Workshop learning Flashcards
Before PHQ9, what quick screening tool can we use and how is this done?
PHQ-2 - also known as the ‘two question screening test’
- During the last month, have you often been bothered by feeling down, depressed or hopeless?
- During the last month, have you often been bothered by having little interest or pleasure in doing things?
Answering yes to either of these questions is considered a positive answer warranting further assessment .
What is a controlled drug?
A drug or other substance that is tightly controlled by the government because it may be abused or cause addiction
The control applies to the way the substance is made, used, handled, stored, and distributed.
List 4 examples of controlled drugs which are legal in the UK
- Benzodiazepines
- Cocaine
- Codeine
- Morphine
What 4 things must a prescription for a Controlled Drug be in order to be valid?
- Indelible
- Signed by the prescriber
- Dateded
- Prescriber’s address
?????
In a prescripton, what can be said about writing the quantity?
MUST be written in both words and numbers
What must be monitored for Warfarin?
INR (once stable monitor every 3 months)
What must be monitored for Insulin?
Glucose and HbA1c
Lithium monitoring?
- Renal function
- Tyroid function
- Cardiac + ECG (in patients with CVD or RFs)
- Body-weight/ BMI
- U&Es
- FBC
Methotrexate monitoring?
- FBC
- Renal function
- LFTs
Azothioprine monitoring?
- FBC
- LFTs
Toxicity a/w Azothioprine
Myelotoxicity - bone marrow suppression
Amioderone monitoring?
- Thyroid function
- LFT’s
- Serum K+
- Chest x-ray
Why chest x-rays in monitoring of Amiodarone?
a/w pulmonary fibrosis - not often used as first line
Monitoring of corticosteroids
- FBC
- HbA1c
????
Triad of reactive arthritis
‘can’t see, can’t pee, can’t climb a tree’
Urethritis, conjunctivitis, arthritis
Diagnostic test for IBD?
Faecal calprotectin
What is a FIT test?
faecal immunochemical test (FIT) - bowel cancer screening
A patient presents to you with suspected hip OA
What patient-reported tool can help us assess severity and potential need for a THR
Oxford Hip Score
A chronic smoker of 35 years requires a THR. What MUST we inform patient prior to booking the surgery
Health risks and surgical complications a/w smoking
Must NOT smoke upto 4 weeks before surgery
Normal serum value for K+
3.5 - 5.5
4 drugs which increase K+
- NSAIDs
- ACEi
- ARBs
- K+ sparing
3 conditions causing increased K+
- Congestive heart failure
- DKA
- Addisons
Values for mild, moderate and sever hyperkalaemia
Mild: 5.5 - 5.9
Moderate: 5.9 - 6.5
Sever: > 6.5
Any patient with a K+ > 6 requires what?
An ECG
ECG changes in hyperkalaemia
- ST elevation
- Tall tented T waves
Causes of low K+
- CKD
- Diarrhea
- Loop diuretics - furosomide
- Excessive alcohol
- DKA
Dosage of paracetamol for an adult?
0.5–1 g every 4–6 hours; maximum 4 g per day
What OTC analgesic is contraindicated in < 16y and WHY?
Asprin - risk of developing Reye’s syndrome
Rare but serious condition that causes swelling in the liver and brain. Most often affects children and teens recovering from a viral infection (ie. flu or chickenpox)
What OTC pain medication should be avoided in a child or individual with chicken pox?
Ibuprofen or any NSAIDs - can stop the inflammation
What assessment/ guidlines are used to assess competence in an under 16yo?
Fraser guidelines
Gillick competence
Why is Ovarian cancer often only diagnosed in late stage disease?
What tumour marker in the blood can aid diagnosis?
Clinical features are non-specific ie. feeling constantly bloated, discomfort in tummy or pelvic area, increased need to pee etc…
Test for Ca-125
Explain the GOLD classification for COPD
Assesses severity of COPD to aid management plan - takes into account mMRC and CAT
All Immunisations can be completed at any stage of life if an individual has missed their childood immunisations
What is the exception to this?
HPV vaccine
Must be given to girls at the age of 12-13 because the thymus is required to produce the desired response.
List 4 pieces of lifestyle advice you can give to an individual with uncontrolled hypertension
- Reduced alcohol consumption if they drink excessively
- decrease consumption of coffee + caffeine-rich products
- Keep dietary sodium intake low
- Increase daily activity
- Quit smoking if applicable
What does the GP management algorithm RAPRIOP stand for?
R - reassurance
A - advice
P - prescription
R - referral
I - investigations
O - observations and follow up
P - prevention and health promotion
What 4 things do we assess in a neuro exam of the musculoskeletal system?
Power, Tone, Sensation, Reflexes
Two most common bacteria causing an URTI + treatment
Streptococcus pneumoniae (+) and haemophilus influenzae (-)
1st line treatment: Amoxicillan
List 4 common s/e of antibiotics (hint GI symptoms)
- nausea and vomiting
- diarrhoea
- thrust (esp if prone to thrush already, may require anti-fungal prescription)
- bloating, indigestion, abdominal pain
- loss of appetite
List 4 differentials for a chronic cough
- Rhinitis and post-nasal drip
- ACEi
- GORD
- Asthma
Compare differences between the blue vs brown inhaler for Asthma, incl the most common medication in each
The purple inhaler for Asthma most often contains what medication(s)
Usually a combined inhaler, both a reliever and a preventor
List 4 risk factor that may increase severity of COVID
- Age
- Co-morbidities
- Obesity
- Underlying respiratory condition
Compare peripheral neuropathy vs PVD in terms of pathophysiology and presentation
Peripheral Neuropathy
Nerve damage due to prolonged ↑ in blood sugar - most commonly due to diabetes “diabetic neuropathy”
Presents as burning, tingling and/or general weakness in the limbs, usually legs, feet or hands. If untreated can progress to complete numbness
Peripheral Vascular Disease
Narrowing, blocking or spasming of the BVs most commonly in the lower regions (legs, calves, thighs, hips or buttocks)
Presents as intermittent claudication - aching, cramping, weakness that occurs when walking and goes away with rest
Do we prescribe Abx for a sore throat? Explain
Acute sore throat (incl pharyngitis and tonsillitis) is self‑limiting and most often triggered by a viral infection of the URT
People with a sore throat caused by _______ bacteria are more likely to benefit from antibiotics
What 2 criteria can help identify people in whom this is more likely?
Streptococcal
Criteria:
- FeverPAIN criteria
- Centor criteria
Explain the FeverPAIN criteria
Explain the Centor criteria
1st line treatment for tonsillitis?
Phenoxymethylpenicillan
What must we NEVER prescribed for a sore throat (of any cause)?
Why?
Amoxicillan - only useful in strep throat
If used for any other sore throat, can develop an antibiotic rash haracteristic of infectious mononucleosis
List 4 contraindications for prescribing the OCP
- Migraines
- DVT or Fx of clots
- breast cancer
- Hypertnesion?
List 2 drugs which display zero order kinetics
- Asprin
- Phenytoin
- Ethanol
- Fluoxetine
