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Round Up Email June 2019

This month's Round Up includes a variety of topics but a highlight is a first in a series about knee joint injections by Dr Elspeth Wise and Dr Alan Walker on behalf of the Primary Care Rheumatology and Musculoskeletal Medicine Society – Annual Conference November 14th to 16th 2019. Other topics highlighted include "cyclist syndrome" – a keen cyclist presenting with perineal pain; sundowning – the sudden appearance of neuropsychiatric symptoms such as agitation, confusion and anxiety in a chronologic fashion, usually during late afternoon or early evening; and the ELF test

  • Question 1

    Cyclist syndrome – a 42 year-old gentleman is a keen cyclist and has noted per perineal and pelvic pain that is exacerbated by "sitting down". He has read a cycling magazine and is concerned he may have "cyclist syndrome": Pudendal neuralgia

    1) Which statement regarding "cyclist syndrome" is false?

  • Question 2

    Sundowning – this is a phenomenon where there is a sudden the sudden appearance of neuropsychiatric symptoms such as agitation, confusion and anxiety in a chronologic fashion, usually during late afternoon or early evening. There is evidence that this syndrome may affect up to 25% of patients with dementia.: Sundown syndrome

    2) Which statement regarding "Sundowning" is false?

  • Question 3

    ELF test – NICE have suggested to consider using the enhanced liver fibrosis (ELF) test in people who have been diagnosed with non-alcoholic fatty liver disease (NAFLD) to test for advanced liver fibrosis. : Enhanced liver fibrosis (ELF) score

    3) Which statement regarding the ELF test is false?

  • Question 4

    High HDL – raised HDL, in general, helps to reduce cardiovascular risk. However in some instances e.g. chronic alcohol usage, then an associated raised HDL does not confer the associated reduction in cardiovascular risk: High or increased HDL cholesterol

    4) Which statement regarding raised HDL is false

  • Question 5

    Exercise in the prevention of Type 2 diabetes – a 45 year old lady has been recently diagnoses with "prediabetes" with an HbA1c of 45. She has asked you about the benefits of exercise in prevention of type diabetes.: Metformin in the prevention of onset of type 2 diabetes

    5) Which statement regarding exercise in the prevention of Type 2 diabetes is false?

  • Question 6

    Nicorandil and mouth ulcers – a 56 year old man with stable CHD had been referred on a 2ww referral because of a persistent mouth ulcer for 4 weeks. After specialist review the cause of the mouth ulcer was identified as the nicorandil medication for his IHD.: Nicorandil and mouth ulcer

    6) Which statement regarding Nicorandil is false?