Free DHA GP Exam Exam Flashcards

Target HbA1c <7% for most adults; start metformin first-line unless contraindicated (e.g., eGFR <30, significant hepatic impairment).

Add an SGLT2 inhibitor or GLP-1 receptor agonist - these classes have proven cardiovascular benefit independent of glycaemic control.

Give 15-20g of fast-acting carbohydrate (e.g., glucose tablets or juice), recheck glucose in 15 minutes, and repeat if still low.

Hyperglycaemia, ketosis (raised blood or urine ketones), and metabolic acidosis (pH <7.3 or low bicarbonate) - all three must be present.

General adult: <140/90 mmHg. Diabetic or CKD patient: a tighter target of <130/80 mmHg because of higher cardiovascular and renal risk.

An ACE inhibitor or ARB - these classes are renoprotective and specifically indicated when albuminuria is present.

Add spironolactone as the step-4 agent for resistant hypertension, provided potassium and renal function allow it.

Never prescribe a long-acting beta-agonist (LABA) alone - it must always be combined with an inhaled corticosteroid (ICS), since LABA monotherapy raises the risk of severe exacerbation and death.

eGFR 30-59 mL/min/1.73m^2 - stage 3 is often subdivided into 3a (45-59) and 3b (30-44).

Levothyroxine, with the dose titrated against serial TSH levels, aiming for TSH within the normal reference range.

Amoxicillin or a macrolide (e.g., clarithromycin) - reserve broader-spectrum agents for more severe or hospital-treated cases.

A score of 2 indicates moderate severity and should prompt consideration of hospital admission; a score of 0-1 suggests outpatient management is usually safe.

Nitrofurantoin for 5 days - first-line for uncomplicated lower UTI because of low resistance rates and minimal systemic absorption.

Flucloxacillin or cephalexin - both cover the streptococcal and staphylococcal organisms typically responsible.

Microcytic anaemia with low ferritin points to iron-deficiency anaemia (investigate for GI blood loss). Macrocytic anaemia with neuropathy points to B12 deficiency, which can cause subacute combined degeneration of the cord if untreated.

FAST = Face drooping, Arm weakness, Speech difficulty, Time to call for help. IV thrombolysis (alteplase) should be given within 4.5 hours of symptom onset.

Thunderclap onset - a sudden, severe 'worst-ever' headache reaching maximum intensity within seconds to minutes - raises concern for subarachnoid haemorrhage.

Airway, Breathing, Circulation, Disability, Exposure - always assessed and treated in this order before moving to the next step.

Rate 100-120 per minute, depth 5-6 cm, ratio 30 compressions to 2 ventilations.

Adrenaline 0.5 mg IM (0.5 mL of 1:1000), given into the anterolateral thigh; repeat every 5-15 minutes if there is no improvement.

Inferior STEMI, most commonly from occlusion of the right coronary artery (RCA). Aim for reperfusion (PCI) within 90-120 minutes of first medical contact.

The Sepsis Six: give oxygen, IV fluids, and IV antibiotics; take blood cultures and serum lactate; monitor urine output - all within the first hour.

Hexavalent (DTaP-IPV-HepB-Hib), PCV, and rotavirus are given at both 2 and 4 months. The rotavirus dose count depends on the brand used: RV1 (Rotarix), used in UAE government facilities, is a 2-dose series (2 and 4 months); RV5 (RotaTeq), used in the private sector, is a 3-dose series with a third dose at 6 months.

BCG vaccine, Hepatitis B vaccine, and intramuscular Vitamin K (to prevent haemorrhagic disease of the newborn).

Drooling with a toxic, tripod-positioned child suggests epiglottitis, a life-threatening emergency - croup is typically less acutely unwell despite the stridor.

Age 6 months to 5 years, generalised (not focal), lasting under 15 minutes, with no recurrence within 24 hours.

Social smile by 6-8 weeks, sits unsupported by 6 months, walks independently by 12-15 months.

Amenorrhoea, abdominal/pelvic pain, and vaginal bleeding - many patients present with only some of these features, so a low threshold for beta-hCG and ultrasound is essential.

New blood pressure >=140/90 mmHg plus proteinuria, arising after 20 weeks of gestation - earlier hypertension is classified separately as chronic hypertension.

An oral glucose tolerance test (OGTT) at 24-28 weeks gestation is the standard screening window.

Ceftriaxone (single IM dose) plus doxycycline, often with metronidazole added for anaerobic/bacterial vaginosis coverage.

Tenderness at McBurney's point (right iliac fossa, one-third of the way from the ASIS to the umbilicus), often with rebound tenderness.

Murphy's sign - arrest of inspiration when the examiner's hand palpates the right upper quadrant as the patient breathes in, due to pain from the inflamed gallbladder.

Explore within 6 hours of symptom onset for testicular torsion - salvage rates fall sharply after this window, making it a same-hour surgical emergency, not an imaging-first workup.

Abdominal or back pain, hypotension, and a pulsatile abdominal mass - the full triad is often absent, so any two features in an older patient warrant urgent imaging.

Plan, intent, and means - a patient with a specific plan, clear intent, and access to lethal means is at highest immediate risk.

Onset and course: delirium is acute (hours to days) with fluctuating consciousness and attention and is often reversible; dementia is chronic, progressive, and consciousness stays stable.

This falls in the peak window for delirium tremens (typically 48-72 hours post-last-drink); first-line treatment is a benzodiazepine such as chlordiazepoxide or diazepam.

Acute angle-closure glaucoma - untreated, rapidly rising intraocular pressure can cause permanent optic nerve damage and vision loss within hours.

Amoxicillin - many uncomplicated cases in children over 2 resolve without antibiotics, so watchful waiting is often appropriate first.

Permethrin 5% cream applied to the whole body - all household and close contacts must be treated simultaneously, even if asymptomatic, to prevent reinfestation.

Asymmetry, Border irregularity, Colour variation, Diameter greater than 6mm, and Evolution (change in size, shape, or colour over time).

It requires considering psychological factors (mood, beliefs, coping) and social factors (family, work, environment) alongside biological disease, not disease alone.

Ask about tobacco use, Advise to quit, Assess readiness to quit, Assist with a quit plan, Arrange follow-up.

Primary prevents disease before it starts (e.g., immunisation). Secondary detects disease early via screening in asymptomatic people. Tertiary reduces complications and disability in patients who already have disease.

Roughly every 3-5 years depending on age and whether cytology alone or HPV co-testing is used - more frequent screening is not recommended for average-risk women.

Sensitivity is the proportion of true positives correctly identified (a highly sensitive test, when negative, helps rule OUT disease - 'SnNOUT'). Specificity is the proportion of true negatives correctly identified (a highly specific test, when positive, helps rule IN disease - 'SpPIN').

The number of patients who must receive a treatment for one additional patient to benefit, compared with the control - a lower NNT means a more effective treatment.

When there is a risk of serious harm to the patient or to others (e.g., safeguarding concerns, notifiable communicable disease, court order) - confidentiality is not absolute in these situations.

The duty of candour - you must disclose the error to the patient promptly, honestly, and with an apology, rather than concealing it.