23 December #2 Flashcards
What are causes of erythema nodosum?
Infection - strep, TB, brucellosis
Sarcoidosis
IBD
Behcet
Malignancy
Pregnancy
COCP
Penicillin
Sulphonamides
What are features of pemphigus vulgaris?
Flaccid blisters and mucosal ulceration
Blisters rupture when touched
Treat with steroids and immunosuppressants
What are features of Lichen planus?
Purple
Pruritic
Papular
Wickham Striae
Commonly found on wrists, lower back, ankles and genitals
Treat with- topical steroids
What are common causes of erythema multiforme?
HSV
Idiopathich
Bacteria- Mycoplasma
Drugs= penicillins, sulphonamides, carbamazepine, NSAIDS
SLT
Sarcoidosis
Malignancy
What formula is used to calculate fluid resus post burns?
Parkland
What is the management of psoriasis on face/flexures/ genital areas?
Mild to moderate steroid for max 2 weeks
What is the management of acne rosacea?
Predominant erythema
- Brimonidine gel
Mild to moderate papules/pustules
- topical ivermectin
- topical metronidazole or azelaic acid
Moderate to severe papules/pustules
- topical ivermectin and oral doxycycline
What is Bechets disease?
Triad of
-oral ulcers
-genital ulcers
-anterior uveitis
Affects people from middle east
What are features of Men 2b?
Phaeochromocytoma
Medullary thyroid ca
Marfanoid
What are features of autoimmune polyendocrine syndrome?
Oral candidiasis
Addison disease
hashimotos
Vitiligo
T1DM
What are features of androgen insensitivity syndrome?
46XY
Primary amenorrhoea
Bilateral groin swellings- undescended testes
Raise as female
Remove testes as increased risk of Ca
What are features of chronic pancreatitis?
Due to alcohol excess
Epigastric pain- worse 15-30mins post meal
N&V
Steatorrhea
Diabetes
Low faecal elastase
Amylase normal
CT-pancreatic atrophy, calcification, pseudocysts
What is the management of VT with a pulse?
Amiodarone 300mg IV
If ineffective then synchronised DC cardioversion
What are features of Cryptococcus meningitis?
HIV/immunocompromise
India ink +ve
What investigations are done in myasthenia gravis?
1) Serum anti-acetylecholine receptor antibody testing
If negative 40% positive for anti muscle specific kinase antibodies
Repetitive nerve stimulation
CT thorax
What are features of familial mediterranean fever?
Autosomal recessive disorder
Seen in turkish/arabic descent
Attacks lasting 1-3 days
- fever
-pleurisy
- peritonitis
- arthritis
-pericarditis
-erysipleoid rash
Treat with colchicine
What are features of narcolepsy?
Daytime sleepiness
Disrupted normal sleep
Can be associated with caraplexy- brief muscle weakness, paralysis
Sleep paralysis
Investigation
- Sleep EEG
Treatment
- Modafinil
-Methylphenidate
What is the management of T2DM?
1) Metformin
- consider SGLT2 inhibitor (dapagliflozin) as well if CVD, CHF, high QRISK, CKD
2) HbA1c rises to 58mmol despite metformin
- add either DPP4 (sitagliptin), Thiazolidinediones (pioglitazone), Sulfonylureas (glicazide), SGLT2 inhibitors if not on
3) HbA1c 58 then triple therapy
4) Triple therapy ineffective consider GLP-1 mimetic (liraglutide) BMI>35 or BMI <35 but insulin therapy would have occupational implications or weight loss would benefit co-morbidities
What are features of Brugada Syndrome?
Autosomal dominant
Present as sudden cardiac death
More common in SE asia
ECG
- convex ST elevation followed by egative T wave
Diagnose by Flecainide or Ajmaline provocation test- ECG changes are more obvious
Manage with ICDo
How can you differentiate between pericarditis and Dressler syndrome post MI?
Dressler syndrome takes 4-6 weeks to onset
What are features of Sharps syndrome?
Combination of SLE, sclerosis and myositis
Myalgia
SoB- pulmonary hypertension
Polyarthralgia
Raynaud
Dactylitis
Rash
Oesophageal dysfunction
Renal/CNS disease unlikely
Anti-U1 ribonucleoprotein antibodies
