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Round Up Email June 2024

In this month's Round Up areas highlighted include an update of the Lynch Syndrome section, coverage of the SELECT trial, and the use of antihistamines (or not) in anaphylaxis.

Question 1
Use of antihistamines (or not) in management of anaphylaxis – should antihistamines be routinely used in the management of anaphylaxis? If used in anaphylaxis is the antihistamine of choice a sedating antihistamine?: antihistamines in anaphylactic shock
With respect to the use of antihistamines in anaphylaxis, which statement is false?
- The mandatory use of a sedating antihistamine is indicated in the management of anaphylaxis
- Antihistamines can be helpful in alleviating cutaneous symptoms (whether these are due to anaphylaxis or non-anaphylaxis allergic reactions)
- Antihistamines have no role in treating respiratory or cardiovascular symptoms of anaphylaxis.
Question 2
SELECT study – investigated the use of semaglutide with respect to cardiovascular outcomes in patients with cardiovascular disease who were overweight or obese. This study is summarised on GPnotebook.: SELECT trial - semaglutide and cardiovascular outcomes in patients with obesity without diabetes
With respect to the SELECT trial, which statement is true?
- The SELECT trial showed that the use of tirzepatide in patients with cardiovascular disease who were overweight/obese reduced the the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke at a mean follow-up of 39.8 months.
- The SELECT trial showed that the use of canagliflozin in patients with cardiovascular disease who were overweight/obese reduced the the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke at a mean follow-up of 39.8 months.
- The SELECT trial showed that the use of semaglutide in patients with cardiovascular disease who were overweight/obese reduced the the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke at a mean follow-up of 39.8 months.
Question 3
Contact lens - related microbial keratitis (CLRMK) – What are the risk factors for CLRMK? What is the commonest bacterial cause of CLRMK? What are the risk factors for development of fungal CLRMK?: Contact lens - related microbial keratitis (CLRMK)
With respect to contact lens - related microbial keratitis (CLRMK) which statement is false?
- Pseudomonas aeruginosa is the commonest bacterial organism in CLRMK.
- Fungal CLRMK characteristically has a ring infiltrate.
- CLRMK is due to bacteria in 90% of cases.
Question 4
Cannabis edibles – what is a “cannabis edible”? How long does it take for the effects of a “cannabis edible” to occur after ingestion? How long can the effects of a “cannabis edible” last?: Cannabis edibles
With respect to cannabis edibles, which statement is false?
- 9-tetrahydrocannabinol (THC) is considered to be the major psychoactive ingredient of the cannabis plant responsible for the “high” that users experience.
- Edibles take time to start working (up to 2 hours to take effect and peak around 4 hours).
- The effects of cannabis edibles last a maximum of 12 hours.
Question 5
Lynch syndrome – this is summarised on GPnotebook.: Familial colorectal cancer syndrome
With respect to Lynch Syndrome, which statement is false?
- Lynch syndrome accounts for approximately 2% to 5% of all cases of CRC (colorectal cancer)
- Individuals with Lynch syndrome have a 60%-80% risk for CRC, as well as an increased risk for cancers, most notably pancreatic cancer.
- One of the major characteristics (phenotype) of Lynch syndrome carriers is that cancer often develops at an earlier age than in the general population.
Question 6
Common acid base disorders associated with hypokalemia – this is summarised on GPnotebook.: Common acid-base disorders associated with hypokalaemia
With respect to common acid-base disorders associated with hypokalaemia, which statement is false?
- Bartter's syndrome is a possible cause of hypokalaemic alkalosis.
- Diuretic use is a possible cause of hypokalemic acidosis.
- Mineralocorticoid excess (such as primary hyperaldosteronism) is a possible cause of hypokalaemic alkalosis.

Round Up Email June 2024

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6