22 December Flashcards
What are features of adenomyosis?
Due to endometrial tissue growth into uterine myometrium
Risk factors
- increased oestrogen exposure
- pre menopausal women
- multiparity
What are symptoms of adenomyosis?
Painful menses
Heavy periods
Chronic pelvic pain
Dyspareunia
Infertility in 10 %
Find boggy enlarged uterus which can be tender
What are investigations and management of adenomyosis?
US or MRI
If pregnancy not desired- hysterectomy
NSAIDs
Hormonal contraception- Mirena 1st line
MRI/US guided thermal ablation
Uterine artery embolisation
Endometrial abolition
Adenomyomectomy
What pathogens cause bloody diarrhoea?
Salmonella
E.Coli
Entamoeba
Campylobacter
Shigella
Yersinia enterocolitica
When is a blood test hCG positive in 98% of women post conception?
On day 11
What is Uthoff phenomenon?
Transient worsening of neurological symptoms related to a demyelinated disorder such as MS
What is Charcot neurological triad?
Nystagmus
Intention Tremor
Staccato speech
Can be associated with MIS
What is Lhermittes sign?
Electric shock like sensation radiating down the spine into arms/legs due to flexion of the neck
What are symptoms of Hodgkins Lymphoma?
Asymptomatic lymphadenopathy
B symptoms in 40%
Intermittent fever
Chest pain/cough/SoB if mediastinal mass
Alcohol induced pain at sights of nodal disease is specific
hepatosplenomegaly in advanced disease
What are features of CML?
Philadelphia chromosome
Incidental finding of raised WCC on bloods
Or abdominal pain due to enlargement of spleen
Early satiety
B symptoms may onset long before disease
What are the 3 phases of CML?
Chronic phase- easily controlled
Accelerated phase- transitional/unstable course
Blast crisis- aggressive and normally fatal
Allogeneic bone marrow transplant is curative but has high mortality so only for patients who have a suitable donor
What are features of HUS?
AKI
Microangiopathic haemolytic anaemia
Thrombocytopenia
Post E.coli infection (can be HIV pneumococcal rarely SLE)
Blood film- shistocytes
What are features of dermoid cysts?
Contain things like hair, teet, nails
Often appear in young children near lateral aspect of eyebrow
Nearly always benign
What are features of seborrheic keratosis?
Variety of clinical appearance from flat, raised or pedunculated normally occur on the trunk in large numbers
Histology- localised proliferation of the basal layer of the epidermis
What is Simmond/Thompson test?
Lie patient flat and squeeze calf if no reflex then rupture of tendon
Achilles tendon rupture can be caused due to ciprofloxacin
