GP Flashcards
(118 cards)
1
Q
Initial investigations in coeliac disease?
A
TTG antibodies
Endomyseal antibodies
2
Q
Gold standard for coeliac diagnosis?
A
Endoscopic intestinal biopsy - duodenum
3
Q
Findings of biopsy in coeliac disease?
A
Villous atrophy
Crypt hyperplasia
Increased intraepithelial lymphocytes
4
Q
Which gene associated with coeliac disease?
A
HLA-DQ2 and HLA-DQ8
5
Q
Investigations for colitis?
A
Colonoscopy and biopsy (flexi sig)
6
Q
Findings on colitis biopsy?
A
Ulceration
No inflammation beyond submucosa
Continuous
Crypt abscesses
Pseudopolyps
7
Q
Findings on crohn’s biopsy?
A
Inflammation in all layers
Skip lesions
Increased goblet cells
8
Q
Fluid analysis findings in gout?
A
Needle shaped, negatively birefringent crystals
9
Q
First line treatment for mild-moderate acne?
A
Topical combination:
Adapalene/Tretinoin/Clindamycin
+ benzoyl peroxide
12 week course
10
Q
First line treatment for moderate-severe acne?
A
12-week course
Topical treatment + PO abx (tetracycline)
11
Q
Alternative to topical antibiotics for women with acne?
A
COCP
12
Q
Acute bronchitis signs over pneumonia?
A
Wheeze and no other focal chest signs (creps, dullness etc)
13
Q
Most common causes of bronchitis?
A
Viruses
14
Q
Treatment for acute bronchitis?
A
Supportive
Abx if:
Very unwell
pre-exisiting co-morbidities
CRP >100
Doxycycline
15
Q
What is acute stress disorder?
A
Acute stress reaction within the first 4 weeks after traumatic event
16
Q
Management of acute stress disorder?
A
Trauma-focused CBT first line
Benzo’s for acute symptoms (with caution)
17
Q
Type 1 hypersensitivity reaction?
A
IgE - acute reaction
18
Q
Investigations for allergies?
A
Skin prick testing
Food challenge testing
RAST
19
Q
Key management/treatments of allergies?
A
Antihistamines e.g. cetirizine
Steroids
IM adrenaline
20
Q
Adrenaline doses for anaphylaxis?
A
Adult (>12yrs) - 500mcg 1/1,000
6-12yrs - 300mcg 1/1,000
6m-6yrs - 150mcg 1/1,000
<6m - 100-150 mcg 1/1,000
21
Q
Common causes of anaphylaxis?
A
Foods e.g. nuts
Drugs
Venom
22
Q
Features of anaphylaxis?
A
Airway:
Swelling of throat and tongue
Hoarse voice/stridor
Breathing:
Respiratory wheeze
Dyspnoea
Circulation:
Hypotension
Tachycardia
23
Q
How regularly can adrenaline doses be repeated?
A
Every 5 minutes
24
Q
When can patients be discharged following an anaphylactic reaction?
A
2 hours - good response to single dose adrenaline
6 hours - 2 doses needed/prev biphasic reaction
12 hours - severe rxn, >2 doses, possible ongoing reaction
25
Causes of microcytic anaemia?
Iron deficiency
Congenital sideroblastic
Thalassaemia
26
Causes of iron deficiency anaemia?
Excessive blood loss
Dietary intake
Poor absorption
27
Symptoms of iron deficiency anaemia?
Fatigue, SOB, Palpitations, pallor, koilonychia
28
Management of iron deficiency anaemia?
Treat underlying causes
PO ferrous sulfate
29
How long to take ferrous sulfate for?
3 months after iron deficiency corrected
30
Causes of macrocytic anaemia?
B12 deficiency, folate deficiency, secondary to MTX
31
How to treat b12 deficiency?
Hydroxocovalamin IM 3x weekly for 2 weeks then 3 monthly
32
What is pernicious anaemia?
Autoimmune disorder affecting gastric mucosa = b12 deficiency
Abs to intrinsic factor
33
Causes of normocytic anaemia?
Anaemia of chronic disease
CKD
Aplastic anaemia
Haemolytic anaemia
Acute blood loss
34
What are anal fissues?
Tears of the squamous lining of distal anal canal
35
Risk factors for anal fissure?
Constipation
IBD
STIs
36
Features of anal fissures?
Painful, bright red, rectal bleeding
37
Management of acute anal fissure?
Stool softener
Lubricants
Topical anaesthetics
Analgesia
38
Management of chronic anal fissures?
Topical GTN cream
39
What is atrophic vaginitis?
Atrophy of vagina usually due to low oestrogen in post-menopausal women
40
Treatment of atrophic vaginitis?
Vaginal lubricants/moisturisers
Topical oestrogen
41
What is blepharitis?
Inflammation of the eyelids
42
Management of blepharitis?
Warm compresses BD
'Lid hygiene'
Artificial tears if needed
43
What is a stye?
Hordeolum - inflammation of glands of the eyelids
44
Management of a stye?
Warm compresses BD
'Lid hygiene'
Incision with a sterile needle
Topical/PO abx if recurrent/severe
45
What is entropian and ectropian (eyelids)?
Entropian = inward turning of eyelid
Ectropian = outward turning of eyelid
46
BPPV symptoms?
Vertigo triggered by change in head position
Lasts 10-20 seconds
47
Diagnosis and treatment manoeuvres for BBPV?
Dx: Dix-Hallpike
Tx: Epley
48
What is bursitis?
Inflammation of the bursa over joints
49
Causes of bursitis?
Friction from repetitive movements
Trauma
Inflammatory conditions (RA/gout)
Infection
50
Management of bursitis?
Aspiration if infx suspected
RICE
Protect joint
Abx if infected
51
What is chronic fatigue syndrome?
At least 3 months of disabling fatigue affecting mental and physical function more than 50% of the time in the absence of other disease
52
Management of CFS?
Refer to specialist service
Energy management
Limit physical activity and exercise
CBT
53
Bacterial vs viral conjunctivitis?
Bacterial = purulent discharge, sitcky eyes
Viral = serous discharge, recent URTI, preauricular lymph nodes
54
Treatment for bacterial conjunctivitis?
Chloramphenicol drops/ointment
Pregnant women - fusidic acid
55
Crystal type (chemical) in gout vs pseudogout?
Gout = monosodium urate monohydrate
Pseudogout = calcium pyrophosphate dehydrate
56
Affected joints in gout vs pseudo gout?
Gout = small joints, lower extremities
Pseudogout = Large joints e.g. hips, knees, shoulders
57
Fluid analysis findings in pseudogout?
Weakly positive birefringent rhomboid crystal
58
Cause of fungal infections?
Ringworm (Tinea)
59
Where can ringworn infect?
Scalp
Foot
Groin
Body
Nail
60
Treatment of fungal infections?
Cream/shampoo/nail lacquer
Anti-fungals = clotrimazole, miconazole, ketoconazole, fluconazole, terbinafine (nails)
61
Treatment for warts?
Topical salicylic acid for 12w
or cryotherapy
62
When is bowel cancer screening offered?
60-74 year olds every 2 years
62
What is diverticular disease?
Out-pouching of the intestinal mucosa
62
What is fibromyalgia?
Widespread pain throughout the body with tender points at specific sites
62
Management of fibromyalgia?
Aerobic exercise
CBT
Meds - neuropathic pain
63
What is folliculitis?
Inflammation of the hair follicles
64
What are haemorrhoids?
Enlarged anal vascular cushions
65
Treatment of haemorrhoids?
Topical treatments
Astringents - shrink haemorrhoids
Anaesthetics
Hydrocortisone - short term use only
66
Symptoms of haemorrhoids?
Painless, fresh red bleeding
Itching/pruritis
67
Most common cause of meningitis in adults?
Neisseri meningitidis
68
Neisseri meningitidis on gram stain?
Gram negative spherical
69
Most common cause of travellers diarrhoea?
Enterotoxigenic e. coli
70
Stage 1 hypertension?
>= 140/90 (135/85)
71
Stage 2 hypertension?
>= 160/100 (150/95)
72
Flow chart for management of HTN in <55 years or T2DM?
1 - ACEi
2 - + CCB/thiazide
3 - All three
4 - + spiro/bb/alpha blocker
73
Flow chart for management of HTN in >55years of black Afro-Caribbean ethnicity?
1- CCB
2 - +ACEi/thiazide
3 - All three
4 - + spiro/bb/alpha blocker
74
When should antibiotics be given immediately in URTI?
Children <2 w/ bilateral otitis media
Children w otorrhoea
Patients with acute sore throat/pharyngitis/tonsillitis when 3+ centor
75
What are the Centor criteria?
Tonsillar exudate
Cervical lymphadenopathy/lymphadenitis
History of fever
Absence of cough
76
What are in the feverPAIN criteria?
Fever
Purulence
Attend rapidly (3 days or less)
Severely inflamed tonsils
No cough or coryza
77
Stages of CKD parameters?
1 - 90-120ml/min
2 - 60-90ml/min
3a - 45-59ml/min
3b - 30-44ml/min
4 - 15-29ml/min
5 - less than 15ml/min
78
Risk factors for AKI?
CKD
Diabetes
Heart failure
>65yrs
Liver disease
Use of nephrotoxic drugd
79
Examples of nephrotoxic drugs?
NSAIDs
Aminoglycosides
ACEi/ARBs
Diuretics
80
Diagnostic criteria for AKI?
Rise in creatinine 26µmol/L in 48hrs
>=50% rise in creatinine in 7d
Urine output <0.5ml/kg/hour for 6+ hours
>=25% fall in EGFR in 7 days (paeds)
81
Typical organisms causing CAP?
Streptococcus pneumoniae
Hib
Staph aureus
82
Atypical organisms causing CAP?
Mycoplasma pneumonia
Chlamydia pneumoniae
Coxiella burnetii
83
Causes of HAP?
Klebisella
E. Coli
Pseudomonas
84
Screening tool for risk of stroke in patients with AF?
CHA2DS2-VASc
85
Risk factors in CHA2DS2-VASc?
Congestive heart failure
Hypertension
Age (2)
Diabetes
Prior Stroke/TIA/VTE (2)
Vascular disease
Sex (F)
86
When to offer anticoagulation following CHA2DS2V-VASC?
Men = score of 1
Women = score of 2
87
First line rate control in AF?
BB or rate limiting CCB (diltazem)
88
Example of rhythm control in AF?
Amiodarone
89
Asthma management steps in adults?
SABA
SABA + ICS
SABA + ICS + LABA
Increases ICS or add LTRA
90
Most common organism causing infective exacerbations in COPD?
Hib
91
Common causes of CKD?
Diabetic nephropathy
Chronic pyelonephritis/glomerulonephritis
HTN
Adult polycystic kidney disease
92
Management for COPD?
SABA/SAMA (always included)
If asthmatic fx = LABA+ICS
No asthmatic fx = LABA+LAMA
LABA+LAMA+ICS
93
Laxative preference in adult constipation?
First-line = bulk-forming
Second-line = osmotic
94
Laxatives for opioid induced constipation?
Osmotic + stimulant laxative
95
When is T2DM diagnosed?
HbA1c >=48mmol/mol
If symptomatic:
Fasting >=7mmol/L
Ransom >=11.1mmol/L
96
Drug management order of T2DM?
1. Metformin (CVD +SGLT2)
2. Add DPP4, Sulfonylurea, SGLT2, Pioglitazone
3. Add another or start insulin
4. If triple therapy and BMI >35, switch one for GLP-1 agonist
97
DPP-4 inhibitor examples and mechanism?
Sitagliptin, Linagliptin, Alogliptin
Increase insulin and lower glucagon
98
Sulphonylurea examples and mechanism?
Gliclazide, Glimepiride
Augment insulin secretion
99
SGLT2 inhibitor examples and mechanism?
Canagliflozin, empagliflozin,
dapagliflozin
Increase urinary glucose excretion
100
Investigation if suspecting diabetes mellitus?
Fasting glucose tolerance test
101
Treatment for scabies?
Premethrin 5% whole household
102
Treatment for threadworm?
Mebendazole for whole household
103
Up to how many IM adrenaline doses in anaphylaxis?
2 doses
104
When to avoid NOACs in renal impairment?
If crcl <15mL/min
105
Blood findings in alcoholic liver disease?
AST and ALT both increased
AST:ALT 2:1
106
Most common causes of IECOPD?
Haemophilus influenzae
Streptococcus pneumoniae
Moraxella catarrhalis
107
Treatment for mild otitis externa?
Topical acetic acid
108
Treatment for moderate otitis externa?
Topical Abx and steroid
Neomycin + dexamethasone + acetic acid
109
Blood results findings in haemophilia?
Prolonged APTT
Bleeding time, thrombin time, prothrombin time normal
110
What is prolonged in haemophilia?
APTT
111
First degree heart block on ECG?
PR interval >0.2s
112
Secondary degree heart block on ECG?
T1 - progressive prolongation of the PR interval until a dropped beat occurs
T2 - PR interval is constant but the P wave is often not followed by a QRS complex
113
Complete heart block on ECG?
There is no association between the P waves and QRS complexes
114
Penicillins mechanism of action?
Inhibit cell wall synthesis
115
How do extra agents with penicillins work e.g. clavulanic acid, tazobactam?
Beta-lactamase inhibitors
