24 December Flashcards
What is the 1st line investigation for lung cancer?
CXR
What is the criteria for urgent CXR 2ww?
Age >40 with at least 2 of the following OR if smoker and 1 of the following
Cough
Fatigue
SoB
Chest pain
Weight loss
Appetite loss
What is the management of Perthes Disease?
Non operative- often if child <6
- restriction of activities or weight bearing, physio and NSAIDs
Operative
- femoral or pelvic osteotomy
- valgus or shelf osteotomies
-Hip arthroscopy
- Hip arthrodiastasis
What are negative symptoms of schizophrenia?
Lack of motivation/initiative
Decreased activity
Social withdrawal
Blunting of affect
Incongruity
Depression
Mood disorder
What are features of rickets?
Widespread bone pain
Proximal muscle weakness and lethargy
Waddling gaiot
Spinal curvature
Signs of hypocalcaemia
Pseudofractures with associated tenderness
What are features of myotonic dystrophy?
Autosomal dominant inheritance
Facial weakness
Ptosis
Atrophy of jaw muscles
Early frontal balding
Hypernasal speech
Muscle weakness and wasting affecting SCM and distal limb muscles first
Cataracts
Dysphagia
Raised liver enzymes
Diabetes
Testicular atrophy
Resp failure
What are features of renal artery stenosis?
Uncontrolled HTN
Worsening Kidney function
Raised potassium
Recurrent flash pulmonary oedema
add in aspirin and high dose statin
Control other XCVD risk factors
What are features of Caplan Syndrome?
Pulmonary fibrosis normally in coal miners with RA
CXR shows multiple round well defined nodules
Treat with steroids
Must exclude TB first
What ECG changes may be seen in hypothermia?
AF
PR elongation
QRS widening
QT elongation
J waves- characteristic
What are features of Calcaneal fracture?
Fall from height >6 feet
Motor vehicle collisions
Impact on a hard surface whilst running/jumping
Avulsion injuries
Overuse injuries
Present with
- pain, oedema, deformity
- inability to weight bear
- Mondor sign bruising distally on sole of foot= definite fracture
When should HbA1c not be used to diagnose diabetes?
Age <18
Pregnant women/2 months postpartum
Symptoms of diabetes <2 months
Acutely ill
On meds that can cause hyperglycaemia
Acute pancreatic damage
End stage renal disease
HIV infection
What are features of Addisons disease?
Lethargy
Anorexia
N&V
Weight loss
Hyperpigmentation
Vitiligo
Loss of pubic hair in women
Hypotension
Hypoglycaemia
Hyperkalaemia
Hypontraemia
What causes croup?
Parainfluenza virus
What are features of aplastic anaemia?
Bone marrow failure
Peripheral pancytopenia
Bone marrow hypoplasia
What is Riluzole?
Glutamate antagonist
Used in amyotrophic lateral sclerosis to prolong time until ventilation required
