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Flashcards in GP Deck (57)
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1
Q

What is the STaRT back tool used for

A

Risk stratification of modifiable risk factors for assessing risk of chronicity/disability of back pain (biopsychosocial approach).

2
Q

After how long do sciatica symptoms usually settle by

A

4-6 weeks

3
Q

At what vertebral level does the cauda equina start

A

L1

4
Q

Features of cauda equina syndrome

A
Urinary/fecal retention/incontinence
Saddle anaesthesia
Reduced anal tone
Bilateral leg pain
Bilateral leg weakness
Erectile dysfunction
Loss of reflexes
5
Q

What are the 3 main types of spinal infection

A

Discitis
Vertebral osteomyelitis
Spinal epidural abscess

6
Q

What is spondylolysis

A

Vertebral fracture - stress fracture of pars interarticularis which are common in sports, hyperextension movements, lumbar

7
Q

What is spondylolithiasis

A

Vertebra slips - nerve root sx, step deformity, height loss, kyphosis

8
Q

In palliative care what can be used to help loss of appetite

A

Prednisolone or Dexamethasone

9
Q

In palliative care what can be used to help with respiratory secretions

A

Hyoscine hydrobromide

10
Q

In palliative care what can be used to help with bowel colic

A
Hyoscine butylbromide
Hyoscine hydrobromide
Loperamide hydrochloride
Hyoscine 
Glygopyronium bromide
11
Q

In palliative care what can be used to help with capillary bleeding

A

Tranexamic acid

Vit K if liver disease related

12
Q

In palliative care what can be used to help with SOB

A

Morphine
Diazepam
Dexamethasone

13
Q

In palliative care what can be used to help with muscle spasm

A

Baclofen

14
Q

In palliative care what can be used to help with nausea and vomiting

A

Metoclopramide

Cyclizine

15
Q

In palliative care what can be used to help with restlessness/confusion

A

Haloperidol

16
Q

In palliative care what can be used to help with insomnia

A

Temazepam

17
Q

In palliative care what can be used to help with hiccups

A

Metoclopramide

18
Q

What is an advanced statement

A

Preferences/wishes/values/beliefs for future care so if cant decide or communicate at any point. Where you want to be cared for, day-to-day preferences, religious beliefs, practical concerns e.g. pet care. Not legally binding but anyone caring for you must take it into account.

19
Q

What is an advanced decision

A

Living will/Advanced directive
Legal document to refuse treatments in the future. Only valid if >18, have capacity, clear on which treatments to refuse and under which circumstances, signed by you (and a witness if refusing life-sustaining treatment), no pressure involved, not said/done anything to contradict it since.

20
Q

What does CPR include

A

Chest compressions
Shocks
Ventilation
Medication

21
Q

What are the 2 types of lasting power of attorney

A

A) Health and welfare

B) Finance and property

22
Q

If handing over a palliative/end of life patient, what additional information is important to mention

A
Understanding of prognosis
The care plan
Preferred place of care
Advanced decisions
Advanced statements
Lasting power of attorney
DNACRP
23
Q

Steps involved in the confirmation of a death

A

Check local minimum timeframe
Wash hands
Confirm patient identity
Inspect for signs of life - response to verbal stimulus, respiration
Pressure on fingernail to check response to pain
Pupils - fixed and dilated
Carotid pulse for 2 minutes
Listen for heart sounds for 2 minutes
Listen to lungs for 3 minutes
Wash hands again
Document findings
Document time of death as when you have confirmed it
Document whether or not they have a pacemaker if they want to be cremated

24
Q

Which vitamin is Thiamine

A

B1

25
Q

Which vitamin is Co-balamin

A

B12

26
Q

What type of anaemia can Metformin cause

A

Macrocytic - B12 deficiency

27
Q

What is the minimum blood sugar that is safe to drive

A

5

28
Q

If you’ve had a hypo whilst driving when can you set off again

A

Once blood sugars have been normal for 45 minutes

29
Q

Describe the NICE weighted 7 point checklist for suspected melanoma

A
Major features (2 points each) = change in size, irregular shape, irregular colour.
Minor features (1 point each) = largest diameter 7mm or more, inflammation, oozing, change in sensation
Refer under 2ww if 7 point checklist score of 3 or more.
30
Q

What does SPIKES stand for

A
Setting
Perception
Invitation
Knowledge
Emotions
Strategy and summary
31
Q

What follow up bloods do you do after starting someone on a statin

A

Cholesterol at 3 months

Cholesterol and LFTs at 12 months

32
Q

How do you calculate BMI

A

Weight in Kg divided by height in metres squared

33
Q

Normal BMI

A

18.5-25

34
Q

Obese BMI

A

30

35
Q

On average how long does it take the body to clear one unit of alcohol

A

1 hour

36
Q

How does herpes simplex encephalitis present

A

Focal neurological signs
Focal seizures
Decreased level of consciousness

37
Q

Diagnostic criteria for Kawasaki disease

A
Fever for >5 days plus 4 of;
Bilateral conjunctival injection
Change in mucous membranes
Change in extremities
Polymorphous rash
Cervical lymphadenopathy
38
Q

Organism associated with epiglottitis

A

Haemophilus influenza B

39
Q

Presentation of epiglottitis

A
2-4 year old
Short history of fever
Irritability
SOB
Dysphonia
Dysphagia
Drooling
Sat forward, tripod position
40
Q

Fraser criteria

A

For <16 year olds wanting contraception;
Understand advice
Won’t tell parents
Likely to continue even without contraception
Physical/mental health likely to suffer without contraception
In best interests without parental consent

41
Q

Contraindications to NSAIDs

A

Active GI ulcer or bleed
Hx of bleed/perforation related to NSAID use
2 or more episodes of recurrent GI haemorrhage or ulceration
Hypersensitivity/allergy
Asthma
Sever liver or renal impairment

42
Q

What is the risk associated with NSAIDs + SSRI

A

Gastric ulcer/bleed

43
Q

What electrolyte imbalances can cause confusion

A

Hyponatraemia
Uraemia
Hyper or hypocalcaemia
B12 deficiency

44
Q

Medications that can cause hyponatraemia

A

ACEi
PPIs
Antidepressants
Diuretics

45
Q

Differentials for diarrhea

A
Infectious gastroenteritis - norovirus, campylobacter, C.diff
Medication side effects
Anxiety
IBD
IBS 
Hyperthyroidism
Coeliac
Diverticulosis
46
Q

In gastroenteritis, after how many days would you expect the diarrhoea and vomiting to settle

A

Vomiting should settle first after 1-2 days

Diarrhea should settle after 3-4 days

47
Q

Do you have to report food poisoning to public health england

A

Yes

48
Q

After D+V when can you return to school/work

A

48 hours after the symptoms stopped

49
Q

What medication can be used for bowel spasm in IBS

A

Hyoscine hydrobromide (Buscopan)

50
Q

What medication can be used to ease vertigo

A

Prochlorperazine

51
Q

Common side effects of opiates

A

Constipation
Nausea
Vomiting
Itch

52
Q

Peripheral causes of vertigo

A
BPPV
Labyrinthitis
Vestibular neuritis
Menieres disease
Herpes zoster oticus/Ramsay Hunt
53
Q

Central causes of vertigo

A

Stroke
SOL
Migraine
MS

54
Q

BPPV;
A) maneuver to diagnose
B) maneuver to treat

A

A) Dix-hallpike

B) Epley

55
Q

How to tell if a COPD exacerbation is mild, moderate or severe

A

Mild - controlled by increasing usual meds
Moderate - needs systemic steroids or antibiotics
Severe - needs admission

56
Q

Goal oxygen saturation for COPD patients

A

88-92%

57
Q

Diagnostic criteria for ADHD

A

6+ symptoms of inattentiveness and 6+ symptoms of hyperactivity and impulsiveness. Symptoms continuous for at least 6 months, symptoms started before the age of 12, symptoms in 2 different settings (home and school), causing difficulty with their social/academics/occupation.