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GP RIA > week 1 > Flashcards

week 1 Flashcards

1
Q

what is a fit note for?

A
  • free of charge
  • statement for fitness to work advising either
    a) not fit for work
    b) you may be fit for work taking account certain pieces of advice
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2
Q

when does a fit note need to be issued

A

when an individual has been off work for more than 7 days

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3
Q

can altered hours be stated as a request for a patient issued with a fit note

A

yes

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4
Q

palliative management of anorexia

A

dexamethasone

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5
Q

palliative management of pruritus

A

cholestyramine

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6
Q

palliative trx muscle spasms

A

baclofen

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7
Q

palliative trx insomnia

A

temazepam

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8
Q

palliative trx hiccups

A

metoclopramide

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9
Q

palliative trx dyspnoea

A

morphine

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10
Q

palliative trx restlessness

A

haloperidol

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11
Q

palliative trx excessive resp secretions

A

hyoscine hydrobramide

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12
Q

palliative trx capillary bleeding

A

tranexamic acid

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13
Q

4 basic principles of end of life care

A
  • autonomy
  • beneficience
  • non maleficence
  • justice
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14
Q

time definition of end of life

A

person likely to die within next 12 months

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15
Q

1st line management of delirium tremens

A

oral lorazepam

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16
Q

presentation of delerium tremens

A

tachycardia, HTN, pyrexia

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17
Q

when does delerium tremens occur

A

1-2 days following cessation of alcohol

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18
Q

other signs of alcohol withdrawal

A
  • n+v
  • headache
  • tremors
  • extreme sweating
  • hallucinations
  • agitation/anxiety
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19
Q

during what period is alcohol withdrawal symptoms worst

A

first 48 hours

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20
Q

peak incidence of alcohol withdrawal seizures

A

36 hours

21
Q

peak incidence of delirium tremens

A

48-72 hours

22
Q

symptoms of delirium tremens

A
  • seizures
  • hallucinations
  • coarse tremor
  • confusion
  • fever
  • tachycardia
23
Q

cause of wernicke’s encephalopathy

A

thiamine deficiency

24
Q

offer thiamine to…. (4)

A
  • those at high risk of wernickes encephalopathy
  • are malnourished
  • decompensated liver disease
  • in acute withdrawal
25
Q

2 supplementations during alcohol withdrawal

A

thiamine + folic acid

26
Q

why is folic acid required in alcohol withdrawal

A

alcohol affects the bodys ability to absorb folate

27
Q

where is alcohol detoxification carried out

A

undertaken by specialist community alcohol services

  • in patient, or
  • close supervision at home
28
Q

treatment for alcohol withdrawal

A

benzodiazepine regimen: chloorodiazepoxide

29
Q

therapy for alcohol dependancy (4)

A
  • self help groups: AA
  • 12 step facilitation therapy
  • CBT
  • family therapy
30
Q

4 medications for alcohol dependancy

A
  • acamprosate
  • disulfiram
  • naltrexone
  • nalmefene
31
Q

mechanism of acamprostate and how long advised course

A
  • weak NDMA antagonist

- 6 months course

32
Q

promotes abstinence if you are concerned you may have a relapse

A

Disulfiram

33
Q

mechanism of disulfiram

A

prevents you drinking by causing an unpleasant reaction when you do drink

  • nausea
  • chest pain
  • vomiting
  • dizziness
34
Q

what must you warn patients about when starting disulfiram

A

May have reaction to other alcohol containing things such as perfume, mouthwash, aftershave

35
Q

blocks opioid receptos

A
  • Naltrexone

- Nalmefene

36
Q

lower back pain red flags (6)

A
  • age <20
  • age >50
  • hx previous malignancy
  • night pain
  • hx trauma
  • weight loss
  • fever
37
Q

gradual onset of unilateral/bilateral pain with numbness, weakness; worse on walking.

  • pain resolves sitting down
  • diagnosed by MRI
A

spinal stenosis

38
Q

causes of spinal stenosis (3)

A
  • tumour
  • disc prolapse
  • degenerative changes
39
Q

Management of disc herniation/prolapse

A
  • NSAIDs
  • PPI protection
  • exercise programme
  • manual therapy
  • epidural injections of local anaesthesia + steroids
40
Q

what tool do GPs use as a prognostic questionnaire to help identify modifiable risk factors for back pain

A

STarT tool

41
Q

presentation of lumbar muscle sprain/strain

A
  • muscle spasms on movement
  • lasting < 30 minutes
  • aggravated by movement
  • usually lasts 2-4 weeks
42
Q
  • saddle anaesthesia
  • urinary/faecal incontinence
  • bilateral sciatics
A

cauda equina

43
Q

spinal cord compression presentation

A
  • gradual onset
  • aching night pain
  • localised spinal tenderness
  • worse with coughing/straining
44
Q

infection e.g. spinal epidural abscess

A
  • fever
  • TB
  • recent UTI
  • HIV infection/immunosuppressed
45
Q

causes of lumbar spinal stenosis

A
  • tumour
  • disc prolapse
  • degen changes
46
Q

easier to walk uphill than downhill

A

lumbar spinal stenosis

47
Q

management of lumbar spinal stenosis

A
  • laminectomy
48
Q

common side effects of Metformin

A
  • Abdo pain
  • anorexia
  • diarrhoea
  • nausea
  • taste disturbances
  • vomiting
49
Q

rarer side effect of metformin

A

decreased B12 absorption

GP RIA (4 decks)

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