Flashcards in Misc Deck (180)
Symptoms of typhoid?
fever, relative bradycardia, abdominal pains, dry cough, constipation, lymphadenopathy, headache, splenomegaly, rose spots
Symptoms of an amoebic liver abscess?
fever, jaundice, RUQ pain
What are sarcomas?
rare (1%) tumours of the mesenchymal tissue and should be managed through specialist care (50 different types)
What does a biopsy show in a high grade sarcoma?
pleomorphic spindled cells arranged in long fasicles
increased mitosis, with necrosis, deep margin
What does a biopsy show in low grade sarcoma?
well differentiated liposarcoma, most of which is lipid like
low mitosis, no necrosis, mostly covered by a pseudocapsule but can have focal capsular breach and tumour present at one margin
How can sarcoma recurrence be reduced?
radiotherapy, usually fractioned
treat the same place each time (RT tattoo)
Side effects of radiotherapy?
depends upon the area treated
early - tiredness, skin inflammation, hair loss
late - lymph-edema, joint stiffening, pathological fracture
When should radiotherapy be used for sarcoma treatment?
for high grade tumours, >5cm with positive surgical margins, reduces distant recurrances but no overall survival effect
What is used in adjuvant chemotherapy?
doxorubicin and ifosfamide
What does a biopsy show in Ewing's sarcoma?
round cell tumour, CD99+, EWSR1 rearrangement
Where does Ewings sarcoma usually affect?
the pelvis or femur
In who is Ewing's sarcoma most common?
young males 10-20
Treatment of Ewing's sarcome?
surgery, chemo, radiotherapy
Side effects of chemo?
early - anaemia, thrombocytopenia, neutropenia, mouth ulcers, thrush, N+V, constipation, neurotoxcity, peripheral neuropathy, encephalopathy, haemorrhagic cystitis, hair loss, tiredness
late - cardiotoxcity, nephrotoxicity, neurotoxicity, osteopenia, fertility, secondary malignancies
Aims of advanced stage sarcoma treatment?
downstage with pre op RT and chemo to make the lesion operable
palliative for symptomatic lesions, with surgery an radiotherapy, typically systemic treatment with cytotoxic chemo or targeted agents
What is used in palliative chemo?
single agent doxorubicin
Treatment of GI sarcomas?
insensitive to traditional chemo agents so used activating mutation in KIT or PDGRF or oral agent imatinib targets KIT and PDGFR
Side effects of imantinib?
nausea, vomiting, diarrhea, fluid retention, skin rash, tiredness
Risk factors for sarcoma?
age (10-20), radiation, previous cancer, family history, exposure to chemical, infections, lowered immunity, arm or leg swelling, body weight, injury, smoking
Symptoms of sarcoma?
painless less that becomes painful, big, getting bigger, deep in body tissues,
Diagnosis of sarcoma?
core needle biopsy with US assistance, mri, ct, xray, fine needle aspiration, PET scan, cytogenetic tests for more specific diagnosis
What 3 things is a sarcoma grade based on?
differentiation - differentiated or abnormal
What are the 3 main types of worm and where do they affect in the body?
nematodes (roundworms)- intestine, larva migrains, tissue
trematodes (flukes) - blood, liver, lung, intestinal
cestodes (tapeworms) - invasive and non invasive in the gut from meat
How are tapeworms detected?
detection of eggs in the stool microscopy (taenia saginata), serology (taenia solium and echinococcus granulosus), imaging of cysts with US, CT and MRI
Symptoms and treatment of tapeworms?
taenia saginata - abdo pain and malabsorption (praziquantel)
taenia solium - disseminated disease in skin and skeletal muscle and brain causing fits and focal signs (albendazole)
echinococcus granulosus - cyst develop in liver lung and brain causing anaphlatic reactions (surgical excision and albendazole)
Treatment of hookworm and threadworm?
Diagnosis of roundworms?
detection of eggs in faeces, serology, larvae in fresh stool (strongyloides stercoralis)
Treatment of round worm?
Symptoms of round worms?
LOCAL DERMATITIS at site of skin pentration, diarrhea, malabsorption, disseminated disease, nausea, epigastirc pain, iron deficient anaemia, prutitus ani (threadworm)