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Integration for Clinical Applications > Conditions > Flashcards

Conditions Flashcards

1
Q

Name 4 pre-syncopal signs/symptoms

A
  1. Sweating
  2. Pallor
  3. Light-headedness
  4. Blurred vision
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2
Q

Describe the normal baroceptor reflex

Name 2 types of syncope that are caused by a default in this reflex

A

Low BP leads to low stretch of the baroreceptors (stretch receptors) at the aortic arch and carotid sinus. CN 9 detects this from the baroreceptors at the carotid sinus and CN 10 detects this from the baroreceptors at the aortic arch and relays the information to the medulla. The medulla reduces its parasympathetic input into CN 10 and increases its sympathetic input into the sympathetic nerves exiting it. These sympathetic nerves increase SAN impulse release, HR and ventricular contractility so BP increases.

Postural hypotension and Reflex hypotension

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3
Q

Name 4 drug groups that commonly induce drowsiness

A

Benzodiazepines
Antipsychotics
Analgesias
Anti-depressants

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4
Q

Why do elderly patients tend to bruise easily?

A

Thin skin as dermis lacks collagen + elastin and hypodermis lacks subcutaneous fat

and

Fragile subcutaneous vessels

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5
Q

What is the name for the inability to retract the prepuce/foreskin

A

Phimosis

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6
Q

Paraphimosis definition

A

Inability to pull the foreskin forward, over the glans

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7
Q

Balanitis definition

A

Inflamed penile glans

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8
Q

What is the name for inflamed prepuce (foreskin)

A

Posthitis

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9
Q

Name 2 causes of painful testicles

A

Testicular torsion

Epididymo-orchitis

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10
Q

What is Epididymo-orchitis and name 3 causes

A

Inflammation of the epididymis and testicle due to a UTI, STI or Mumps (all infections)

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11
Q

What is a rare complication of Epididymo-orchitis, that can lead to death in 50% of cases?

What is it?

A

Fournier’s gangrene - necrotic scrotal skin tissue

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12
Q

Hydrocoele definition

A

Production of fluid is greater than the reabsorption of fluid in the layer between the tunica vaginalis and tunica albuginea

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13
Q

Name 2 testicular deformities that transilluminate

A

Spermatocele/Epididymal cysts (separate from testis) and Hydrocoeles (not separate from testis)

(Pro-tip: Varicoceles DO NOT transilluminate)

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14
Q

What is a varicocele?

NOT tender

A

Enlargement of the veins in the pampiform plexus, above the testis, in the scrotum, due to valve impairment, preventing the flow of venous blood.

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15
Q

How would a patient with a varicocele complain about?

A

Painless ache at the end of the day

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16
Q

On examination, what would you see in a patient will a varicocele?

A

A bag of worms, above the testis, in the scrotum

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17
Q

Discuss 2 treatments for BPH

A
  1. Tamsulosin, an alpha adrenoceptor blocker relaxes the smooth muscle of the prostate and bladder, so the urethra is wider
  2. Finasteride, a 5-a reductase inhibitor, shrinks the prostate by depriving it from androgens, so urethra is wider
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18
Q

Name some factors of frailty

A

Delirium

Falls

Incontinence and UTIs

Immobility and pressure sores

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19
Q

Discuss the Kubler-Ross model

A

Shock. Denial. Anger. Bargaining. Depression. Acceptance.

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20
Q

Discuss what Fitzpatrick skin types shows

A

Type 1 (pale white) to Type 6 (dark black):

The darker you are, the less you burn and the more easier it is for you to tan

21
Q

Regarding dermatology, what is SCAM used for?

What does each letter stand for?

A

Skin complaints:

Site and distribution for rashes/Size and shape for lesions

Colour

Associated skin changes

Morphology

22
Q

Regarding dermatology, what is ABCD used for?

What does each letter stand for?

A

Pigmented lesions

Asymmetry

Border - irregular or blurred

Colour

Diameter

23
Q

Name 4 skin functions : PTSD

A

Protection from environmental insult

Temperature regulation

Sensation

Vit D synthesis

24
Q

What 4 cell types are present in the Epidermis?

What are their functions?

A

Keratinocytes - protection

Langerhans - APC

Melanocytes - produce melanin which provides pigment and protects cell nuclei from UV DNA damage

Merkel cells - nerve endings for sensation

25
Q

What is the epidermal turnover time?

A

30 days

26
Q

What are the layers of the epidermis?

A

Stratum corneum (horny layer)

Stratum lucidum (palms and soles)

Stratum granulosum

Stratum spinosum

Stratum basale

‘come get some bread’

27
Q

What glands regulate temperature?

Where are they found?

A

Apocrine glands are found in the axilla, genitals in the dermal layer (become active after puberty)

Eccrine glands are widespread (throughout the body) and are also found in the dermal layer

(Both glands are sweat glands)

28
Q

What are the 3 types of hair?

A
  1. Lanugo
  2. Vellum
  3. Terminal
29
Q

Where are the erythemous and crusting vesiculations, in eczema, found on

A) infants
B) children/adults

A

A) face and extensors

B) flexors (inner elbow, behind knee)

30
Q

Regarding sepsis risk, high results of this sign will indicate a higher risk

A

Lactate is more sensitive (than BP)

HIGH LACTATE over 2- GIVE FLUID BOLUS

31
Q

Why are lactate levels high in sepsis?

A

Poor perfusion leading to anaerobic respiration

32
Q

What is the paediatric sepsis 6 bundle?

A
  1. Give O2
  2. Find iv access and take bloods
  3. Give iv antibiotics
  4. Give fluids to treat high lactate
  5. Consult senior
  6. Consider giving peripheral inotropes - Warm shock give Noradrenaline, Cold shock give Adrenaline
33
Q

What antibiotics can be given to …. to treat sepsis

A) <1 yo
B) 1-3 yo
C) >3 yo

A

A) Gentamicin, Amoxicillin, Cefotaxime

B) Amoxicillin, Ceftriaxone

C) Ceftriaxone

34
Q

20% of breast cancers have what receptor present?

What does this receptor encode for?

What drug specifically targets this receptor?

A

Her2-R

Encodes for a transmembrane tyrosine kinase receptor

Trastuzumab

35
Q

Name and describe a stromal tumour that occurs in female breasts in < 30’s

A

Fibroadenomas, localised hyperplasia of stromal and epithelial tissue, macroscopically they are white/grey and rubbery

36
Q

What 3 pathological changes occur in Fibrocystic change in the breasts?

This is a benign epithelial change in the breast and it is the commonest breast lesion.

A
  1. Fibrosis of connective tissue
  2. Cyst formation
  3. Apocrine metaplasia
37
Q

With Leidig testicular tumour cells, how are the hormone levels?

A

High testosterone

Low/normal:
FSH and LH

38
Q

What breast malfunction, in men, can liver cirrhosis cause and why?

A

Gyaenecomastia due to reduced oestrogen metabolism

39
Q

What is Paget’s disease?

What do you see?

A

A ductal carcinoma in situ that has invaded the nipple skin but not the basement membrane

See flaky, eczema, crusting nipple

40
Q

What type of breast cancer is a precursor to an invasive carcinoma?

A

Ductal carcinoma in situ

41
Q

What breast cancer can spread to the peritoneum?

A

Invasive lobular carcinoma

42
Q

What is intraductal papilloma?

A

A unilateral benign growth in a mammary duct, leading to the secretion of discharge from the nipple

43
Q

Name a drug that can given for short term treatment of severe resistant inflammatory skin conditions (e.g. psoriasis, recalcitrant eczema)

Also give its trade name.

A

Clobetasol propionate

Dermovate

44
Q

Use 2 words to describe a Pseudomonas skim infection

A

Green and smelly.

45
Q

Gentamicin can be used to treat a Pseudomonas skin infection. Ciprofloxacin can also be used to treat Pseudomonas skin infection but why isn’t it first line?

A

It causes a Clostridium difficile infection (so get diarrhoea)

46
Q

What are the 6 stages in the transtheoretical (Stages of Change) model?

A
  1. Pre-contemplation
  2. Contemplation
  3. Determination/Preparation
  4. Action
  5. Maintenance
  6. Relapse
47
Q

Balanitis treatment

A

Fusidic acid cream 4x day for 1 week

48
Q

Give 6 possible causes of haematospermia

A
      1. Inflammation: Prostatitis, Urethritis
  2. Prostate biopsy
    (1-3 are the most common reasons)
  3. UTI Calculi
  4. Chlamydia
  5. Schistosomiasis
  6. Severe hypertension

Integration for Clinical Applications (3 decks)

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