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AMC Key > AMC GP/Public Health > Flashcards

AMC GP/Public Health Flashcards

1
Q

Nicotine replacement therapy

A

Dependence with 3 criteria
Waking
No of sticks
Agitation

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2
Q

Frequency for screen colon ca

A

Asymptomatic
Low: FOBT 50-74 2 yr
Mod: FOBT 2 yr 40-49, scope 5 yr
High: FOBT 2yr 35-45, scope 5yr

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3
Q

Apnoea : refuse stop driving

A
  1. empathy advise
  2. Civil right to inform DVLA
  3. Fail, to do by the Dr
  4. Weight reduction if the cause
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4
Q

Travel to southeast Asia
Post splenecetomy
Watch out for comm disease

A

Malaria

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5
Q

Biochemical marker for CV risk

A

Waist : hip ratio
0.01 unit increase= 5% RR of CV risk

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6
Q

Relative risk or risk ratio

A

Expose gp RR= % exposed group / % unexposed or placebo X 100
Unexposed gp RR : % unexposed gp/ %exposed group X 100

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7
Q

Post exposure Hepatitis B
Pregnancy Vs non pregnant

A

Same therapy

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8
Q

Pregnancy nurse exposed to hep B+ needle stick injury.

A

No ab/<10 : IvIg & hep B vaccine 0.1.6 ( less than 72hrs, 12 hr best)
AB +( >10) : No action

*Ag + in RPT serology 3/12: baby receive IvIg and HepB 12 hrs from birth

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9
Q

Breast cancer BRCA +

A

Autosomal dominant
State funded
Eligible for genetic testing
Not by Medicare

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10
Q

BRCA candidates

A
    • BRCA gene in family
  2. Breast ca less than 30yr
  3. Breasts ca less than 40 yr with triple test negative
    Many q 66 on GP section
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11
Q

Post exposure chicken pox in a child

A

Give Vaccine ( live) within 1st 5 days of exposure ( earlier better)

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12
Q

Exposure to school Chicken pox

A

After vesicles dries off

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13
Q

Reliability of studies

A

Highest(1-4) : meta analysis}systematic review } practise guidelines} RCT
Lowest 5-9:cohort }case ctrl }cross sectional} case report) individual opinion

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14
Q

Salmonella outbreak in area. Teenage boy is infected. Important information?

A

Part time job

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15
Q

Case control Vs Cohort Vs Cross sectional Vs case report

A

Finding cause of outbreak/ disease
Vs link btw cause& effect Vs study incidence of disease in a target population within a specific period
Vs detail writing of a single case

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16
Q

Prevalence studies

A

Cross sectional studies (observational type)

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17
Q

Lipid target in IHD

A

LDL< 1.8
HDL>1.0
TG<2.0
NHDL< 2.5

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18
Q

Vaccination for febrile child

A

<38.5 : Give Vaccine
>38.5 : w/hold, give later once febrile settles
Anaphylaxis: avoid vaccine
Other conditions: Give !!!!

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19
Q

Measles incubation & symptoms

A

2 days BEFORE onset of symptoms - 4 days of RASH development
Sym: fever, conjunctivitis, Koplik spots, rash, coryza, cough (3C+R+K)

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20
Q

Measles post exposure for immunocompetent Vs immunocompromised

A

Competent but unsure of immune status : within 72hrs MMR vaccine
Sure of status: observe

Compromised: give NHIG ( MMR vaccine contraindicated for pregnant& low immunity)
Babies: preterm, upto 8mths: NHIG
9-11 mth: if <72hrs: MMR
> 72Hrs: NHIG

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21
Q

Child missed all immunization

A

Start catch up vaccination NOW!

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22
Q

Child with pneumococcal meningitis despite vaccination. Why?

A

Serotype of Invasive Pneumococcal Disease not covered in the vaccine. Current vaccine covers upto 7 serotypes, there are 90 serotypes of Strep pneumoniae

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23
Q

Q fever vaccination

A

Travel to Africa and central/south American
1-2weeks onset which lasts 10years
Single dose 0.5ml IM/Sc

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24
Q

Q fever
Important prevention

A

Vaccination!
Netting, repellant
Avoid jungles

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25
Q fever symptoms
Same like dengue fever sx Reservoir: monkey Vector: aedes Aegyptus Endemic : Africa
26
CAD major risk
🚭 always advised cessation 1st !!! 32% risk reduction by stopping
27
CAD steps in smoker with high cholesterol
Stop smoking Exercise and diet > 6/12 no changes: STatin
28
Absolute CVD risk assessment calculations:
Age Sex Smoking HDL & Total Chol Systolic BP DM present or not LVF present or not
29
Absolute CVD risk assessment
Age above 45 2 yearly check-up Not having hx or current CVD Does not fall under high risk
30
CVA/ Stroke important Risk fx
Hypertension
31
Attributable risk
a/a+b - c/c+d
32
Urine Albumin creatinine ratio
Normal <2.5mg)mmol MALE <3.5mg/mmol FEMALE
33
Clinical determined high risk for CVD
Age >60 with DM Urine microalbumin Urine ACR > 2.5 male, > 3.5 female SBp > 180 ; > dbp110mmhg eGFR 45 Familial hypercholesterolemia Straits and Torrent Islander
34
Familial hypercholesterolemia
Tendon xanthomas MI death in family < 50 yrs male <60yrs female Very high cholesterol not related with other conditions
35
Child of father with familial hypercholesterolemia
Pretest genetic counseling Informed consent Genetic testing 50% risk of being affected
36
Smoking in pregnancy Rx
1. Behavioural counseling and support : initial mngt 2. Nicotine replacement: short, intermittent therapy upto 8 weeks Lozenges, spray , gum, patch remove before bedtime
37
Seizure for driving
1.Chronic seizure: non commercial: 12mth Commercial: 10yrs 2. 1st time seizure: Non commercial: 6mth Commercial: 5yrs 3. Seizure due to known causes Eg head injury , metabolic Non commercial: 6 mth Commercial: 12mth 4. Epilepsy on treatment 1st time Non commercial: 6 mth Commercial: 10yrs 5. Breakthrough seizure: Non commercial: 3 mth Commercial: 10yrs 6. Dose tapering: Non commercial: 3 mth Commercial: review license 7. Withdrawal one of medicine: Non commercial: 3 mth but seizure happen, maintain old meds and review 4 weeks then resume driving
38
Post Stroke : can drive after
4 weeks
39
Post Stroke assessment on fitness to drive
1. Occupational therapist ( simulation, on road off road etc)
40
1.Intermittent seizure to see well controlled for driving 2. 1 episode of breakthrough seizure , cause unknown Vs cause known
1:12 month free from seizure with therapy 2: cause unknown: 3 mth Cause known: 4weeks
41
Aortic aneurysm repair Fitness to drive
Private: 4 weeks Commercial: 3mth
42
MI Fitness to drive
Mi = P : 2 weeks C : 4 weeks Post PCI = P : 2 days C: 4 weeks CABG= P: 4 weeks C: 3mth *P Private *C Commercial
43
Q 18 GP section
Fitness to drive chart hafal
44
Father has Prostate cancer
Counsel benefits and risk of DRE and PSA If agree : BOTH
45
Skin Check
High Med/Low Fitzpatrick type 1-6 Check q 12 GP section
46
Skin cancer (doctor assessment)
High risk: 12 mth Med risk: 2-5 yrs Low risk: 1 shot skin check
47
HIV post exposure prophylaxis for HCW
1. 4 week therapy 2. Baseline,6 weeks, 3 mth , 6 mth serology check Choice: 2 NRTI
48
Post exposure Hepatitis B Now +HbsAg
1. Reassurance and Counseling 2. 6/12 later still positive, refer to specialist
49
Aboriginal common cause for blindness
Chlamydia trachoma>>>> trichiasis
50
Chlamydia trachoma of eye
SAFE Surgery: early entropion repair Azithromycin Face washing Environmental ctrl : fly, dust
51
IPV booster
4yrs old Primary: 2,4,6 mth
52
Obesity BMI : 30-40 no co-morbidity Rx
Stepwise approach RED VLED Pharmacotherapy
53
VLED
2 meal replacement and 1 lean protein 12 weeks regiment Aim 1-1.5kg weight loss/week
54
Pre Exposure Prophylaxis HIV (Q82 GP)
Receptive MSM with CLI Receptive MSM with hx rectal Chlamydia, Gonorrhoea, Syphilis Methamphetamine use MSM with HIV+ve partner with undetectable viral load/not on treatment
55
Eye for driving Fail:
If > 6/12 in corrected eye If > 6/18 in less eye, and > 6/9 in better eye with correction
56
Gonorrhoea +
Treat Notify Health Authorities Contact tracing : 2 month Patient referral/provider referral
57
Chlamydia+ve
1.treat 2.notify 3. Contact tracing 6mth
58
Smoking and depression treatment
Nicotine replacement therapy (more nicotine dependent ) + Varenicycline or Bupropion
59
Sex worker screening (State Law)
3 monthly HVS Chlamydia/ Gonorrhoea/trichomonas Pharyngeal: as above Vaginalvulva: warts Blood: HIV Hep B Syphilis Offer HepB and HepA vaccine
60
MSM (RACGP) screening
3 To 6mth Serology: hiv HepB Syphilis Swab : rectal/ throat for Chlamydia/Gonorrhoea/ Urine: same above Offer HepB HepA vaccine

AMC Key (11 decks)

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