Management of Chronic Diseases for MRCGP AKT Exam

Dr Geraint Preest, Clinical Section Editor at BMJ OnExamination, gives you some hints and tips for management of chronic diseases.

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Management of Chronic Diseases - Video Transcript

You are bound to get Management of Chronic Diseases in the exam. It’s a very common area. One of the areas where candidates perform badly, is in relation to clinics where perhaps there isn’t as much exposure as a Registrar. If you think about Diabetes Clinics that are perhaps run by a Diabetic Nurse or Asthma Clinics by an Asthma Nurse or Antenatal Clinics.

Another area perhaps is Multiple Sclerosis. Now Multiple Sclerosis tends to be fairly secondary care lead, but candidates sitting the exam will need to be familiar with management of relapse. We thought it would be useful to cover this with a few bullet points:

The first thing with somebody with an MS Relapse is
- Consider the possibility of infection as a possible cause. Consider a UTI or respiratory infection.
- Treatment - if you’re treating a relapse, then the recommendation is to treat with methylprednisolone, 0.5g for five days. If the patient still deteriorates, then they may need to be admitted to hospital for intravenous treatment.

There are a few rules when treating an MS relapse. The first is don’t treat less than 0.5g for less than five days. Unlike the treatment of COPD, patients don’t have a rescue pack at home so they shouldn’t have steroids at home to initiate themselves. You shouldn’t prescribe vitamin D, or omega-3 or omega-6 supplements for treating MS relapses.


Management of Chronic Diseases - More Info for MRCGP AKT Exam Revision

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