28/2 Flashcards
triad - renal cancer
loin mass, loin pain, haematuria
bladder cancer - presentation
visible haematuria
recurrent UTIs
voiding symptoms
most likely cause of third cranial nerve compression
extradural bleed
sign of third cranial nerve compression
blown R pupil
most common cause of ascending cholangitis
E.coli
klebsiella
ascending cholangitis - Ix, Mx
Ix - USS first line (duct dilation, bile duct stones)
Mx - Iv abx, ERCP after 24-48hrs
what is carcinoid syndrome
when mets in liver release serotonin
Ix - carcinoid syndrome
urinary 5-HIAA
plasma chromogranin A y
GBS - features
resp mm weakness
weakness ascends
reduced or absent reflexes
sensory symtpoms - mild
CN - diplopia, bilateral facial nn palsy, oropharyngeal weakness
autonomic - urinary retention, diarrrhoea
HNPCC - genetics
lynch syndrome
auto dom
90% develop cancers, prox colon
MSH2, MLH1
endometrial cancer
FAP - genetics
rare auto dom
polyps by 30-40yrs
carcinoma
APC - tumour supressor gene
breast cancer - mx
surgery - except frail, elderly with mets
prior to sx - no palpable axillary lymph need pre-op axillary uss, if axillary lymph then clearance needed in surgery
radiotherapy - wide local excision or mastectomy AND T3/4, four or more axillary nodes
hormonal therapy - if ER+ve
biological therapy - herceptin if HER2 positive, CI in heart disorders
chemo - prior to surgery or after e.g. if axillary node
type of surgery - breast cancer mx
mastectomy - multifocal, central, large lesion, DCIS>4cm
wide local excision - solitary, peripheral, small, DCIS<4cm
behcet’s triad
oral ulcer
genital ulcer
uveitis
VTE also seen
painful ulcer - dx
chancroid herpes (2 if genital, 1 if oral)
painless ulcer - dx
syphilis
_______ reduce the absorption of levothyroxine and should be given ___ apart
iron/ calcium supplements reduce absorption of levothyroxine and should be given 4 hours apart
DM drug used in obese pt
sitagliptin (DDP-4 I)
furosemide MOA
loop diuretic
inhibits NaKCl transportr in thick ascending limb of loop of henle
first line insulin regimen in newly diagnosed T1DM
basal-bolus regimen with b.d. insukin determir
Rf for pericarditis
infection - coxsackie
TB
uraemia
trauma
post mi, dresslers
CTD
hypothyroidism
malignancy
SLE
mx of SIADH
fluid restriction
recognising SIADH
hyponatraemia + low serum osmolality
high urine osmolality
most common tpe of breasty cancer
invasive ductal carcinoma of no special type
types breast cancer
invasive ductal carcinoma - no special type
invasive lobular carcinoma
ductal carcinoma-in-situ
lobular carcinoma-in-situ
rare - medullar, mucinous, tubular, adenoid cystic carcinoma, metaplastic, lymphoma, basal type, phyllodes, papillary
paget’s disease of nipple
eczematoid change of nipple - underlyinh breast malignancy
1-2% breast cancer
mucinous carcinoma
2-3% of all breast cancers
better prognosis than non special type
comedo necrosis is a fature of ______
high nuclear grade ductal carcinoma in situ
snowstorn sign on uss of axillary lymph node
extracapsular breast implant rupture
Mx - mastitis
first line - continue breast feeding
unwell/ not improve in 12-24hrs of effective milk removal - 10-14D fluclox
complication - breast abscess
SE of anastrazole
osteoporosis - DEXA scan first
hot flushes
arthralgia, myalgia
insomnia
tamoxifen - SE
menstrual disturbance - vag bleed, amenorrhoea
hot flushes
VTE
endometrial cancer
bloody nipple discharge in young women indicates
intraductal papilloma
