GP Flashcards
(48 cards)
What is the HbA1c target if managed with diet/single drug?
48 (6.5%)
What is the HbA1c target if taking a drug associated with hypos?
53(7%)
How often should you measure HbA1c?
Every 3-6 months until stable
Then every 6 months
What is next line mx if metformin is contraindicated or not tolerated?
Gliptins (DPP4 inhibitor)
Pioglitazone
Sulfonylurea
SGLT-2 inhibitor
Standard dual therapy for diabetes is metformin + ….
Gliptins (DPP4)
Pioglitazone
Sulfonylurea
SGLT2 inhibitor
What dual therapies can be considered if metformin is contraindicated?
Gliptin + pioglitazone
Gliptin + sulfonylurea
Pioglitazone + sulfonylurea
What should be asked at an asthma review?
Number of asthma attacks Steroid use in last year Nocturnal sx Adherence Possession of self management plan Exposure to smoke
What should be monitored for people on a long term steroid?
BP Urine/blood sugar Cholesterol Bone mineral density Vision
What advice should be given to people with acne vulgaris?
Avoid over cleaning the skin
Make sure to use non-comedogenic make up/emollients
Avoid picking or squeezing spots - scarring
Healthy diet
Treatments are effective but take time to work and may irritate the skin at first
What should you prescribe for mild-moderate acne?
Single topical treatment
- topical retinoids
- topical antibiotic + benzoyl peroxide
- azelaic acid
What should we prescribe for someone with moderate acne, not responding to topical preparations alone?
Oral antibiotic eg. Lymecycline, doxycycline
(Should always co-prescribe a topical retinoid or benzoyl peroxide to prevent antibacterial resistance)
Change abx if no response in 3 months
Consider COCP
When to refer a patient with acne to dermatology?
Severe variant of acne Associated with visible scarring or significant risk of scarring Multiple treatments have failed Significant psychological distress Diagnostic uncertainty
Who should I refer to secondary care with primary amenorrhoea?
Girls with no secondary sexual characteristics and have not started menstruating by 13
Girls with normal secondary sexual character and haven’t started menstruating by 15
When should I urgently admit someone with AF?
Signs of haemodynamic instability Loss of consciousness Severe dizziness Syncope Chest pain/SoB
What is the advice for school for children with chickenpox?
Keep away form school until all vesicles have crusted over
When should I refer a patient with COPD to a specialist?
Lung cancer suspected Diagnostic uncertainty COPD is very severe or rapidly worsening Cor pulmonale suspected Person is <40 or family hx of alpha 1 Frequent infections
Which COPD patients should I refer for LTOT?
Oxygen sats <92% Severe obstruction FEV1 <49% Cyanosis Polycythaemia Peripheral oedema Raised JVP
What is the first line therapy for COPD patient who has exercise limitations?
SABA or SAMA
What is second line therapy for COPD if not responsive?
Add in a LABA and LAMA
What mx options are available for primary dysmenorrhoea?
NSAIDs
Paracetamol
oral contraceptives
Recommend heat/TENS
What are the red flags for urgent referral if seen associated with dysmenorrhoea?
Ascites Pelvic/abdo mass Abnormal cervix on examination Persistent IMD/post coital bleed US scan suggestive of cancer
What antibody do we test if ?wegener’s?
cANCA
What antibody do we look for in Sjögren’s syndrome?
Anti-Ro
What antibodies do we test for in SLE?
ANA
Anti ds DNA
