second yr help prt 3 Flashcards
(118 cards)
1
Q
what is the definition of pyrexia?
A
a temp of 38.3 or above
2
Q
What disease causes a bullseye rash?
A
borreliosis or lymes disease. the rash is also called erythema migrans
3
Q
What disease are koplik spots associated with?
A
Measles
4
Q
erythamatous macules and papules begin on the face and spread cephalocaudaly and centrifugally. koplik spots.
A
Measles
5
Q
puritic pink to red macules and papules wich begin on the face and spread to the neck and extremities over 24 hours. Forchheimers sign.
A
Rubella
6
Q
pink macules and papules surrounded by white halos. begins on trunk and spreads to neck and to proximal extremities.
A
roseola infantum
7
Q
What does IgA do?
A
Found in Mucosal linings, Sliva, mothers milk and tears. 15% of immunoglobulin produced on a daily basis.
8
Q
What does IgG do?
A
Is the main antibody accounting for 75% of antibody. it plays a key role in the adaptive immune system. It can cross the placent and confers immmunity in the child for the first 3-6 months.
9
Q
What does IgD do?
A
No one knows? posibily activates basophils and mast cells. Sticks to B cells.
10
Q
What does IgE do?
A
Parasite and allergies. 0.05%percent of all antibodies
11
Q
What does IgM do?
A
Is the basic antibody and first to appear in an immune response. Can trap stray pathogens by “sticking” to them.
12
Q
Which part of the G+ve bacteria retains stain during gram staining?
A
Peptidoglycan wall
13
Q
which part of the bacteria is responsible for conferring resistance?
A
the plasmid
14
Q
Run through all the parts of the immune system! do it!
A
mentally run through all the different cells systematically!
15
Q
Which nerve is damaged when someone presents with winging of the scapula?
A
the long thoracic nerve. It innervates Serratus anterior protracting the scapula. damage = retracted scapula
16
Q
What muscles abducts the arm to 19°?
A
Supraspinatous. deltoid 19° - 90°, trapizius 90°-180°
17
Q
what type of collagen is in articular cartilage?
A
type 2. Type II collagen is the basis for articular cartilage and hyaline cartilage. It makes up 50% of all protein in cartilage and 85-90% of collagen of articular cartilage.
18
Q
What is the most abundant collagen in the body?
A
Type I collagen is the most abundant collagen of the human body. Type I: skin, tendon, vascular ligature, organs, bone (main component of the organic part of bone)
19
Q
which collagen is in hair, placenta?
A
Type V: cell surfaces, hair and placenta
20
Q
What does the Scarf test, the empty cup test, and the drop arm test test?
A
Torn AC joint, shoulder impingement and rotator cuff.
21
Q
what does the thomas test test?
A
primary hip flexor muscles, including the rectus femoris, illiopsoas and illiotibial (IT) band.
22
Q
what does the Trendelenburg sign show?
A
Trendelenburg’s sign is found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius and gluteus minimus
23
Q
Patient with loss of sensation in the regimental badge area of the upper arm. which nerve root is affected?
A
Musculo cutaneous/median - C5/6
Axilliary/radial nerve C7.
Ulnar C8/T1
24
Q
Most common cause of CAP Pneumonia with rusty coloured sputum? Abrupt onset, mutlilobar. G+ve.
A
Streptococcus Pneumoniae.
25
Pneumonia, redcurrant jelly sputum? Alcoholic, COPD. G-ve.
Klebsiella
26
pneumonia that is an opportunistic aerobic bacteria common in patients with Cystic Fibrosis + neutropenia, produces green sputum. G-ve.
Psudemona aeringosa
27
pneumonia that presents as an upper resp. tract infection. can cause small pleural effusion. G+ve.
Hemophilus influenza
28
pneumonia that often complicates viral illness. causes local destruction - septicemia, cavitation, empyema. Common in IVDU. G+ve.
Staphyloccocus Aureus. MRSA is noscomial.
29
What is CURB 65?
Confusion7mmol/l Resp >30/min B/P >90/60 Age >65
30
CURB score 1
Amoxicillin. manage in community
31
CURB score 2
Inpatient or supervised outpatient. Amoxicillin + clarythromicin.
32
CURB score 3
severe Pneumonia. ITU. IV Co-Amoxiclav (Augmentin) (or Cefuroxime or cefuroxione and clarythromicin
33
pneumonia transmitted via stagnant warm water (air conditioning) affects elderly and immunosuppresed. Causes oliguria, acute renal failure, Rhabdomyolisis.
Legionella
34
pneumonia normally hospital acquired, affecting chronically ill patients. Often affecting lower lobes of the lung.
E. Coli.
35
pneumonia affecting closed population (schools, nurseries, nursing homes). A common cause in
children less than 4yrs old.
Mycoplasma pneumoniae.
36
pneumonia caught from birds.
Chlamydia psittaci
37
which lung cell produces suffecants?
type 2 pneumocyte.
38
What does Hyaline membrane disease cause?
a condition in newborn babies in which the lungs are deficient in surfactant, which prevents their proper expansion and causes the formation of hyaline material in the lung spaces. Can be given steroids prior to delivery.
39
What is Coarctation of the aorta
presents with poor perfusion of distal limbs and absent femoral pulses. Aortic coarctation is considered when a section of the aorta is narrowed to an abnormal width. It is a congenital heart condition.
40
what is transposition of the great arteries?
presents cyanotic. All pulses are palpable and there is no murmur on auscultation of chest. 02 sats are 55% on room air. With Aorta coming off right ventricle and Pulmonary artery off left ventricle it is essentially a
swapping of the aorta and pulmonary arteries.
41
Patent ductus arteriosis?
is a congenital heart defect wherein the ductus arteriosus fails to close after birth. It presents with a "machine like" murmur.
42
Fallots tetralogy
Presenting as Cyanotic with a murmur. It is the most common cyanotic heart defect and the most common cause of blue baby syndrome. TOF is usually a right-to-left shunt, in which higher resistance to right ventricular outflow results in more severe cyanosis symptoms
43
Diagnostic test for Cystic Fibrosis?
CF characterised by falling Centiles, recurrent chest infections. +/- 6 months old. no GI problems. SWEAT TEST. looks for excess chloride ions in sweat.
44
What is downs syndrome?
3 copies of chromosome 21. Trisomy.
45
How do you test for Down's
Amniocentesis or chorionic vilus sampling (CVS) definite diagnosis.
46
What appearence does a down's syndrome child have?
Reduced muscle tone that results in loppiness (hypotonia)
A small nose and flat nasal bridge
A small mouth with a protruding tongue
Eyes that slant upwards and outwards
A flat back of the head
A big space between the first and second toe (sandal gap)
Broad hands with short fingers
Their palm may have only one crease across it (single transverse palmar crease)
A below-average weight and length at birth
47
What is the appearance of turners syndrome?
Some individuals with Turner syndrome have a short neck with a webbed appearance, a low hairline at the back of the neck, and low-set ears. Hands and feet of affected individuals may be swollen or puffy at birth, and often have soft nails that turn upward at the ends when they are older.
48
What is the cause of turners?
A girl with Turner syndrome only has one normal X sex chromosome, rather than the usual two (XX). Autosomy.
49
What causes kleinfelters syndrome?
An extra X chromosome in males most often occurs when the genetic material in the egg or sperm splits unevenly. it is not a familial inherited trait. (xxy)
50
What is the appearance of kleinfelters?
Kleinfelters affects testosterone so doesn't usually show untill puberty (development affected by testosterone). they usually present with Infertility, Small testes, with the possibility of testes shrinking slightly after the teen
Lower testosterone levels, which lead to less muscle, hair, and sexual interest and function +
Breasts or breast growth
51
What is foetal alcohol syndrome?
Foetal alcohol syndrome happens when a mother has been drinking alcohol while pregnant. It affects the baby's development, particularly the brain and spinal cord.
It also damages the important cells in the baby's body that are necessary for growth and disrupts the connection of the nerves in the brain. The damage to the cells by alcohol results in poor growth, smaller body size and a delay in development.
52
What are the physical signs of foetal alcohol syndrome?
poor growth while in the womb and after birth, so the baby is shorter and smaller than average, sometimes with deformed limbs
small head and jaw
distinctive facial features, especially:
- small eyes set far apart
- a thin upper lip
- a smooth philtrum (ridge that runs below the nose to the top lip)
53
What si the most likely cause of a childs growth tailing off between 6 months and a year?
Growth hormone deficiency.
54
What does GHEN stand for?
Genetics, Hormones, Environment and Nutrition.
55
When does Coeliac disease present in Babies? and what is the appropriate test?
At about 6 months (weening) and the appropriate test is a TTG IgA (tissuetransglutimase antibody test).
56
How do you calculate mean parental height?
Find the mean parental height, then! for a boy add 7cm and minus 7 for girls. The last height is then subject to +/-8.5cm deviation.
57
What is the pathology if bone age is delayed?
Growth hormone problem.
58
If its gallstone or gall bladder related, what is the appropriate investigation?
Ultrasound as first line!
59
What are the 3 types of Gallstone?
Cholesterol (above 80% cholesterol), Brown (mixed) and black (above 80%pigment and below 20%cholesterol)
60
what is cholecystitis?
inflammation of the gallbladder. normally follows gallstones lodging in the cystic duct or biliary tree.
61
What is cholangitis?
Cholangitis is an inflammation of the bile duct system that is usually related to a bacterial infection
62
What is the test for Pancreatitis?
Serum Amylase (or serum lipase, more specific but not done as often), followed by computed tomography, magnetic resonance imaging, or ultrasonography
63
What is the double duct sign?
Constriction of the pancratic and bile ducts near the head of the pancreas
64
name 4 drugs that cause cholestasis?
Clavulanic acid
Oestrogens
Penicillin
Erythromycin
65
What tumor marker is associated with pancreatic cancer?
CA 19-9 tumour marker
66
What are symptoms of pancreatitis?
upper abdominal pain, which radiates to the back, gets worse with eating and better with leaning forward.it can include nausea and vomiting and weight loss.
67
What is courvoisiers law?
states that in the presence of an enlarged gallbladder which is nontender and accompanied with mild jaundice, the cause is unlikely to be gallstones. It is likely cancer of the pancreas.
68
what is charcots triad?
Most commonly Charcot’s triad is used with regard to ascending cholangitis. Definitions commonly describe three common signs and symptoms:
right upper quadrant pain,
jaundice, and
fever.
69
what are the 2 major classification systems for depression?
ICD-10 (international classification of disease) + the DSM-5 (diagnostic system of mental disorders)
70
Using the ICD-10, What are the key symptoms?
Low mood, Anhedonia (lack of finding pleasure in things previously enjoyed) + fatigue or low energy.
71
what do you need to diagnose mild depression?
2 core symptoms + 2 others (4 total)
72
what do you need to diagnose moderate depression
2 core symptoms + 3-4 others.
73
what do you need to diagnose mild sever depression?
All core symptoms + 4 or more other symptoms.
74
How many symptoms do you need to have to be classified as depressed?
At least 4 symptoms from ICD-10. Less is called a low mood or dysthymia.
75
What are the 7 non core parts of depression diagnosis?
```
I C DAGAS
Indecisiveness
Confidence loss
Disturbed sleep
Agitation
Guilt
Appetite change
Suicidal thoughts
```
76
What is first line treatment for mild depression?
CBT
77
What is the first line treatment for depression and anxiety?
TCAs amitriptyline
78
what is Hematopoiesis?
the production of blood cells and platelets, which occurs in the bone marrow.
79
What are 3 contraindications to vaccination?
Egg allergy - do not give yellow fever vaccine
Live vaccines delayed if possible till after pregnancy
Immunosuppression - live vaccination contra-indicated
80
What is the primary pathological process in early primary OA
Disorganisation of the collagen matrix in the cartilage.
81
What ligament does the varus test test?
Lateral colateral ligament.
82
What ligament does the valgus test test?
Medial colateral ligament
83
If someone's knee hit a dashboard during an accident, what test for which ligament would you conduct?
Posterior draw test for the PCL (posterior cruciate ligament)
84
If someone's knee is damaged when they stop suddenly, what test for which ligament would you conduct?
anterior draw or lachman test for the anterior cruciate ligament.
85
What is the unhappy triad?
This is an injury to the anterior cruciate ligament, medial collateral ligament, and the medial meniscus.
86
What are the diagnosing criteria in primary (idopathic/unknown cause) OA?
Diagnose OA clinically in anyone who:
Is over 45
Activity related joint pain
No morning stiffness (seen more in RA)
87
What drugs lower colesterol?
Statins. Simvastatin.
88
What is the first line treatment for stable angina?
GTN spray Glyceryl trinitrate
89
name 3 B-blockers?
Atenolol, bisoprolol, metoprolol
90
Name 4 Calcium channel blockers?
amlodipine, nifedipine,
| verapamil, diltiazem
91
What is the mechanism of action in GTN spray?
Glyceryl trinitrate works by being converted to nitric oxide. This has the effect of making the veins and arteries dilate.
92
What is stable angina?
Stable angina is chest pain or discomfort that most often occurs with activity or emotional stress. Angina is due to poor blood flow through the blood vessels in the heart.
93
What is the first line SSRI?
citalopram
94
Name one selective tricyclic?
Nortryptaline
95
Name one non-selective tricyclic antidepressant?
Amitryptaline
96
Name a mono amineoxidase inhinitor antidepressant?
Maclobemide
97
What is the major interaction of MAOI's?
Tyramine → NO cheese, beer, soy, herring or chocolate. causes htpertensive crisis.
98
What is the major contraindication of taking an SSRI?
Age.
99
What Antidpressant should be used post MI?
Sertraline
100
What is one major sideeffect of cirtalopram and other SSRI's?
Hyponatraemia!!!
101
Name one receptor blocker?
Mirtrazipine → Major depressive disorder
102
What is the main excitatory neurotransmitter in the brain?
Glutamate → blocked by glutamate and alcohol causing sedation
103
What is the main inhibitory neurotransmitter in the brain?
GABA (gamma-amino butyric acid)→ activated by benzodiazepines and alcohol
104
What are astrocytes?
Support cells in the brain
105
What are oligodendrocytes?
They myelinate the nerves in the brain
106
What are microglia?
the macrophages of the brain
107
What are Ependymal cells?
They line the ventricles and make CSF
108
What are Glia?
General term for brain cells.
109
What is the only ionotropic inhibitory neurotransmitter?
Glycine
110
What are the 2 main methods of action of neurotransmitters?
* ionotropic →quick response
| * Metabatropic →long response
111
What receptors are targeted by drugs trying to affect serotonin?
5-ht
112
What is the principle neurotransmitter of the chiolinergic system?
Acetylcholine
113
What is the serotonin hypothesis of major depression?
↓serotonin =depression
SSRI's ↑serotonin
therefore! SSRI's stop depression
114
What is parkinsons disease associated with?
Lack of Dopamine
115
What is another major site of serotonin production?
The GI/stomach.
116
What is the major adrenergic neurotransmitter?
Noradrenaline
117
What are endogenous opioids called?
endorphines
118
What neurotransmitter is sythesized in the hypothalmus?
Histamine
