Mix 1 Flashcards by Ben Habashi

Cat Scratch Disease

Organism, what does it cause

Cause: Bartonella henselae

Common cause of chronic lymphadenopathy in children/young people in UK

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Cat Scratch Disease Mx

1,2,3

co-trimoxole (trimethoprim-sulfamethoxazole), ciprofloxacin, azithromycin

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Ormands disease
- describe
- causes
- management

Retroperitoneal fibrosis - Anterior surface of L4-5,

AA diseases, metastatic cancer, methyldopa, beta blockers, methysergide

Mx - steroids, surgery, tamoxifen/azathioprine

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Fifth disease, Erythema infectiosum, slapped cheek disease
- cause
- natural history

Human parvovirus B19

Long incubation, prodromal symptoms, symptom-free period then red cheek rash that can fade and recur

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CMI
- presentation
- cause

Chronic Mesenteric Ischaemia

abdo pain + nausea, fear of eating and weight loss

Cause - atherosclerosis 95%, vasculitis, radiation damage

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CAGE Questionnaire

C-ut down
A-nnoyed by questions
G-uilty about drinking
E-ye opener (morning drink)

2+ should be investigated

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Steroid creams - least to most potent

Hydrocortisone 0.5-2.5%
Betamethasone valerate(betnovate)
Clobetasone butyrate(eumovate)
Fluticasone propionate(cutivate)
Clobetasol proprionate(dermovate)

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Amoebiasis (Entamoeba histolytica)
- infection source
- symptoms
- risk factors
- management

Ingestion of cystic form of protazoa

Can cause fever, weight loss, abdominal pain (RUQ) liver abscess, bloody diarrhoea

Immunosuppressed, anal sex, institutionalised, migrants to UK

Mx - Metronidazole

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Acne conglobata
- describe
- associated with

Unusual severe form of acne, erupting scarring lesions
Associated w Hydradenitis suppurverita and steroid use

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Normal Pressure Hydrocephalus
- triad
- radiology
- management

Gait disturbance, dementia, urinary incontinence

CT - large ventricles, normal subarrachnoid space

Ventriculoperitoneal shunt may relieve it

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What are milia

Tiny cream coloured sebaceous cysts on the nose/cheeks/below eyes

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Port wine stain

Erythematous macular lesion present from birth, usually on face

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Stork mark
- AKA
- Describe
- when does it appear

Telangiectatic naevus

multiple erythematous macular lesions - back of neck, or face

Present from birth

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Anterior uveitis
- presentation
- test
- associated with

Red, painful eye
Talbots test (pain on pupil constriction)
HLA-B27 disease

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Cervical ripeness assessment

Bishops score - PEDSS
P-osition
E-ffacement/length
D-ilation
S-oftness/consitency
S-tation of baby’s head

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Shingles

Mx - Oral acyclovir within 72-120hr

Direct lesion contact = infectious

Rash does NOT cross the midline

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Pupil dilators

Antimuscarinics -
Atropine, cyclopentolate, tropicamide

Sympathomimetics -
Phenylepherine

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Primary hyperaldosteronism

Conn’s (unilateral aldosterone producing adenoma)
Bilateral adrenal hyperplasia or idiopathic hyperaldosteronism

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Measles- features

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Red maculopapular rash, classically starts behind the ears spreads to face, body

Kopliks spots - WHITE spots in buccal mucosa opposite lower molars

Prodrome including conjunctivitis, cough, coryza

Hypocalcaemia
Symtpoms and ECG

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Parasthesia, cramps, spasms
Isolated prolonged QTc

Suggestive of Downs Sydrome

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Thickened nuccal transleucency
Increase B-HCG
Reduced PAPP-A

Dermatomyositis

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Skin rash on knuckles and cheeks/eyelides
Muscle weakness

Idiopathic, connective tissue disorder or cancer - ovarian, breast, lung,

Migraine Mx

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Acute: oral triptan + NSAID(or paracetamol)

Prophylaxis: propranolol or topiramate

Gestational diabetes

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5678

Fasting > 5.6

2 hour post-glucose >7.8

Desogestrel

Inhibits ovulation Thickens cervical mucous

Panayiotopoulos syndrome

characterised by seizures, often prolonged, with predominantly autonomic symptoms such as nausea and retching.

Idiopathic childhood occipital epilepsy of gastaut

Mainly visual hallucinations

Benign Rolandic epilepsy

Partial seizures at night in childhood

Local anaesthetic toxicity

Rapid cardiopulmonary deterioration after local anaesthetic 20% lipid emulsion IV

Patent ductus arteriosus

Indomethacin or ibuprofen will close prostaglandin will keep it patent

Bisphosphonates

In patient >75yrs Start Alendronate + Ca2+ supplementation

Treating acute gout

NSAID or colchicine 'cover' should be used when starting allopurinol

Rinne test

Rinne under the pinny! Conductive hearing loss BC > AC Normal AC > BC

Weber test

Weber it's R or L sensorineural hearing loss Localises to the good ear if unilateral sensorineural hearing loss

Perthe's disease

Avascular necrosis of the femoral epiphysis Age 4-8 years, 5:1 boys

Perthe's management

To keep the femoral head within the acetabulum: cast, braces If less than 6 years: observation Older: surgical management with moderate results Operate on severe deformities

Methotrexate Antibiotics

Avoid trimethoprim and co-timoxazole due to the risk of bone marrow aplasia

Gestational diabetes Mx

Trial diet and exercise but most need metformin +/- short acting insulin

Alpha-1 anti-trypsin deficiency

Investigations A1AT concentrations spirometry: obstructive picture Management no smoking supportive: bronchodilators, physiotherapy intravenous alpha1-antitrypsin protein concentrates surgery: lung volume reduction surgery, lung transplantation

Alpha-1 anti-trypsin deficiency genetics

Chromosome 14 PiZZ PiSS PiMZ

GORD in infants

Commonest cause of vomiting in infants, presents before 8 weeks milky meal vomit, excessive crying at meal time Mx - alginate (gaviscon) -> PPI

Labial adhesions

Oestrogen cream

Treponema pallidum

Syphilis can cause a painless ulcer (chancre) which classically resolves within six to eight weeks even without treatment.

Penile cancer

Strong association with HIV weight loss, malaise

UC flare

Truelove and Witts severity index May need to admit for IV corticosteroids

Heel prick test (neonatal blood spot test)

Phenylketonuria, Sickle cell disease, Cystic fibrosis and Hypothyroidism

Dermatitis herpetiformis

Itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks) IgA deposition in the dermis Dapsone, gluten free diet

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