Samenvatting
Summary General Practice Conditions MLA
- Vak
- Instelling
Document providing a summary of symptoms, signs, investigations and management of all MLA (medical licensing exam) conditions.
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Condition Signs and Symptoms Investigations Management ExtraAcne Vulgaris Macules- flat marks Observation Conservative: Benzoyl Peroxide-
Papules- small lumps - Washing face reduces inflammation
Pustules- small lumps - Eat well which helps unblock the
with pus - Stay hydrated skin and the toxic
Come domes- skin- - Don’t touch the bacteria
colored papules that face Topical retinoids- slow
Medical: production of sebum.
show blocked units
Topical: Need adequate
Blackheads- open
- Retinoids contraception
comedowns with black
- Benzoyl Peroxide
pigmentation
- Topical ABx e.g., Topical ABx e.g.,
Ice Pick scars- small
clindamycin. clindamycin
indentations in the skin Always prescribe
that are scars with benzoyl Oral Abx e.g., lymecycline
Hypertrophic Scars- small peroxide
lumps in the skin Oral:
COCP- Dianette is the
Rolling Scars- wave like - Abx
best as it has anti-
irregularities of the skin - COCP androgen effects. High
- Isotretinoin VTE risk
Acute Bronchitis Cough Clinical evaluation Symptom relief e.g., Cough can take 2-3
infection in the large - Clear sputum or CXR (rule out) paracetamol and weeks to subside
airways. Commonly viral purulent ibuprophen
and not bacterial Low grade Fever
Headache Rest
Flu- like symptoms
Scattered bronchi and
wheezing
Anemia Fatigue FBC Depends on the cause but TIBC and transferrin will
SOB LFT treat with be high in iron deficiency.
Lightheadedness UE supplementation in most
Pallor Iron Studies (TIBC, cases
transferrin and ferritin)
B12 and folate
Blood Film
Bone Marrow Biopsy
Test for blood loss e.g.,
stool test
Anal fissure Pain on defecation ‘white Abdominal Examination General: Referral:
,tear in mucosa of the knuckle ride’, ‘like putting May be able to visualize - Keep stool regular - Children when not
anal canal. a cut in vinegar’ the fissure on external and soft e.g., healed in 2 weeks
Acute - <6 weeks examination. Most increase fluid and - Ongoing pain in
Chronic- >6 weeks Bleeding on passing stool. commonly posterior and fiber intake or use adults for 6-8
Primary- no cause on the midline. laxatives weeks
Secondary- Pain Relief: Problem is there is
Bright red and on the
Constipation, IBD, STI or Not necessary to do a PR - Oral analgesia reduced blood supply to
tissue
rectal malignancy exam. - Warm baths the area which prevents
- GTN ointment can healing so need to relax
Rule out RED FLAGS e.g., the smooth muscle in
Acute- clean tear be effective
bowel habit, abdo pain,
Chronic- tend to have a - Topical Anesthetic secondary care e.g botox
weight loss and rectal or nifedipine or surgery
discharge and FHx skin tag attached
relating to IBD and
malignancy
Arrythmia
Asthma SOB NICE guidance: NICE Guidance: Additional:
Episodic Symptoms - Diagnostic hub SABA - Annual flu jab
Diurnal variation (worse where they have SABA + ICS - Yearly asthma
at night) Feno and SABA + ICS + LRTA review
Dry cough Spirometry with SABA + ICS + LABA - Advise exercise
Wheeze reversibility - Avoid smoking
SOB BTS Guidance:
Atopy Hx Diagnosis: reversibility SABA SABA- salbutamol
with SABA SABA + ICS LABA- salmeterol
Bilateral widespread SABA + ICS + LABA SAMA- ipratropium
polyphonic wheeze SABA + ICS + LAMA / LAMA – tiotropium
LRTA or Oral Theophylline LRTA- montelukast
Eczema
Balanitis Non retractable foreskin - Blood or urine for - Daily cleaning RFx:
- Caused by Penile ulceration diabetes mellitus and gentle drying - Diabetes
irritation, fungus Penile plaques - Swab for culture, - Avoid soap and - Oral Abx
and bacteria Satellite lesions stain and bubbles - Poor hygiene in
, Purulent or foul-smelling sensitivity - Nonspecific NON circumcised
discharge (bacterial) - STI test prescribe males
Dysuria hydrocortisone - Immunosuppressi
Obscuration of anatomy - Allergic on
Impotence or pain in sex Dermatitis- avoid - Chemical or
Regional the trigger physical irritation
Lymphadenopathy - Candida-
Itch (fungal) Canesten
- Bacterial- fusidic
acid and steroid if
discomfort
Bell’s Palsy Drooping of one side of Differential Diagnosis: Oral prednisolone within No improvement in 3
loss of function of the the face Ramsay Hunt Syndrome 72hours of onset of bell’s weeks then refer
facial nerve. Lesion on NO forehead sparing Reactivation of the palsy. URGENTLY to ENT
the facial nerve 20–40-year-olds varicella zoster virus in
Pregnancy (RFx) the geniculate ganglion of +/- antivirals
Post- auricular pain the 7th cranial nerve
Altered taste - Auricular pain is
Eyecare is important to
Dry eye s the first feature prevent keratosis
hyperacusis - Facial nerve palsy - Eye drops
- Vesicular rash - Eye lubricants
around the ear - Tape closed at
- Vertigo and
nighttime
tinnitus
Mx- Oral Acyclovir and
UMN would spare the Corticosteroids
forehead
Benign Eyelid Blepharitis: Management Stye: Chalazion:
Disorders - Inflammation of - Soften the lid - External: Aka Meibomian Cyst
- Blepharitis the eyelid margin. margin with hot infection of the - Firm painless
- Stye - Posterior: due to compresses twice glands of Zeiss lump in the eyelid
- Chalazion meibomian gland daily (sebum) or - Resolve by
- Entropion dysfunction - Lid hyenine with glands of Molls themselves but
- Ectropion - Anterior- mechanical (sweat) may need surgical
seborrheic removal of lid - Internal: infection drainage
dermatitis/ staph debris e.g water in the Meibomian
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