Bakr GP Past Papers Notes (PDF)

• i intracranial pressure Bulging fontanelle (babies); drowsiness/ d level of consciousness; vomiting; irritability; d pulse rate; i BP; fitting; neurological signs, e.g. abnormal tone/ posturing • Septicaemia/ septic shock Figures 29.11, 29.12, and 29.13. A petechial rash suggests meningococcal se...

• i intracranial pressure Bulging fontanelle (babies); drowsiness/ d level of consciousness; vomiting; irritability; d pulse rate; i BP; fitting; neurological signs, e.g. abnormal tone/ posturing • Septicaemia/ septic shock Figures 29.11, 29.12, and 29.13. A petechial rash suggests meningococcal septicaemia - Antibiotics for suspected meningococcal sepsis • Give benzylpenicillin. Dose: adult or child ≥10y— 1.2g; child 1– 9y—600mg; infant <1y— 300mg • Withhold penicillin ONLY if clear history of anaphylaxis in response to a previous dose. Rash following penicillin is not a contraindication • Cefotaxime is an alternative: adult or child >12y— 1g; child <12y— 50mg/ kg 14. Shoulder pain + FHX of OA + painful arc à IA injection/refer to ortho/MRI/X-ray (PAINFUL ARC= SHOULDER IMPINGEMENT-> REST, NSAIDS, THEN PHYSIO THEN SUBACROMIAL STEROID INJECTION) – MSK - Investigate with X-ray - You would do X-ray to look for loss of joint space, and other oa findings then you would also do ESR and FBC to look for other causes of OA – inflammatory causes. Then you will do; pain control and joint injection and other theapries after investigation. Refer to rheumo only if young patient, odd distribution, suspected inflammatory arthritis, or if you do not know how to give joint injections. REFER TO ORTHO ONLY if joint replacement and sepsis. - Rest and NSAIDs, followed by physiotherapy an subacromial steroid injection - If conservative measures fail refer for specialist management.