1st year Flashcards
fever, pleuritic chest pain relieved by leaning foreward
pericarditits
irregularly irregular pulse
atrial fibrillation
saw tooth baseline + 150bpm
atrial flutter
alveolar bats wings, kerley b lines, cardiomegaly
pulmonary odema
raised JVP/ hepatojugular
right sided heart failure
sense of impending doom
MI
saddle shaped ST elevation
pericarditis
Broad complex tachycardia
ventricular problem
mid diastolic murmur with tapping, undisplaced apex
mitral stenosis
broad QRS with slurred upstroke on R wave (delta wave)
Wolff parkinson white
tall tented T waves (may have wide QRS)
hyperkalaemia
pericarditis 4-6 weeks post MI
Dressler’s
blurred yellowing vision headache
digoxin toxicity
janeway lesions, osler nodes
sub acute bacterial endocarditis
machine like heart murmer
patent ductus arteriosus
rib notching on CXR
coarcation of aorta– likely to lead to dissection
crescendo decrescendo murmer
aortic stenosis
diminished absent lower limb pulses
coarcation of aorta
MRS ASS
mitral regurge systolic
aortic stenosis systolic
stony dull to percuss
pleural effusion
right sided pleuritic chest pain
most likely pneumonia
ground glass appearance on Xray
pulmonary fibrosis and respiratory distress syndrome on the newborn
Zeihl-Neelson stain positive for acid fast bacilli
TB
caseous necrosis
TB
Apical disease (lesion- assman focus)
secondary TB most likely
miliary TB
spread of organism into bloodstream
pulmonary artery- miliay dissemination of lung
pulmonary vein- systemic dissemination
positive anti-glomerular basement membrane antibodies
goodpastures
chest infection with parrot/pigeon pet
chlamydophilia psittaci
positive urine antigen test
legionella pneumonia
tall thin (marfans) weed smoker male
pneumothorax
bilateral hilar lymphadenopathy, erythema nodosum (rash on legs) afrocaribean woman
sarcoidosis
signet ring sign on CT (bronchiole wider than neighboring arteriole)
bronchiectasis
obese, hypoventilation
pickwickians
sigmoid rings
adenocarcinoma
rule of 2’s (2% population, 2 feet of ileoceacal valve, 2 inches)
Meckels diverticulum
bibasal plaques
aspestosis
leads ii, iii, avF
inferior
restrictive pattern
usually pulmonary fibrosis
farmers lung
extrinsic allergic allveolitis
Ig in mucosa?
IgA (also found in saliva tears breast milk), dimer
IgD?
membrane bound on B cells, monomer
IgE?
Allergies, parasitic worms
binds to allergens and triggers histamine release from mast cells and basophils
monomer
IgG?
crosses placenta, majority of protection against pathogens, monomer
IgM?
surface of B cells monomer, secreted as pentamer, early response before IgG accumulates
Cf gen?
autosomal recessive
Stony dull percussion
pleural effusion
right sided pleuritic chest pain
most likely pneumonia
caseous necrosis
TB
apical disease, (assman focus)
most likely secondary tb (infiltrate in apex
miliary TB?
spread of organism in blood
urine antigen test, holiday abroad, dry cough, diarrhoea
legionella
bronchiole wider than neighboring (cignet ring)
bronchiectasis
D sign on Xray
empyema
steeple sign on Xray
laryngotracheobronchitis/ croup
child barking cough
croup
pneumocytis pneumonia
HIV (treat with Cotramoxazole +/- prednisolone if severe)
samter’s triad
asthma, nasal polyps, salicylate sensitivity
alcoholic danger of aspiration
klebsiella pneumonia
red jelly sputum
klebsiella pneumonia
red jelly sputum
klebsiella pneumonia
mucoid sputum
Chlamydia psittaci
rusty sputum
pneumococcal pneumonia
cannonball metastases (also weight loss and haematuria)
classically from primary renal cell carcinoma
morning headache
hypercapnia or SE of organic nitrates
ACTH secreting carcinoma
small cell, adenocarcinoma
PTH secreting cancer
squamous cell
raised JVP/ hepatojugular
right sided heart failure
mid diastolic murmer with tapping, undisplaced apex
mitral stenosis
broad QRS with slurred uptsroke on R wave (delta wave)
wolf parkinson white
blurred yellowing vision headache
digoxin toxicity
SE ACEi
dry cough, renal artery stenosis
gingival hypertrophy
gingivectomy/ biting on gums, SE CA channel blockers or phenytoin
bird beak appearance and distended oesophagus
achalasia, if lower down bowel obstruction
CD4
helper T cells, MHC2, class switching, activate Tc
CD8
cytoxic T cells, MHC1, secrete molecules eg IL10
type 1 hypersensitivity
immediate, antigen binds to CD4Th2 activates Bcell production of specific IgE antibodies that bind to allergen
Fc receptors
expressed on mast cells
type 2 hypersensitivity
direct cell killing, antibodies produced bind to antigens on own cell surface (eg ABO blood)
IgM or IgG bind to antigens and activate classical complement pathway
Type 3 hypersensitivity
immune complex mediated
complement process
all activate C3
amplifies and increases rate of response
chemotaxis (atracts macrophages and neutrolphils), opsonisation (enhances phagocytosis), direct cell killing (activation of membrane attack complex on bacterial cell walls) solubilization
classical
C1, C2, C4
lectin
MBL
lectin
MBL
type 4
delayed type
type 3
immune complex mediated
Chest pain at rest
Acute coronary syndrome
Chest pain tearing and radiating to the back
Aortic dissection
Cushing’s syndrome
Excess cortisol
Secondary hypertension
Conns syndrome
Excess aldosterone
Secondary hypertension
Phaeochromocytoma
Catechilamine secreting tumour of adrenal glands
Secondary hypertension
grey turners (lumbar redness) and cullens sign (umbilical redness)
acute pancreatitis
GET SMASHED
gallstones, ethanol, trauma, steroids, mumps, autoimmune, scorpian stings, hyper(lipidemia, erthermia, calcaemia), ERCP, Drugs
murpheys sign
cholecystitis
pale stools, jaundice, abdo pain
biliary obstruction
abdo distension, caput medussa, shifting dullness
portal hypertension + ascites
pyoderma gangrenosum, erythema nodosum
Crohn’s/ UC
tinkling bowel sounds`
obstruction
large PE
thrombolyisis
small PE
LMW herapin
D dimer
small protein fragment present in the blood after a blood clot is degraded by fibrinolysis
negative d dimer
basically rules out PE
positive d dimer
suspect PE, send for CTPA or V/Q
squamous and small cell
central
non smoker and cancer, peripheral
adenocarcinoma
infective exacerbation of COPD
iSOAP
ipratropium, salbutamol, amoxicillin, prednisilone
snow storm appearance on x ray
baritosis, silicosis
inspiratory whoop/ barking cough
pertussis
thumbprint sign on xray
epiglottitis
asthma acute management
OSHIT MAN oxygen 100% non rebreather salbutamol nebulised back to back hydrocortisone iv or prednisilone po iprtropium bromide nebulised hourly theophylline iv magnesium anaeshetist
horners syndrome info
sympathetic trunk damage
squashed from intrathoracic nodes or pancoasts tumour in upper lungs
horners syndrome signs
ptosis (drooping eyelid), enophthalmos (sunken eye), miosis (small pupil), lack of sweating. all on same side as obstruction
assman focus
apical lesion, secondary tb
coin lesion
rounded solitory lesion, common- primary bronchial or lung carcinoma, metastic (esp kidneys), bronchial hamartoma, granulomatous inflammation, lung absess
ghon focus
infection and caseous necrosis periphery of lung beneath pleura, tb
ghon focus rupture
through viceral into pleural cavity- tb pleurisy
eggshell calcification at hilar region
silicosis
increased serum ACE and Ca2
sarcoid
small cell carcinoma
neuroendocrine, highly malignant, may be linked to ectopic endocrine symptoms
heart failure cells in alveolar spaces
macrophages that have absorbed haemosiderin, chronic pulmonary oedema and left severe HF, long standing pulmonary hypertension
cryptogenic fibrosing alveolitis
idiopathic pulmonary fibrosis
TB drugs
RIPE
2 ripe, 4 ri
vesicular rash and weight loss
coeliac
virchows node (left supraclavicular)
gastric cancer
urea breath test
Hpylorie
14C breath test
bacterial overgrowth
rice waterlike stools
vibrio cholera
primary biliary cirrhosis
prescence of AMA
AMA
anti mitochondrial antibodies
autoimmune hepatitis
prescence of AMA
alpha feto protein assay
hepatocellular carcinoma or teratoma
cobblestone mucosa, deep fissures, granulomatas
crohns
diuretic for ascites (due to cirrohosis)
spironolactone
corkscrew oesophagus on ba swallow
diffuse oesophageal spasm
severe abdo pain and D&V after raw milk
campylobacter
russells sign
self induced vomitting
mallory’s hyaline bodies
alcoholic liver disease (acute hepatitis)
onion skinning fibrosis, beading of bile duct
primary sclerosing chlangitis
signet rings
linitis plastica, diffuse stomach cancer
thumbprinting, x ray at splenic flexure
ischaemic colitis
charcots triad
acute colangitis ie fever jaundice abdo pain secondary to cholelithiaisis
abdo mass causes
A CHEMICAL
AAA, chrons, hernia, enlarged organ, malignancy, intersusception, cyst or abcess, appendicitis, lymphadenopathy
bowel obsturction
BATH VIPS
bolus, adhesions, tumour, hernia, volvulous, interussception, pseudo-obstruction, stricture
Spironolactone SE
gynaecomastia
stronmatitis gangrenosum
mouth disease in crohns