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Flashcards in Year 3 Deck (33)
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1

Chronic multi-system disease with unknown aetiology.
- Lymphadenopathy - enlarged, non-tender (typically cervical and submandibular)
- CXR: bilateral hilar lymphadenopathy
- Elevated calcium and serum ACE
- Erythema Nodosum, lupus pernio
- Weight loss, low grade fever
- Treatment: corticosteroids if severe

Sarcoidosis

2

Cholestatic liver disease
- Bile duct destruction, cirrhosis, end stage liver disease
- Predominantly young, middle aged men
- Obstructive jaundice, priuritis
- Link to IBD (UC>CD)
- No specific auto-antibodies, but ANCA often present
- Tx: Liver transplant
- Leading cause of dead is liver failure and cholangiocarcinoma

Primary Sclerosing Cholangitis

3

Constant aching pain around eye, radiating to forehead
- Reduced vision, N&V, haloes
- Red congested eye
- Cloudy cornea
- Dilated non-responsive pupil
- Attacks precipitated by sitting in the dark, dilating eye drops or emotional upset
- Tx: acetazolamide

Acute Glaucoma

4

Tight band around head
- Dull pulsatile constricting bilateral pain
- Related to stress, commonest headache
- Worsens as day progresses
- F>M, lower SES
Tx: rest and simple analgesia

Tension headache

5

Headache lasting a few weeks
- Tender thickened pulseless temporal artery
- Jaw claudication, especially on chewing
- Associated with PMR
- Can -> blindness
- Ix: raised ESR and CRP
- Tx: Steroids

Giant cell (temporal) arteritis

6

Rapid onset, severe headache
- Same time each time 15mins-3hours
- Often begins around eye, occurs in cluster periods
- Eye redness, rhinorrhea
- Due to hypothalamic activation with secondary autonomic and trigeminal activation
- Lacrimation, rhinorrhoea, nasal congestion, partial Horner's
- Tx: 100% O2 (acute)
- Preventers: verapamil, lithium, steroids,

Cluster Headache

7

Idiopathic disorder
- Paroxysms of intense sharp stabbing pain in CNV distribution
- Triggered by touching affected area (eating, chewing, hair brushing, shaving)
- Causes: Aneurysm, tumour, chronic meningeal inflammation, MS, zoster
- Ix: MRI to rule out secondary cause
- Tx: carbamezapine, lamotrigine, phenytoin

Trigeminal Neuralgia

8

LOC due to transient arrhythmia (decreased CO)
- Often post MI
- Palpitations
- Pale before, flushed after
- Recovery in seconds
- Tx: pacemaker

Stokes-Adams Attack

9

Hereditary Neuropathy beginning in puberty with weak legs and foot drop, with variable loss of sensation and reflexes
- Pes Cavus, high foot arches
- Areflexia, hammer toes
- Distal atrophy hands and legs, champagne bottle appearance
- May need to excessively lift legs to clear the toes
- Tx: Rehab and orthototics

Charcot-Marie-Tooth Disease
- CMT1A: atrophy hand and arm muscles - mutation PMP22 myelin gene

10

TRIAD: Opthalmoplegia, mental change, gait dyfunction

Wernicke's Encephalopathy: due to acute thiamine deficiency
RFs: alcoholics, malnutrition, GIT surgery, AIDS, Cancer, Chemotherapy

11

Demyelinating CNS condition, Characterised by:
- 2 or more episodes of neurological dysfunction distinct in both time and space

MS: white woman, 20-40years
- Temporary visual/sensory loss usually
- MRI sensitive, but not as specific as spinal MRI

12

Frontotemporal denegeneration
- Disruption personality and social conduct
- Primary language disorders
- Components of dys-executive syndrome
- Many display Parkinsonism and subset also have MND

Pick's Disease

13

Loss of vision in a normal eye due to damage to visual area of occipital cortex = Cortical blindness
Often lack of insight into condition and confabulate sight
Pupillary light reflex intact as doesn't involve cortex
Normal fundoscopy

Anton's Syndrome

14

Insidious onset gait apraxia (falls).
- Cognitive impairment, urinary problems
- Dilated ventricles on CT
- Periventricular leukomalacia
- Cerebral infarction

Normal pressure hydrocephalus

15

AD defect in haem synthesis
- Abdo pain, vomiting, tachycardia, confusion, motor neuropathy
- Precipitated by alcohol and OCP

Porphyria

16

Mixed neuropathy and CCF (SOB, peripheral oedema, motor and sensory)
- Vitamin B1 (thiamine deficiency)

Beri-Beri

17

Raccoons sign: periorbital bruising
Battle's sign: Mastoid bruising
Bloody otorrhoea, CSF otorrhoea/rhinorrhoea
Hearing impairment (sensorineural due to CN VIII damage or conductive due to haemotympanium)

Base of skull fracture

18

Streptococcus
Staphylococcus
Enterococcus

Gram positive cocci

19

Clostridium
Listeria

Gram positive bacilli

20

Neisseria
Haemophilis

Gram negative cocci

21

Salmonella
Shigella
Pseudomonas
Legionella
Vibrio
ESBL
Proteus

Gram negative bacilli

22

Tick borne infection caused by spirochete Borrelia burgdorferi
- Erythema migrans, arthritis
- Tick bite -> Bull's Eye appearance

Lyme disease

23

Popliteal cyst: synovial fluid from a knee effusion escapes in a subgastrocneumius bursa.
- Usually in response to injury/inflammation (arthritis)
- Sudden onset pain behind knee

Baker's Cyst
- Tx: Rest, Ice, Compression, elevation, gentle mobilisation, analgesia.
- If severe corticosteroid (intra-articular) injections/surgery

24

- Frank haematuria post URTI/gastroenteritis
- IgA nephropathy: commonest glomerulonephritis causing renal failure
- Increased IgA titre

Berger's Disease
Dx: renal biopsy - focal/diffuse mesangial proliferation and extracellular expansion. IF: diffuse mesangial IgA
Tx: ACEI to decrease proteinuria, early corticosteroids can delay renal failure

25

Hemisection/Unilateral cord lesion
- Ipsilateral UMN weakness below lesion (severed corticospinal tract -> spastic paraparesis, brisk reflexes, extensor plantars)
- Ipsilateral loss of proprioception and vibration (dorsal columns)
- Contralateral loss of pain and temp sensation (spinothalamic)

Brown-Sequard Syndrome

26

Hepatic vein obstruction by thrombosis or tumour -> ischaemia and hepatocyte damage
- Liver failure or insidious cirrhosis
- Abdo pain, hepatomegaly, ascites, increased ALT
- Chronically: portal hypertension

Budd-Chiari Syndrome
Due to hyper coagulable states (OCP, pregnancy, malignancy, PN haemoglobinuria, polycythaemia rubra vera, thrombophilia), liver, renal or adrenal tumour

27

Thromboangitis Obliterans
- Smoking related inflammation of veins, nerves and middle sized arteries, which thrombose -> gangrene

Buerger's Disease

28

Multiple lung nodules in coal worker's with RA
- Due to an inflammatory reaction to external allergen
- CXR: bilateral nodules
- Dx: CT (needle biopsy)

Caplan's Syndrome
RFs: Silica, asbestosis, anthracite exposure

29

TRIAD: late onset asthma, eosinophilia, granulomatous small vessel vasculitis affecting lungs, nerves heart and skin (vasospasm, MI, DVT)

Churg-Straus Syndrome: can cause septic shock/systemic inflammatory response
Tx: steroid, INF-alpha

30

Progressive dementia, focal CNS signs, myoclonus (95%), depression,
- Eye signs: diplopia, supra nuclear palsies, homonymous field defects, hallucinations, cortical blindness

Creuzfeldt-Jakob Disease (CJD): transmitted via meat contaminated by tissue affected by bovine spongiform encephalopathy.
- Prion -> spongiform changes in the brain