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3 REVISION > 2nd year stuff > Flashcards

2nd year stuff Flashcards

1
Q

what is the first line treatment for acne rosacea

A

topical metronidazole

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2
Q

what is the first line treatment for acne vulgarisms

A

benzyl peroxide or topical clindamycin

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3
Q

what is epidermolysis bullosa

A

inherited breakdown of anchoring between epidermis and dermis

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4
Q

red, flaky, crusty patches skin patches covered with silvery scales normally on elbows, knees, scalp and lower back k

A

psoriasis

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5
Q

treatment of psoriasis

A

corticosteroid or vitamin D3 analogue cream

coal tar/keratolytic

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6
Q

what causes a neurogenic pruritus

A

an effect on the CNS receptors, thyroid disease or malignancy

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7
Q

how are autoimmune blistering conditions confirmed

A

diagnostic biopsy with immunofluorescence

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8
Q

what is toxic epidermal necrolysis

A

severe, acute superficial desquamating eruption secondary to a drug

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9
Q

how does toxic epidermal necrolysis

A

fever
malaise
painful erosions
generalised erythema

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10
Q

what do meissner’s corpuscles detect

A

vibration

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11
Q

what do pacinian corpuscles detect

A

pressure

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12
Q

what are risk factors for skin cancer

A 
childhood sunburn
occupation related to high sun exposure 
sun beds type 1 skin
pre-cancerous lesions
Fix of skin cancer 
immunosuppressed
exposure to radiation treatment
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13
Q

why are creams more likely to cause contact sensitisation than ointments

A

they contain preservatives

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14
Q

what condition is dermatitis herpetiformis associated with

A

coeliac

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15
Q

which type if insulin do you give once a day

A

basal (long acting)

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16
Q

which diabetic drug is weight neutral

A

DPP4 inhibitors (gliptins) and metformin

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17
Q

which diabetic drugs cause weight loss

A

GLP1 agonists

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18
Q

which diabetic drug causes glycosuria

A

SGLT2 inhibitor

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19
Q

‘strawberry milkshake coloured blood’

A

hyperlipidaemia

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20
Q

what are features of hyperparathyroidism

A 
bone disease
renal stones 
GI complications 
depression 
lethargy 
seizures 
weakness
fatigue 
calcification of aortic and mitral valves
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21
Q

what are features of hypoparathyroidism

A 
neuromuscular irritability 
Chvostek's sign 
Trousseau's sign
emotional lability 
anxiety 
confusion 
psychosis 
basal ganglia calcification 
cataracts
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22
Q

which hormone peaks before ovulation

A

LH about 12 hours before

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23
Q

what hormone do you test to check for ovulation

A

progesterone

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24
Q

what is the pathophysiology of Paget’s disease of bone

A

increased abnormal osteoclastic reabsorption followed by increased osteoblastic activity
results in abnormal bone structure with reduced strength and increased fracture risk

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25
Q

presentation of Paget’s disease of bone

A 
old man
bone pain (pelvis, lumbar spine, femur)
deformity 
deafness
compression neuropathies
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26
Q

how is Paget’s disease treated

A

bisphosphonates

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27
Q

what do osteoclasts do

A

breakdown bone for maintenance, repair and remodelling

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28
Q

what do osteoclasts do

A

synthesise and lay down new bone

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29
Q

what causes osteomalacia

A

vitamin D deficiency (malabsorption, poor diet, lack of sunlight)

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30
Q

what is the pathophysiology of osteomalacia

A

abnormal softening of the bone due to deficient mineralisation of osteoid (immature) bone

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31
Q

what are symptoms of osteomalacia

A

bone pain
tenderness
fractures (femoral neck)
proximal myopathy

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32
Q

what is the treatment for osteomalacia

A

vitamin D therapy with Ca and phosphate supplements

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33
Q

how do you assess the risk of osteoporosis

A

DEXA scan

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34
Q

features of grave’s

A 
gradual onset 
mild/moderate thyroid enlargement 
diffuse enlargement on palpation
hyperdynamic tachycardia 
heat intolerant 
eye disease 
etc
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35
Q

TFTs in grave’s

A

raised T4 and fT3, suppressed TSH

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36
Q

features of Hashimoto’s

A 
slow onset 
firm and well-defined lymph nodes 
bradycardia 
cold intolerance 
no tremor 
hoarseness
dysphagia 
etc
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37
Q

TFTs in Hashimoto’s

A

low T4 and fT3

raised TSH

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38
Q

symptoms of De Quervain’s thyroiditis

A 
acute, painful
moderate swelling 
smooth, diffuse and tender bilateral swelling 
transiently hyper dynamic and tremor 
painful dysphagia
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39
Q

TFTs of De Quervian’s thyroiditis

A

raised T4 and fT3

suppressed TSH

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40
Q

what is the commonest thyroid cancer

A

papillary thyroid cancer

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41
Q

which thyroid cancer has a poor prognosis

A

medullary thyroid cancer

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42
Q

what is the purpose of thyroid remnant ablation

A

removes residual tissue to prevent recurrence

always combined with surgery

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43
Q

what conditions are present in MEN1

A

hyperparathyroidism
prolcatinoma
pancreatic tumour

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44
Q

what conditions are present in MEN2a

A

parathyroid hyperplasia
medullary thyroid carcinoma
phaeochromocytoma

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45
Q

what conditions are present in MEN2b

A

marfanoid body habitus
mucosal neuroma
medullary thyroid carcinoma
phaeochromocytoma

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46
Q

what is the function of oxytocin

A

breastfeeding let down reflex

induction of labour

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47
Q

how are ketone bodies generated in DKA

A

lipolysis

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48
Q

which drug classes are associated with reactivation of latent TB

A

TNF alpha inhibitor (etanercept, infliximab)

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49
Q

what causes cubital tunnel syndrome

A

compression of ulnar nerve n cubital fossa

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50
Q

presentation of cubital tunnel syndrome

A

tingling in ring and pinky finger

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51
Q

how do you treat necrotising fasciitis

A

debridement + penicillin + clindamycin

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52
Q

which DMARD causes interstitial pneumonitis

A

methotrexate

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53
Q

which drug used in the management of rheumatoid conditions can cause black tarry stool

A

NSAIDs

gastric ulcer

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54
Q

which rheumatoid drugs are nephrotoxic

A

gold

penicillamine

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55
Q

which DMARD causes bone symptoms

A

prednisolone

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56
Q

what type of hypersensitivity is RhA

A

type IV

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57
Q

what is the pathophysiology of RhA

A

synovial fills with macrophages, fibroblasts and giant cells

the membrane expands and erodes bone and cartilage

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58
Q

what are signs of poor prognosis in RhA

A 
pre-menopausal status 
smoker 
young onset 
high inflammatory markers at onset
positive RF
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59
Q

what are X-ray signs of OA

A

loss of joint space
osteophyte formation
subchondral sclerosis/cysts

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60
Q

where are hederden’s and Bouchard’s nodes found

A

DIP and PIP respectively

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61
Q 
20-55 years old 
well patient 
back/buttock/thigh pain
normally neurology 
pain changes with position of movement
A

simple backache

mechanical

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62
Q 
unilateral leg pain
paraesthesia in same distribution 
leg>back pain
abnormal neurology 
weakness
reflex/sensory changes 
nerve stretch pain
A

nerve root pain

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63
Q 
osteoporosis/long term steroid use
premature menopause 
cancer Hx
weight loss
unremitting pain 
sleep loss 
under 20 or over 55
A

serious spinal pathology

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64
Q

saddle anaesthesia
altered bladder control
bowel incontinence
gait disturbance

A

cauda equina syndrome

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65
Q

treatment of carpal tunnel

A

corticosteroid injection, splint, workplace task modification, standard open carpal tunnel release, arthroscopic

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66
Q

cubital tunnel treatment

A

splint
neurolysis
anterior transposition

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67
Q

dupuytren treatment

A

radiation therapy
needle aponeurotomy
collagenase injection

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68
Q

trigger finger treatment

A

corticosteroid injection

surgery

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69
Q

which nerve is most likely to be damaged in humeral shaft fractures

A

radial nerve

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70
Q

which nerve is most likely to be damaged in a supracondylar fracture of distal humerus

A

median nerve damage

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71
Q

how does dupuytren’s contracture develop

A

nodule develop

during active contractile phase, contraction forms because of contractile myofibroblasts within the lesion

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72
Q

why is hydroxyquinolone used as a last-line treatment in RhA

A

rarely causes retinopathy

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73
Q

Charcot foot is often associated with which condition

A

diabetes

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74
Q

how does Charcot arthropathy present

A

unilateral ankle swelling with no pain
slight erythema
paraesthesia of the foot ankle instability

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75
Q

what are typical features of seronegative arthritis

A

sacra-iliac joint erosions
soft tissue swelling
irregular peri-articular new bone formation
pencil-in-cup deformity
spinal ligament ossification (syndesmophyte)

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76
Q

how does RhA present

A

symmetrical polyarthritis usually affecting small peripheral joints with red hot swelling and raised inflammatory markers

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77
Q

which antibody is associated with RhA

A

anti-CCP

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78
Q

which antibody is associated with APS

A

anti-cardiolipin

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79
Q

which conditions is investigated by anti-centromere antibodies

A

systemic sclerosis

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80
Q

features of ankylosing spondylitis

A

acute pain and stiffness of cervical spine
bilateral foot pain
trouble breathing

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81
Q

signs of prolapsed disc

A

pain and numbness in spinal nerve distribution with foot drop

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82
Q

signs of burst fracture

A

severe lumbar pain following a fall from height or severe axial loading

83
Q

what causes a colles fracture

A

FOOSH

84
Q

what are features of a colles fracture

A

extra-articular fracture of distal radius
dorsal angulation
dorsal displacement

85
Q

what are complications of colles fracture

A

median nerve compression
EPL rupture
CRPS
loss of grip strength

86
Q

what are features of bone mets

A

high calcium
osteoclast proliferation
bone pain

87
Q

what causes inflammation and degeneration of skeletal muscle throughout the body

A

polymyositis

88
Q

features of polymyalgia rheumatica

A

pain or stiffness, usually in the neck, shoulder, upper arms and hips

89
Q

signs of systemic sclerosis

A 
Calcinosis 
Raynaud's 
Esophageal dysmotility 
Sclerodactyly 
Telangiectasia
90
Q

why should tetracycline not be prescribed to children under 12 years

A

causes permanent tooth discolouration and occasional dental hypoplasia

91
Q

what are features of Aspergers

A

impaired social interaction without delays in cognition or language development

92
Q

2-day-old infant with non-projectile bilious vomiting

A

volvulus

93
Q

4-day-old infant with projectile vomiting and associated constipation, eager to feed

A

pyloric stenosis

94
Q

week old infant vomiting small amount after every feed, child well and gaining weight

A

gastro-oesophageal reflux

95
Q

placental artery carries oxygenated/deoxygenated blood

A

deoxygenated blood

96
Q

placental vein carries oxygenated/deoxygenated blood

A

oxygenated blood

97
Q

how long do episodes of BPPV last

A

seconds to minutes

98
Q

how is BPPV diagnosed

A

hallpike

99
Q

treatment of BPPV

A

epley manoeuvre

100
Q

compression of CN VII in facial canal

A

Bell’s palsy

101
Q

what causes Ramsay Hunt Syndrome

A

reactivation of VZV n geniculate ganglion of CN VII

102
Q

what are features of Ramsay hunt syndrome

A

auricular pain
facial nerve palsy
vesicular rash around ear, vertigo and tinnitus

103
Q

management of Ramsay hunt syndrome

A

oral acyclovir and corticosteroids

104
Q

which condition causes aural fullness

A

meniere’s disease

105
Q

symptoms of labyrinthitis

A

dizziness
hearing loss
vertigo

106
Q

signs of vestibular schwannoma

A

loss of corneal reflex
sensorineural hearing loss
vertigo
tinnitus

107
Q

bilateral vestibular schwannoma is a feature of…

A

neurofibromatosis II

108
Q

which nerve supplies sensory innervation of the cornea

A

ophthalmic division of the trigeminal nerve

109
Q

what is central scotoma

A

absence of central vision

110
Q

what type of visual loss is associated with dry ARMD

A

central scotoma

111
Q

signs of CN III palsy

A

eye looking down and out
fixed dilated pupil
proptosis
ptosis

112
Q

signs of CN IV palsy

A

eyes look upwards
vertical diplopia
cannot look down and in
head held tilted

113
Q

signs of CN VI

A

horizontal diplopia
eyes medially deviated
cannot move laterally from midline
convergent squint

114
Q

what causes cataracts

A

denaturation of the lens protein as part of ageing

115
Q

gradual painless loss of vision, reduced visual acuity, diminished red reflex

A

cataracts

116
Q

sudden painless profound loss of central vision in one eye following few days distorted vision

A

ARMD

117
Q

what causes wet ARMD

A

neovascularisation leads to large solitary haemorrhage at the macula leading to scarring

118
Q

what are characteristics of primary open angle glaucoma

A

raised IOP
disc cupping
field defects

119
Q

red irritable sticky eyes with normal visual acuity

A

bacterial conjuncitivitis

120
Q

red irritable itchy eyes with normal visual acuity

A

allergic conjunctivitis

121
Q

sudden onset unilateral visual loss associated with poorly controlled diabetes

A

retinal haemorrhage

122
Q

what is the first line treatment for BPH

A

alpha blocker (tamsulosin)

123
Q

what is second line treatment for BPH

A

5 alpha reductase (finestride)

124
Q

what is the biggest cause of kidney disease

A

diabetes

125
Q

what is the first line investigation for a hydrocele

A

doppler ultrasound with colour

126
Q

non-transilluminable scrotal swelling

A

testicular tumour

torsion

127
Q

hard lump scrotal swelling

A

testicular tumour

torsion

128
Q

scrotal swelling associated with absence of cremasteric reflex

A

torsion

129
Q

scrotal swelling associated with a ‘blue dot’ sign

A

torsion of appendix

130
Q

CKD stage 1

A

GFR >90

evidence of kidney damage (proteinuria, haematuria or abnormal imaging)

131
Q

CKD stage 2

A

GFR 60-90

with evidence of kidney damage (proteinuria, haematuria or abnormal imaging)

132
Q

CKD stage 3

A

GFR 30-60

dependent on GFR alone

133
Q

CKD stage 4

A

GFR 15-30

dependent on GFR alone

134
Q

CKD stage 5

A

GFR <15 or on renal replacement therapy

135
Q

what do you give in proteinuria and HTN

A

ACEI

136
Q

what is the commonest cause of glomerulonephritis

A

IgA nephropathy

137
Q

HSP is associated with which type of glomerulonephritis

A

IgA nephropathy

138
Q

IgA nephropathy pathology

A

mesangial cell proliferation and expansion on light microscopy with IgA deposits in mesangium

139
Q

minimal change glomerulonephritis is common in which age group

A

children

140
Q

how is minimal change glomerulonephritis managed

A

oral steroids

141
Q

what is seen on EM in minimal change glomerulonephritis

A

foot process fusion

142
Q

what antibody is associated with Churg-Strauss (eGPA)

A

p-ANCA

143
Q

which antibody is associated with GPA (Wegner’s)

A

c-ANCA

144
Q

rhinitis, epistaxis, saddle nose deformity, conductive hearing loss

A

GPA

145
Q

investigations for suspected renal colic caused by obstruction

A

KUB X-ray

CT non-contrast or MRI

146
Q

investigation of macroscopic haematuria in over 50

A

CT urography

cystoscopy

147
Q

investigation of macroscopic haematuria in under 50

A

US
cystoscopy
CTU when other two fail

148
Q

when might CTU be contraindicated

A

contrast allergy
renal impairment
pregnancy

149
Q

investigation for renal mass

A

CT
US for simple cyst
MRI with contrast instead of CT if young/pregnant

150
Q

how to assess AKI

A 
USS
U&amp;E
coat screen 
urinalysis 
immunology 
protein electrophoresis
151
Q

what is reabsorbed in the proximal convoluted tubule

A 
all glucose  
all amino acids 
sodium 
Cl-
water 
phosphate
sulphate
lactate
152
Q

what is secreted in the proximal convoluted tubule

A 
H+
hippurates 
bile pigments 
uric acids 
drugs 
toxins
153
Q

the descending limb is permeable to

A

water

154
Q

the descending limb is impermeable to

A

NaCl

155
Q

what is reabsorbed in the ascending limb

A

Na+ and Cl-

156
Q

which diuretics work on the PCT

A

carbonic anhydrase inhibitors

157
Q

which diuretics work on the thick ascending limb of the loop of henle

A

loop diuretics

158
Q

which diuretic work on the DCT

A

thiazides

159
Q

which diuretics work on the collecting tubule

A

potassium-sparing diuretics

160
Q

signs of kyperkalaemia on ECG

A

peaked T waves
widened QRS
small or absent P waves

161
Q

how to treat hyperkalaemia

A 
calcium glutinate (stabilise myocardium)
insulin glucose IV infusion (insulin drives K+ into cells, glucose maintains blood glucose)
NEB salbutamol (drives K+ into cells)
calcium resonium (bind K+ in the large intestine to be excreted)
162
Q

which Ig is found in mucosa

A

IgA

163
Q

what bacteria produces endotoxin

A

gram negative

164
Q

what is a side effect of ACEI

A

dry cough

165
Q

ACEI are contraindicated in

A

renal stenosis

166
Q

inferior MI shows up on which ECG leads

A

2, 3, avF

167
Q

which artery is blocked in inferior MI

A

right coronary

168
Q

lateral MI affects which leads

A

1 and avL, V5, V6

169
Q

sharp stabbing chest pain which worsens on breathing in
sudden breathlessness
dry cough (maybe blood)

A

PE

170
Q

risk factors for PE

A

OCP

long haul flight

171
Q

investigation of PE

A

CXR
CTPA
ventilation-perfusion scan

172
Q

management of PE

A

LMWH

warfarin

173
Q

sudden severe ripping/tearing chest pain that radiates down back LOC
SOB
Hx of HTN

A

aortic dissection

174
Q

management of campylobacter

A

clarithromycin/azithromycin

175
Q

management of salmonella

A

ciprofloxacin

176
Q

management of E coli

A

supportive

177
Q

management of C diff

A

oral metronidazole

178
Q

what are the 4Cs

A

cephalosporin
clindamycin
ciprofloxacin
clarithromycin

179
Q

bird pneumonia

A

chlamydiophilia psittaci

180
Q

sheep/farmer pneumonia

A

coxiella burnetti

181
Q

water foreign holiday air conditioner pneumonia

A

legionella

182
Q

what is the incidence

A

the number of NEW cases within a specified time period divided by the size of the population initially artist

183
Q

what is the prevalence

A

the number of people found to have the condition with the total number of people studied

184
Q

how is carpal tunnel syndrome caused

A

the median nerve passes through the carpal tunnel at the level of the wrist
if the contents of the tunnel swells, the space is too small and the nerve is compressed

185
Q

which fingers are affected by carpal tunnel

A

thumb
index
middle
lateral side of ring

186
Q

what imagining is required for a scaphoid fracture

A

two obliques
AP
lateral
(4 in total)

187
Q

Paget’s disease predisposes to which malignancy

A

osteosarcoma

188
Q

side effects of methotrexate

A

myelosuppresssion
liver cirrhosis
pneumonitis

189
Q

side effects of sulfasalazine

A

rashes
oligospermia
Heinz Body anaemia

190
Q

side effects of leflunomide

A

liver impairment
ILD
HTN

191
Q

side effects of hydroxychloroquine

A

retinopathy

corneal deposits

192
Q

side effects of prednisolone

A 
cushingoeid features 
osteoporosis 
impaired glucose tolerance 
HTN
cataracts
193
Q

side effects of gold

A

proteinuria

194
Q

side effects of penicillamine

A

proteinuria

exacerbation of myasthenia graves

195
Q

side effects of etanercept

A

demyelination

reactivation of TB

196
Q

side effects of mabs

A

reactivation of TB

197
Q

what causes sjorgens

A

lymphocytes invading glands

198
Q

what do people with systemic sclerosis die of

A

pulmonary hypertension

199
Q

dermatitis herpeticum looks like

A

monomorphic punched out lesions

200
Q

dermatitis herpeticum is caused by

A

secondary infection of eczema by HSV

201
Q

what are gout crystals made of

A

monosodium urate

202
Q

gout crystal birefringence

A

negatively birefringent needle shaped crystals

203
Q

pseudo gout crystals are made of

A

calcium pyrophosphate dehydrate

204
Q

pseudo gout crystal birefringence

A

positively birefringent rhomboid-shaped crystals

3 REVISION (7 decks)

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