Y1 + Y2 Flashcards
(206 cards)
1
Q
A superior homonymous quadrantanopia is due to a lesion in the …?
A
Temporal lobe
PITS (Parietal-Inferior, Temporal-Superior)
2
Q
An inferior homonymous quadrantanopia is due to a lesion in the …?
A
Parietal lobe
PITS (Parietal-Inferior, Temporal-Superior)
3
Q
Duration of PR interval?
A
<0.20 secs
4
Q
How many boxes make up 1 second on an ECG?
A
5 big boxes
5
Q
How long does each big box represent on an ECG?
A
0.2 seconds
6
Q
How to calculate HR on ECG if regular?
A
300/number of large squares between beats
7
Q
How to calculate HR on ECG if IRregular?
A
Number of QRS COMPLEXES in 30 big boxes x 10
8
Q
How many cords are used in a 12 lead ECG?
A
10
9
Q
Where does lead 1 go to/from on an ECG?
A
Right arm to left arm
10
Q
Where does lead 2 go to/from on an ECG?
A
Right arm to left leg
11
Q
Where does lead 3 go to/from on an ECG?
A
Left arm to left leg
12
Q
If both leads 1 and aVF are upstrokes, the cardiac axis is?
A
Normal (90 to -30)
13
Q
If lead 1 is upstroke and aVF is downstroke, the cardiac axis is?
A
Left axis deviation (-30 to -90)
14
Q
If lead 1 is downstroke and aVF is upstroke, the cardiac axis is?
A
Right axis deviation (90 to 180)
15
Q
4 steps to ECG interpretation before looking at rhythm strip?
A
- Patient details
- Date/time of ECG
- Calibration of paper
- Determine axis
16
Q
Which is the only part of the eye with lymphatic drainage?
A
Conjunctiva
17
Q
Layers of the skin?
A
Keratin layer Granular layer Prickle cell layer Basal layer Dermis
(Kerry Grafts People Buying Drinks)
18
Q
Cells in the keratin layer of skin?
A
Corneocytes (no nucleus)
19
Q
Cells present in prickle cell layer of skin + function?
A
Langerhans cells
Sample surface antigens + present
20
Q
Cells present in basal cell layer of skin + function?
A
Merkel cells
For mechanoreception
21
Q
How do topical/transdermal creams work?
A
By passive diffusion
22
Q
Investigations of allergic skin reactions?
A
Serum IgE
Skin prick test
Challenge testing
23
Q
Type of hypersensitivity and investigations of allergen contact dermatitis?
A
Type 4
Patch testing
24
Q
How to diagnoses fungal skin infections?
A
Wood lamp (fluorescence) Skin scrapings
25
What is post-herpatic neuralgia?
Pain 4+ weeks after shingles
26
What causes gingiostomatitis?
Herpes simplex
27
Cause of blistering rash at back of throat?
Herpangina
28
Presentation of erythema multiforme and associations?
Target lesions
HSV, drugs
29
What is erythema infectiosum caused by and features?
Parovirus B19
Slapped cheek
30
Pathology of eczema?
Spongiosis (oedema) and inflammatory infiltrates
Due to mutation in fillagrin gene
31
What causes sawtooth acanthosis in skin?
Lichen Planus
32
Which skin cancer can present as a painless plaque or raised shiny lesion- pearly white/rolled edge?
BCC
33
Which skin cancer can present as an ulcer/painful or bleeding lesion?
SCC
34
Features of venous ulcer?
Shins + ankles
Varicose veins
Brown iron rich
Blue
35
Features of arterial ulcer?
Feet + toes
Deep, punched out
Dry and scabbed
Pale cool shiny hairless
36
ABPI of 0.8-1.3?
Compress stockings
37
ABPI of <0.8?
Vascular disease
38
ABPI of >0.8?
Calcification
39
Effect of sympathetics on the eye? (3)
Emotional lacrimation
Pupil dilation
Focus on far objects
40
Central corneal ulcers are more likely to be caused by?
Infection
41
Peripheral corneal ulcers are more likely to be caused by?
Autoimmune
42
Rice-grain follicles on eyelids?
Chlamydial conjuncitivis
43
Contact lens wearer with unilateral eye pain, redness and photophobia?
Keratitis
44
Drusen is a sign of?
Dry MD
45
Which nerve palsy causes difficulty in walking down stairs or reading?
4th nerve palsy
Struggle to focus down and in
46
Painless loss of vision and cherry red spot?
CRAO
47
How often are taste buds replaced?
10 days
48
How often are olfactory receptor cells replaced?
2 months
49
Membrane in ear that vibrates?
Basilar membrane
50
Treatment of candida sore throat?
Nystatin
51
Causes of nasal polyps?
Allergies
Infection
Asthma
CF!
52
Cause of nasopharyngeal carcinoma?
EBV
53
Most common salivary gland tumour?
Pleomorphic adenoma
54
Where does most epistaxis arise from?
Little's area
55
What is longitudinal temporal bone fracture associated with?
Lateral blows
CONDUCTIVE hearing loss
56
What is transverse temporal bone fracture associated with?
Frontal blows
SENSORINEURAL hearing loss
57
Symptom and test of BPPV?
Brief vertigo, mostly on looking up
Ix: Dix-Hallpike
58
Features of vestibular neuronitis?
Vertigo days-wks
Day 1 worst, gets better
No hearing loss/tinnitus
? Viral cause
59
Features of labyrinthitis?
Vertigo days-wks
TINNITUS/HEARING LOSS
?Viral cause
60
Features of Meniere's disease?
Recurrent spontaneous rotational vertigo (>20 mins)
TINNITUS/HEARING LOSS
AURAL FULLNESS
61
Treatment of Meniere's disease? (4)
Supportive (buccastem)
Tinnitus therapy
Hearing aids
Grommet/Meniette
62
6 Ds of ear disease?
```
Deafness
Discomfort (pain)
DinDin (tinnitus)
Discharge
Dizziness
Defective facial movement (CN VII)
```
63
Treatment of otitis externa? (4)
Topical aural toilet
Avoid water/hearing aids
Topical clotrimazole (fung.)
Gentamicin (bact.)
64
Features of bacterial tonsillitis (CENTOR criteria)?
```
Fever
Exudates
NO cough
Tender lymph nodes (~1 wk)
Often can't work/school
<15 or >44
```
65
What not to give in glandular fever?
Amoxicillin
66
What causes epiglottitis?
Haemophilus influenza B
67
MRI features of rheumatoid arthritis?
Periarticular osteopenia + erosions
68
Scoring used for rheumatoid arthritis?
```
DAS28 score (disease activity score)
>5.1= active
```
69
Treatment of rheumatoid arthritis?
```
Steroids (before DMARDs)
Methotrexate 15mg/week
Sulphasalazine
Hydroxychloroquine
Analgesia
Physio
Biologics- anti-TNF (infliximab)
```
70
X ray features of OA?
LOSS
Loss of joint space
Osteophytes
Sclerosis
Subchondral cysts
71
Which drugs are gout associated with?
DIURETICS
| lisinopril
72
What does joint aspirate show in gout?
Negative birefringence needle crystals
73
What does joint aspirate show in pseudogout?
Positive birefringence calcium pyrophosphate crystals
74
Symptoms of SLE?
```
Fatigue
Weight loss
Malar rash
Reynaulds
Alopecia
Arthritis
Pericarditis
Nephritis
etc.
```
75
Markers of SLE?
ANA
Anti-dsDNA
Low complement
76
Treatment of SLE?
Hydroxychloroquine
Steroids/NSAIDs
+/- methotrexate/azathioprine
Rituximab
77
Diagnosis of Sjogren's?
Anti-Ro
Anti-LA
Schirmer's test
78
Treatment of Sjogren's?
Tear/saliva supplement
PILOCARPINE
Hydroxychloroquine
79
Which bullous disorder is more superficial?
Bullous pemphiguS
| pemphigoiD= Deep, through DEJ
80
Which bullous disorder is painful?
Bullous pemphigus
81
What is Nikolsky's sign, and when is it positive?
Top layer of the skin slips away from lower layer when slightly rubbed
in Bullous pemphigus
82
Which conditions are associated with pANCA?
EGPA (+anti-MPO antibody)
| MPA
83
cANCA and PR3 are associated with?
GPA
84
What does GPA commonly cause?
ENT features- nasal crusting, epistaxis, 'saddle nose' deformity and ulcers
Lung features
85
Bone affected by nightstick fracture?
Ulnar
86
Bone affected by pilon fracture?
Tibia
87
Galeazzi fracture dislocation?
Fracture of the distal third of the radius +
| Dislocation of the distal radioulnar joint
88
Monteggia fracture dislocation
Fracture of the proximal third of the ulna +
| Dislocation of the proximal head of the radius
89
RHEUM: Symmetrical muscle weakness affecting big muscles (pelvic girdle, shoulder)?
Polymyositis
90
RHEUM: Perivascular inflammation and muscle necrosis
Polymyositis
91
Is polymyalgia rheumatica autoimmune?
NO
92
Features of limited systemic sclerosis?
CREST
```
Clacinosis
Raynaulds
Esophageal dysmotility
Sclerodactyly
Telangectasia
```
93
Features of diffuse systemic sclerosis?
CREST
Thickened skin on torso/forearms
Lung/renal involvement
94
Anti-centromere?
limited systemic sclerosis
95
Anti-Scl-70?
diffuse systemic sclerosis
96
Anti-Jo-1?
Polymyositis
97
Pain + stiffness of shoulder/pelvic girdle, no weakness?
Polymyalgia rheumatica
98
Treatment of simple polymyalgia rheumatica?
15mg pred
99
Treatment of headache (arteritis) with polymyalgia rheumatica?
40mg pred
100
Treatment of visual loss with polymyalgia rheumatica?
60mg pred
101
Anti-smooth muscle antibody?
Autoimmune hepatitis
102
Anti-mitochondrial antibody?
Primary biliary cirrhosis
103
Pain in ankylosing spondylitis?
Better with exercise
| Worse at night
104
Xray- pencil in cup?
Psoriatic arthritis
105
Aspiration results in reactive arthritis?
No viable organisms
106
What to avoid in enteropathic arthritis?
NSAIDs
107
t11:22 translocation?
Ewing's sarcoma
108
Bloods in osteomalacia?
Low Ca
Low phosphate
High alk phos
109
Osteogenesis imperfecta defect in which type of collagen?
Type 1
| AD inheritance
110
Knee alignment at age 2-3 years?
Knock-kneed
111
Causes of fixed flat feet in children?
Tarsal coalition
112
DDH?
Developmenal Dysplasia of Hip
In girls, breech, LEFT hip
+ Barlow/Ortolani
113
Cause of Perthes?
Idiopathic avascular necrosis of femoral head
114
Typical presentation of SUFE?
Male, puberty, overweight:
| Pain, limp, loss of internal rotation
115
Investigation of meniscal tear?
MRI
116
Conn's syndrome?
Excess aldosterone
117
Triad of phaeochromocytoma?
Headache
Palpitations
Sweating
118
Cause of negative straight leg raise?
Knee extensor mechanism rupture
119
What is pes cavus?
High arches
120
What does loss of medial arch of foot suggest?
Tibialis posterior tendon dysfunction
121
Tennis elbow?
Lateral epicondyle (extensor origin)
122
Golfer's elbow?
Medial epicondyle (Flexor origin)
123
Investigation of scaphoid fracture?
4 Xrays! (AP, lateral, 2 obliques)
124
Management of femoral shaft fracture?
Thomas' splint
| Closed reductions + IM nail
125
Amine hormones?
Adrenaline
| T3, T4
126
Steroid hormones?
Cortisol
Progesterone
Testosterone
127
Diagnosis of T1DM?
Fasting gluc >7mmol/l
| Random gluc >11mmol/l
128
Target BG in T1DM insulin therapy?
4-8 mmol/l
129
How do diabetes complications occur?
Poyol pathway- try to lower glucose by converting to sorbitol then fructose
130
Examples of sulphonylureas?
Gliclazide
| Tolbutamide
131
How are ketones produced?
Through lipolysis
132
Hypothyroidism with Goitre?
Hashimoto's thyroiditis
133
Antibodies in Hashimoto's thyroiditis?
TPO antibodies
134
Blood T3/4, TSH, Ca, Alk phos in Grave's?
High T3/4
Low TSH
High Ca
High Alk phos
135
Eye and skin features of Grave's?
Eyes- exophthalamus + lid lag
Skin- pretibial myxoedema
136
Treatment of hyperthyroidism? (4)
Carbimazole
PTU
Radioiodine 131
Thyroidectomy
137
Cause of myxoedema coma and symptoms?
Severe hypothyroidism
T2 resp failure + acidosis, bradycardia, heart block, t wave inversion
138
Cause of thyroid storm?
Severe hyperthyroidism
139
Most common thyroid cancer causing goitre and what is it associated with?
Papillary carcinoma
Associated with Hashimoto's
140
Investigation of goitre? (3)
Thyroid screen (bloods)
US FNA
Thyroid isotope scan
141
Which thyroid cancer is part of MEN2?
Medullary
142
Ketones and BG in DKA?
Ketones >3mmol/l
| BG > 11mmol/l
143
Features of hyperglycaemic hyperosmolar state? (4)
Hypovolaemia
Hyperglycaemia
Hyperosmolar
+ renal impairment
144
Size of pituitary micro vs macro-adenoma?
<1cm microadenoma
| >1cm macroadenoma
145
Investigation of acromegaly?
Glucose tolerance test (no suppression of GH)
| Brain MRI
146
Treatment of acromegaly?
Surgery
Cabergoline
GH antagonists
147
Cushing's disease?
Cushing's syndrome due to pituitary tumour
148
Diagnosis of Cushing's?
Low dose dexamethasone test (no cortisol suppression)
then
High dose dexamethasone test (50% suppression= pituitary)
149
Which drug can normalise cortisol in Cushing's?
Metyrapone
150
What does congenital adrenal hyperplasia cause?
No cortisol/aldosterone production- become TESTOSTERONE
Leads to Addison's + masculine features
151
Effect of aldosterone?
When low BP- causes vasoconstriction (through angiotensin II)
152
Where is adrenaline produced?
Adrenal medulla
153
2 causes of secondary adrenal insufficiency?
Excess steroid use
| Pituitary/hypothalamic cause
154
Symptoms of Addison's?
```
Dehydration
Hyperpigmentation
Weight loss
Hyponatraemia
Amenorrhea
Fatigue
Abdo pain
```
155
Investigation of Addison's?
Short synACTHen test (no increase in cortisol= addison's)
| MRI brain
156
Treatment of Addison's?
Hydrocortisone + Fludrocortisone
157
What is Conn's Syndrome + causes?
High aldosterone
Adrenal adenoma
Bilateral hyperplasia
Genetics
158
Symptoms of Conn's Syndrome?
HYPERTENSION
hypokalaemia
metabolic acidosis
159
Investigation of Conn's Syndrome?
Aldosterone:Renin ratio (high)
| Saline suppression test (no suppression of aldosterone seen)
160
Treatment of Conn's Syndrome?
Remove tumour
| Spironolactone
161
Diagnosis of phaeochromocytoma?
24 hour urinary catecholamines
162
Treatment of phaeochromocytoma?
Phenoxybenzamine
| Propranalol
163
3Ps of cancer associated with MEN1?
Parathyroid
Pituitary
Pancreas
164
3 things associated with MEN2?
Parathyroid cancer
Medullary thyroid cancer
Phaeochromocytoma
165
PTH is released in response to..?
Hypocalcaemia
166
Hyperparathyroidism scan?
Sestamibi scan
167
Symptoms of hypocalcaemia?
```
Pins + needles
Numbness
Muscle cramps
Weakness/fatigue
Prolonged QT
```
168
Juxtamedullary nephrons make more.. urine?
Concentrated
169
Glomerulus is within the?
Bowman's capsule
170
Plasma moves into the proximal convoluted tubule as..?
Tubular fluid
171
Function of granular cells AKA juxtaglomerular cells?
Produce and secrete renin (part of RAAS)
172
Function of macula densa?
Monitor how much salt is present in tubular fluid as it passes through
173
3 layers to glomerular filtration?
1. Glomerular Capillary Endothelium (barrier to RBC- too big)
2. Basement Membrane (basal lamina) (plasma protein barrier)
3. Slit processes of podocytes (plasma protein barrier)
174
Constriction of arterioles occurs in response to..?
Low BP
- less blood to glomeruli- low GRF + urine output (increase BP)
175
What substances can be used to estimate GFR?
Inulin
| Creatinine
176
How much urea is reabsorbed?
50%
177
How much creatinine is reabsorbed?
0%
178
What absorption occurs at the proximal tubule?
67% of SALT + WATER
100% glucose + amino acids
Reabsorbed
179
Which part of the nephron has extensive cilia surface?
Proximal tubule
180
What secretion occurs at the proximal tubule? (5)
```
H+ ions
Neurotransmitters (adrenaline, acetylcholine etc.)
Bile pigments
Uric acid
Drugs and toxins
```
181
In the loop of Henle, which limb is highly permeable to water?
Descending limb (via aquaporins)
182
In the loop of Henle, which limb reabsorbs NaCl?
Ascending limb (via. triple co-transporter)
183
Where is H+ secreted into the urine?
Distal tubule
184
Fluid entering the distal tubule is .... to plasma?
Hypo-osmotic
185
Endocrine hormones only act on the ... of the kidneys?
Distal tubules and collecting ducts
186
How does ADH increase water reabsorption?
Increase the expression of water channels (aquaporin) on basolateral membrane
187
How does ANP regulate BP?
Released when cells are mechanically stretched due to an increase in the circulating plasma volume
--> promote Na excretion + diuresis
188
How do carbonic anhydrase inhibitors work as diuretics?
In proximal convoluted tubules
Block Na+/H+ exchange (increase HCO3 excretion)
189
How do loop diuretics work?
In thick ascending limb
Block Na+/K+/2Cl- co-transporter
190
How do thiazide diuretics work?
In distal convoluted tubule
Block Na+/Cl- co-transporter
191
What can loop and thiazide diuretics lead to? (2)
Hypokalaemia
| Metabolic alkalosis
192
Pre-renal causes of AKI?
Anything involving:
Hypovolaemia
Hypotension
Hypoperfusion
193
What can untreated pre renal AKI cause?
Acute tubular necrosis
194
Renal causes of AKI?
Glomerulonephritis
Vasculitis
Interstitial nephritis
Haemolysis/Rhabdomylolysis
195
Post-renal causes of AKI?
Obstruction:
renal stones
enlarged prostate
tumour compression
196
Non-proliferative glomerulonephritis presents with .... and includes (3)?
Nephrotic syndrome
Minimal change GN
Focal segmental GN
Membranous GN
197
Proliferative glomerulonephritis presents with .... and includes (4)?
Nephritic syndrome
IgA nephropathy
Membranoproliferative GN
Post Infectious GN
Rapidly Progressive GN
198
Most common glomerulonephritis in adults?
IgA GN
199
What does IgA nephropathy often occur after?
URTI
200
What is nephrotic syndrome?
Proteinuria > 3 g/day (mostly albumin)
Hypoalbuminaemia
Oedema
(Hypercholesterolaemia)
201
What is nephritic syndrome?
```
Acute Kidney Injury
Oliguria
Oedema/ Fluid retention
Hypertension
Active urinary sediment (casts, RBCs)
```
202
Woman with RUQ pain that radiated to shoulder tip?
Cholecystitis
203
First degree heart block?
Prolonged PR interval >0.2s
204
Mobitz I Second Degree Heart Block?
Increasing PR interval then dropped beat
205
Mobitz II Second Degree Heart Block?
Some missing P waves
QRS complex dropped
(Can be 2:1, 3:1, 4:1)
206
Complete (Third Degree) Heart Block?
No relationship between P waves and QRS complex
