Passmed TANGS Flashcards by Hamish Reed-Embleton

Name 3 features of hereditary haemochromatosis?

Inheritance ?

early symptoms include fatigue, erectile dysfunction and

arthralgia (often of the hands)

‘bronze’ skin pigmentation

diabetes mellitus

liver: stigmata of chronic liver disease, hepatomegaly, cirrhosis, hepatocellular deposition)

cardiac failure (2nd to dilated cardiomyopathy)

hypogonadism (2nd to cirrhosis and pituitary dysfunction - hypogonadotrophic hypogonadism)

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ACS Mx ?

Post Mx?

Morphine
Oxygen
Nitrates
Aspirin

STEMI -> PCI

ABSeeD
ACEI
B blocker 
Statin 
Dual antiplatelet - clopi / aspririn

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Nec Fash most common cause? Microbiology will report?

Streptococcus pyogenes
- Gram-positive in chains

Staphylococcus aureus is usually found in clusters.

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Foreign travel and fever alternating days?

malaria

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At what point do pregnancy-induced hypertension or pre-eclampsia occur?

After 20 weeks

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Mx of gonno

single dose of:

oral azithromycin and intramuscular ceftriaxone

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Features of cephalohaematoma

Several hours after birth, doesn’t cross suture lines, can take months to resolve

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Normal pressure hydrocephalus pres ? mx?

Urinary incontinence + gait abnormality + dementia

ventriculoperitoneal shunting

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What is charcot triad ? indicitive of?

Mx?

right upper quadrant pain, fever and jaundice

Ascending cholangitis

Management
intravenous antibiotics
ERCP after 24-48hrs to remove blockage

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Which lobe if seizure has movement of arms/legs

frontal

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Seen on bloods of:

Hyposplenism e.g. post-splenectomy

Iron-deficiency anaemia

Myelofibrosis

Intravascular haemolysis

Megaloblastic anaemia

Hyposplenism e.g. post-splenectomy
target cells
Howell-Jolly bodies
Pappenheimer bodies
siderotic granules
acanthocytes

Iron-deficiency anaemia
target cells
‘pencil’ poikilocytes
if combined with B12/folate deficiency a ‘dimorphic’ film occurs with mixed microcytic and macrocytic cells

Myelofibrosis
‘tear-drop’ poikilocytes

Intravascular haemolysis
schistocytes

Megaloblastic anaemia
hypersegmented neutrophils

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Sickle cell aplastic anaemia crisis ?

Parvovirus B19

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Drug for smoking cessation

Varenicline

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Brown sequard

ipsilateral weakness below lesion
ipsilateral loss of proprioception and vibration sensation

contralateral loss of pain and temperature sensation

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PCOS hirtuism

COCP

Spirolactone

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copd cxr

hyperinflation, bullae, flat hemidiaphragm

What marker for severity of COPD

FEV1
(NOT ratio)

> 80 = mild
50-80 - mod
30-50 - severe

4 sezure lobes and features

Temporal lobe (HEAD)	
Hallucinations (auditory/gustatory/olfactory), Epigastric rising/Emotional, Automatisms (lip smacking/grabbing), Deja vu/Dysphasia post-ictal)

Frontal lobe (motor)	
Head/leg movements , posturing, post-ictal weakness

Parietal lobe (sensory)	
Paraesthesia

Occipital lobe (visual)	
Floaters/flashes

Lung Ca paraneoplastic features

Squamous - PTH = HyperCa

Small cell - ACTH / LES

3 causes of upper lobe fibrosis

SCART (upper lobe):

Sarcoidosis
Coal miners pneum.
Ank spon
Radiation
TB

RASIO (lower lober)

Rheumatoid
Asbestosis
Scleroderma
Idiopathic Pulmonary fibrosis (most common cause overall)
Othe

Cor pulmonale mx

loop diuretic for oedema

consider long-term oxygen therapy

Acute mesenteric ischaemia 1st Ix

serum lacate

Med to avoid in obstruction

Metoclopramide

prophylaxis of oesophageal bleeding from varicies

If bleeding?

propranolol

Terlipressin

dyspnoea, fatigue and lethargy | lemon tinge to skin?

Pernicious

Cushing's disease - response to dexamethasone

pit adenoma - responds to high levels (secretes less) SSLC - does not respond

2 ECG changes pericarditis Name 3 causes

widespread 'saddle-shaped' ST elevation PR depression: most specific ECG marker for pericarditis ``` viral infections (Coxsackie) tuberculosis uraemia (causes 'fibrinous' pericarditis) trauma post-myocardial infarction, Dressler's syndrome connective tissue disease hypothyroidism malignancy ```

2 features ECG hypoK

``` U waves small or absent T waves (occasionally inversion) prolong PR interval ST depression long QT ``` [U have no Pot and no T, but a long PR and a long QT]

Most common cause of pepperpot skull

primary HPT

2 features of somatosation disorder

multiple physical SYMPTOMS present for at least 2 years patient refuses to accept reassurance or negative test results

What is conversion disorder

typically involves loss of motor or sensory function the patient doesn't consciously feign the symptoms (factitious disorder) or seek material gain (malingering)

What is dissociative disorder

dissociation is a process of 'separating off' certain memories from normal consciousness in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor

What is facticious disorder

Munchausen's syndrome the intentional production of physical or psychological symptoms

What is malingering disorder

fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain

MgSO4 antidote

calcium gluconate

Compare Ruptured cyst and torsion Sx

- Cyst - acute onset pain, maximal at onset, may have prior hx of others - Torsion - Gradually progressively worsening pain, associated with hx of sport - USS - Whirlpool sign

Lynch syndrome? common ca?

HNPCC Colo rectal cancer 30-70% Endometrial cancer 30-70% Gastric cancer 5-10%