Vol 2 Flashcards by Jack Wildman

What is haemachromatosis?

Failure of regulation of iron transport from the gut, leading to iron overload and organ deposition

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3 scoring systems related to stroke?

ROSIER (stroke vs stroke mimics)
ABCD2 (short term stroke risk after TIA)
CHADVAS2C + HASBLED (AF management)

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What organ is mainly affected by haemachromatosis?

Liver

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Side effect that occurs in 50% of haemachromatosis patients?

Osteoarthritic changes and arthralgias

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What is gold standard for diagnosing haemachromatosis?

Liver biopsy
(serum iron and ferritin also raised, LFTs may or may not be deranged)

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What is the spectrum of SIRS to septic shock?

SIRS -> sepsis (SIRS + bacteraemia) -> severe sepsis (end organ damage) -> septic shock (severe sepsis + hypotension)

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5 RFs for skin cancer?

Acute or long term sunburn
Skin types 1 or 2
Age
Immunosuppression
Previous skin cancers

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What findings on AXR indicate small bowel obstruction?

Valvulae coniventes visible + dilation >3cm

Consider ileus

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What findings on AXR indicate large bowel obstruction?

Haustra visible and dilation >6cm (9 for cecum)

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What finding on AXR suggests sigmoid volvulus?

Coffee bean

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What does a trochlear nerve lesion do and which test makes it easier to see?

Superior oblique underactivity so hard to tell

Bielchowsky head tilt test

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What is the bielchowsky head tilt test?

Used to isolate trochlear nerve lesions

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4 causes of a normocytic anaemia?

Pregnancy
Chronic disease
Bone marrow failure
Reticulocytosis

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4 causes of a peripheral neuropathy?

DM
B12/folate deficiency
Alcohol
Drugs (amiodarone)

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Discuss anaplastic thyroid cancer

Rarest and most aggressive
More common in over 60s
Only <1/10 alive after 5 years

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What is bronchial breathing?

Physiological in large airways e.g. Over trachea
Pathophysiological otherwise - consolidation (pneumonia) or fibrosis
Typically loud and high pitched

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What is vesicular breathing?

Normal, inspiration > expiration, fades on expiration

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What are rhonchi?

Low pitched breath sounds, bit like snoring, due to secretions in the bronchial airway

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Pathophysiology behind psoriasis?

Keratinocyte hyperproliferation and inflammatory infiltration

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3 nail changes associated with psoriasis?

Onycholysis
Pitting
Subungual hypertrophy

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What lesions define eczema?

Papules or vesicles on an erythematous base, particularly on flexor aspects
Tendency to weep, exudate

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What is the MUST tool used for?

Analysing malnutrition risk for inpatients

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What is a normal INR?

2 or 3

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What measurement is INR an alteration of and what pathway of coagulation does it measure?

Prothrombin time (PT) - extrinsic pathway

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2 drugs that can cause INR to increase?

Clarithromycin | Sodium valproate

What drug can cause a fall in INR?

Rifampicin

What is Mirizzi's syndrome?

Gallstone impacts in neck of gallbladder/cystic duct, leading to multiple and large gallstones collecting Fistulae/obstructive jaundice

What is Prinzmetal's Angina?

Angina that occurs cyclically at rest | Not due to atherosclerosis and not typically related to exercise - coronary vasospasm

What drugs should be given for Prinzmetal's angina and what should not be given?

Nitrates and Ca blockers good | NOT B blockers

3 symptoms associated with thyroid cancer?

Painless lump Voice change Dysphagia

5 types of thyroid cancer?

``` Papillary Follicular Medullary Lymphoma Anaplastic ```

What is the most common thyroid cancer? Discuss

Papillary Women under 40 typically Well differentiated Requires thyroidectomy and radiotherapy, good prognosis

What congenital disorder is a common cause of syringomyelia?

Arnold-Chiari malformation

What is the distribution and type of sensory disturbance in syringomyelia?

'Shawl' pain and temp loss | Feet light touch, vibration and proprioception loss

What happens to the upper limbs in syringomyelia?

Claw hand and arm weakness

4 other features of syringomyelia?

Charcot joints, scoliosis, allodynia and areflexia

At what age does syringomyelia commonly present?

20s/30s

What is a bulla?

A fluid-filled papule > 0.5cm (blister)

What is a macule?

A flat lesion/area of altered pigmentation sized < 0.5cm (freckle)

What is the common cause of lateral medullary syndrome?

PICA stroke

What is the typical sensory disturbance in lateral medullary syndrome?

Contralateral pain and temp loss below Ipsilateral pain and temp loss in face CN signs and DANISH

What is the pathophysiological background of Guilian-Barre syndrome and what are the 3 most common causes?

Molecular mimicry causing autoimmune attack, usually as a result of infection Campylobacter, CMV, flu

What is the course of Guilian-Barre?

Ascending paralysis/paraesthesia | Areflexia, ANS disturbances and eventually respiratory failure if not treated

What is Miller Fisher syndrome?

Like Guilian-Barre but starts at top, includes eyes and descends

What is a papule?

A raised lesion of <0.5cm

What is Brown-Sequard syndrome?

Contralateral pain + temp loss below, ipsilateral spastic paralysis, light touch, proprioception and vibration loss below

What is the pathophysiology of Brown-Sequard syndrome?

Lateral cord hemisection | Causes: trauma, cervical spondylosis, MS

What is a pustule?

A pus-containing papule e.g. Acne

What are the defining features of an UMNL?

``` Hypertonia Hyperreflexia Spastic paralysis Pronator drift Hoffman's and Babinski responses ```

What is Pemberton's sign?

SVC obstruction (e.g. Big goitre), raise arms leading to facial swelling, purple, vein distension and stridor

What is a vesicle?

A blister (fluid filled) of <0.5cm

What is a plaque?

A raised, scaly lesion >0.5cm

What sex is PBC more common in and why?

Females - autoimmune link

What are the early symptoms of PBC?

TATT and pruritis | Eventually leading to liver cirrhosis

What are the investigation results suggestive of PBC?

Raised AMA, obstructive jaundice picture of LFTs

What is a nodule?

Raised lesion >0.5cm

Risk factors for osteoporosis?

``` Female (post-menopause/oophorectomy) Steroids Rheumatoid disease Short + thin Alcohol Vit D deficient Age + FH ```

Features characteristic of a LMNL?

``` Hypotonia Hyporeflexia Flaccid paralysis Fasciculations Muscle wastage ```

3 drug treatments for BPH?

Doxazocin Dutasteride Finasteride

What is doxazocin?

An alpha blocker used for BPH treatment

What are dutasteride and finasteride?

5a reductase inhibitors used in the management of BPH

4 causes of Cushing's Syndrome?

Iatrogenic - exogenous steroids Cushing's Disease - a pituitary adenoma secreting ACTH Adrenal tumour Ectopic ACTH secreting tumour e.g. SCC lung

Vol 2 Flashcards

(62 cards)