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TCD Cases > Clinical Situations - Additional Reading > Flashcards

Clinical Situations - Additional Reading Flashcards

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1
Q

Approximately what % of hospital admissions can be linked to some form of non-adherence?

A

10-25%

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2
Q

Suggest 4 common causes of metabolic acidosis

A
  1. DKA
  2. Lactic acidosis
  3. Renal failure
  4. Chronic diarrhoea
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3
Q

Pneumonia is likely to cause what type of acid-base disturbance?

A

Respiratory acidosis

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4
Q

Define pyloric stenosis

A

Narrowing of the opening between the stomach and the first part of the duodenum (i.e. constriction of the pyloric antrum and sphincter)

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5
Q

What is the principle symptoms of pyloric stenosis

A

Projectile vomiting (that does not contain bile) after feeding

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6
Q

Excluding salbutamol, name 3 other short acting beta- 2 agonists

A
  1. Terbutaline
  2. Levalbuterol
  3. Perbuterol
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7
Q

Give 2 potential causes of a mixed respiratory and metabolic acidosis

A
  1. Cardiac arrest

2. Multi-organ failure

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8
Q

Give 3 potential causes of a mixed respiratory and metabolic alkalosis

A
  1. Liver cirrhosis with diuretic use
  2. Hyperemesis Gravidarum
  3. Excessive ventilation in COPD
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9
Q

Suggest 5 potential causes of excessive renal hydrogen ion loss (leading to a metabolic alkalosis

A
  1. Loop and thiazide diuretics
  2. Heart Failure
  3. Nephrotic syndrome
  4. Cirrhosis
  5. Conn’s syndrome
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10
Q

Define nephrotic syndrome

A

A collection of symptoms that indicate kidney damage

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11
Q

What are the key characteristics associated with nephrotic syndrome?

A
  1. Proteinuria
  2. Hypoalbunemia
  3. Hyperlipidaemia
  4. Oedema
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12
Q

When recalling the clinical manifestations of hypercalcaemia, the phrase ‘stones, bones. groans and psychiatric overtones’ referees to what symptoms?

A
  1. Nephrolithiasis
  2. Bone pain
  3. Abdominal pain
  4. Depression, anxiety, confusion
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13
Q

What are the 4 principle clinical manifestations associated with hypercalcemia?

A
  1. Dehydration
  2. Renal insufficiency
  3. Nephrogenic diabetes insipidus
  4. Type 1 (distal) RTA (renal tubule acidosis)
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14
Q

What is the most common cause of primary hyperparathyroidism?

A

Parathyroid adenoma

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15
Q

What are the 3 possible aetiologies of primary hyperparathyroidism?

A
  1. Adenoma
  2. Diffuse Hyperplasia
  3. Carcinoma
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16
Q

What are the 3 major side effects associated with the use of bisphosphonates?

A
  1. AKI
  2. Osteonecrosis of the jaw
  3. MSK pain
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17
Q

Suggest 5 causes of a normocytic anaemia

A
  1. Anemia of chronic disease
  2. Chronic kidney disease
  3. Aplastic anemia
  4. Haemolytic anemia
  5. Acute blood loss
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18
Q

Describe the type of anemia characteristically seen in patients with liver disease

A

Macrocytic (normoblastic anemia)

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19
Q

Give 6 potential causes of a macrocytic normoblastic anemia

A
  1. Alcohol
  2. Liver disease
  3. Hypothyroidism
  4. Pregnancy
  5. Reticulocytosis
  6. Myelodysplasia
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20
Q

What are the 5 potential causes of a microcytic anemia?

A
  1. Iron deficiency anemia
  2. Thalassaemia
  3. Congenital sideroblastic anemia
  4. Anemia of chronic disease (although more commonly seen as a normocytic anemia)
  5. Lead poisoning
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21
Q

What is the most common form of leukaemia seen in adults?

A

Chronic lymphocytic leukaemia

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22
Q

Define a ‘Richter’s transformation’

A

The transformation of a chronic lymphocytic leukaemia into a high-grade lymphoma

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23
Q

What are the 4 principle complications associated with chronic lymphocytic leukaemia?

A
  1. Anemia
  2. Hypogammaglobulinaemia
  3. Warm autoimmune haemolytic anemia in 10-15% of patients
  4. Richter’s transformation
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24
Q

Suggest 2 conditions that can cause osteomalacia

A
  1. Coeliac disease

2. Type 2 renal tubular acidosis

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25
What are the characteristic cell types associated with B cell lymphoma?
Giant B cells with bilobed nuclei that have prominent eosinophilic inclusions
26
Give the 5 potential causes of intravascular haemolysis
1. Mismatched blood transfusion 2. G6PD deficiency 3. Red cell fragmentation 4. Paroxysmal nocturnal haemoglobinuria 5. Cold autoimmune haemolytic anemia
27
Suggest 4 potential causes of red cell fragmentation intravascularly
1. Prosthetic heart valves 2. TTP 3. DIC 4. HUS
28
What is TTP?
Thrombotic thrombocytopenic purpura
29
What is HUS?
Haemolytic-uremic syndrome
30
What are the 3 principle characteristics of haemolytic-uremic syndrome?
1. Low RBC count 2. Acute kidney failure 3. Low platelets
31
Name the 4 causes of extracellular haemolysis
1. Haemoglobinopathies 2. Hereditary spherocytosis 3. Haemolytic disease of the new-born 4. Warm autoimmune haemolytic anemia
32
Heinz bodies present on a blood film is indicative of what condition?
Thalassaemia
33
What are the 3 blood film abnormalities associated with Thalassaemia?
1. Heinz bodies 2. Basophilic stripping 3. Target cells
34
What is the underlying aetiology of Haemophilia A?
Deficiency of factor VIII
35
What is the underlying aetiology of haemophilia B?
Deficiency of factor IX
36
Reticulocytes differentiate from which cell type?
Myeloid progenitor cells found in the bone marrow
37
Name 3 hormones that can increase the differentiation of myeloid progenitor cells into reticulocytes
1. EPO 2. Thyroid hormones 3. Androgens
38
Give 3 causes of a microcytic anemia
1. Iron deficiency 2. Chronic inflammatory disease 3. Thalassemia
39
Suggest 2 causes of a normocytic anemia with a raised reticulocyte count
1. Haemolytic anemia | 2. Blood loss
40
What is the primary cause of a normocytic anemia with a low reticulocyte count?
Bone marrow disorders e.g. aplastic anemia
41
Suggest 3 causes of a megaloblastic macrocytic anemia
1. Vitamin B12 deficiency 2. Folate deficiency 3. Drug induced
42
What are the 2 main characteristics features of a megaloblastic anemia seen on blood film?
1. Immature large RBC's (megaloblasts) | 2. Hypersegmented neutrophils
43
Suggest 3 potential causes of a non megaloblastic macrocytic anaemia
1. Alcohol abuse 2. Hypothyroidism 3. Pregnancy
44
Give the 4 main causes of intravascular haemolysis
1. DIC 2. TTP 3. HUS 4. Mechanical heart valves
45
Give 3 possible causes of extravascular haemolysis
1. Hypersplenism 2. Inherited haeomolytic anemia 3. Acquired haemolytic anemia
46
Name an infection that can induce haemolytic anemia
Malaria
47
Name 2 types of inherited haemolytic anemia
1. Sickle cell | 2. Hereditary spherocytosis
48
Pernicous anemia is an example of what type of hypersensitivity reaction?
Type II hypersensitivity reaction
49
Which vitamin deficiency is likely to cause a sideroblastic anemia?
Deficiency in vitamin B6
50
Recall the components of the mnemonic TOP CaRS for remembering the sections of a neurological examination
``` TO - Tone P - Power C - Co-ordination R - Reflexes S - Sensation ```
51
Name 3 types of primary headache
1. Migraine 2. Cluster 3. Tension
52
Give 5 causes of secondary headache
1. SAH 2. Acute glaucoma 3. Raised ICP 4. Temporal arteritis 5. Meningitis
53
The red flag symptom: 'thunder clap headache' is associated with what condition?
SAH
54
The red flag symptom: 'headache worse on lying down' is indicative of what condition?
Raised ICP
55
Scapulas tenderness is associated with which cause of secondary headache?
Temporal arteritis
56
What is the normal duration range associated with migraine?
4-72 hours
57
Approximately what % of migraine patients experience an aura?
25%
58
What symptom is associated with a somatosensory aura?
Paraesthesia
59
What 2 symptoms are associated with a visual aura?
1. Scotoma | 2. Hemianopia
60
What 2 symptoms are associated with a motor aura?
1. Dysarthria | 2. Ataxia
61
What is the mainstay treatment for an acute migraine attack?
NSAIDS + Paracetamol + oral triptan
62
Suggest 3 potential options for the long term prophylaxis of migraine
1. Topiramate 2. Propanolol 3. Amitryptaline
63
Give 4 potential treatments for the management of chronic tension headaches
1. Antidepressants 2. Relaxation training 3. CBT 4. Myofascial trigger massage
64
What are the 3 major causes of subarachnoid haemorrhage?
1. Berry aneurysms 2. Trauma 3. Arterovenous malformations
65
What other condition has a strong association with Berry aneurysms?
Autosomal dominant polycystic kidney disease
66
During investigation of a subarchnoid haemorrhage, what are you looking for on a head CT?
Blood in the basal cisterns
67
What is the use of an LP in investigating a subarachnoid haemorrhage?
1. Look for Xanthochromia | 2. Culture the sample for a potential infective agent
68
Name the 4 major complications associated with SAH
1. Rebleeding 2. Cerebral ischaemia 3. Hydrocephalus 4. Hyponatremia
69
What 2 signs on fundoscopy are associated with raised ICP?
1. Venous congestion | 2. Inflammation of the cup
70
Name 5 symptoms/ clinical manifestations that can be associated with giant cell arteritis
1. Headache 2. Temporal scalp tendereness 3. Jaw claudication 4. Amaurosis fugax 5. Symptoms of polymyalgia rheumatica
71
Give 7 side effects associated with long term steroid use
1. Cushingoid appearance 2. Osteoporosis 3. Reduced immunity 4. Gastric damage 5. Hyperglycaemia 6. Hypertension 7. Cateracts
72
Name the 3 most common causative agents of meningitis
1. Neisseria Meningititis 2. Strep Pneumonia 3. Listeria monocytogenes
73
Give the 4 principle signs of an UMN lesion
1. Spasticity 2. Hypertonic 3. Positive babinski sign 4. Generalised weakness
74
What causes Wallenberg's syndrome
A stroke in the vertebral or posterior cerebellar arteries supplying the brainstem.
75
Define Weber's syndrome
Form of stroke characterised by an ipsilateral oculomotor nerve palsy and controlateral hemiparesis
76
Give 10 potential complications of MI
1. Cardiac arrest 2. Cardiogenic shock 3. Chronic heart failure 4. Tachyarythmia 5. Bradyarrythmia 6. Pericarditis 7. Left ventricular aneurysm 8. Left ventricular free wall rupture 9. Ventricular septal defect 10. Acute mitral regurgitation
77
AV block is most common after which form of MI?
An inferior MI
78
What are the 4 characteristics of Dressler's syndrome on clinical presentation?
1. Fever 2. Pleuritic pain 3. Pericardial effusion 4. Raised ESR
79
Define myelofibrosis
Myeloproliferative neoplasm, in which the proliferation of an abnormal clone of haematopoietic stem cells in the bone marrow and other sites results in fibrosis or the replacement of the marrow with scar tissue.
80
Suggest 2 haematological causes of secondary myelofibrosis
1. Polycythaemia vera | 2. Essential thrombocythaemia

TCD Cases (25 decks)

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