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MSRA > Gen med > Flashcards

Gen med Flashcards

1
Q

What is light’s criteria?

A

Effusion is exudative if any of the following present:

Pleural protein and serum protein >0.5

Pleural LDH and serum LDH >0.6

Pleural LDH >2/3 Upper limit of normal for serum LDH

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2
Q

Common causes of transudative pleural effusion?

A

CHF
Liver disease
Hypoalbuminaemia
Peritoneal dialysis

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3
Q

What are the common causes of exudative pleural effusion?

A

Infection
Cancer
Autoimmune
Drugs

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4
Q

What is congenital adrenal hyperplasia?

A

Autosomal recessive metabolic disorder related to enzymatic defects in the biosynthesis of cortical steroids.

21 hydroxylate deficiency

Deficient cortisol and/or aldosterone production and excess precursor steroids –> increased ACTH secretion from the anterior pituitary producing adrenocortical hyperplasia

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5
Q

What are the clinical features of congenital adrenal hyperplasia?

A
  1. females are virilised at birth and post pubertal amenorrhoea is common
  2. Hyperpigmentation
  3. Adrenal crisis –> salt loss and circulatory collapse.
  4. Hypoglycaemia
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6
Q

What is the treatment of congenital adrenal hyperplasia?

A

Life long replacement hydrocortisone
Salt retaining steroid e.g. fludrocortisone.

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7
Q

Things that can increase formation of uric acid

A

Alcohol
Diuretics - loop and thiazide
Salicylates
Pyrazinamide
Ethambutol
Niotinic acid
Cytotoxic agent

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8
Q

What is the centor criteria?

A

If 3 or moe of the following present then there is a 50% chance the sore throat is caused by group A beta-haemolytic streptococcus

  1. presence of tonsiillar exudate
  2. tender anterior cervical lymphadenopathy or lymphadenitis
  3. History of fever
  4. absence of cough

If abs indicated then 10 day course of either phenoxymethylpenicillin or erythromycin

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9
Q

What is achalasia?

A

Idiopathic motility disorder characterised by failure of lower oesophageal sphincter relaxation as well as loss off peristalsis in the distal oesophagus

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10
Q

Criteria of hypertension

A

Stage 1: clinic BP randing from 140/90 to 159/99

Stage 2: clinic BP >160/100 but <180/120

Stage 3: Clinic systolic BP >180 o diastolic >1200

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11
Q

What is selective IgA deficiency?

A

mild genetic immunodeficiency due to lack of IgA which usually protects against infections of the mucous membranes

Most common off the primary antibody deficiency

More common in males

No treatment for underlying disorder - can lead to anaphylaxis to blood transfusions or IV immunoglobulins

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12
Q

What is severe combined immunodeficiency (SCID)?

A

Life threatening syndrome of recurrent infections, diarrhoea, dermatitis and failure to thrive.

Caused by compromise in the number and function of T-cells, B-cells and occasionally natural killer cells

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13
Q

What is hereditary angioedema?

A

Inherited disease caused by low levels of plasma protein C1 inhibitor

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14
Q

What Is dissociate fugue?

A

Purposeful travel beyond the usual everyday range

Maintenance of self-care

Dissociative amnesia

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15
Q

What is akathisia?

A

Restlessness of the lower limb

Starts within hours or weeks of starting antipsychotics or increasing dose

Does not affect sleep unlike restless leg syndrome

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16
Q

What Is borderline personality disorder?

A

disorder of mood and interpersonal interactions

Emotional instability
Disturbed patterns of thinking or perception
Impulsive behaviour
Intense but unstable relatioinships

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17
Q

What is histrionic personality disorder

A

Constant attention-seeking
Emotional overreaction
Suggestibility

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18
Q

Define optic neuritis?

A

Demyelinating inflammation of the optic nerve usually associated with multiple sclerosis

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19
Q

What is the presentation of optic neuritis?

A

Rapidly deteriorating vision usually in one eye

dyschromatopsia

Ocular pain

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20
Q

What is the characteristic symptom of tobacco-alcohol amblyopia?

A

Central loss of colour vision

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21
Q

What is the presentation triad of normal pressure hydrocephalus?

A

Gait disturbance
Urinary incontinence
Dementia

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22
Q

How long should anti-depressants be continued following remission?

A

6 months at least

23
Q

What are the characteristics of poly myalgia rheumatica?

A

Severe bilateral pain and morning stiffness of the shoulder, neck and pelvic girdle

Muscles are tender rather than the joints

Raised ESR

24
Q

What is the max dose of lidocaine that can be used for local?

A

3mg/kg or 7mg/kg with ephinephrine

25
Q

What are the clinical features of SLE?

A

Fever, malaise, fatigue and weightless

26
Q

What does the FEV1/FVC ratio imply?

A

Ratio <70% implies obstructive

If value is >70% then obstruction is excluded

Restrictive would have both FEV1 and FFVC low but in proportion

27
Q

What is primary biliary cirrhosis?

definition, investigation and presentation

A

Autoimmune disease of the liver with destruction of the bile canaliculi

Fatigue
Puritus
Steatorrhoea
Jaundice

Anti-microbial antibody

28
Q

Which virus is most commonly associated with nasopharyngeal carcinoma?

A

Epstein-barr virus

29
Q

Which malignancies are associated with asbestos?

A

Mesothelioma
Lung carcinoma
Gastrointestinal lymphoma
Renal adenocarcinoma

30
Q

What are the 3 major mechanisms by which hypercalcaemia of malignancy can occur?

A
  1. osteolytic metastases
  2. tumour section of parathyroid hormone-related protein
  3. tumour production of 1,25-dihydroxyvitamin D
31
Q

Which drugs worsen glycemic control?

A

Beta blocker
Thiazides
Glucocorticoids
Anti-psychotics

32
Q

What is the use of amantadine?

A

Management of Parkinson’s disease, post herpetic neuralgia and influenza A

33
Q

Comorbidities associated with Down’s syndrome?

A
  1. Early onset alzheimers
  2. T1DM
  3. Acute leukaemia
  4. Duodenal atresia
  5. Hirschsprung’s disease
  6. Hypothyroidism
34
Q

Beneath what age can an individual NEVER consent to sexual activitiy?

A

13

35
Q

Management off rosacea?

A

Topical metronidazole

36
Q

What does joint aspiration in gout and pseudo gout show?

A

gout: needle-shaped negatively birefringent crystals

peudogout: rhomboid-shaped and weekly positively birefringent

37
Q

Most common cause of bacterial meningitis in adults?

A

Streptococcus pneumoniae

38
Q

what is and what are the Lab findings in Addison’s disease

A

Hyponatraemia and hyperkalaemia

Primary adernocotical deficiency

39
Q

What is one’s syndrome and what are the lab findings?

A

Primary aldosteronism due to aldosterone producing adenoma

Hypokalaemia and hypernatramia

40
Q

What is Cushing’s disease and what are the lab findings?

A

ACTH-producing pituitary tumour that produces excess aldosterone and adrenal androgen secretion

Hypokalaemia and hypenatraemia

41
Q

What is Cushing’s syndrome?

A

Adrenal hyperplasia, adrenal neoplasm or exogenous causes leading to excess aldosterone and adrenal androgen secretion

42
Q

What is erythema ab igne

A

Skin reaction caused by exposure to heat

Seen in people with hypothyroidism and lymphoedema

43
Q

What is primary sclerosis cholangitis and what is the presentation?

A

Chronic inflammation and fibrosis of the bile duct

Suspected in patients with UC, abnormal LFTs.

44
Q

What is hemiballismus?

A

Involuntary flinging motions of the extrermities due to infarction/haemorrhage in the contralateral sub thalamic nucleus

45
Q

What is chorea?

A

Characterised by involuntary, irregular, random and flowing movements which flit from one part of the body to another

46
Q

What is pyogenic granuloma?

A

Chronic inflammatory lesion of the dermal layer that occurs as a result of minor trauma

47
Q

What is Uhthoff’s phenomena?

A

Worsening of neurological condition when the body is overheated

48
Q

What’s the triad of presentations for Wernick’s encephalopathy?

A

Ataxia
Acute mental confusion
Opthalmoplegia

49
Q

triad of bronchiectasis presentation

A

repeated infections
chronic cough
excess purulent sputum production

50
Q

Triad of presentation for meniere’s disease

A

Vertigo
Tinnitus
Hearing loss

51
Q

Presentation of Vestibular neuritis

A

Recurrent episodes of vertigo lasting days
No tinnitus or hearing loss

52
Q

What is Fredrick’s ataxia?

A

most common inherited (autosomal recessive) ataxia in the UK

degenerative disease that primarily affects nervous system and the heart

53
Q

What is Zenker’s diverticulum?

A

Also known as pharyngeal pouch. out pouching at the level of hypopharynx

MSRA (4 decks)

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