10/4/22 Flashcards
Why check footwear in diabetic foot examination?
Reduced sensation can mean you can’t feel parts of your shoe that could be cutting in or hurting you.
Important to check to make sure appropriate.
Can also assess the sole so can see if any peripheral neuropathy is affecting gait
What cells are produced by myeloid and lymphoid progenitor cells?
Myeoloid
- RBC
- platelets
- granulocytes
- macrophage
- dendiritic
Lymphoid
- dendritic
- T-cells
- B-cells -> plasma cells
- NK cells
Why is the drug Phenytonin used?
Older convulsant
B12 and folate deficiency cause megaloblastic macrocytic anaemia.
What can cause normoblastic?
Alcohol
Liver disease
Hypothyroidism
What is the most common form of leukemia in adults?
CLL
How do you establish the defintive diagnosis of sickle cell anaemia?
Haemoglobin electrophoresis
What are the ferritin levels like in iron deficency anaemia?
Low
If a patient has an immune reaction to O negative blood what could this suggest they have?
Primary immunodeficency - selective IgA deficency
What is first line management for Raynauds?
CCB
What are the 3 clusters of personality disorder?
What is the management?
Cluster A - odd and ecentric
Cluster B - dramatic and unpredicitable
Cluster C - anxious and fearful
Psychotherapy and CBT - no medical intervention is indicated for personality disorder itself but may be for things like anxiety and depression that come with the condition
A = Adam Swan B = boobs are unpredictable and dramatic C = Claire
What is the first line drug that should be offered after diagnosis of a DVT?
Apixaban
Ribaroxaban
If neither suitable -> LWMH
What condition is Rouleuax formation assoc with?
Multiple myeloma
When patient presents with symptoms of thrombocytopenia (easy brusing, prolonged bleeding, heavy periods) but normal platelete count. What would you think it would be?
vWF disease
- reduced VIII - reduced clotting by reducing intrinsic pathway
What condition is assocaited with the Philadelphia chromosome?
How do you investigate and manage the condition?
CML
Investigate
- FBC and blood film
- Chromosome analysis
- Bone marrow aspirate
Treat
- if asymptomatic no speicific treatment
- chemo and radio
- splenectomy
- bone marrow transplant
How do you manage an ectopic pregnancy that has a high bCG level but no foetal heart beat?
How does this change if there is a foetal heart beat?
Methotrextae injection
Salpingectomy
What is the lifespan of the following blood cell types:
- RBC
- neutrophils
- platelets
RBC ~120 days
Neutrophils - 7-8hrs
Platelets 7-10days
How many years are you screened for breast cancer?
Between what age range?
3 years
50-70
How would you explain cervical screening process to a paitent?
25-64 - every 5 years
The first sample gets tested for certain types of HPV (human papilloma virus). It’s a sexually transmitted virus that the majority of us have at least one form of - some forms do however make it more likely that you contract cervical cancer - so we test for these.
If the sample comes back -ve for HPV we invite you back in 5 years as normal.
If it comes back +ve we have a closer look at the sample (cytology). If that comes back normal we invite you back in a year to have another HPV test.
If it comes back abnormal we will do a colopscopy. This involves us using the speculum again and just having a proper better look at the cervix.
What is the most common type of cervical cancer?
Squamous cell carcinoma
How do you record a snellen chart score where someone can read down to the 6 line but gets 3 wrong?
6/6-3
if had got all right but managed 2 of next line = 6/6+2
What is the pathology of BPPV?
How is it diagnosed?
How is it managed?
Otolith stone production in utricle - physiological
If gets dislodged into semicircular canals - rub against cilia - brain gets confused as to where it is
Dix-Hallpike manouver - causes urticle to go into semicircular canal
Epley maneouver - manage
Bilateral acoustic neuromas = ?
Neurofibromatosis 2
What is the way to remember Meniere’s disease symptoms?
How is it managed?
Men get STV’s
Sensironeural hearing loss
Tinnitus
Vertigo
Tinnitus therapy
Hearing aid
Prevent episodes
- reduce salt
- reduce alcohol
- reduce caffiene
- reduce stress
Grommets
Labyrinithitis and vesitbular neuritis are both inflammatory causes of vertigo. They are normally preceded by a ?? They can cause N+V and the sensation can last ??
What is the one way to try and differentiate them?
What is the advise you would give a patient.
Upper resp infection
Days-weeks
Labrynithis causes assoc. hearing loss/tinnitus unlike vestibular neuritis
Usually self-limiting - rule of 3s
In bed for 3 days
Off work for 3 weeks
Off balance 3 months
What is the way to work out between viral and bacterial causes of sore throat?
When are antibiotics indicated and what are they?
Bacterial = FeverPAIN score
Fever Purulence? Admission urgently (3/7) very Inflammed tonsils No cough/coryza
0-1 = no ABs 2-3 = consider 4-5 = IMMEDIATE ABS
Penicillin V/clarithomycin
What is the BP aim in diabetics?
140/90
A HbA1c of over what indicates diabetes?
6.5%
What is the antibiotic of choice in mastitis?
Fluoxicillin
