GP

Question 1

What is telangiectasia

Answer 1

small dilated blood vessels near the surface, commonly in mucous membranes

Question 2

MO in impetigo?

Answer 2

staph aureus

Question 3

Tx of impetigo?

Answer 3

Localised disease:
• 1st line - topical fusidic acid

Extensive:
Oral fluclox. Erythromycin if allergic.

Question 4

Describe rash of impetigo

Answer 4

Yellow brown crusts which may be bulbous.

Question 5

pathogen of cellulitis? Tx??

Answer 5

Group A strep or staph aureus

amox or iv co-amox

Question 6

Patho of chickenpox

Answer 6

Varciella Zoster Virus

Question 7

Tx of chickenpox?

Answer 7

• Trim nails
• Calamine lotion
IV aciclovir if immunocompromised

Question 8

Complications of chickenpox?

Answer 8

• Pneumonia
• Encephalitis
Disseminated haemorrhagic chickenpox

Question 9

Diagnosis of eczema?

Answer 9

Itchy skin condition in last 12 mths and 3+ of:
	• Onset below age 2
	• History of flexural involvement
	• History of generally dry skin
	• Personal history of atopy
Visible flexural dermatitis

Question 10

Tx of eczema?

Answer 10

First line:
• Emollients
• Steroids
• Antihistamines

Second line:
UV radiation

Question 11

Name topical steroids mild, moderate, potent and v potent

Answer 11

• Mild - Hydrocortisone 0.5-2.5%
• Moderate - betamethasone 0.025%
• Potent - Betamethasone 0.1%
Very potent - Dermovate 0.05%

Question 12

what are the 2 types of contact dermatitis

Answer 12

• Irritant contact dermatitis - non allergic reaction due to weak acids or alkalis. Eythema.
• Allergic Contact dermatitis:
type 4 hypersensitivity.

Question 13

Patho of psoriasis

Answer 13

Patho:
• Excess Keratinocyte proliferation in epidermis
Can be worsened by environmental stressors

Question 14

S&S of psoriasis

Answer 14

• Extensor distribution
Erythromatous, scaly patches

• Psoriatic arthropathy
	• Nail signs - pitting, onycholysis (separation of nail from nailbed)
	• Systemic complications:
		○ CVS disease
		○ HTN
		○ Venous thromboembolism
UC and Crohns

Question 15

What is guttate psoriasis, epid and tx?

Answer 15

Psoriasis - Guttate:
	• More common in children and adolescents
	• Precipitated by strep infection
	• Tear drop papules on trunk and limbs
	• Tx:
		○ Self resolving most cases
Psoriasis Tx

Question 16

Tx of psoriasis

Answer 16

emolients + betamethasone + calcitriol

Question 17

What types of HSV cause what?

Answer 17

• HSV-1 - oral lesions

HSV-2 - genital herpes

Question 18

Complication of HSV?

Answer 18

Herpes Simplex Encephalitis

Question 19

Tx of HSV

Answer 19

• Cold sores - topical aciclovir

Genital sores and gingivistomatitis- Oral aciclovir

Question 20

S&S of herpes simplex encephalitis, investigations, and Tx

Answer 20

• Affects Temporal lobe
	• S&S:
		○ Fever, headache, vomiting
		○ CNS signs eg aphasia
	• HSV-1 most likely responsible
	• Investigations:
		○ CSF + PCR for HSV
		○ MRI scan
Tx - IV aciclovir

Question 21

S&S of shingles

Answer 21

• Acute, unilateral painful blistering rash

Dermatomal distribution

Question 22

Tx of shingles

Answer 22

• Aciclovir
• Prevention - Shingles vaccine:
Live attenuated vaccine therefore immunosuppressed are contra.

Question 23

Tx for sinusitis?

Answer 23

Abx not effective.

Steroid nasal sprays

Question 24

Causes of CKD

Answer 24

Causes:
	• Diabetes
	• Chronic glumerulonephritis
	• HTN
Adult Polycystic kidney disease

Question 25

Systemic results of CKD?

Answer 25

``` Systemic results: • Bone problems due to Vit D: ○ Osteomalacia ○ Osteitis fibrosa cystica ○ Osteoporosis • Anaemia due to: a. Erythropoietin b. Reduced red cell survival c. Reduced iron absorption Hyperkalaemia ```

Question 26

Contraindications due to CKD?

Answer 26

LMN: • L - Lithium • M - Metformin N - NSAIDs and Nitrofurantoin

Question 27

Tx of CKD

Answer 27

• Treat any underlying causes • ACEi • Anemia - Erythropoietin • Hypocalcaemia - Calcium, Vit D analogues • Hyperkalemia - Furosemide Consider Haemodialysis or renal transplant

Question 28

RFs of adhesive capsulitis?

Answer 28

DM

Question 29

S&S of adhesive capsulitits

Answer 29

• External rotation most affected • Both passive and active movements affected • 3 phases - Painful freezing phase --> adhesive phase --> recovery phase Can be bilateral

Question 30

Tx of adhesive capsulitis

Answer 30

Tx: • NSAIDs • Physio Intra articular steroids

Question 31

Which vaccines are live attenuated? Why need to know?

Answer 31

• BCG • MMR • Flu Polio Risk to immunocompromised

Question 32

Diagnosis of DM?

Answer 32

• Fasting glucose >7mmol/l | Random glucose >11.1 mmol/l

Question 33

Tx of DM?

Answer 33

``` 1st line - dietary advice 2nd line - metformin 3rd line - Metformin + 1 of GaSPS 4th line - + another of GaSPS 5th line - Metformin + sulfonylureas + GLP-1 mimetic OR insulin ``` ``` Diabetic GaSPS G - Gliptin S - sulfonylureas P - Pioglitazone S - SGLT2 inhibitor ```

Question 34

Headache red flags

Answer 34

``` • Immunocompromised • Age <20 and malignancy history • Vomiting with no other cause • Worsening headache with fever • Sudden onset headache with peak intensity within 5 mins • Impaired consciousness Neuro or cognitive deficit ```

Question 35

Ix for tired all the time

Answer 35

• TFTs - thyroid • FBC - anaemia and WCC • HbA1c for diabetes Full history and assess meds

Question 36

Physical triggers for tired all the time

Answer 36

``` • Diabetes • Anaemia • Asthma • Arthritis • Thyroid • Alcohol/drugs Infections ```

Question 37

Physical problems for sleep trouble

Answer 37

• Overweight • HF • Sleep apnoea Narcolepsy

Question 38

Tx for sleep trouble

Answer 38

• Supportive therapy • Sleep hygiene education Last resort - Zopiclone for ST use only

Question 39

Give ABCD2 scoring system. used for?

Answer 39

TIA ``` A - Age > 60 = 1 B - Blood pressure >140/90 = 1 C - Clinical features speech disturbed no weak = 1 Unilateral weakness = 2 D - Duration <60 = 1 >60 mins = 2 D - Diabetes = 1 ```

Question 40

Tx according to ABCD2 score?

Answer 40

4+ = aspirin 300mg + specialist referral 24 hrs | 3 or less = Specialist referral 1 wk + brain imaging