GP High Yield Sheet PDF 2023 RCSI

GP High Yield Sheet – Dr. Manar AlMansoor (RCSI Class of 2023) • • • • • • • • • • • • • • • • o Osteoporosis is -2.5 and less. Shingles rash in the face involving the tip of the nose, what do you do? Examine cornea for ulceration with fluorescein drops then give patient oral acyclovir. LOC/sedat...

GP High Yield Sheet – Dr. Manar AlMansoor (RCSI Class of 2023) • • • • • • • • • • • • • • • • o Osteoporosis is -2.5 and less. Shingles rash in the face involving the tip of the nose, what do you do? Examine cornea for ulceration with fluorescein drops then give patient oral acyclovir. LOC/sedation, pinpoint pupils, low RR? Opioid overdose. REVERSE WITH NALOXONE AKA NARCAN What are some lab features associated with alcohol use? Raised GGT and macrocytic anemia. Possibly also B1/thiamine deficiency. What is Centor criteria? Used in sore throat to predict the likelihood of a streptococcal infection. 4 features, 1 point for each: tonsillar exudate, tender anterior cervical lymph nodes, history of fever >38, absence of cough. IF ¾ OR MORE THEN GIVE ANTIBIOTICS What is the drug used to prevent symptoms of alcohol withdrawal? Chlordiazepoxide. What medication to give for diabetic patients with microalbuminuria? ACE inhibitors such as ramipril. Child with suspected meningococcal disease including high fever, lethargy and purpuric lesions, hospital is a few minutes away, what do you give? IM benzylpenicillin or IV cefotaxime. DEFINITIVE TREATMENT WITH IV CEFTRIAXONE What is the HAS-BLED score? HTN, Abnormal renal and/or liver function, stroke, bleeding, labile INRs, >65 years, drugs and/or alcohol (N.B. high risk of bleeding if 3 or more points). What are side effects of ACE inhibitors? Cough, renal impairment, hyperkalemia, hypotension, angioedema. REMEMBER THAT ACE INHIBITORS AND ARB ARE TERATOGENIC How do we manage gout? Acute attacks are managed with NSAID+PPI OR colchicine OR corticosteroid and reviewed after 4-6 weeks where urate-lowering therapy can be considered. Start with allopurinol, if it doesn’t work or can’t be tolerated switch to febuxostat. Consider sulfinpyrazone either in addition or instead if target serum levels are not reached. N.B. Do not stop urate-lowering therapy during an acute attack of gout. Special considerations to the cervical spine in RA? Atlantoaxial instability leading to a risk of cord compression, which makes X-rays important to acquire prior to general anesthesia. N.B. RA classically spares the spine (except for cervical spine) and DIPs. Example of autoantibodies which can be seen in RA? RF which is an IgM autoantibody directed against Fc portion of IgG, anti-CCP MORE SPECIFIC THAN RF, ANA. What is the definition of critical limb ischemia? ABPI <0.5. What are the commonest causes of the common cold? Rhinoviruses, coronaviruses, influenza viruses. OTHERS ALSO INCLUDE RSV, ENTEROVIRUS, ADENOVIRUS What are the commonest causes of pneumonia? Streptococcus pneumoniae, haemophilus influenzae MORE COMMON IN ELDERLY, influenza A and B, mycoplasma pneumoniae LESS COMMON IN THE ELDERLY. What are the screening tests used for TB? Tuberculin skin test i.e., Mantoux test and interferon gamma release assay. IF PATIENT IS SYMPTOMATIC, WE DON’T GET ANY OF THESE; GET A CXR!