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This email highlight various diverse subjects including: "sick day rules" in type 2 diabetes, update concerning use to topical HRT in atrophic vaginitis and the use of FIT in the 2ww urgent lower GI cancer pathway.
Updated "sick day rules" for type 2 Diabetes. Which medication to stop and which to continue is detailed in this page on GPn.: Type 2 diabetes and intercurrent illness
1) Which of the following statements about sick day rules in type 2 diabetes is true?
The patient should continue metformin if has gastroenteritis
The patient should continue ramipril if has gastroenteritis
The patient should continue gliclazide if has gastroenteritis
Updated guidance regarding use of topical HRT for atrophic vaginitis.: Topical HRT in the management of urogenital symptoms
2) Which statement regarding use of topical HRT in urogenital atrophy is true
NICE state topical HRT should be used for a maximum of 5 years
vaginal oestrogen is contraindicated if systemic oestrogen is contraindicated
moisturisers and lubricants can be used in addition to vaginal oestrogen
FIT in the 2ww Urgent Lower GI pathway – what does this mean for us GPs.: FIT as screening or triage of 2ww lower GI referrals
3) Which statement regarding use of Faecal Immunochemical Testing (FIT) in the 2ww lower GI pathway is true?
A negative predictive value of 99% means that 99% of colorectal cancers will be identified
A sensitivity of 90% for FIT at the level of 10 in the 2ww pathway means that 10% of cancers will not be detected by a positve FIT
The level of FIT used for bowel cancer screening to identify a positive test is the same as used in symptomatic patients who do not fit NG12 criteria
Diabetes and dementia risk.: Diabetes (DM) and dementia risk
4) Which statement regarding diabetes and dementia risk is true?
evidence suggests the greatest contribution of risk in type 2 diabetes is hyperlipidaemia
evidence suggests the greatest contribution of risk in type 2 diabetes is hypertension
evidence suggests the greatest contribution of risk in type 2 diabetes is hyperglycaemia
The UKONS primary care assessment tool for assessing patients with systemic anti-cancer therapies is summarised on GPn.: Primary Care Risk Assessment Tool for Oncology / Haematology Patients
5) Which statement regarding the UKONS primary care assessment tool is true?
Is not appropriate if a patient is receiving or recently received radiotherapy
Is not appropriate if a patient is at risk of disease related immunosuppression.
Red hands and/or red feet (palmar plantar syndrome) is part of the UKONS assessment criteria
Management of Vitamin D deficiency in a child – a "key facts" page on GPn.: Vitamin D deficiency in a child
6) Which statement regarding vitamin D deficiency in a child is true?
< 25 nmol/l is considered the level to diagnose vitamin D insufficiency
infants who are fed infant formula will not need vitamin D supplements unless they are receiving less than 1000ml of infant formula a day, as these formulas are fortified with vitamin D
breastfed infants may need supplements containing vitamin D from one month of age if their mother may be deficient in vitamin D and has not taken vitamin D supplements throughout pregnancy