Schofield GP SAQs Flashcards by Kim lam

Questions to ask about rash:

Itchy?
Painful?
Does it occur anywhere else?
Has it spread?
Aggrevating/relieving factors?
FHX?
History of atopy?

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Describe the appearance of psoriasis

Red, scaly, well demarcated

Silver scales

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Name the types of psoriasis?

Plaque psoriasis
Guttate psoriasis
Flexural psoriasis
Pustular psoriasis

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What other areas should you examine in someone presenting with a psoriasis lesion?

Scalp
Nails
Other extensor surfaces

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Treatments for psoriasis?

Emollients
Topical steroids
Vit D analogues (calcipotriol)
Phototherapy

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Ashkenazi Jew with eruption of blisters, particularly in the mouth, easily burst?

Pemphigus vulgaris

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Medical term for large blister?

Bulla

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Questions to ask about a mole?

Any changes in colour?
Does it itch?
Does it bleed?
Is it symmetrical?
Fhx of melanoma?
Does it have a regular border?

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Risk factors for malignant melanomas?

Fair complexion
Sun exposure
Fhx
Sunburn

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Describe appearance of BCC?

Pearly-white nodule
Telangiectasia
Rolled edges
Central ulcer

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Pathophysiology of acne?

Increased production of sebum. Pilosebaceous follicles become blocked and infected.

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Bacterial organism in acne?

Propionibacterium acnes

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Name for carcinoma in situ of squamous cell carcinoma?

Bowen’s disease

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Which virus causes shingles?

Varicella-zoster virus

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2 groups more susceptible to shingles?

Elderly
Immunocompromised

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Differentials for RLQ pain (women)

Ectopic pregnancy
Acute appendicitis
Ovarian torsion
Renal colic

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Factors predisposing to ectopic pregnancy?

Previous PID
Previous ectopic pregnancy
Presence of intrauterine contraceptive device

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How is diagnosis of postural hypotension made?

Drop in systolic BP 20mmHg and/or drop in diastolic BP 10mmHg within the first 10 minutes of standing.

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Causes of postural hypotension?

Antihypertensives
Drugs (diuretics, nitrates, SSRIs)
Excessive alcohol use
Hypovolaemia
Primary autonomic failure (Parkinson’s)
Secondary autonomic failure (e.g. diabetic neuropathy)

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How to manage postural hypotension?

Lifestyle:
Increase salt in diet
Stand slowly

Pharmacological:
Midodrine
Fludrocortisone

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Factors that increase risk of falls in the elderly?

Reduced muscle strength
Reduced proprioception
Reduced cognition
Arthritis
Polypharmacy

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Define delirium

Delirium is defined as a acute onset transient reversible state of reduced cognition with impaired consciousness.

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What test helps distinguish between delirium and dementia?

Study These Flashcards

4AT test

Causes of delirium?

Study These Flashcards

Infection
Electrolyte imbalance
Constipation
Urinary retention
Hypoxia
Uncontrolled pain

How may bacteria develop resistance to penicillin based abx?

Beta-lactamase production (breaks down the beta-lactam ring)

Many penicillins are used in combination e.g Co-amoxiclav (amoxicillin + clavulanic acid) Tazocin (tazobactam + piperacillin) How do these additional drugs work?

Beta-lactamase inhibitors

How does dementia present?

Personality change Memory loss Inattention Loss of judgement Disorientation

Reversible causes of dementia?

B12 deficiency Thiamine deficiency Uraemia Hypothyroidism Hypoglycaemia

What will a MRI brain scan show in Alzhemier's?

Cortical atrophy Ventricular enlargement Hippocampal atrophy

What class of medication is given for Alzhemier?s

Anticholinergics: Donepezil Rivastigmine

How do anticholinergics work?

They inhibit acetylcholinesterase, so less acetylcholine is broken down and hence more is available at the synapse.

Drugs that may precipitate urinary incontinence?

Diuretics Sedatives (e.g. opiates, antipsychotics)

Drugs that cause urinary retention?

Anticholinergics (e.g. oxybutynin, tolterodine) NSAIDS (e.g. naproxen, diclofenac, ibuprofen)

Conservative measures for stress incontinence?

Pelvic floor exercises Reduce caffeine Stop smoking Lose weight

What drug can be given for stress incontinence and how does it work?

Duloxetine (SNRI) Inhibits noradrenaline reuptake at the synapse so increased NA available which increases the tone of the internal urethral sphincter.

How does warfarin work?

Inhibits the reductase enzyme responsible for regeneration of active vitamin K. Hence inhibits the production of Vit K dependent clotting factors. (II, VII, IX, X)

Contraindications for thrombolysis?

Active internal bleed Recent haemorrhage, trauma or surgery Coagulation/ bleeding disorders Stroke <3 months Recent head injury Severe HTN

Common sites where osteoporotic fragility fractures occur?

Pubic ramus Hip Distal radius Proximal humerus Vertebrae

DEXA scan T score and Z score meaning?

T score: based on bone mass of young reference population Z score: adjusted for age, gender and ethnic factors T score: >-1.0 = normal -1.0 to -2.5 = osteopenia <-2.5 = osteoporosis

Side effects of bisphosphonates?

Oesophageal ulcers Ostenecrosis of the jaw Increased risk of atypical stress fractures

What is Parkinson's?

A progressive neurodegenerative disorder caused by degeneration of dopaminergic neurone in the substantial nigra. Triad: bradykinesia, tremor and rigidity

Why is levodopa given with carbidopa?

They are peripheral decarboxylase inhibitors, preventing L-dopa from being broken down outside the CNS.

Clinical signs of bronchiolitis?

Fever Dry cough Increasing dyspnoea Wheeze

Most common cause of bronchiolitis?

Respiratory syncytial virus

What features of bronchiolitis prompt admission?

Apnoea Severe resp distress (e.g. grunting, chest recession, RR>70, central cyanosis) Oxygen sats <92%

Symptoms of croup?

Barking cough Stridor Fever Hoarseness

Most common virus causing croup?

Parainfluenza virus

Croup treatment?

Single dose oral dexamethasone (0.15mg/kg) regardless of severity

Signs of respiratory distress?

Nasal flaring Tracheal tug Rib recession Cyanosis

What age does pyloric stenosis present?

2-8 weeks

Acid-base disturbance in pyloric stenosis?

Metabolic alkalosis

Electrolyte abnormalities associated with pyloric stenosis?

Hypokalaemia Hypochloraemia

What cartilage makes up the epiphyseal plate?

Hyaline cartilage

Causes of jaundice in a newborn?

Rhesus haemolytic disease ABO incompatibility Hereditary spherocytosis G6PD deficiency

Causes of prolonged jaundice (14 days)?

Biliary atresia Baby will also have pale stools and raised conjugated bilirubin levels.

In a febrile seizure lasting >5 mins what class of drug should be given?

Benzodiazepines

Describe intussusceptions?

One segment of bowel telescopes into a distal segment of bowel, causing obstruction

Schofield GP SAQs Flashcards

(57 cards)