GP Flashcards

Question

what is QRISK

Answer 1

a tool, used in primary care, to calculate a patient’s risk of suffering a cardiac event, or a stroke, over the next 10 years as a percentage. It takes into account the patient’s age, cholesterol results, family history, ethnicity, blood pressure and other existing conditions.

Answer 2

a tool, used in primary care, to calculate a patient’s risk of suffering a cardiac event, or a stroke, over the next 10 years as a percentage. It takes into account the patient’s age, cholesterol results, family history, ethnicity, blood pressure and other existing conditions.

Answer 3

have a discussion about health behaviour modification, support to make changes and the offer to re-assess their risk again after they have tried to change some behaviours. If behavioural intervention is ineffective or inappropriate, then statin treatment should be offered.

Answer 4

20mg atorvastatin for the primary prevention of CVD

Answer 5

strength exercises on 2 or more days week, and 150 minutes of moderate activity or 75 minutes of vigorous activity (or a combination of both) and to reduce time sitting.

Answer 6

The FeverPAIN criteria are: score 1 point for each (maximum score of 5) o Fever over 38°C. o Purulence (pharyngeal/tonsillar exudate). o Attend rapidly (3 days or less) o Severely Inflamed tonsils o No cough or coryza A score of 0 or 1 is associated with a 13% to 18% likelihood of isolating streptococcus. A score of 2 or 3 is associated with a 34% to 40% likelihood of isolating streptococcus. A score of 4 or 5 is associated with a 62% to 65% likelihood of isolating streptococcus.

Answer 7

Copper coil - most effective. up to 5 days Levonorgestrel - EHC. Up to 72 hours Ulipristal - EHC up to 5 days

Answer 8

irregularity in her cycle and if her next period is light or more than 3 days late, she’d need a pregnancy test.

Answer 9

Gout Septic arthritis Cellulitis Inflammatory arthritis Osteoarthritis Trauma DVT

Answer 10

black “tarry” sticky faeces due to upper GI bleeding; the black colour is due to haemoglobin being altered by digestive chemicals and intestinal bacteria.

Answer 11

stomach upset, cramps, dark grittiness of the stools and altered bowel habit, either towards constipation or diarrhoea differentiating from upper GI bleed; stool are dark but gritty and pain is relieved by defection

Answer 12

ACE inhibitors, diuretics, anti-depressants, and proton pump inhibitors

Answer 13

Campylobacter are a group of bacteria that cause food poisoning, often due to eating undercooked meat no treatment is usually required except good hydration during the illness stay off until 48 hrs after last episode of diarrhoea it is a notifiable disease to Public Health England

Answer 14

hyperthyroidism IBS IBD anxiety coeliac disease colorectal cancer

Answer 15

TFTs Faecal calprotectin - normal reduces likelihood of IBD CRP + ESR FBC renal function - might put strain on kidneys Tissue Trans-glutaminase antibodies - coeliac

Answer 16

buscopan ( hyoscine butylbromide)

Answer 17

most common cause of diarrhoea in hospitalised patients especially if they have received antibiotics and are elderly bacteria which can be found in healthy people’s intestines but can cause diarrhoea when the normal gut and intestinal bacteria flora are compromised (e.g. due to antibiotics and other medications, including Proton pump inhibitors), which then lead to an overgrowth of C.difficile in severe cases can cause pseudomembranous colitis it is a notifiable disease treated with other oral antibiotics, such as vancomycin/metronidazole and in the community there would need to be strict hygiene measures

Answer 18

constipation itch nausea and vomiting

Answer 19

increased consumption of fruit and vegetables physical activity hydration feet on low stool when opening bowels

Answer 20

cardio resp GI - could be bleed, dehydration etc neurological ENT

Answer 21

A vestibular sedative such as cyclizine, cinnarazine, or prochlorperazine A vasodilator in the inner ear called Betahistine - review and stop if not helping both should be limited courses

Answer 22

prednisolone doxycycline to be started if increased breathlessness or discoloured sputum

Answer 23

Severe breathlessness. Inability to cope at home (or living alone). Poor or deteriorating general condition. Acute confusion or impaired consciousness. Cyanosis or reduced oxygen saturation esp <90% Worsening peripheral oedema. A new arrhythmia.

Answer 24

mild gastro-intestinal disturbances postural hypotension electrolyte disturbances (including hyponatraemia, hypokalaemia, hypocalcaemia, hypochloraemia, and hypomagnesaemia) hypersensitivity reactions (including rash, photosensitivity, and pruritus)

Answer 25

screening tool for domestic abuse H-humilation A-afraid R-rape K- kick or other physical violence 1 point for each yes sometimes S is added for is it safe to go home

Answer 26

if HbA1C confirmed >48 after two tests then first start with lifestyle changes for 3 months - diet - weight - exercise - address other factors such as smoking and alcohol useful if pt can see HbA1C come down if still diabetic then metformin is first line

Answer 27

48 mmol/L normally 53 if medication can cause hypos such as a sulphonylurea

Answer 28

-They are aged 40 and over with unexplained weight loss and abdominal pain or -They are aged 50 and over with unexplained rectal bleeding or -They are aged 60 and over with: -Iron-deficiency anaemia or -Changes in their bowel habit -Tests show occult blood in their faeces

Answer 29

blood tests before Repeat blood tests would be required at 3 months for total cholesterol, HDL and non-HDL cholesterol, plus liver function tests at 3 months and 12 months - small risk atorvastatin can affect liver

Answer 30

inhibiting or at least delaying ovulation by preventing follicular rupture

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