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4 Flashcards

1
Q

what does membranous look like on light microscopy

A

spike and dome

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2
Q

what does diffuse proliferative look like on LM

A

wire loop

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3
Q

what complication is associated with RTA type 1

A

renal stones

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4
Q

what complication is associated with RTA type 2

A

osteomalacia and coeliac disease

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5
Q

what is alports syndrome associated with

A

splitting of lamina densa

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6
Q

what is Bartters syndrome

A

defect in the Na/K/Cl cotransporter

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7
Q

what is Fanconi syndrome

A

generalised disorder of renal tubular transport in the PCT

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8
Q

what causes apple green birefringence on congo red staining

A

amyloidosis

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9
Q

what is renal cell carcinoma associated with

A

smoking, VHL syndrome, tuberous sclerosis

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10
Q

what is filtered load

A

GFR x plasma conc

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11
Q

where are the desmosomes

A

in the prickle cell layer

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12
Q

where are the hemidesmosomes

A

dermo-epidermal junction

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13
Q

where is the dorsalis pedis artery felt

A

lateral to the EHL tendon

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14
Q

what nerve roots does the knee jerk test

A

L3,L4

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15
Q

what type of drug is latanoprost

A

prostaglandin analogue

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16
Q

how does latanoprost work

A

it increases the uveascleral outflow

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17
Q

how do B blockers such as timolol work

A

they reduce the aq production

should be avoided in heart block and asthmatics

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18
Q

how do carbonic anhydrase drugs work

A

they decrease the aq production

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19
Q

give an example of a carbonic anhydrase drug

A

dorzolamide

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20
Q

what virus causes dendritic ulcers

A

Herpes simplex

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21
Q

how do you treat a dendritic ulcer

A

3% eye ointment of acyclovir 5x a day

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22
Q

how do you treat a herpes zoster virus that involves the cornea

A

oral aciclovir

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23
Q

how do you treat anterior uveitis

A

refer to opthamology

cyclopegics-eg atropine, cyclopenate

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24
Q

what muscle does froments test test

A

looking for ulnar nerve palsies

ADDUCTOR pollicis

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25
Q

what are langherhans cells

A

they are antigen presenting cells

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26
Q

where are Langerhans cells made

A

in the bone marrow

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27
Q

where are the hemidesmosomes found

A

in the basal layer

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28
Q

where are the desmosomes found

A

prickle cell layer

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29
Q

A 3 year old boy presents on a sunny day in June. His mother reports he keeps crying and rubs at his skin when playing outside and this has been going on for a few weeks. His skin is sometimes a bit red, but there is never a rash and his skin is clear on examination now. He is skin type 1 with a few freckles evident, generally well, on no medication and there is no family history of skin problems.

A

erythropoeitc protoporphyria

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30
Q

what happens in catagen phase

A

it is the involuting phase

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31
Q

what happens in telogen phase

A

resting phase

32
Q

which layer are the odland bodies found in

A

the granular layer

33
Q

describe mucosal membranes

A

they are highly specialised for function, Mucosal membranes are often affected by skin disease e.g. blistering diseases. They aren’t keratinised, have many sensory functions e.g. taste, and often contain glands e.g. lacrimal glands, sebaceous glands

34
Q

where are the filaments in the prickle cell layer

A

the filaments are Intercellular

35
Q

where are melanocytes found

A

in the basal layer

36
Q

where does nuclei loss happen

A

starts in the granular layer and is complete in the keratin layer

37
Q

what is the mediator for type IV hypersensitivity reactions

A

TH1

38
Q

58 year old man presents in July with blisters on the dorsal aspect of his hands which have been appearing over the last few months, crust over and heal leaving scarring. He works as a joiner and is aware that his skin has also been more fragile than usual. You notice that he has a lot of hair growing on his cheeks. He is generally well and on no medication
What is the most likely diagnosis?

A

porphyria cutanea tarda

39
Q

what do the sebaceous glands do

A

they maintain the skin barrier

40
Q

whats the most common causal organism for dermatophyte infections

A

trichophyton mentagraphytes

around 70%

41
Q

what is erysipelas

A

a more superficial cellulitis and typically more raised and demarcated than cellulitis
caused by group A strep

42
Q

when should you suspect necrotising fasciitis

A

when there is little to see on the surface but there is SEVERE pain

43
Q

describe what staph looks like

A

gram positive cocci in clusters

44
Q

for psoriasis which topical treatment is the most clean and least smelly

A

vitamin D analgogue, it is easy to apply, non greasy and non smelly

45
Q

what is the first line treatment for rosacea

A

topical metronidazole

46
Q

what happens to the sebaceous glands in rosacea

A

there is sebaceous glans hyperplasia but sebum excretion is normal

47
Q

how to you treat arterial ulcers

A

DONT USE COMPRESSION BANDAGING
keep the ulcer clean and covered
adequate analgesia and vascular reconstruction

48
Q

what is mycosis fungoides

A

commonest T cell lymphoma

it progresses from well defined itchy red scales and plaques to red-brown infiltrated plaques and ulcerating tumours

49
Q

which embryological layer is the epidermis formed from

A

ectoderm

50
Q

what embryolocical layer is the dermis formed from

A

mesoderm

51
Q

what type of cells are melanocytes

A

dendritic cells

52
Q

where are Langerhans cells found

A

in the prickle cell layer and also in dermis and lymph nodes

53
Q

what are birbeck grnaules

A

found in Langerhans cells

54
Q

what genetic mutations are found in melanomas

A

50% melanomas have an activating B raf mutation

genetic markers eg CDKNA mutations

55
Q

where is filaggrin found

A

in the granular layer

large keratohyalin grnaules, contain structural filaggrin and involucrin proteins

56
Q

what is an arthus reaction

A

a localised type III hypersensitivity reaction

57
Q

mutations in which gene is associated with BCC

A

PTCHI

58
Q

what damage does benign hypertension do to the kidneys

A

firbointimal thickenening and luminal narrowing

atrophy and ischaemia of the nephrons

59
Q

what does malignant hypertension do to kindeys

A

fibrinoid necrosis

60
Q

what does diabetes do to the kidneys

A

widespread ischaemic atrophy secondary to atheroma of renal arteries, arteriolar hyalinosis and luminal narrowing
diffuse and nodular glomerulosclerosis

61
Q

what are sympathomimetics

A

used in open angle glaucoma, usually when topical B blocker is inappropriate eg brimonidine

62
Q

what is tocilizumab

A

IL6 receptor blocker

63
Q

what is abatercept

A

t CELL FUNCTION DISRUPTION

64
Q

what causes eczema herpeticum

A

herpes simplex virus

65
Q

what is keratoderma

A

cutaneous manifestation of reiters disease

66
Q

what causes exacerbation of psoriasis

A

B blocker, lithium, chloroquine and hydroxychloroquine, NSAIDs and ACEI and infliximab

67
Q

describe helicobacter

A

gram negative bacteria

68
Q

how is H pylori eradicated

A

PPI, amoxicillin, clarithromycin

69
Q

management of heart failure

A

1st line ACEI and Bblocker
2nd line aldosterone antagonist, hydralazine and nitrate
3rd line cardiac resynchronisation therapy or digoxin

70
Q

how do you treat dyspepsia without any alarm features and not on any medication

A

test and treat for h pylori or advise on lifestyle factors and then full dose PPI for one month and reassess

71
Q

how do you give oxygen to COPD patients

A

28% venture mask at 4l/min and aim for o2 sats of 88-92% adjust target if pco2 is normal

72
Q

what is Blatchford score

A

used at first assessment of a GI bleed

73
Q

what is Rockall score

A

used after endoscopy

74
Q

what is characteristic about hypokalaemia

A

U waves, small or absent T waves,prolong PR interval, ST depression, long QT

75
Q

how is heart rate calculated

A

if the heart rate is regular then it is calculated by 300 divided by the number of large squares between beats

76
Q

how is an irregular heart rate calculated

A

count the number of QRS complexes in 30 large squares and multiple by 10

77
Q

how do you treat a displaced fracture of olecranon

A

tension wire band

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