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Phase 2a > Misc Diseases > Flashcards

Misc Diseases Flashcards

1
Q

What is the epidemiology of sarcoma?

A
  • 1% of all adult tumours

- Soft tissue sarcoma is more common than bone sarcoma (80% are soft tissue)

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2
Q

What are the two types of sarcoma?

A

Soft tissue sarcoma or bone sarcoma

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3
Q

What are the clinical features of soft tissue sarcoma?

A
  • Lump that is painless at first
  • Pain as lump grows and presses against nerves and muscles
  • A leiomyosarcoma in the womb may cause bleeding outside period
  • Most sarcoma metastasis to lung initially
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4
Q

How is soft tissue sarcoma diagnosed?

A
  • MRI and core needle biopsy

- CT thorax for lung metastasis

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5
Q

How is soft tissue sarcoma treated?

A
  • Surgical resection (if possible) + chemotherapy

+/- radiotherapy

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6
Q

How is bone sarcoma diagnosed?

A
  • X ray, CT or MRI

- Bone scans and biopsy

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7
Q

How is bone sarcoma treated?

A
  • Wide surgical resection/ reconstruction

- Chemotherapy +/- radiotherapy

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8
Q

What are the clinical features of bone sarcoma?

A
  • Non mechanical bone pain that is still present when still
  • Swelling
  • Feeling tired
  • Pyrexia
  • Weight loss
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9
Q

What is lymphoedema?

A
  • Chronic non-pitting oedema causing by lymphatic insufficiency
  • Most commonly affects the legs and tends to progress with age
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10
Q

How is lymphoedema treated?

A
  • Compression stockings
  • Physical massage
  • For filariasis infection, give oral diethylcarbamazine
  • If recurrent cellulitis, long term cellulitis
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11
Q

What are the causes of primary lymphoedema?

A
  • Inherited deficiency of lymphatic vessels
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12
Q

What are the causes of secondary lymphoedema?

A
  • Obstruction of lymphatic vessels e.g. filarial infection (parasitic worms)
  • Malignant disease
  • Trauma
  • Radiotherapy
  • Surgery
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13
Q

Briefly explain the pathophysiology of paracetamol poisoning

A

Paracetamol is predominantly metabolised via a phase II reaction and conjugated with glucuronic acid and sulphate. If glucuronic acid and sulphate stores are low, paracetamol will undergo a phase I metabolism via oxidation to produce a toxic compound NAPQI that is immediately conjugated. An excess of paracetamol leads to a toxic build up of NAPQI.

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14
Q

How is paracetamol overdose treated?

A
  • Gastric decontamination= activated charcoal

- Give IV Acetycysteine

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15
Q

Give 3 types of amyloidosis

A
  • AL amyloid (primary)
  • AA amyloid (Secondary)
  • ATTR familial amyloidosis
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16
Q

How is amyloidosis diagnosed?

A
  • Biopsy of rectum/ subcut fat= congo red staining with red-green birefringent under polarised light microscopy
17
Q

What is amyloidosis?

A

A group of disorders of protein metabolism in which there’s extracellular deposition of an insoluble fibrillar protein called amyloid.

18
Q

What is the most common cancer in women?

A

Breast (Infiltrating duct carcinoma)

19
Q

What is the epidemiology of breast cancer?

A
  • Affects 1 in 8 women
20
Q

What are the clinical features of breast cancer?

A
  • Painless, increasing mass
  • Nipple discharge
  • Skin tethering
  • Ulceration
  • Oedema and erythma
21
Q

What are the risk factors for breast cancer?

A
  • Increasing age
  • Family history of breast cancer
  • BRCA1 or BRCA2 mutation
  • Never having a child
  • Not having breast-fed
  • Late menopause
  • HRT
  • COCP
22
Q

How is breast cancer diagnosed?

A
  • Clinical examination
  • Radiology (USS for under 35s, Mammography and USS for over 35s)
  • Histology and cytology
23
Q

How is stage 1 and 2 breast cancer treated?

A
  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Endocrine therapy if oestrogen or progesterone receptor +Ve disease
24
Q

How is stage 3 and 4 breast cancer treated?

A
  • Radiotherapy to bony lesions
  • Oral tamoxifen in ER +ve
  • Trastuzumab for HER2 +Ve
25
Q

What is stage 1 breast cancer?

A

Confined to breast, motile

26
Q

What is stage 2 breast cancer?

A

Growth confined to breast, mobile, lymph nodes in ipsilateral axilla

27
Q

What is stage 3 breast cancer?

A

Tumour fixed to muscle, ipsilateral lymph nodes matted and may be fixed

28
Q

What is stage 4 breast cancer?

A

Complete fixation of a tumour to chest wall, distant metastases

29
Q

List some benign breast lumps

A
  • Fibroadenoma
  • Breast cysts
  • Duct etasia
  • Intraductal papilloma
30
Q

What are the clinical features of an acute primary infection with HIV?

A
  • Fever
  • Malaise
  • Myalgia
  • Pharyngitis
  • Macropapular rash
  • Significant weight loss
  • Usually roughly 3 weeks self limiting disease
31
Q

What are the clinical features of early symptomatic HIV?

A
  • Fever
  • Night sweats
  • Diarrhoea
  • Weight loss
  • Minor opportunistic infections
32
Q

How is HIV diagnosed?

A
  • markers; Low CD4 Count and HIV viral load
  • Detection of IgG antibody to envelope contents
  • Detection of IgG antibody to p24
  • Genome detection assays
33
Q

What is HAART?

A

Highly active antiretroviral therapy
2 NRTI and 1 NNRT
or
2 NRTI and 1 PI

34
Q

What is the epidemiology of HIV/AIDs?

A
  • In general, more men infected than women
  • Sub-Sarahan Africa remains most seriously infected
  • Majority of new infections in 15-24 year olds
  • Most at risk; MSM, Heterosexual women, IV drug users, Commercial sex workers, users of commercial sex
35
Q

What are the ways HIV/AIDs are acquired?

A
  • Sexual intercourse
  • Mother to child transmission
  • Contaminated blood, blood products
  • Contaminated needles
36
Q

How long does HIV take to develop into AIDs?

A

8 years

37
Q

List some AIDs defining conditions

A
  • Candidiasis
  • Extra pulmonary cryptococcosis
  • Mycobacterium TB
  • Persistent herpes simplex
  • Pneumocystitis jiroveci pneumonia
  • Kaposi’s carcinoma
38
Q

How can HIV be prevented?

A
  • Educate on transmission
  • Increase use of contraception
  • Reduce sexual violence
  • Male circumcision
  • Give IV drug users clean needles

Phase 2a (31 decks)

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