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Flashcards in Amir Sam's conditions Deck (40)
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1
Q

A patient presents with an ataxic gait, failure to abduct the right eye and is very confused. What is the likely diagnosis?

A

Wernicke’s encephalopathy

TRIAD: confusion + ataxia + opthalmoplegia (nystagmus + LR palsy)

2
Q

Wernicke’s encephalopathy presents with what distinctive lab result?

A

Reduced red cell transketolase

3
Q

A known alcoholic patient presents confusion, ataxia and opthalmoplegia. He is also noted to be slightly hypoglycaemic. In what order do you provide treatment options for this patient.

A

IV thiamine (Pabrinex) BEFORE giving glucose.

Glucose metabolism uses up thiamine so precipitates an acute worsening of any Wernicke’s

4
Q

Definition of dementia

A

Global impairment of higher cortical function in clear consciousness.

ICD-10 definition
Decline in:
- memory
- other cognition: planning, organising, problem solving
Absence of clouded consciousness
Change in emotion, personality or behaviour

5
Q

Most common organism that causes Septic arthritis

A

Staph aureus

6
Q

Cause of septic arthritis in a young, sexually active person

A

Neisseria gonococcus

7
Q

Initial choice of antibiotics in septic arthritis

A

IV Vancomycin and 3rd generation cephalosporin: cefotaxime.

Change once culture and sensitivities tested.

8
Q

A patient presents with a shooting radicular pain in the C7 distribution. Below this level he is complaining of increasing loss of sensation and weakness.
The patient is known to have lung cancer.

What are you most worried about in the acute setting?

A

Acute cord compression = neurosurgical tumour.

Probably due to bony mets.

Cancers that spread to bone:
Breast
Prostate
Lungs
Thyroid
Kidneys
Testes
9
Q

Definition of erythroderma

A

Exfoliative dermatitis involving >90% of the skin

10
Q

What are the 4 types of sickle cell crisis?

A

1) Thrombotic painful crisis
2) Sequestration crisis
3) Aplastic crisis
4) Haemolytic crisis (rare)

11
Q

What are the 3 main medical options for smoking cessation

A

Nicotine replacement therapy

Varenicline

  • nicotine R partial agonist
  • CI in depression and pregnancy

Bupropion

  • NA + DA reuptake inhibitor, nicotine antagonist
  • CI in epilepsy and pregnancy
12
Q

Treatment for Torsades des pointes

A

IV MgSO4 2g over 10 mins

13
Q

A patient presents with a severe headache and a fixed dilated,oval-shaped pupil. What is the diagnosis?

A

Acute glaucoma

14
Q

6 Stages of Death verification

A

1) Unresponsive to voice or pain
2) No palpable carotid pulse
3) No heart sounds - 2 minutes
4) No breath sounds - 2 minutes
5) Pupils fixed & dilated - unresponsive to light
6) Document in notes.

15
Q

3 types of autopsy

A

1) Consented autopsy
- Appropriate consent allowing for teaching, audit and/or research

2) Coronial autopsy
- Coroner instructs pathologist to take tissue samples to determine cause of death within the balance of probability.

3) Forensic autopsy
- Police involvement to determine cause of death beyond reasonable doubt.

16
Q

5 types of psoriasis

A

1) Chronic plaque psoriasis
2) Flexural
3) Guttate
4) Pustular - generalised or palmo-plantar
5) Erythroderma

17
Q

5 types of psoriatic arthritis

A

Asymmetrical oligoarthritis (

18
Q

Large vessel vasculitis in a 30 year old Japanese lady in whom you cannot feel the pulse

A

Takayasu arteritis

19
Q

55 year old lady with jaw pain on eating, scalp tenderness and reducing vision

A

Giant cell arteritis

20
Q

A gentleman with a history of HBV infection has angiography that reveals microaneurysms

A

Polyarteritis nodosa

21
Q

A man with a saddle nose, haemoptysis and haematuria.

A

Granulomatosis with polyangitis = Wegener’s

22
Q

Patient with asthma and vasculitis

A

Eosinophilic granulomatosis with polyangitis = Churg-Strauss

23
Q

Urine osmolality expected in Diabetes insipidus

A

> 200 mmol

24
Q

Painful asymmetrical wasting of the quadriceps muscles in T2DM associated with weight loss and autonomic failure.

A

Diabetic amotrophy

25
Q

Chondrocalcinosis visible on Xray is associated with which cause of arthritis?

A

Pseudogout

26
Q

1st line treatment for Ank Spond

A

NSAIDs + spinal exercises

27
Q

Which is painful polymyositis or polymyalgia rheumatica

A

Polymyalgia rheumatica

28
Q

Shirmer’s Test

A

Test for Sjogren’s

Filter paper on lower eyelid to measure tear production.

29
Q

Behcets triad

A

Oral ulcers + genital ulcers + anterior uveitis

30
Q

Anion Gap calculation

A

= (Na + K) - (Cl + HCO3)

31
Q

3 Phases of CML

A

Chronic phase: 10% blasts

Blast phase: >20% blasts

32
Q

Gout and massive splenomegaly are associated with which haematological malignancy

A

CML

33
Q

Evan’s Syndrome =

A

AIHA + ITP

Associated with CLL

34
Q

Richter transformation

A

Transformation of CLL → DLBCL

35
Q

Smear cells

A

CLL

36
Q

Staging system in CLL

A

Binet staging
Stage A: 3 enlarged lymph nodes
Stage C: anaemia or thrombocytopenia

37
Q

BM aspirate findings in multiple myeloma

A

> 10% plasma cells

>30 g/L paraprotein

38
Q

BM aspirate findings in MGUS

A
39
Q

BM aspirate findings in Smouldering myeloma

A

> 10% plasma cells
30 g/L paraprotein

= Same as multiple myeloma but NO CRAB

40
Q

Prognostic factors in Myeloma

A

B2 microglobulin and albumin