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capsule > Schofield GP SAQs > Flashcards

Schofield GP SAQs Flashcards

1
Q

Questions to ask about rash:

A

Itchy?
Painful?
Does it occur anywhere else?
Has it spread?
Aggrevating/relieving factors?
FHX?
History of atopy?

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2
Q

Describe the appearance of psoriasis

A

Red, scaly, well demarcated

Silver scales

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3
Q

Name the types of psoriasis?

A

Plaque psoriasis
Guttate psoriasis
Flexural psoriasis
Pustular psoriasis

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4
Q

What other areas should you examine in someone presenting with a psoriasis lesion?

A

Scalp
Nails
Other extensor surfaces

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5
Q

Treatments for psoriasis?

A

Emollients
Topical steroids
Vit D analogues (calcipotriol)
Phototherapy

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6
Q

Ashkenazi Jew with eruption of blisters, particularly in the mouth, easily burst?

A

Pemphigus vulgaris

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7
Q

Medical term for large blister?

A

Bulla

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8
Q

Questions to ask about a mole?

A

Any changes in colour?
Does it itch?
Does it bleed?
Is it symmetrical?
Fhx of melanoma?
Does it have a regular border?

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9
Q

Risk factors for malignant melanomas?

A

Fair complexion
Sun exposure
Fhx
Sunburn

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10
Q

Describe appearance of BCC?

A

Pearly-white nodule
Telangiectasia
Rolled edges
Central ulcer

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11
Q

Pathophysiology of acne?

A

Increased production of sebum. Pilosebaceous follicles become blocked and infected.

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12
Q

Bacterial organism in acne?

A

Propionibacterium acnes

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13
Q

Name for carcinoma in situ of squamous cell carcinoma?

A

Bowen’s disease

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14
Q

Which virus causes shingles?

A

Varicella-zoster virus

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15
Q

2 groups more susceptible to shingles?

A

Elderly
Immunocompromised

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16
Q

Differentials for RLQ pain (women)

A

Ectopic pregnancy
Acute appendicitis
Ovarian torsion
Renal colic

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17
Q

Factors predisposing to ectopic pregnancy?

A

Previous PID
Previous ectopic pregnancy
Presence of intrauterine contraceptive device

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18
Q

How is diagnosis of postural hypotension made?

A

Drop in systolic BP 20mmHg and/or drop in diastolic BP 10mmHg within the first 10 minutes of standing.

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19
Q

Causes of postural hypotension?

A

Antihypertensives
Drugs (diuretics, nitrates, SSRIs)
Excessive alcohol use
Hypovolaemia
Primary autonomic failure (Parkinson’s)
Secondary autonomic failure (e.g. diabetic neuropathy)

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20
Q

How to manage postural hypotension?

A

Lifestyle:
Increase salt in diet
Stand slowly

Pharmacological:
Midodrine
Fludrocortisone

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21
Q

Factors that increase risk of falls in the elderly?

A

Reduced muscle strength
Reduced proprioception
Reduced cognition
Arthritis
Polypharmacy

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22
Q

Define delirium

A

Delirium is defined as a acute onset transient reversible state of reduced cognition with impaired consciousness.

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23
Q

What test helps distinguish between delirium and dementia?

A

4AT test

24
Q

Causes of delirium?

A

Infection
Electrolyte imbalance
Constipation
Urinary retention
Hypoxia
Uncontrolled pain

25
Q

How may bacteria develop resistance to penicillin based abx?

A

Beta-lactamase production (breaks down the beta-lactam ring)

26
Q

Many penicillins are used in combination e.g
Co-amoxiclav (amoxicillin + clavulanic acid)

Tazocin (tazobactam + piperacillin)

How do these additional drugs work?

A

Beta-lactamase inhibitors

27
Q

How does dementia present?

A

Personality change
Memory loss
Inattention
Loss of judgement
Disorientation

28
Q

Reversible causes of dementia?

A

B12 deficiency
Thiamine deficiency
Uraemia
Hypothyroidism
Hypoglycaemia

29
Q

What will a MRI brain scan show in Alzhemier’s?

A

Cortical atrophy
Ventricular enlargement
Hippocampal atrophy

30
Q

What class of medication is given for Alzhemier?s

A

Anticholinergics:

Donepezil
Rivastigmine

31
Q

How do anticholinergics work?

A

They inhibit acetylcholinesterase, so less acetylcholine is broken down and hence more is available at the synapse.

32
Q

Drugs that may precipitate urinary incontinence?

A

Diuretics
Sedatives (e.g. opiates, antipsychotics)

33
Q

Drugs that cause urinary retention?

A

Anticholinergics (e.g. oxybutynin, tolterodine)

NSAIDS (e.g. naproxen, diclofenac, ibuprofen)

34
Q

Conservative measures for stress incontinence?

A

Pelvic floor exercises
Reduce caffeine
Stop smoking
Lose weight

35
Q

What drug can be given for stress incontinence and how does it work?

A

Duloxetine (SNRI)

Inhibits noradrenaline reuptake at the synapse so increased NA available which increases the tone of the internal urethral sphincter.

36
Q

How does warfarin work?

A

Inhibits the reductase enzyme responsible for regeneration of active vitamin K.

Hence inhibits the production of Vit K dependent clotting factors. (II, VII, IX, X)

37
Q

Contraindications for thrombolysis?

A

Active internal bleed
Recent haemorrhage, trauma or surgery
Coagulation/ bleeding disorders
Stroke <3 months
Recent head injury
Severe HTN

38
Q

Common sites where osteoporotic fragility fractures occur?

A

Pubic ramus
Hip
Distal radius
Proximal humerus
Vertebrae

39
Q

DEXA scan T score and Z score meaning?

A

T score: based on bone mass of young reference population

Z score: adjusted for age, gender and ethnic factors

T score:
>-1.0 = normal
-1.0 to -2.5 = osteopenia
<-2.5 = osteoporosis

40
Q

Side effects of bisphosphonates?

A

Oesophageal ulcers
Ostenecrosis of the jaw
Increased risk of atypical stress fractures

41
Q

What is Parkinson’s?

A

A progressive neurodegenerative disorder caused by degeneration of dopaminergic neurone in the substantial nigra.

Triad: bradykinesia, tremor and rigidity

42
Q

Why is levodopa given with carbidopa?

A

They are peripheral decarboxylase inhibitors, preventing L-dopa from being broken down outside the CNS.

43
Q

Clinical signs of bronchiolitis?

A

Fever
Dry cough
Increasing dyspnoea
Wheeze

44
Q

Most common cause of bronchiolitis?

A

Respiratory syncytial virus

45
Q

What features of bronchiolitis prompt admission?

A

Apnoea
Severe resp distress (e.g. grunting, chest recession, RR>70, central cyanosis)
Oxygen sats <92%

46
Q

Symptoms of croup?

A

Barking cough
Stridor
Fever
Hoarseness

47
Q

Most common virus causing croup?

A

Parainfluenza virus

48
Q

Croup treatment?

A

Single dose oral dexamethasone (0.15mg/kg) regardless of severity

49
Q

Signs of respiratory distress?

A

Nasal flaring
Tracheal tug
Rib recession
Cyanosis

50
Q

What age does pyloric stenosis present?

A

2-8 weeks

51
Q

Acid-base disturbance in pyloric stenosis?

A

Metabolic alkalosis

52
Q

Electrolyte abnormalities associated with pyloric stenosis?

A

Hypokalaemia
Hypochloraemia

53
Q

What cartilage makes up the epiphyseal plate?

A

Hyaline cartilage

54
Q

Causes of jaundice in a newborn?

A

Rhesus haemolytic disease
ABO incompatibility
Hereditary spherocytosis
G6PD deficiency

55
Q

Causes of prolonged jaundice (14 days)?

A

Biliary atresia

Baby will also have pale stools and raised conjugated bilirubin levels.

56
Q

In a febrile seizure lasting >5 mins what class of drug should be given?

A

Benzodiazepines

57
Q

Describe intussusceptions?

A

One segment of bowel telescopes into a distal segment of bowel, causing obstruction

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