MICGP CKT flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Inverse care law

Tudor Hart's 1971 principle that the availability of good medical care varies inversely with the population's need for it, so deprived communities receive relatively less care despite greater morbidity.

Rule of halves

Epidemiological heuristic: half of those with a condition are detected, half of those are treated, and half of those treated are controlled, leaving about one eighth adequately managed.

Calgary-Cambridge model

A consultation framework with five stages: initiating the session, gathering information, physical examination, explanation and planning, and closing, each with content and process skills.

Safety netting

Explaining the likely diagnosis, expected timeline, specific red flags, and exactly how and when to recontact, then documenting this plan in the record.

SPIKES protocol

Six-step framework for breaking bad news: Setting, Perception, Invitation, Knowledge, Empathy, and Strategy or Summary, guiding the clinician through each stage.

ABPM threshold

Ambulatory blood pressure monitoring defines hypertension at a daytime average of 135/85 mmHg or higher, compared with a clinic threshold of 140/90 mmHg.

QRISK3 statin threshold

A 10-year cardiovascular risk of 10% or more on QRISK3 warrants offering atorvastatin 20 mg; consider statins at 7.5% or above with risk enhancers.

CHA2DS2-VASc anticoagulation

Anticoagulation is indicated in atrial fibrillation when the score is 2 or more in men or 3 or more in women, using DOACs in preference to warfarin in most cases.

ABPI interpretation

An ankle-brachial pressure index below 0.9 supports peripheral arterial disease; above 1.3 suggests medial calcification giving a falsely normal reading and needs duplex assessment.

Asthma reversibility criteria

A rise in FEV1 of more than 12% and more than 200 mL after a bronchodilator supports asthma, alongside FEV1/FVC below 0.7 and compatible symptoms.

CRB-65 score

Community pneumonia severity score: confusion, respiratory rate 30 or more, blood pressure systolic below 90 or diastolic 60 or less, and age 65 or above.

Long-term oxygen criteria

In COPD, arterial PaO2 below 7.3 kPa, or below 8.0 kPa with polycythaemia, pulmonary hypertension or peripheral oedema, on two stable assessments warrants home oxygen.

Faecal calprotectin thresholds

Values below 50 micrograms per gram make inflammatory bowel disease unlikely; values above 250 micrograms per gram in a symptomatic patient warrant referral for specialist assessment.

Glasgow-Blatchford score

A score of 1 or less in upper gastrointestinal bleeding predicts very low risk and may permit outpatient management rather than urgent inpatient endoscopy.

Hepatitis B serology

HBsAg positivity with IgM anti-HBc indicates acute infection; HBsAg persisting beyond six months defines chronic infection requiring fibrosis assessment and antiviral consideration.

HbA1c diagnostic threshold

An HbA1c of 48 mmol/mol (6.5%) or above diagnoses diabetes, but requires confirmation with a repeat sample in asymptomatic patients to exclude transient causes.

SGLT2 inhibitor indication

In type 2 diabetes with established cardiovascular disease or chronic kidney disease, an SGLT2 inhibitor is added to metformin to reduce cardiovascular and renal events.

Subclinical hypothyroidism

A raised TSH with normal free T4; treatment with levothyroxine is indicated if TSH exceeds 10 mIU/L, or if 5-10 with symptoms or positive thyroid peroxidase antibodies.

Short Synacthen test

A test of adrenal reserve using synthetic ACTH with cortisol measurement; a blunted response supports adrenal insufficiency, but hydrocortisone should not be delayed in suspected crisis.

Gout urate target

Allopurinol is titrated to achieve serum urate below 360 micromol/L, or below 300 micromol/L in tophaceous disease, with colchicine or NSAID prophylaxis for three to six months.

Giant cell arteritis action

New headache, jaw claudication or visual symptoms in a patient over 50 require immediate high-dose glucocorticoid; temporal artery biopsy or ultrasound follows but must not delay treatment.

Cauda equina red flags

Bilateral sciatica, saddle anaesthesia, urinary retention or incontinence, and faecal incontinence require emergency MRI and same-day neurosurgical referral to prevent permanent deficit.

Serotonin syndrome features

Clonus, hyperreflexia, agitation and hyperthermia following serotonergic drugs; management is stopping the agent, supportive care, and cyproheptadine in severe cases.

4AT delirium screen

A four-item tool assessing alertness, the abbreviated mental test, acute change or fluctuating course, and attention, used to detect delirium quickly at the bedside.

UKMEC category 4

A UK Medical Eligibility Criteria category meaning the method is contraindicated; examples include combined hormonal contraception in migraine with aura or in smokers over 35.

NICE fever traffic light

A three-colour system stratifying febrile children: green features indicate low risk, amber intermediate risk needing review, and red features urgent assessment or admission.

Clinical Frailty Scale

A nine-point scale from very fit to terminally ill, used to identify frailty; a score of 5 or above indicates mild to severe frailty and informs treatment escalation planning.

Surprise question

Asking whether you would be surprised if the patient died within twelve months identifies people who may benefit from advance care planning and palliative care input.

Seven-point melanoma checklist

Major features are change in size, irregular colour and irregular border; minor features are diameter over 6 mm, inflammation, oozing and change in sensation; referral is urgent.

Dix-Hallpike manoeuvre

A positioning test that provokes vertigo and nystagmus in posterior canal benign paroxysmal positional vertigo; the Epley manoeuvre is the corresponding therapeutic repositioning procedure.

Montgomery consent standard

The 2015 UK Supreme Court ruling that consent requires disclosure of what a reasonable patient in that position would want to know, not what a reasonable doctor would disclose.

Mental Capacity Act test

A person lacks capacity if unable to understand, retain, weigh or communicate information about a decision, after all practicable steps to support them have been taken.