 1 = 300mg
1 - 9 = 600mg
10+ and adults = 1200 mg
What antibody test is used to screen for pernicious anaemia?
Intrinsic factor
How much moderate physical activity is needed per day to protect from obesity and how much should people that have previously been obese aim to do to prevent relapse?
45-60 mins moderate activity per day to prevent obesity
If prev obese, recommended to do 60-90 minutes mod activity per day to prevent relapse
What is the daily recommended calcium intake for adults?
700 - 1200mg per day
For adults with osteopenia/osteoporosis, what dose of calcium and vitamin D should they be having daily?
1200mg calcium & 400-800 IU of Vitamin D
(If dietary calcium is inadequate ie less than 700mg then prescribe at least 1,000 mg calcium and 400IU Vit D if not exposed to much sunlight, 800IU if elderly or in a care home)
What is the minimum visual acuity required to be allowed to drive group 1 vehicles (cars and motorbikes)?
Must have at least 6/12 vision with both eyes open and must have adequate visual fields
What is the inheritance pattern for duchenne muscular dystrophy?
X Linked Recessive (only boys can get it)
2/3rds of cases inherited from the maternal line
1/3 occurs from spontaneous mutation (so mother NOT always a carrier)
A mother that is a carrier has a 50% chance of passing it on. So 50% chance her daughter will be a CARRIER and 50% chance her son will be affected.
What is the presentation of obesity hypoventilation syndrome?
Obesity + raised pCO2 when awake + breathing abnormalities when asleep e.g OSA
