Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y2 Revision > CCE1 Specialities revision > Flashcards

CCE1 Specialities revision Flashcards

1
Q

What is the anion gap

A

Difference between certain measured cations and the measured anions in serum, plasma, or urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do you calculate the anion gap

A

Anion Gap = (Na + K) − (Cl + HCO3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normal anion gap

High anion gap

How does this occur and give examples of causes

A

Normal anion gap Metabolic acidosis

  • Primary loss HCO3- but with compensatory Cl-
  • Diarrhoea, Carbonic anhydrase inhibitors, Addison’s disease

High anion gap Metabolic acidosis

  • Increased [organic acids] but NO compensatory Cl- increase
  • Cyanide, Ethanol, Paracetamol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DSM 5 criteria for GAD

What screen could you do?

A

At least 3 of the following symptoms AND chronic, excessive worry >6 months (causing distress/ impairment)

  • Muscle tension
  • Sleep disturbance
  • Feeling on edge/ Restless
  • Fatigue
  • Irritabilty
  • Poor concentration

Screen: GAD-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Haemophillia A

Genetic inheritance and what is the pathophysiology?

A

X linked recessive

FVIII deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Haemophillia B

Genetic inheritance and what is the pathophysiology?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

VWD

Genetic inheritance

A

Autosomal dominant

(vWF normally binds to FVIII which when FVIIIa & FIXa combined –> activation FX)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

On the intrinsic pathway what helps activate prothrombinase

Once prothrobinase is activated what is the cascade?

What can thrombin directly activate

A
  • FVIIIa & FIVa

Common pathway

  • Prothrobinase (FXa) + Ca + FVa –> Prothrombin to Thrombin
    • Thrombin activates fibrinogen –> Fibrin
    • Thrombin activates FXIII–> FXIIIA

FXIIIa + Fibrin form cross linkages

Thrombin can directly activate FV (helps convert more prothrombin) & FVII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give some examples of HEREDITARY THROMBOPHILIAS

What inheritance are they?

A
  • Factor V Liden (mutation of FV –> hypercoagulable state)
  • Antithrombin III (normally bind and inactivate FXa & thrombin)
  • Protein s (if low causes overactivity of FV & FVIII)

Generally autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Rheumatoid Arthritis

  1. Genetics
  2. Patho
A

1/ HLA- DR4

2/

  • Citrulination of own antigens –> immune response
  • RF usually IgM but can be IgG or IgA. When not present referred to as seronegative RA.
    • IgM targets Fc portion of IgG antibody in joint synovium= synovial inflammation
  • Recruitment of PMNs (granules- neutrophils, basophils..), macrophages, lymphocytes TNF alpha, IL-1, IL-6
  • Phagocytosis of complex and release of lysosomal enzymes
  • Destruction of joint cartilage, vasodilation redness swelling= hyperplasia of synovium and angiogenesis- vascular granulation tissue= pannus formation
  • Inflammatory cells in pannus destroy cartilage and bone= ankylosis (stiffening and fusion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ankylosing spondylitis

  1. Features on Examination
  2. X-Ray
  3. Genetic component
A

1/

  • Lower back & SI pain. Worse on rest & improve with movement
  • Schober’s test positive
  • Extra-articular:
    • Weight loss, Fatigue, CP, Enthesitis, Dactylitis, Anaemia, Anterior uvelitis, Heart block, Restrictive lung disease, IBD

2/

  • Bamboo spine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Psoriatic arthritis

  1. O/E
  2. X-ray
A

O/E: (multiple presentations)

  • Oligarthritics
  • Symmetrical- hands, wrists, DIPS (less common MCP)
  • Asymmetrical pauciarthritis- digits & feet
  • Spondylitic presentaiton
  • Oncholysis, Dactylitis, Enthetisis
  • Psoriatic plaques

X-ray:

  • Periostitis (thickened & irregular bone outline)
  • Ankylosis
  • Osteolysis
  • `Dactylitis (digit appears as soft tissue swelling)
  • Pencil in a cup
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What types of chronic joint disease often have extra-articular manifestations

A
  • Ankylosing spondylitis (HLA-B27)
  • Systemic sclerosis
    • Milder form is scleroderma/ limited cutaneous systemic sclerosis
  • SLE (HLA- DR2/3)

eg: all cause pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

There are 3 types of emergencgy contraception

a) Name them
b) When can you use them

A

Levonorgestrel

  • ​Up to 72hrs post intercourse

Ulipristal

  • Up to 120hrs post intercourse

Interuterine device- copper coil

  • 5 days before unprotected intercourse or within 5 days of unprotected intercourse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 theories that can cause depression

A
  • HPA dysregulation
  • Monoamine theory- underactivity of 5HT & NA
  • Brain-derived neurotrophic factor
    • promotes cell growth & long term potentiation
    • Depression = [BDNF]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DSM V- Major Depressive Disorder

A

>5 symptoms for during a 2 week period AND at least one of them must be: depressed mood OR loss of interest or pleasure

  • Depressed mood most of the day, nearly every day
  • Diminished interest of pleasure in almost all activities, most of the day, nearly every day
  • Weight loss, Weight gain, Loss of appetite
  • Insomnia, Hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue/ loss of energy
  • Fellings of worthlessness, excessive or inappropriate worry
  • Diminished abilty to concetrate/ think
  • Suicidal ideal
  • Mild:* Enough to make dx with minor functional impairment
  • Moderate:* More than required for dx. Moderate funcitonal impairment
  • Severe:* Many symptoms for dx. Intense impairment- psychotic features possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the difference between Bioplar I & II according to the DSMV?

What sort of behaviours would you expect to see during a manic/ hypomanic episode

A

Bipolar 1: 1 or more manic (>1 week) OR mixed episodes- mania followed by hypomanic or MDD

Bipolar 2: Never had a full manic episode. At least 1 hypomanic episode (>4- <7 days) & 1 MDD episode

During mania/ hypomanic episode >3 symtoms:

  • Inflated self-esteem/ granduosity
  • Pressured speech
  • Racing thoughts/ flight of ideas
  • Distractability
  • Increased activity
  • Excess pleasurable or risky activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 5 key symptoms of psychosis

A

Psychosis- grossly distorted version of reality

DH-DAN

  • Delusions
  • Hallucinations
  • Disorganised thought (eg- Flight of ideas, Loosening of associations, Word salad)
  • Abnormal motor behaviour (eg- catonia)
  • Negative symptoms
    • Apathy, Alogia/poverty of thought, Blunting, Social isolation, Poor self-care & Cog impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What pathways in the brain cause psychosis

A
  1. Mesocortical (negative symptoms)
    1. Ventral tegmental- low Dopamine levels –> PFC D1 receptors
  2. Mesolimbic (positive symptoms)
    1. Ventral tegmental- high dopamine levels –> Nucleus accumbens D2 receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the pathophysiology behind schizophrenia?

A

Not enitrely sure!

Imbalance between: Dopamine, Seratoning, Glutamate

Hyperdopaminergic theory: Hyperactivity of DA in mesolimbic tract is key to imbalance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

DSM-V Schizophrenia diagnosis

A

>2 present:

  • Delusions
  • Hallucinations
  • Disorganised speech, Disorganised behaviour, Catatonic behaviour
  • Negative symptoms
    • Avolition, Anhedonia, Alogia, Apathy

At least one of above must be a +ve symptom

Occur for a period of 1month & are assoicated with at least a 6 month period of funcitonal decline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

MSE

A
  1. Appearance
  2. Behaviour- including eye contact
  3. Speech
    1. Rate, Quantity, Tone, Volume, Fluency
  4. Mood & Affect
    1. Affect (what you see currently)
    2. Mood (what they tell you eg- anxious, low, euphoric)
  5. Thought
    1. ​Form (processing & organisation)
    2. Content
    3. Possession (eg- insertion, withdrawal, broadcasting)
  6. Perception (hallucinations)
  7. Cognition
  8. Insight & Judgement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Most common bacterial cause of

a) Acute otitis media
b) Tonsilitis
c) UTI
d) Meningitis

A

a) Step pneumoniae
* Heamophilus influenzae, Moraxella cararrhalis
b) Group A strep
c) E.Coli
d) Nsisseria meningitidis (diplococcus, grame negative) OR if neonates consider- Group B Strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

CENTOR criteria

A
  • Fever >38
  • Exudate
  • Anterior cervical lymph node tenderness
  • No cough

Score 3/4 give Abx

25
Q

What organisms cause

a) genital discharge (5)
b) Genital ulcers

A

a)

  • Chlamydia
  • Gonorrhea
  • Candidia
  • Bacterial vaginosis
  • Trichomonas vaginalis
26
Q

What testing would you order for

a) Chlamydia
b) Gonorrhoea
c) Syphilis

A

a) NAAT
b) Charcol swab- mc&s OR NAAT
c) Dark field microscopy or PCR

27
Q

What type of epithelium can chlamydia & gonorrhoea be found in?

A
28
Q

Types of MND

A
  1. ALS (lateral corticospinal damage)
  2. Progressive Bulbar palsy (CN 9,10,11,12)
    1. Psueobulbarpalsy (5,7,9,10,11,12)
  3. Progressive muscular atrophy (anterior horn cells- often LMN of UL)
  4. Primary lateral sclerosis (corticospinal)
29
Q

Classic characteristics of PD

A
30
Q

Classic triad of NPH

A
  • Hydrocephalus
  • Gait apraxia
  • Incontinence or cognitive impairment
31
Q

Postpartum

a) Uterine involution
b) Lochia- how does this change
c) Lactation- hormones and composition

A

a) After delivery uterus to size at 20 weeks. By day 10 it’s a pelvic organ. Normal size after 6-8 weeks
b) Lochia Rubra (4 days post); Lochia Serosa (2-3 weeks)- brown, red, watery; Lochia alba (1-2) weeks
* Pass for around 4 weeks post partum

c)

  • Prolactin (AP): Stimulation of continued lactogenesis & disruption of pulsitile GnRH
  • Oxytocin (PP): Milk letdown (myoepithelial cells) & uterine contractions

Colostrum- Ig & protein rich –> Mature milk

32
Q

When MUST you start using contraception- after what day post partum?

Lactational amenorrhea- how long and how frequent must you be feeding

IUD insertion

A

21 days post partum

6months must feed every 4 hours in day & 6hrs at night

up to 48hrs post partum OR after 28 days

33
Q

Trimesters in pregnancy

A
  1. 1-13 weeks
  2. 14-28 weeks
  3. 29-40 weeks
34
Q

Define a wart and what is it oftern caused by

A

Hyperkeratosis and hyperplasis of epidermis often caused by HPV

35
Q

What is seborrheic keratosis

A

Begnign growth of immature keratinocytes

(in elderly, dark pigmented papule- sharply demarcated & soft)

36
Q

Where would you find a ganglion cyst and what property does it have O/E

A

Tendons/ joints

Transilluminates or gel filled nodule

37
Q

What is a dermatofibroma? What sign O/E?

A

Proliferation of fibroblasts

O/E: dimple sign on pinching

38
Q

What is Bowen’s disease (dermatology)

A
  • SCC in situ in skin
39
Q

What is a BCC & how does it present

A

Slow growing, locally invasive arising from epidermal basal cells

Pearly, nodule with raised red edge.

40
Q

SCC & O/E

A

Has gone beyond BM & invaded dermis

  • Actinic keratosis is a precursor
    • Rough, scaly pathches. Browny- erythematous plaque

SCC: Solitary nodule/ papule. Eroded at centre- purulent, crusting, bleeding. Slow growing

41
Q

Examaning a lump

A

Size and shape

Position

Attachment

Consistence

Edges

Transillumination

Inflammation

Thrills/ pulsitations

42
Q

Causes of Pruritis

A
  • Scabies
    • ​Papular rash
  • Urticaria
    • ​Pale, blanching superficial swellings
  • Exzema
  • Insect bites
  • Dermatitis
    • ​Herpetiformis associated with coeliac disease. Blisters & papules
  • Lichen planus
    • ​Chornic inflammatory found on limbs, mucus membranes & genitalia (due to keratinocytes apoptosis)
    • Forearms, wrists, legs, symmetrical, flat topped papules. Wickham’s striae on oral mucuos membrane
  • Generalised itching- liver, renal, haematological
43
Q

Acute skin rashes

A
  • Erythroderma
  • Dermatitis (contact & seborrheic)
    • Contact
    • Seborrheic- often caused by fungus. Nasolabial folds can be found. Scaling of scalp and erythema
  • Drug
  • Toxic epidermal necrolysis
  • SJS
  • Urticarial
  • Infective (herpes, varicella, impetigo)
  • Purpuric (meningococcal, septic emboli)
44
Q

Erythroderma presentation & causes

A
  • Skin appears inflamed, oedematous & scaly
  • Systemically unwell with lymphadenopathy & malaise

Causes- exsiting skin conditions, drugs-penicillin, idiopathic

45
Q

SJS and TEN

A

SJS:

  • Mucocutaneous necrosis (>2 sites)
  • Drugs, infection main causes
  • Few inflammatory cells on histopathology

TEN:

  • Usually drug induced
  • Extensive severe skin & muscosal necrosis
  • Full thickness epidermal necrosis & subepidermal detachement
46
Q

Herpes Simplex

Varicella Zoster

A

HSV (see below)

  • HSV1
  • HSV2 often on genitalia

VZV- Dermatomal like pattern. Painful. Shingles

47
Q

Impetigo classic characteristic of what organis

A

Golden crust (Staph A)

48
Q

Septic emboli O/E

A
  • Small-red purpuric spots
  • DON’T BLANCH
  • Flat or raised and painful
49
Q

Chronic skin rashes

A
  • Acne vulgaris
  • Lichen Planus
  • Eczema
  • Psoriasis
  • Seborrheic wart
  • Infective
    • Fungal
      • Tinea versicolour
      • Tricophyton- athletes foot
  • TB
  • Vasculitis
    • Often purpura (larger & rasied) or petechiae. Suggests bleeding
50
Q

Lupus Vulgaris (TB) O/E

A

redish, brown nodules with gelatinous consistency

51
Q

Skin infections

Viral

Bacterial

Funal

A
  • Viral warts (see warts)
  • Molloscum contagiosum
  • Herpes simplex & zoster
  • Folliculitis
  • Impetigo
  • Streptococcal cellulitis
  • Candida
    • Candidiasis albicans most common
  • Tinea versicolor aka Pityarisis versicolor
52
Q

Molluscum contagiosom

A
  • Pearl smooth papule with small depression
  • Non tender
53
Q

What kind of symptoms can cannabis produde?

A
  • Anxiety/ depression
  • Schizophrenia
  • Slowing of thorught process & memory loss
54
Q

Effect of cocaine

A

Stimulant (DA release) –> autonomic arounsal- short lived.

Nausea, jitteriness, anxiety, paranois, euphonia, cardiotoxic

55
Q

CAGE

A

Screening test

  • felt you should Cut down
  • Annoyned by people critising your drinking
  • Guilty about drinking
  • have you ever had a drink first thing in the morning to steady your nerves or to get rid of a

hangover (Eye opener)?

>2 suggests significant alcohol problems

56
Q

What other alcohol assessment tools are there?

A
  • FAST
    • >3 on all sections OR scoring greater than 3 on first question complete AUDIT
  • AUDIT- C (>5 complete audit)
  • AUDIT
57
Q

List some risks of alcohol abuse

A
  • Pancreatitis
  • Peptic ulcers from increased gastric secretion
  • Liver
    • Alcoholic liver disease starts as: fatty liver –> alcoholic heptitis (inflam & necrosis) –> aloholic liver cirrhosis
    • Bleeding as clotthing factors 2,7,9,10 reduced
    • Reduced albumin –> peripheral oedema
    • Asterexis
    • Jaundice
  • Seizure (NS oversimulation)
  • HTN
  • Depression & anxieity
  • Weknicke’s and Korsakoff’s
58
Q
A

Y2 Revision (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions