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KMMS > SCP 2 RE > Flashcards

SCP 2 RE Flashcards

1
Q

In a diabetic foot exam, you notice that one of the patient’s feet is a reddish/purple colour, and the other is their normal skin colour. What could this indicate?

A

Unilateral discolouration is a sign of acute iscaemia

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2
Q

Name some factors that contribute to the development of foot ulcers:

A 
Sustained hyperglycaemia
Angiopathy (peripheral vascular disease)
Abnormal immunity
Neuropathy and loss of sensation
Foot deformity
Skin atrophy- dryness/cracks in the skin
Friction/footwear/calluses
Trauma- mechanical, chemical, or thermal
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3
Q

“A break in the skin which is failing to heal”

A

ulcer

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4
Q

What does the acronym “SINBAD” stand for?

A 
Site
Ischaemia
Neuropathy
Bacterial infection
Area
Depth
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5
Q

Most common site of foot ulcers?

A

the forefoot

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6
Q

___________ is necrosis secondary to inadequate perfusion (can be wet or dry)

A

Gangrene

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7
Q

Erythema of the foot could be due to infection or acute ________

A

ischaemia

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8
Q

It’s important to remove dead tissue in foot ulcers in order to prevent _______

A

sepsis

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9
Q

One sign of chronic lack of blood perfusion in the lower extremities is _____ loss.

A

hair

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10
Q

Sudden onset unilateral warmth, redness and oedema over the foot/ankle, usually with a history of minor trauma

A

Charcot arthropathy

NB: 30% can present without pain or discomfort

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11
Q

__________ sounds should heard in a Doppler ultrasound of the lower extremity . As the disease progresses, only _________ sounds are heard.

A

Triphasic, monophasic

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12
Q

The ________ _______ pulse is palpable on the dorsum of the foot in the first intermetatarsal space just lateral to the extensor tendon of the great toe

A

dorsalis pedis

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13
Q

Where would you palpate the posterior tibialis pulse?

A

Behind the medial malleolus

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14
Q

Impaired sense of vibration and proprioception indicate an impairment in which area of the CNS?

A

the dorsal columns

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15
Q

What are the sites on the foot at highest risk of peripheral neuropathy?

A

Toes and heads of the metatarsals

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16
Q

What type of tool is used to test for peripheral neuropathy in the feet?

A

10g monofilament

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17
Q

Where should you place a tuning fork to test a patient’s sense of vibration?

A

Start by placing the tuning fork on the patient’s sternum to test whether they can feel it, then move it to the interphalangeal joint of the 1st hallux. Move to proximal bony prominences if they cannot feel vibration distally.

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18
Q

Which nerve root is associated with the “ankle jerk” reflex?

A

S1

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19
Q

What is one of the first nerve roots affected in diabetic neuropathy (due to its long length?)

A

S1

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20
Q

If someone has a “moderate” diabetic foot risk score, how often should they be screened, and by whom?

A

Annual screening by a podiatrist

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21
Q

If someone has a “high” diabetic foot risk score, how often should they be screened, and by whom?

A

Annual screening by a specialist podiatrist

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22
Q

What are the four components of a diabetic foot exam?

A

Inspection
Palpation
Sensation
Gait assessment

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23
Q

Difficulty rising from a chair could potentially be a sign of what endocrine condition?

A

hypothyroidism (proximal muscle weakness)

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24
Q

What is a major (lifestyle) risk factor for eye disease in Grave’s patients?

A

smoking

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25
Q

A rare complication of autoimmune thyroid disease that presents with digital clubbing and swelling of digits and toes is known as

A

thyroid acropachy

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26
Q

Oncholysis can be a sign of what endocrine condition?

A

Hyperthyroidism

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27
Q

How might a patient’s pulse be affected in underactive and overactive thyroid conditions?

A

Hypothyroid- bradycardia

Hyperthyroid- tachycardia and/or AF

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28
Q

Medical term for protrusion specific to the eyes

A

Exopthalmos

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29
Q

Name eye signs that could be seen in hyperthyroid (Graves disease) patients

A 
Exopthalmos/proptosis
Chemosis (conjunctival injection)
Corneal inflammation
Lid retraction
Lid lag (with downward eye movement)
Pain with eye movements
Double vision
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30
Q

Inflammation of orbital tissue, retrobulbar pain, diplopia, lid-lag, chemosis, and proptosis/exopthalmos are signs of?

A

Thyroid eye disease.

NB: The higher the TSH receptor antibody levels, the more likely it is that the eyes are going to be affected

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31
Q

What are NOSPECS classification or EUGOGO activity scores used to determine?

A

How quickly a patient with signs of thyroid eye disease should be referred to an opthalmologist

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32
Q

What abnormality presents as a painless, firm, midline neck mass that elevates with swallowing and tongue protrusion?

A

A thyroglossal duct cyst

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33
Q

How would you differentiate a thyroglossal duct cyst from a thyroid nodule on physical exam?

A

While both thyroglossal duct cysts and thyroid nodules move up with swallowing, only the thyroglossal cyst moves up with tongue protrusion

34
Q

“Retrosternal extension,” or dullness to percussion over the sternum, can be a sign of a

A

goitre

35
Q

infiltrative skin condition caused by circulating Ab. (Can be caused by either TPO Ab or TSH receptor Ab)

A

Pre-tibial myxedema

36
Q

What is the gold standard imaging technique used for assessing thyroid nodules?

A

Ultrasound +/- fine needle aspiration

37
Q

Peau d’orange is a RED FLAG sign of?

A

Breast cancer

38
Q

Name 6 important characteristics to note/document when palpating a breast lump

A 
Location
Size
Shape
Consistency
Whether it is mobile
Overlying skin (puckering, etc)
39
Q

Which lymph nodes do breast cancers spread to first?

A

Axillary lymph nodes

40
Q

What further imaging is recommended for women after finding a breast lump? Younger/older women?

A

Ultrasound for younger women

Mammogram for older women

41
Q

List some of the circumstances in which patient data can be shared without their consent

A
  • If there is concern about the safety of someone <18, or a vulnerable adult
  • A contact is at risk of serious harm, where the patient has not informed them, and can’t be persuaded to do so
  • An order is received from a judge or a court to disclose information
42
Q

How are GUM clinic services different from general medical services?

A 
Anonymous
Self-referral
Direct access
Free
Confidential
43
Q

List some clinical features of female GU disease

A 
Vaginal discharge
Abnormal bleeding
Abdominal pain/dyspareunia
Dysuria
Itching/soreness
Ulceration (can be painful or painless)
Lumps
Systemic symptoms
Can be asymptomatic
44
Q

List some clinical features of male GU disease

A 
Urethral discharge
Testicular pain
Dysuria
Itching/soreness
Ulceration (can be painful or painless)
Lumps
Systemic symptoms
Can be asymptomatic
45
Q

What are the “Three C’s” of an intimate examination?

A

Consent
Communication
Chaperone

46
Q

Sexual symptom that can be experienced by men with diabetes or heart disease

A

erectile dysfunction, low libido

47
Q

Cyst that can form within the vulva, which can become infected and swollen

A

Bartholin’s cyst

48
Q

What is the most common type of speculum used for a female pelvic exam?

A

Cuscoe (bivalve) speculum

49
Q

Mucous-filled cervical cyst

A

Nabothian cyst

50
Q

red appearance to the centre part of the central cervix externally- often d/t hormonal changes, but it can happen when the glandular cells from inside the cervix come down onto the external part of the cervix

A

Ectropion

51
Q

What would be the concern if a cervix appeared “macerated” and irregular when visualised during the speculum exam?

A

Cervical cancer

52
Q

When would it be most appropriate to use a Sims speculum?

A

To assess for prolapse

53
Q

What is another name for a prolapsed bladder?

A

Cystocele

54
Q

In about 15% of women, the position of the uterus is

A

retroverted

55
Q

How can adnexal masses be palpated in a bimanual examination?

A

With fingers pressed into the lateral fornices of the vagina, with other hand pressing on top of the lower abdomen

56
Q

Describe the correct procedure for inserting a bivalve/Cuscoe speculum

A

Ensure correct size is used +/- lubricant/water
Gently part labia with left hand
Insert bivalve speculum, with blads vertical
Rotate 90 degrees so handles point anteriorly and blades are now horizontal
Slowly open blades to see cervix between them
If cervix cannot be seen, reinsert speculum at a more downward angle as cervix may be behind the posterior blade

57
Q

Protrusions of bowel or fat through the musculature of the abdomen

A

hernias

58
Q

Collection of fluid within the tunica vaginalis of the testicle

A

hydrocele

59
Q

Dilation of the testicular veins within the spermatic cord

A

varicocele

60
Q

What are the two attachment sites of the inguinal ligament?

A

the ASIS and pubic tubercles

61
Q

Site of origin of an indirect inguinal hernia

A

Deep inguinal ring

62
Q

This type of hernia does not pierce the posterior wall. The abdominal contents pass through the deep inguinal ring, passing through the inguinal canal and exiting via the superficial ring.

A

Indirect inguinal hernia

63
Q

This type of hernia is caused by a weakness in the posterior wall of the inguinal canal. The abdominal contents (usually just fatty tissue, sometimes with bowel) are forced through this defect and enter the inguinal canal. This means that the contents emerge in the canal medial to the deep ring

A

Direct inguinal hernia

64
Q

Bladder enlargement can be felt above the

A

symphysis pubis

65
Q

Congenital hernia that can form if the two folds of tunica vaginalis fail to fuse

A

Patent process vaginalis (congenital hernia seen in children)

66
Q

Which type of hernia is due to muscle weakness, and therefore occurs more commonly in older men?

A

Direct inguinal hernia

67
Q

External spermatic fascia is derived from

A

external oblique muscles

68
Q

Cremaster muscle is derived from

A

Internal oblique

69
Q

Internal spermatic fascia is derived from

A

Transversalis fascia

70
Q

Where does lymph from the testicles drain to?

A

The common iliac and para-aortic lymph nodes

71
Q

Where does lymph from the penis, the scrotum, and lower limb drain into?

A

Superficial inguinal lymph nodes

72
Q

What are three important landmarks to identify towards the beginning of a male pelvic exam?

A

ASIS’s
Pubic tubercles
Pubic symphysis

73
Q

How can you differentiate between a solid testicular lump and a cystic testicular lump on physical examination?

A

cystic lumps will transilluminate

74
Q

Scarring in the tunica albinguinea of the corpus cavernosum can indicate?

A

Peyronie’s disease

75
Q

Varicoceles become more obvious to spot when patients are in what position?

A

standing

76
Q

If the fingers can “get above” a testicular mass, this indicates

A

A scrotal swelling

77
Q

If the fingers CANNOT “get above” a testicular mass, this indicates

A

Hernia

78
Q

If a swelling feels separate from the testicle, the lesion is likely in the

A

Epidiymus

79
Q

3 key questions for differentiating common scrotal pathologies:

A

Can you get above it?
Is it separate from the testicle?
Does it transilluminate (cystic or solid?)

80
Q

Abrupt haemorrhage or infarction of the pituitary gland

A

Pituitary apoplexy (Sheehan’s syndrome)

81
Q

complete loss of outer (peripheral) visual fields

A

bi-temporal hemianopia

Associated with lesions of the optic chiasm, such as tumours of the pituitary gland

KMMS (58 decks)

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