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Flashcards in Misc Deck (180)
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151

Symptoms of typhoid?

fever, relative bradycardia, abdominal pains, dry cough, constipation, lymphadenopathy, headache, splenomegaly, rose spots

152

Symptoms of an amoebic liver abscess?

fever, jaundice, RUQ pain

153

What are sarcomas?

rare (1%) tumours of the mesenchymal tissue and should be managed through specialist care (50 different types)

154

What does a biopsy show in a high grade sarcoma?

pleomorphic spindled cells arranged in long fasicles

increased mitosis, with necrosis, deep margin

155

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

156

How can sarcoma recurrence be reduced?

radiotherapy, usually fractioned

treat the same place each time (RT tattoo)

157

Side effects of radiotherapy?

depends upon the area treated

early - tiredness, skin inflammation, hair loss

late - lymph-edema, joint stiffening, pathological fracture

158

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

159

What is used in adjuvant chemotherapy?

doxorubicin and ifosfamide

160

What does a biopsy show in Ewing's sarcoma?

round cell tumour, CD99+, EWSR1 rearrangement

161

Where does Ewings sarcoma usually affect?

the pelvis or femur

162

In who is Ewing's sarcoma most common?

young males 10-20

163

Treatment of Ewing's sarcome?

surgery, chemo, radiotherapy

164

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

165

Aims of advanced stage sarcoma treatment?

downstage with pre op RT and chemo to make the lesion operable

or

palliative for symptomatic lesions, with surgery an radiotherapy, typically systemic treatment with cytotoxic chemo or targeted agents

166

What is used in palliative chemo?

single agent doxorubicin

167

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

168

Side effects of imantinib?

nausea, vomiting, diarrhea, fluid retention, skin rash, tiredness

169

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

170

Symptoms of sarcoma?

painless less that becomes painful, big, getting bigger, deep in body tissues,

171

Diagnosis of sarcoma?

core needle biopsy with US assistance, mri, ct, xray, fine needle aspiration, PET scan, cytogenetic tests for more specific diagnosis

172

What 3 things is a sarcoma grade based on?

differentiation - differentiated or abnormal

mitotic count

necrosis

173

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

174

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

175

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)

176

Treatment of hookworm and threadworm?

Mebendazole

177

Diagnosis of roundworms?

detection of eggs in faeces, serology, larvae in fresh stool (strongyloides stercoralis)

178

Treatment of round worm?

Levamisole

179

Symptoms of round worms?

LOCAL DERMATITIS at site of skin pentration, diarrhea, malabsorption, disseminated disease, nausea, epigastirc pain, iron deficient anaemia, prutitus ani (threadworm)

180

How do fluke worms infect?

the schistosoma species have parasite eggs realeased in urine or faeces and hatch on contact with water, infecting fresh water snails who penetrate human skin (swimmer's itch), they migrate to the pelvic veins and bladder causing haematuria, hydronephrosis and renal failure, treat with praziquantel