11/04/18 Flashcards
1
Q
What is the diagnosis with a non-painful flexion contracture which isn’t correctable?
A
Dupuytren’s
2
Q
What is seen with flexor tendinitis?
A
pain and clicking or trigger signs
3
Q
What is proliferative diabetic retinopathy characterised by?
A
growth or proliferation of new vessels at the discs or elsewhere at the retina
4
Q
What age typically gets bronchiolitis?
A
<2 years
5
Q
What infectious diarrhoea are patients on PPIs more at risk of?
A
C.diff
6
Q
What causes a neurogenic pruritis?
A
effect on CNS receptors e.g renal, liver fialure, thyroid disease or assocaited with malignancy
7
Q
What is the mechanism of pruritis in shingles?
A
neuropathic
8
Q
What is the mechanism of pruritis in insect bites and eczema?
A
pruritoceptive
9
Q
What intracompartmental pressure is diagnostic of compartment syndrome
A
> 30mmHg
10
Q
Waht is the most reliable symptom of compartment syndrome?
A
pain out of proportion
11
Q
What is the treatment for bronchiolitis?
A
admit, supportive therapy
12
Q
What is heard on the chest with bronchiolitis?
A
good air entry with widely scattered high pitch ronchi and fine creps
13
Q
What is Charcot arthropathy also known as?
A
neuropathic arthropathy
14
Q
Who gets Charcot arthropathy?
A
diabetics
15
Q
What colour of vomit in children is always abnormal?
A
bile coloured
16
Q
What is first line ix for bile coloured vomit?
A
plain abdo xray
17
Q
What is suggested by a 2 day infant with non-projectile green vomiting?
A
volvulus
18
Q
What is average age of pyloric stenosis?
A
2 weeks
19
Q
What is the investigation for pyloric stenosis?
A
ultrasound
20
Q
What is suggested by small, effortless vomiting after every feed, with a well baby?
A
GORD
21
Q
What is seen histologically with dermatitis herpetiformis?
A
granular IgA at dermal papillae
22
Q
what is seen with linear IgA disease?
A
linear IgA and basemenet membrane
23
Q
What is diagnostic test for gout?
A
negatively birefringent urate crystals on polarising exam of synovial fluid
24
Q
What drugs are associated with urticarial eruptions?
A
codeine; aspirin; ACEi
25
What drugs are assocaited with photosensitivity?
doxycyline; bendroflumethiazide and some NSAIDs
26
What is the best imaging for the paranasal sinuses?
CT
27
What HPV protein target p53?
E6
28
What happens in wet macular degeneration?
neovascularisation causes haemorrhage with eventual sccarring
29
What may precede haemorrhage in we macular degeneration?
distortion of vision due to swellling at the macula
30
Are glass foreign bodies normall visible on xray?
yes
31
Which pathway is responsible for ketone development in insulin depletion?
lipolysis
32
What is the most biologically active form of thyroid hormone?
T3
33
what is the main transporter of thyroxine in the plasma?
thyroxine binding globulin
34
What is the cause of a DM vomiting after large meals?
gastroparesis- autonomic neuropathy
35
Where are hemi-desmosomes found?
DEJ
36
Why is there a decrease in circulating blood volume in sepsis?
endotoxins causing vasodilatation and intravascular fluid leaking into adjacent tissue
37
what is disorganised attachemnt?
child appears stressed, exhibiting tension movemetns, activated by departure and return of caregiver
38
What is ambivalent?
child will typically explore little and is often wary of strangers even when parent is present, when mother departs of reunite child is highly distressed or uncertain
39
For respiratory distress in an infant which is acute what is the most likely diagnosis?
croup- epiglottitis has longer prodromal symptoms than a few hours
40
How does the ICA enter/exit the skull?
foramen lacerum
41
How does the middle meningeal artery enter/ exit the skull?
spinosum
42
How does the facial nerve enter/exit the skll
stylomastoid foramen
43
What are hte crystals in pseudogout?
calcium pyrophosphate dihydrate crystals
44
When does dislocation as a complication of a hip replacement usually occur?
early (can be late)
45
What is the first line genetic test for chromosomal imbalance?
array CGH
46
What type of hand washing should be done before inserting an IV cannula?
soap and water
47
What is presbyopia?
defect of vision where there is difficulty focussing on near objects
48
What is assocaited with highly virulent strains of S.aureus causing necrotising fasciits?
PVL
49
A bone with a tuberosity and a malleolus?
tibia
50
Flat bone with an attachemnt for abdo wall muscles and forms part of the acetabulum?
ilium
51
Bone which has a proximal head, tuberosity for biceps tendon and sulci for several tendons on distal dorsal aspect
radius
52
Where is the biceps distal attachemtn?
radial tuberosity
53
What is hyphaema?
bleeding into the anterior chamber
54
what does hyphaema indicate?
a significant injury that has damaged ocular structures
55
Why does increased ACTH cause increased MSH?
come from same pro-hormone
56
What is the energy source for 4 seconds?
ATP
57
What is the main energy source for 15 second?
phophocreatinine
58
What is the main energy source for 4 minutes?
free circulating glucose
59
What is the main energy source ofr 77 mins?
glycogen stores
60
What is the main energy source for 4 days?
fat stores
61
What parts of the colon are intraperitonieal?
caecum; transverse and sigmoid
62
What is the active contractile phase of Dupuytrens?
second stage which starts with development of nodules and continues with the appearance of myofibroblasts
63
What type of lens do myopic eyes need?
concave- to diverge the rays
64
What cells make up the periphery of follicles?
follicular cells
65
What virus causes oropharyngela tumours in the young?
HPV
66
What is the treatment for anteiror shoulder dislocation?
closed reduction; application of sling and movilisation after 4 weeks
67
What is scirrhous carcinoma?
subtype of ductal carcinoma
68
How does scirrhous carcinoma present?
hard lump
69
What is significant about scirrhous tumours in elderly?
slow growing and slow to metastasise
70
What happens when alpha-1 receptors are stimulated?
vasconstriction
71
What Tourette's syndrome?
multiple motor tics and one or more vocal tics - dont need to occur concurrently
72
which type of tic usually develops first in Tourette's?
motor tics
73
When is the typical onset of Tourette's?
childhood and adolesence
74
What is conduct disorder?
persistent and repeitits pattern of behaviour that violates the basic rights of otehrs or goes against age-developmental norms
75
what is childhood onset conduct disorder linked to?
ADHD
76
When can antisocial personality disorder be diagnosed?
when patient reaches age 18 and has disotry of conduct disorder
77
What forms the right heart border of the CXR?
SVC; RA and IVC
78
Where does the normal RV lie in the heart?
anteriorly
79
What is the most posteiror structure in the heart?
LA
80
What is see with the central and peripheral pulmonary arteries in pulmonary hypertension?
central- enalrged but peripheral pruning
81
How is amyloid related to medullary carcinoma of the thyroid?
local production of amyloid- preicipated clacintonin
82
Where is the genetic defect associated with medullary thyroid cancer?
10
83
What is the shape of parafollicular cells?
polygonal cells
84
What is the effect of amiodarone on liver enzymes?
inhibitor
85
What does tqachycardia; increased RR and right axis deviation on ECG suggest?
PE
86
What is often the presentation of testicular tumours?
following minor trauma and some discofort
87
Why should testicular tumours never be biopsied?
may seed tumour to scrotal skin
88
What is trachelectomy?
removal of uterine cervix
89
What is the inheritance of leber hereidatry optic neuropathy?
mitochondrial
90
What is the inheritance of duchennes?
x-inked recessive
91
What is the inheritance of vitamin-D resistance rickets?
x-linked dominant
92
Which chormosome is CF gene on?
7
93
What are typical antipsychotics mostly derived from>
phenothiazines
94
which patietns are at a higher risk of SJS?
HIV postive
95
What is the prodromal phase of SJS?
fever; cough and sore throat
96
What other vein does the left renal vein receive?
left adrenal vein and left gonadal vein
97
What 2 veins create the portal vein?
splenic vein and SMV
98
Where does the IMV drain?
splenic vein
99
What are the signs of an acute cavernous sinus thrombosis?
retro-orbital pain; ophthalmolplegia; loss of sensation over the ophthalmic divions of the trigeminal nerve
100
How does a carotid cavernous fistula present?
acutely painful visual loss; proptosis, conjunctival injection and a firm, tender and pulsatile eyeball
101
What is the malignant form of Guillain-barre syndrome linked to?
HIV
102
How is familial hypercholesterolamia inherited?
AD
103
What is the most common issue in familial hypercholesterolaemia?
LDL receptor
104
What is the amino acid cahnge in sickle cell anaemia?
glutamic acid to valine
105
What is type 2 HS?
antibodies are directed against antigens on the surface of cells or other tissue compoenets
106
What happens in type III HS?
excess of antigen leading to immune complexes which fix complemetn
107
What type of HS is post-strep glomerulonephritis
HS III
108
Where is the compartment syndrome if pain is maximal on testing the tibial nerve?
anterior compartment
109
How is diagnosis of trichomoniasis made?
wet saline mount or after 48 hours of anaerobic culture
110
What does a high RDW mean?
large variation in the size of RBCs
111
What is a lrge variation in the size of RBCs called?
anizocytosis
112
Why might MCV be normal with anisocytosis?
mixture of large and small RBCs
113
When might anisocytosis occur?
haemolytic anaemia; IDA; after blood transufusion and in malabsorption syndromes
114
What is the function of inhibin?
inhibits FSH
115
Which cells produce inhibin?
Sertoli cells
116
What can failure of testosterone production in the first trimester of gestation result in?
pseudohermaphoditism
117
What is pseudohermaphroditism?
gonads are consistent with chromosomal sex but has genitalia of the opposite sex
118
What is an example of pseudohermaphroditism?
androgen insensitivity syndrome
119
Who gets fungal meninigtis ?
immunocompromised patients
120
What is the most common gynae problem pre-pubertally?
vulvovaginitis
121
What is CD40?
co-stimulatory protein found on APCs required for their activation
122
How is vitamin B12 administered?
IM
123
What is syringomyelia?
cyst forms in spinal cord which compresses and damaged spinal cord from centre outwards
124
What is the most common complciation of untreated subdural?
recurrent heamorrhgae
125
What is cerebellar speech like?
slurred or staccato in nature
126
What is the cause of pseudohypoparathyroidism?
target cell failure to respond to PTH appropriately
127
What antibody is assocaited with neonatal heart block?
anti-ro
128
What do babies born to mothers with Anti-ro have?
neonatal SLE wtih permanaent heart block
129
What antibodies are positive with drug-induced lupus?
ana but not dsDNA- homogenous staining of ANA
130
What type of staining is seen with CREST syndrome?
centromere staining pattern of antinuclear antibodies
131
Where is a branchial cyst typically found?
near angle of mandible
132
What does mosaic Down's syndrome result from?
abnormal cell division after fertilisation
133
what do echogenic foci in an ovarian cyst mean?
always pathological
134
Why is the bCG vaccine CI in HIV?
HIV eliminates the protective quality of BCG against TB
135
What is the most common fetal anomaly?
cardiac problems
136
What is the acute medical treatment for cluster headache?
100% oxygen and sumatriptan
137
What fissure separates the right middle lobe from the right lower lobe?
oblique fissure
138
What is the level of the horizontal fissure?
4th costal cartilage
139
What is the best surface alndmark for the boundary between right middle and lower lobes?
6th rib
140
What is craniosynostosis?
preamture fusion of the coronoal suture
141
What are nucleated RBCs known as?
normoblasts
142
What is unique about NK cells?
recognised cells in the absence of MHC molecules
143
What happens to the aortic arch during pregnnacy?
unfolds
144
What type of tissue is used in a deep inferior epigastric perforator flap reconstruction?
fat, skin and blood vessels
145
What is the most common type of primary lung cnacer?
adenocarinoma
146
What type of lung cancer is most likely to cavitate?
SCC
147
Why is an upper abdo CT required for staging of lung cancer?
liver and adrenal mets are common
148
What condition are periungal fibromas seen in?
tuberous sclerosis
149
What can cause obstructing hydrocephalus?
tumours of the posterior fossa; SAH; tuberculous meningitis; colloid cyst of third ventricle
150
What is lochia?
vaginal discharge after giving birth containing blood; mucus and uterine tissue
151
What is the type of hypersensitivity in extrinsic allergic alveolitis?
type III
152
What is the most common SE of verapamil?
constipation
153
Whati s the effect on the AP with class III anti-arrhythmics?
prolong
154
What is an Argyll-Robertson pupil?
small, irregular pupil in which the accomodation reflex is rpesent but the light reflex is lost
155
What is osteonecrosis a SE of?
bisphisphonate therapy
156
What is found at the cerebellopontine angle?
cerebellar tracts; Vth; VIIth and VIIIth
157
What differentiates anaemia of chronic disease and IDA?
increased ferritin level and decreased TIBC
158
What causes anaemia of chronic disease?
poor use of iron in erythropoeisis; cytokein-induced shortening of RBC survival and decreased production or and response to erythropoietin
159
What does the heart produce under stretched conditions?
B-type natruiretic peptide
160
Why is subcut absorption slower than IM?
blood perfusion is poor
161
How does C1 initiate the classical pathway of complemetn activation?
binds to the Fc portion of 2 adjacent IgG molecules
162
What happens to the CSF pressure in bacetrial vs viral meningitis?
bacteria- raised; viral- normal
163
What is the rate of new mutation with Huntington's ?
very rare
164
What is opisthotonos
spasm of muscles causing backward arching of the head, neck and spine
165
What is the most common inheritance of nephrogenic DI?
X-linked recessive
166
What is splitting?
only able to see people as all good or all abd
167
What produced by gram-negative organisms plays a key role in the induction of the monocyte-macrophage system?
lipopolysaccharide
168
What is the function of lipoproetin lipase?
hydrolyses chylomicrons and VLDLs
169
Waht type of AIHA does SLE typically cause?
warm AIHA
170
What is dysfunctional uterine bleeding defined as?
abnormal bleeding from the uterus in the absence of tumour; foreign body or inglammation
171
Who is DUB more common in ?
obese and diabetic women due to anovulation
172
When does the first trimester end?
12 weeks
173
When does the 2nd trimester end?
27 weeks
174
When should women with a risk factor GDM be offered an OGTT?
24-28 weeks
175
What is the priamry regulator of REM sleep?
NA
176
Where is the acrosome derived from?
golgi apparatus
177
What are the actions of the copper IUD?
creates hostile environment and inhibits capacitation
178
What is the function of centrioles in the sperm?
contribute to hte flagellum or tail of the sperm
179
What disease can impair the function of the centrioles in the sperm?
Kartageners
180
What lobe is dyscalculia associated iwth?
parietal
181
What are the nerve roots fo the superior gluteal nerve?
L4,5 S1
182
What are the nerve roots for the inferior gluteal nerve?
L5, S1,2
183
What are primitive reflexes in dementia a sign of?
frontal lobe
