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Round Up Email July 2025

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.

Question 1
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
Question 2
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
Question 3
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
Question 4
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
Question 5
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
Question 6
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

Round Up Email July 2025

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6