Round Up Email March 2022

Question 1

NHS Galleri Trial – This trial is designed to assess the performance and clinical utility of a multi-cancer early detection test (GalleriTM) for population screening in the United Kingdom (UK). The trial is summarised on GPnotebook.: NHS Galleri Trial

1) With respect to the NHS Galleri trial, which statement is false

the positive predictive value (PPV) for a positive Galleri test is about 40%
Lui et al reported that sensitivity was 99.3% for Stage I-III cancers
the Galleri test recognises methylation patterns in cell-free DNA (cfDNA) isolated from peripheral whole blood

Question 2

Burns associated with emollient use – if using a paraffin containing emollient then are only those containing more than 50% paraffin associated with significant fire risk? Is there a fire risk associated with paraffin-free emollients?: Burns (burn) with paraffin-containing and paraffin-free emollients

2) With respect to burns associated with emollient use, which statement is false

if using a paraffin containing emollient then only those containing more than 50% paraffin associated with significant fire risk
fire risk is not associated with use of paraffin-free emollients
washing clothing or fabric at a high temperature may reduce emollient build-up but not totally remove it

Question 3

Antibiotics and Sore Throat update – A Cochrane review has analysed antibiotic use in children and adults – does it conclude that antibiotic use reduces sore throat complications?: Antibiotics in sore throat

3) With respect to antibiotics for sore throat, which statement is false

if FeverPAIN score of 2 or 3 then the patient is likely to benefit from antibiotics
a FeverPAIN score of 2 or 3 is thought to be associated with a 62 to 65% likelihood of isolating streptococcus
antibiotics probably reduce the number of people experiencing sore throat, and reduce the likelihood of headache, and some sore throat complications

Question 4

Use of DOACs in Cancer patients – how do DOACs compare to low molecular weight heparin in prevention of cancer-associated thrombosis (CAT)? Which agent is more likely to be associated with an increased risk of bleeding?: DOACs in cancer patients

4) With respect to the use of DOACs in cancer, which statement is false

DOACs decreased recurrent venothromboembolic (VTE) events compared with dalteparin in patients with CAT (cancer associated thrombosis)
DOACs were associated with increased rates of clinically relevant non-major bleeding compared to dalteparin
current evidence favors the use of rivaroxaban for the treatment of cancer associated thrombosis (CAT) among other DOACs

Question 5

Updated NICE Type 2 Diabetes Guideline – this is summarised on GPnotebook.: NICE - algorithm for management of glycaemia (glucose) in type 2 diabetes

5) With respect to the updated NICE Type 2 Diabetes guideline, which statement is false

a person following a very low carbohydrate or ketogenic diet is at increased risk of developing diabetes ketoacidosis (DKA) if started on an SGLT2 inhibitor
for first-line therapy in type 2 diabetes, if a patient has established atherosclerotic cardiovascular disease, offer an SGLT2 inhibitor with proven cardiovascular benefit in addition to metformin
for first-line therapy in type 2 diabetes, if a patient has hypertension, offer an SGLT2 inhibitor with proven cardiovascular benefit in addition to metformin

Question 6

Long term use of Proton Pump Inhibitors (PPIs) – is long-term use associated with hearing loss? Is there a risk of hearing loss/tinnitus if PPIs are used in patients with type 2 diabetes?: Proton pump inhibitors (PPIs) and hearing loss

6) With respect to PPIs and hearing problems, which statement is false

use of proton pump inhibitors haven shown a statistically significant correlation with the presence of chronic tinnitus
use of proton pump inhibitors haven not shown a statistically significant correlation with the presence of tinnitus in type 2 diabetes patients
there is an association between proton pump inhibitor (PPI) use and risk of sensorineural hearing loss in type 2 diabetes patients