RCGP Flashcards
DOAC Dialysis in Overdose
Dabigatran (direct thrombin inhibitor) with low plasma binding levels
SSRI for GAD min lenght tx
6 months after tx control
Genetic condition with subluxation cord & why
Down due to increased ligament laxatiy due to abnormality in collagen ( lots of ortho problems)
Brimonidine in ptx open angle glaucoma and IHD
Brimonidine, an adrenoceptor stimulant, can aggravate coronary insufficiency.
high risk neural tube defects/ high dose folic acid groups
either partner has neural tube defect
either partner fhx neural tube defect
Previous baby with neural tube defect
Woman - coleiac/malabsorption stuff, diabetes, sickle cell anaemia, or on antiepileptics
First line mx symptomatic partially retractile phimosis
Moderate to potent steroid creams with regular gentle retraction (warm bath, with each void ). R
mild lichen sclerosus of a phimotic foreskin tx
Moderate to potent steroid creams
cap bleeding palliative
adrenaline gauze
travellers diarrhoea most common and timeline
e coli - should resolve in 72hours . more than 14days then something wierd
Deep gluteal syndrome - symptoms
Buttock pain
Aggravated by prolonged sitting
Tenderness on deep palpation
Passive stretching/resisted contraction cause pain ( passive stretching of flexed, adducted and internally rotated hip)
Acute bacterial rhinosinusitis
Acute bacterial rhinosinusitis would be indicated by the presence of at least 3 of:
1. Discoloured discharge (unilateral predominance)
2. Severe local pain (unilateral predominance)
3. Fever > 38 °C;
4. Elevated inflammatory markers (CRP)
5. ‘Double sickening’ whereby the patient’s condition deteriorates.
<2yrs b/l otitis media with ottorhea mx
Abx
Salmon patches type
Stork bite- neck nape
anegls kiss- glabella
duration infective exacerbation bronchiectasis abx
14 days
Orlistat mx of obesity requirements
1) Diet, Exercise, Behavioural approaches
2) BMI >28 with RF or BMI 30
Orlistat in Kiddos (12yrs)
Specialists when stuff is very bad, loads of physical comorbidities
Biting lips cystic, translucent papulonodule lower lip
Mucocele
Ranula??
retention cyst floor of mouth from sublingual salivary glands in babies and kiddos
Ranula issues
enlarges slowly and can get big enough to cause repisratory issues
Sturge–Weber syndrome
Cap naevus/port wine stain unilateral over forehead conforming to 1st/2nd division in trigeminal nerve, epilepsys, developmental delay, behaviour issues
1st term miscarriage
chromosomal errors
heart med causing change in taste
amiodarone
Familial Hypercholesterolaemia testing for fammily
DNA testing & LDL-C Concentration (first, second and sometimes third degree relatives)
PPV of FIT
7% ( i.e. postive test means 7% chance of hving cancer )
HF with left ventricular systolic dysfunction first line
BB ( bisoprolil, carvedilol, nebivolol ) and ACEI
Hypothyroidism tx incl dose and monitotring ( prsuming to cardiovascular disease)
Levothyroxine 1.6mcg/kh/body weight for adults <65yrs
They are having a heartattack/ sounds like they had one in the last 12 hrs with an abnormal ECG mx
Ambulance/ ED
They sound like they are having a heart attack/sounds like they had one in the past 12hrs but ECG is fine
Urgent same-day assessment
Sounds like had a heart attack 12-7hrs ago
Urgent same day assessment
Gestational diabetes RF
BMI >30
Previous big baby 4.5kg or above !!
gestational diabetes
FH/first degree relative with diabetes
Minority ethnic family with high prevelence of diabetes
Chonky, with a previous chonky baby
Syrupy previously, family got syrup blood, or ethnicity has syrup blood
Vaginal thrush when pregnant mx
intravaginal clotrimazole/miconazole for 7 days or clotrimazole pessary (dont use an applicator if thyre preggo)
Trinucleotide disorders - myotinic dystrophy nd Freidreichs attaxia mobidty from which issue
cardiomyopathy
Case- control propsective or retrospecitive
retrospective
Black post partum hTN
Nifedipine
first trimester ectopic presentation
Bleeding or pain ( light compared to degree of shock)
how to wean diazepam
one tenth to one quarter every 2 weeks
5mg Diazepam is how much chlordiazepoxide
15mg
5mg diazepam is home much loprazolam.lorazepam/lometazepam
0.5-1mg
Diazepam 5mg equivalency to nitrazepam
5mg
Diazepam 5mg equivaelncy oxazepam
15mg
Diazepam 5mg equivalency Temazepam
10mg
Abx to treat human bite incl duration
Co-amox 3/7
When to treat human bite
-drawn blood
hasnt drawn blood but sensitive area / low circulation spot/over cartilage or likely to get infected due to comorbidity
How many doses of Vit K given to newborn babies who are breast-fed
3 doses ( if bottlefed its 2 doses, given to prevent haemorrhagic disease of the newborn)
Babies GORD tx order
stop overfeeding/2 week trial smaller volumes more frequently
2 week carobel in-between feeds
4 weeks Alginates
If faltering growth refer
tx chlamydia if preggo
azithromycin 500mg OD for 2/7
Gilberts bloods
intermittent mild unconjugated hyperbilirubinaemia
is Very low calorie diet a thing
yh if they big and need to lose the weight quick for surgeyr or fertility
Old person+ NSAID+ HF
Bad
> 75yrs + NSAID
Bad
Interstitial Cystitis Mx
Manage pain with simple analgesics
Amitriptylline ( could consider other wierd stuff like hydroxyzine, pentosan polysulphate sodium)
Boutonnière
PIP Flexion
DIP Extension
DM in remission definition
HbA1c <48 mmol/mol should be measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion.
DM remission mx
annual review with HBA1c reading (as still high risk of Cardiovasc stuff as compared to non-diabetic )
Worst prognosis Bells palsy
Complete palsy, no signs recovery by 6 weeks, Age>60, severe pain
saturday night palsy
radial nerve - palmar ring and little finger
Type 1 diabetes - genetic
Assoc Down’s
Sex after tx with azithro for chlamydia
wait 7 days
NAFLD should be on statins- when to stop ?
if liver enzymes double within 3 months of starting
tell me about chloroquine and malaria
it’s rubbish.
( high resistance in malaria places, dont’ bother)
Pregnant 2nd/3rd trimester need malaria prophylaxis
mefloquine
side effect inhaled steroids
Glaucoma
tx anogential warts
bro refer them to sex health specialist
Primary care : suspecting ADHD mx
watch adn wait for 10 weeks with some advice about behavioural mx. Remember drugs are done secondary care shared management - i.e you can’t prescribe
Sounds like Rheumatoid Arthritis for about 2months
Refer at THREE months
Dont give steroids or NSAID before assessment
7 point checklist for assessing skin lesion
Major features (two points each):
Change in size
Irregular shape
Irregular colour
Minor features (one point each):
Inflammation
Altered sensation
Largest diameter 7 mm or more
Oozing of lesion
How many points from 7 point weighted checklists warrants a referral to derm
3
Occupational asthma , is it sensitization to work place agent or irritant induced
90% sensitization to workplace agent
Parental leave amount and conditions
worked for 1 year
18 weeks upto their 18th brithday (4 weeks max in one year)
To be a paretn you have to be on the birth certificate. Not a foster parent ( unless parental responsibility through court)
Abortion when and who
24th week
If you continue the pregnancy would cause risk of mental and physical health issues with mother
Rate-limiting Ca channel blockers ( diltiazem/verapamil) with AF with Congestive HF
Bad
Give them Beta blockers
