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Hhghlights in this month’s Round includes updates with respect to laxatives in pregnancy; exercise and reduction of cardiovascular risk; and withdrawal from benzodiazepine anxiolytic.
Exercise and reduction of cardiovascular risk – is there a difference in benefit if an individual exercises regularly during the week to fulfil his/her 150 minutes of exercise per week or fulfils his/her exercise requirements over the weekend (“a weekend warrior”)?: Exercise - effect on development of cardiovascular disease (CVD)
With respect to exercise and reduction of cardiovascular risk, which statement is false?
incidental physical activity (IPA) encompasses activities of daily living outside the leisure-time domain:
evidence suggests that the "weekend warrior" approach and undertaking 150 exercise duration in a few days, in comparison to a more consistent approach to the fulfilling the 150 minutes of exercise over a week, is associated with greater reduction in cardiovascular risk
NICE advise people to do muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms
Pulmonary fibrosis – this section has been updated.: Pulmonary fibrosis
With respect to interstitial lung disease, which statement is false?
interstitial lung disease is more common in females, but IPF (idiopathic pulmonary fibrosis) affects males about 3 times more often
about 5% of patients with interstial lung disease develop progressive fibrosis which causes respiratory failure and is associated with an average survival of 2.5 to 3.5 years after diagnosis without lung transplant
interstitial lung disease (ILD) consists of a group of pulmonary disorders characterised by inflammation and/or fibrosis of the lung parenchyma associated with progressive dyspnoea that frequently results in end-stage respiratory failure
Pseudohaemoptysis – this is a new section on GPnotebook.: Pseudohaemoptysis
With respect to pseudohaemoptysis, which statement is false?
Serratia marcescens bacterium can produce a red pigment called prodigiosin, which can stain sputum red, creating the appearance of blood without actual blood cells being present
the pH of blood in true hemoptysis is acid
the blood in haematemesis is dark red or brown and may be mixed with food particles
Laxatives in pregnancy – is lactulose safe to prescribe in pregnancy? Is senna safe to prescribe in pregnancy?: Laxatives in pregnancy
With respect to laxatives in pregnancy, which statement is false?
lactulose is safe to prescribe in pregnancy
senna is safe to prescribe in pregnancy
has been a case report of maternal chronic use of docusate sodium throughout pregnancy, which was associated with symptomatic hypomagnesemia in the neonate
Withdrawal from benzodiazepine anxiolytic – this section has been updated.: Withdrawal from benzodiazepine anxiolytic
With respect to benzodiazepine withdrawal, which statement is false?
lorazepam 500 micrograms is approximately equivalent to diazepam 5mg
temazepam 10mg is approximately equivalent to diazepam 10mg
nitrazepam 5mg is approximately equivalent to diazepam 5mg
Guidance regarding malaria prophylaxis if on a cruise – when is malaria prophylaxis indicated when a patient is going on a cruise? This section of GPnotebook answers this query.: Malaria prophylaxis if going on a cruise (cruises)
With respect to malaria prophylaxis when going on a cruise, which statement is false?
most travellers on cruises are only ashore during daylight hours when the Anopheles vector of malaria is not feeding, and therefore do not require malaria chemoprophylaxis
cruises along the East African coast may include a stop for a night or more in the port of Mombasa, Kenya and passengers may be ashore or on deck after dusk these itineraries will require malaria chemoprophylaxis
doxycline is an oxidant drug and can lead to significant haemolysis in G6PD-deficient individuals