primary care learning points Flashcards
what diabetic drug can cause diarrhoea
metaformin
what would you see in urinalysis of cystitis?
leukocytes!! WBC - suggestive of pyuria (pus) in urine
what is the Rx of vaginal thrush?
150mg stat fluclonazole
what is lichen sclerosis?
itchy/ white/ smooth or crinkled patches of skin usually on the vulva/anus/foreskin or end of penis. cause unknown - not contagious. common in pt’s >50y/o. Rx = steroid cream
define AF
- an arrhythmia
- irregular, disorganized electrical activity in the atria, leading to an irregular ventricular rhythm
- cardiac causes of AF = ischaemic heart disease, HTN, valvular heart disease, HF
- respiratory causes = chest infection, lung Ca
- systemic causes = excessive alcohol intake, hyperthyroidism, electrolyte depletion, ifection, diabetes
- complications of AF include: Stroke and thromboembolism; Heart failure; Tachycardia-induced cardiomyopathy and critical cardiac ischaemia; Reduced quality of life
- suspected in people with an irregular pulse. If AF is present, an ECG will have no P-waves, a chaotic baseline, and an irregular ventricular rate
what is the Rx of AF>
rate control:
drug BB (not sotalol) or CBB (verapamil and diltiazem)
1b. digoxin is suitable for non paroxysmal AF and are sedentary
anti-coagulate:
assess risk of stroke and risk of bleeding
rhythm control:
electrical cardioversion
amiaderone and electrical cardioversion are used in acute AF where pt is haemodynamically unstable
what are the indications for dexa scan?
- low force fracture
- steroid use
- ?osteoperosis e.g. early menapause
what would you use to calculate risk of low impact fracture?
FRAX score
- looks at clinical risks as well as bone mineral density of the NOF
- gives 10 yr propability of a fracture and osteoperotic risk
what is the importance of treatment of rib/ chest wall msk pain?
risk of chest infection due to not fully breathing in to avoid pain. take seriously. NSAID + co-codomol -> tramadol + paracetamol
what medications can be used to help with sleep?
zopiclone
promethazine
amitriptyline if pain
why might WBC be raised?
infection
steroid use
what is the antibiotic Rx of OM if required?
amoxicillin (5-7days)
- if pen allergy –> clarithromycin or erythromycin (erythrimycin prevered in pregnancy)
what are the potential causes of fainting?
- anaemia
- orthostatic hypotension
- medications (anticholonergics)
- arrhythmia’s (unexpected sudden drop to floor, dont really remember it)
- epilepsy (seizure activity)
how can you treat fainting if no aparent cause?
- compression stockings
- steroids (but not ideal longterm becasue of SE profile - would have to be severely life disrupting)
reasons why MCV is raised
alcohol!
- if Hb low think B12 or folate deficiency
