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MBBS - Year 1 > Primary care - Bone Pain > Flashcards

Primary care - Bone Pain Flashcards

1
Q

Examples of condns managed in non chronic management

A

Diabetes, copd, hypertension, asthma, cardiac disease

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2
Q

Why are more people attending the GP

A 
Higher population
Aging population 
Worse diets 
Better trining for nurses 
Better diagnostic tools
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3
Q

The difference in life expectancy between skilled and unskilled workers

A

5 yrs due to b being more educated, less manual work, more likely, to get time off work, better nutrition, lifestyle, living condns

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4
Q

Alcohol’s effect on their body

A

Starts off causing fatty liver and leads to fibres and scar tissue being laid on liver
Destroys synapses and acts as a risk factor for condns e.g. gout and hypertension

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5
Q

Classes of anti-hypertensive drugs

A

ACE inhibitors (-il)
Ca channel blockers (-ine)
Mild diuretics
Alpha blockers

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6
Q

Factors stopping pts from consulting a GP

A 
Ignorance 
Lack of knowledge 
Embrassment 
Bad past experience 
Fear of wasting time 
Being male 
Unsympathetic
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7
Q

Treatment of impetigo

A

Flucloxacillin

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8
Q

Abx used for UTI

A

Cephalosporin (limited use due to resistance)
Trimethoprim
Co-amoxiclav
Nitrofurantoin (not in pt w/ renal failure)

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9
Q

What is heart failure

A

Weakness of heart muscle

Cant pump blood as well –> swollen ankles (can’t counter gravity), fluid build-up in lungs

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10
Q

Treatment of heart failure

A

Beta blockers

Cant be given to asthmatics (causes bronchoconsstriction)

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11
Q

Red flag symptoms for bone cancer

A 
Wt loss 
Fatigue 
Sweat
Aches 
Pain that wakes pt at night
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12
Q

Primary cancers that spread to bone

A 
Breast 
Prostate 
Thyroid 
Kidney 
Bowel 
Lung (bronchiole)
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13
Q

Lab tests for bone cancer

A 
FBC 
Leikocytes 
Infl markers 
Bone group (Ca, PO4, ALP)
Urine 
X-rays 
Isotope bone scans
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14
Q

Prognosis for bone cancer

A

Not good, manage w/ radiotherapy, analgesia, steroids & hormonal treatment

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15
Q

Why is osteoporosis common in menopause

A

Due to the lack of oestrogen

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16
Q

How does osteoporosis usually present

A

Low trauma fracture e.g. FOOSH

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17
Q

Common osteoporotic fracture site

A

Collapsed vertebrae
Colles
NOF

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18
Q

Why is osteoporosis very expensive to treat

A

Long lasting psychological effects on the pt

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19
Q

Pathophysiology of OP

A

Increased osteoclast and reduced osteoblasts

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20
Q

What can increase risk of OP

A

Long term steroids

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21
Q

What drugs can be given for OP

A

Bisphosphonates - zeolendronate

AdCal

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22
Q

Treatment of OP

A

Weight bearing exercise can help, stop smoking and drinking, OT & physio
HRT can also help but increases risk of strokes so prescribe lowest dose and give for shortest time

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23
Q

Dx of osteomyelitis

A

Swabs

Lab tests

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24
Q

Treatment of OM

A

Surgical debridement

IV abx

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25
Usual infections causing OM
Staph A | Strep
26
Types of shoulder dislocation
Anterior | Posterior
27
Treating skin infections of Strep and Staph
Penicilins e.g. flucloxacillin | Macrolides e.g. erythromycin
28
Characteristics of multiple myeloma
Overproduction of plasma cells Bone marrow does not produce enough Hb Increased Ca and thrombocytopenia on bloods
29
X-rays of multiple myeloma
Thinning of bone
30
Urine of MM pts
Bence Jones proteins
31
Treatment of MM
Chemo Bisphosphonate Radiotherapy
32
What can atrial fibrillation cause
Blood clotting, treat w/ Warfarin
33
Varicose veins
Increase pressure on superficial veins, veins dilate and valves stop working can cause varicose eczema or ulcers
34
Causes of varicose veins
Pregnancy, inactivity, obesity -treated by stripping veins
35
Golfers elbow
Affects medial epicondyle
36
Tennis elbow
Affects lateral epicondyle
37
What can cause elbow effusions
infections Rheumatic disease Olecranon bursitis (resting on your elbow a lot, more proximal than rheumatoid nodules - drain fluid)
38
Oedema definition
Accumulation of interstitial fluid in lower limbs
39
Common causes of oedema
``` Infection DVT Neoplastics Iatrogenic Congenital & trauma - can be uni or bilateral and usually acute ```
40
Things that can lead to oedema
``` Increased capillary pressure Decreased lymphatic drainage Increased venous pressure (heart failure) Infections Ruptured Bakers cyst Decreased protein in blood Amlodypine ```
41
Treatrnent of oedema
Elevation of legs, elastic stockings, diuretics
42
Main risk associated with DVT
PE
43
What can air in the bloodstream cause
Blood clots
44
How can fat enter the bloodtsream
Trauma (fracture)
45
Presentation of DVT
``` Normally unilateral swelling V similar to cellulitis Tender, swollen calf Red Hot Painful to dorsiflex If the girth of one thigh is 3cm bigger than the other - clear sign ```
46
Risk factors for DVT - Virchow's triad
Stasis - immobility, bed, post-op, leg in cast, long journeys, varicose veins Damage to blood vessel wall - trauma, infection Hypercoagability
47
Conditions increasing risk of DVT
``` Age Infection Infl Vascular factors e.g strokes Neoplasms Haematological factors Immunological problems(anti phospholipid) Iatrogenic (surgery, drugs) Combined pill and HRT Congenital Obstetrics Nephrotic syndrome Lifestyle (smoking) Idiopathic Family hx ```
48
Wells riks score fro DVT
Help GP diagnose whether pt needs to be referred to secondary care -2 to 9. Points for diff things and cellulitis reduces 2 points
49
Treatment for DVT
Refer to DVT clinic Tests d dimer - degradation of clot Give heparin s/c or NOAC
50
Lower limb infections
Usually bacterial, come from break in skin | Mainly cellulitis, can present similar to DVT
51
Treatment from lower limb infections
Erythromycin | Clarithromycin
52
Investigations for soft tissue swelling
FBC - wbc as sign of infection Raised infl markers Swabs for ulcerative condns
53
Haemotoma
Bruise
54
Thrombolitis
Varicose veins get inflamed, treat w/ oral anti-infl or gel
55
Ulcer definition
Break in continuity of surface membrane
56
Benefits of exercising
Increased circulation Increased mental health Weight control - being overweight is a risk factor for several diseases Prevents limbs from seizing up
57
Peptic ulcers cause
Excess acid, steroid, smokin
58
Presentation of peptic ulcers
Pain epigastric then radiates to back
59
Haematesisis
Vomiting fresh blood
60
Malena
Sign of upper gastric bleed

MBBS - Year 1 (93 decks)

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