Diseases

Question 1

Measles

Answer 1

Corzya at start
Dry cough
Red eyes
Classic descending exanthema of measles
Koplik spots in the mouth

Question 2

Parkinsons quintet

Answer 2

2 or more signs = parkinsons

1. Tremor at rest
2. Rigidity
3. Bradykinesia
4. Postural instability
5. Gait freezing

Question 3

Cushings

Answer 3

Plethoric moon face + thin extremities + muscle weakness

Question 4

Cushings investigations

Answer 4

2 of
Overnight 1mg Dexamethasone suppression test
Late night salivary cortisol (2x)
24hr urinary free cortisol (2x)

Question 5

Primary hyperaldosteronism

Answer 5

Aka conns
Htn
Weakness from low k
High na
Cramps
Pokyuria and polydipsia

Question 6

Investigation for conns

Answer 6

Serum and urine aldosterone
Plasma renin low
Na high
K low
Alkalosis
Imaging of adrenals - mri or ct

Question 7

Addison’s disease

Answer 7

Fatigue + a/n/v + abdominal pain (+/- skin discoloration)

Weight loaa

Question 8

Investigation for addisons

Answer 8

Elevated k
Low na
Short synacthen test is definitive
Morning serum cortisol level
Consider adrenal auto antibodies and ?calcification of adrenals

Question 9

Phaeochromocytoma investigation

Answer 9

Series of 3x 24hr free catecholamines

Ct or mri abdomen

Question 10

Vestibular neuritis

Answer 10

acute or subacute rotatory vertigo, nausea, NO hearing loss

if severe prednisone 1mg/kg up to 75mg PO mane for 5 days then taper over 15 days

Question 11

Hypercalcemia

Answer 11

bones, moans, stones, abdominal groans

weakness + constipation + polyuria

Question 12

hypocalcemia

Answer 12

cramps + confusion + tetany

Question 13

Carcinoid symptoms & ix

Answer 13

facial flushing + diarrhea + valvular heart disease

serum chromograna A + urine 5HA, hepatic USS

Question 14

Reactive arthritis

Answer 14

urethritis + conjuncitivits +/- iritis + arthritis

from Chalmydia, or enteric such as Salmonella

Question 15

Lichen planus

Answer 15

4 Ps
papule
purple
polygonal
pruritic

Question 16

Pagets disease

Answer 16

raised ALP

xrays, bone scan is sensitive but not specific

Question 17

acute lymphoblastic leukemia ALL

Answer 17

malaise, pallor, bone pain

Question 18

AML acute myeloid leukemia

Answer 18

malaise, pallor, oral problems

Question 19

chronic myeloid leukemia CML

Answer 19

fatigue + fever/night sweats + abdominal fullness (splenomegaly)

Question 20

chronic lymphocytic leukemia CLL

Answer 20

fatigue + weight loss + fever/night sweats + lymphadenoaathy

Question 21

Typhoid

Answer 21

‘stepladder’ fever + abdo pain + relative bradycardia

Question 22

Mesenteric artery occlusion

Answer 22

anxiety & prostration + intense central pain + profuse vomiting +/- bloody diarrhea

Question 23

Cystic fibrosis

Answer 23

failure to thrive + chronic cough + loose bowel actions

Question 24

Multiple myeloma

Answer 24

weakness + back pain + susceptibility to infection

Question 25

Complex regional pain syndrome diagnsotic criteria

Answer 25

1. continuing pain disproportionate to any inciting event 2. at least one symptoms of: - sensory - - vasomotor - suodomotor/oiedema - motor/trophic changes 3. displace sign of (one of the above categories) 4. no other diagnoses better explains S/S

Question 26

muscular dystrophy

Answer 26

duchenne muscular dystrophy = male child + abnormal gait + bulky calves

Question 27

symptoms characteristic of restless legs syndrome

Answer 27

URGE = Urge to move, Rest induces symptoms, Gets better with activity, Evening and night time worsening

Question 28

Rheumatoid arthritis poor prognostic features

Answer 28

``` RF+ anti-CCP + >20 joints swollen at presentation high disease activity at onset elevated ESR smoking early functional impairment early radiological bone erosions exta-articular disease manifestations long disease duration at presentation >3-6 months earlier age at onset of symptoms ```

Question 29

management of CKD

Answer 29

``` advanced care planning aim BP <130.80 review eGFR every 1`-3 months review ca/po/PTH 6-12 months monitor FBC for anemia of CKD low salt diet <6g/day adequate protein intake dietician exercise CVD risk, statin stop denosumab ```

Question 30

COPD spirometry

Answer 30

FEV/FVC <0.7 | FEV <80% predicted

Question 31

restriction on spirometry

Answer 31

FEV/FVC normal for age | FVC <80% predicted for age

Question 32

fetal alcohol syndrome

Answer 32

abnormal facies + growth retardation + microcephaly

Question 33

Depression DSM 5 criteria

Answer 33

A. 5 or more of the following symptoms present during the same 2 week period, represent a change from previous functioning, at least one of the symptoms os depressed mood or loss of interest 1. depressed mood most of the day, nearly every day 2. diminished interest or pleasure 3. weight loss or gain 4. insomnia or hypersomnia 5. psychomotor agitation or retardation 6. fatigue 7. worthlessness/guilt 8. reduced concentration 9. thoughts of death/suicidal ideation B. cause clinically significant distress/impairment C. not attributable to of substance/medical condition

Question 34

DSM Schizophrenia

Answer 34

``` A. at least 2, for 1/12 - delsuion, hallucinations, disorganised speech, negative symptoms B impaired function C. disturbance >6/12 D. mood order excluded E. not due to substance F. not ASD/developmental ```