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Flashcards in GP Deck (20):
1

Risk factors for asthma?

Atopy family history, prematurity and low birth weight
Early exposure broad spec abx, maternal smoking/smoking and obesity.

2

o2 sats

92%

3

Peak flow during severe asthma attacks?

33-50% predicted.

4

Chest signs in asthma attack?

Tightness, hyperinflation, expiratory polyphonic wheeze.

5

Initial management of asthma if mild or intermittent?

Salbutamol prn 100mcg/dose 2 puffs

6

Asthma not controlled with salbutamol or initial presentation is severe and gives history?

Regular inhaled steroid 200-800ug daily beclomethasone (1 puff 100mcg)
b2 continued

7

If inhaled steroids are not preventing or stabilising asthma what is next step?

Add LABA or leukotriene antagonist. Consider steroid/LABA in one inhaler as preventer and reliever

8

Persistent poor control of asthma despite preventer, inhaled steroid, LABA, montelukast?

Discontinue montelukast and or LABA if no benefits seen, increase inhaled steroid up to 2000mcg daily

9

Acute asthma attack treatment?

5mg nebulised salbutamol with oxygen. Pred or hydrocort - 30mg. aminophylinne in severe with respiratory specialists

10

Metformin (standard release) recommended when Hba1c >?

48mmol

11

If metfomrin not tolerated what can be used?

Gliclazide, sitagliptin pioglitazone or empagliflozin

12

Default NICE target when on treatment for NIDDM? mono and dual?

hypo risk 58mmol mono
53 mmol dual
48mmol if not hypo risk

13

If hba1c not at target with metformin dual therapy with metformin and?

Gliclazide, sitagliptin pioglitazone or empagliflozin

14

Dual therapy without metformin?

sitagliptin and pio, sitagliptin and gliclazide, gliclazide and pio

15

If dual non metformin therapy inadequate consider?

Insulin

16

Dual metformin therapy not adequate consider?

Triple therapy

17

If egfr <50ml/min use which gliptin?

Linagliptin

18

When to use GLP-1 mimetics?

If insulin not suitable or weight loss likely beneficial (liraglutide or dulaglutide) GLP1's

19

Max hba1c for frail/elderly?

70

20

Example of SGLT2i?

Dapagliflozin etc