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General Medicine > Gen med > Flashcards

Gen med Flashcards

1
Q

what do the centracinar cells of the exocrine pancreas secrete? And what is the signal for this cell to secrete it?

A

Secrete bicarbonate ions

Signal = secretin

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2
Q

What do the basophilic cells of the exocrine pancreas secrete?
What is the signal?

A

Digestive Enzymes

CCK

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3
Q

What proteases does the pancreas secrete?

A

trysinogen, chymotripsonogen, lipase, amylase

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4
Q

What enzyme activates trypsinogen

A

enteropeptidase

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5
Q

What is Conn’s Syndrome

A

Aldosterone producing adrenal adenoma

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6
Q

2 main features of hyperaldosteronism

A

Hypertension, Hypokalemia

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7
Q

Best means of differentiating between primary and secondary hyperaldosteronism

A

ARR: aldosterone to renin ratio

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8
Q

Clinical Features of Infective Endocarditis

A 
Osler's nodes
Splinter haemorrhages
Janeway lesions
Clubbing
New or changing murmurs
Arthralgia
Roth spots
Conjunctival haemorrhages
Splenomegaly
Cerebral emboli
Mycotic aneurysm, and
Haematuria
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9
Q

Side Effects of Amiodarone

A

Arrythmias - torsades de pointes, QT prolongation, hepatotoxicity, pulmonary fibrosis, photosensitivity, neuropathy, hyperthyroidism

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10
Q

Amiodarone mechanism of action

A

potassium channel blocker, it prolongs cardiac action potential duration. It also prolongs the effective refractory period. As well as potassium, it also blocks sodium and calcium channels hence slows phases 0 and 3 and blocks alpha and beta adrenoceptors.

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11
Q

Felty’s Syndrome

A

arthritis, splenomegaly, neutropenia

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12
Q

Tietze Syndrome

A

Tietze syndrome is a rare, inflammatory disorder characterized by chest pain and swelling of the cartilage of one or more of the upper ribs (costochondral junction).

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13
Q

blindness resulting from parietal lobe tumour

A

inferior homonymous hemianopia

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14
Q

Bilateral occipital lobe infarction

A

cortical blindess

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15
Q

Medical treatment for LUTS in men

A

alpha1 adrenergic blocker

Tamsulosin: uroselective

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16
Q

Kerh’s Sign

A

Refers to shoulder tip pain that occurs due to blood in the peritoneal cavity that is irritating the diaphragm

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17
Q

causes of tender hepatomegaly

A

hepatitis

Factors which cause rapid enlargement: Right heart failure, Budd-Chiari Syndrome, Hepatoma

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18
Q

Reidel’s Lobe

A

projection of the liver from the inferior surface of the right lobe, normal anatomical variant

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19
Q

Pulsatile liver causes

A

Most common cause is tricuspid incompetence
Neoplasms: HCC, haemangioma, haemangiosarcoma
AVMs

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20
Q

Budd-Chiari Syndrome

A

Occlusion of the hepatic veins

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21
Q

3 drugs that cause gingival hypertrophy

A

Nifedipine, Ciclosporin, Phenytoin

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22
Q

BeriBeri

A

Deficiency in Thiamine (vitamin B1)

CHF, Peripheral Neuritis, Psychic Disturbances

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23
Q

Pellagra

A

Lack of NIacin (vitamin B2)
Diarrhoea
Dermatitis
Dementia

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24
Q

Inherited form of zinc deficiency

A 
acrodermatitis enteropathica
- skin changes
alopecia
diarrhoea
weight loss
emotional disorder
increased infections
can be fatal
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25
Q

Adult Onset Still’s Disease

A

rare systemic inflammatory disease characterised by the classic triad of persistent high spiking fevers, joint pain and a distinctive salmon coloured bumpy rash

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26
Q

severe abdominal pain + abnormal illness behaviour + ‘red’ urine

A

Acute intermittent porphyria

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27
Q

Bactrim

A

Trimethoprim-Sulfamethoxazole

antifolate drug

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28
Q

what cells does carcinoid tumour arise from

A

enterochromaffin cells

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29
Q

What do carcinoid tumours secrete

A

excessive serotonin (5HT)

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30
Q

Test for carcinoid syndrome

A

24 hour urine levels of 5-HIAA

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31
Q

Charles Bonnet Syndrome

A

Complex visual hallucinations in a person with partial or severe blindness

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32
Q

Ludwig’s Angina

A

potentially life threatening cellulitis or connective tissue infection of the floor of the mouth, usually occurring in adults with concomitant dental infections and if left untreated, may obstruct the airways, necessitating tracheotomy

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33
Q

as what is carbon dioxidde primarily transported as in the blood?

A

bicarbonate

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34
Q

treatment for motion sickness

A

cyclizine

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35
Q

tapping apex beat

A

mitral stenosis

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36
Q

non infective endocarditis

A

Libman-Sacks syndrome

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37
Q

Howel-Evan syndrome

A

extremely rare condition involving thickening of the skin in the palms of the hands and soles of the feet
associated with high lifetime risk of oesophageal cancer

38
Q

What type of cancer is associated with Barret’s oesophagus

A

adenocarcinoma

39
Q

Diffuse oesophageal spasm on barium xray

A

corkscrew pattern

40
Q

Achalasia on barium xray

A

Birds beak appearance

41
Q

Risk factors for testicular cancer

A

cryptorchidism, family history, age 20-40, Klinefelter’s, HIV

42
Q

Investigations for testicular tumour

A

Testicular ultrasound
tumour markers: BHCG, AFP
Radical Inguinal Orchidectomy

43
Q

What medications can be used as adjunct therapy in alcohol dependence

A

alcamprosate
naltrexone
Disulfiram

44
Q

CAGE Questionaiire

A

Have you ever felt you ought to Cut down on your drinking?

Have people Annoyed you by criticizing your drinking?

Have you ever felt bad or Guilty about your drinking?

Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover ( Eye-opener)?

One or more “yes” responses constitute a positive screening test.

45
Q

Buproprion

A

non nicotine oral therapy - It is effective for smokers with depression, cardiac or respiratory diseases, and also to improve short-term abstinence rates for people with schizophren

46
Q

5As in smoking cessation

A

Ask about and document tobacco use at every opportunity
Assess motivation and confidence to quit - ‘are you interested in quitting?’
Advise the smoker to stop
Assist the smoker to stop
Arrange follow-up to maintain non-smoking

47
Q

Morton’s Neuroma

A

benign neuroma of an intermetarsal plantar nerve
entraps affected nerve
pain and numbness and shooting pains
direct pressure between metatarsal heads can replicate pressure

48
Q

most common complication of high dose corticosteroid therapy

A

insomnia

49
Q

Tumours most likley to metastasise to bone

A

Breast, prostate, lung, colon, kidney, thyroid

50
Q

most common cause of death after spinal cord injury

A

pulmonary failure

51
Q

Autonomic Dysreflexia

A

baroreceptor response that frequently causes bradycardia

52
Q

Acute management of GI dysfunction after a spinal cord injury

A

GI decompression via IG tube,
increased protein in diet,
use of PPIs,
placement of PEG or NET for dietary support

53
Q

Incomplete tetraplegia

A

arms are paralysed but legs are spared

54
Q

Neurogenic bowel management plan

A

high fibre, scheduled stool softners, GI stimulants and rectal stimulants

55
Q

Problems resulting immediately after spinal cord injury

A

GI dysfunction; cognitive dysfunction; neurogenic bladder; pressure ulcers

56
Q

most common outcome of spinal cord injury

A

incomplete tetraplegia

57
Q

CREST Syndrome

A

Calcinosis: calcium deposits on skin
Raynaud’s phenomenon
Esophageal dysfunction: acid reflux
Sclerodactyly: tightening of skin on digits
Telangiectasia: superficial dilated blood vessels

Limites Systemic Sclerosis

58
Q

Haemophilia B

A

Factor 9 deficiency

59
Q

Haemophilia A

A

Factor 8 Deficiency

60
Q

Anal Disease in IBD

A

Crohn’s

61
Q

Rectum always involved in IBD

A

Ulcerative colitis

62
Q

Treatment for haemophilia A

A

desmopressin

63
Q

which cause of anaemia most classically has the hair on end appearance on xray

A

thalassemia

64
Q

DRESS

A

Drug Reaction with Eosinophilia and Systemic Symptoms
Liver most commonly involved
Fever, liver abnormalities, lymphadenopathy

65
Q

Difference between spacticity and rigidity

A

Spacticity is velocity dependent

rigidity is present throughout all movements

66
Q

Ichthyosis

A

‘fish scale’

group of genetic disorders that cause dry scaly thickened skin

67
Q

Howel-Evan Syndrome

A

condition involving thickening of the skin in the palms of the hands and soles of the feet (hyperkeratosis)
associated with high lifetime risk of oesophageal cancer

68
Q

Marjolin’s ulcer

A

squamous cell ulcer that develop in areas of chronic inflammation such as burn sites or varicose ulcers

69
Q

Brodie’s Abcess

A

cavity surrounded by a ‘halo’ of sclerosis, most commonly occur in metaphases of long bones

70
Q

pituitary mass with calcification in a child with visual field defect

A

Craniopharyngioma

71
Q

Features of aspirin overdose

A

Encephalopathy, deranged coagulation, renal failure, hypoglycaemia

72
Q

MEN 2A syndrome

A

Thyroid, parathyroid and phaeochromocytoma

Mutation in the RET gene

73
Q

Whipple’s Triad

A

Suggest the patients symptoms result from hypoglycaemia (could be pancreatic insulinomas) and consists of: fasting hypoglycemia. symptoms of hypoglycemia. immediate relief of symptoms after the administration of IV glucose.

74
Q

Akithesia

A

motor restlessness, constant semi purposeful movements of arms and legs

75
Q

athetosis

A

writhing slow sinuous movements, especially of the hands and wrists

76
Q

Wernicke’s Area

A

posterior superior temporal lobe (first temporal gyrus)

Receptive dysphasia

77
Q

Broca’s Area

A

posterior inferior frontal lobe

78
Q

Nominal dysphagia lesion

A

dominant posterior temporparietal area

79
Q

Gerstmann Syndrome

A 
Dominant hemisphere parietal lobe
Acalculia
Agraphia
Left-Right disorientation
finger agnosia
80
Q

occipital lobe

A

homonomyous hemianopia
alexia (inability to read)
seizures (flashing light aura)

81
Q

Frontal Lobe

A 
personality changes
primitive reflexes
anosmia
optic nerve compression
leak weakness
gait apraxia
dysphagia (expressive)
loss of micturition control
82
Q

Temporal Lobe

A

Memory loss
upper quandrantopic hemianopia
dysphagia (receptive if dominant lobe)

83
Q

Psuedobulbar palsy

A

upper motor neuron weakness that causes spastic dysarthria

84
Q

What is the distribution of the capillary haemangioma in Sturge Weber Syndrome

A

Trigeminal

85
Q

Conversion Disorder

A

Neurological complaint with motor, sensory deficit, with seizures or convulsions. Initiation is preceeded by conflict or other stressors
not intentionally produced or feigned
cannot be explained by a medical condition
causes distress

86
Q

Side effect of cisplatin

A

renal damage and neural toxicity

87
Q

Side Effect of cyclophosphamide

A

haemorrhagic cystitis adnd alopecia

88
Q

side effect of blemoycin

A

Pulmonry fibrosis

89
Q

doxarubicin side effect

A

cardiac toxicity

90
Q

vincristine

A

peripheral neuropathy

91
Q

Drug of choice in severe delirium

A

Halloperidol

General Medicine (15 decks)

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