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3 Flashcards

1
Q

what is the unhappy triad

A

MCL injury, ACL rupture, medial meniscus tear (usually from a valgus force )

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2
Q

what is another name for Jacks test

A

Hubscher’s manoeuvre-it involves dorsiflexion of the great toes to see if this exaggerates the medial arch formation, if it does then you have mobile flat footedness if not you have rigid flat footedness

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3
Q

how is the bone affected in osteoporosis

A

quantitiative defect of bone

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4
Q

how is the bone affected in osteomalacia

A

qualitative defect in bone with abnormal softening of bone due to deficient mineralisation of osteoid (immature bone)

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5
Q

what is an osteoid osteoma

A

small nidus of immature bone surrounded by an intense sclerotic halo, most commonly in adolescence and common sites are proximal femur, diaphysis of long bones and vertebrae, usually small, lesss than 1.5cm in diameter

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6
Q

what type of drug is latanoprost

A

prostaglandin

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7
Q

what does latanoprost do

A

can be used to treat ocular hypertension and open angle glaucoma

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8
Q

how does latanoprost work

A

it increases the uveoscleral outflow

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9
Q

what should eye pressures be below

A

21mmhg

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10
Q

what is scleritis associated with

A

50% have systemic disease eg RA, GPA

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11
Q

give the appearance of scleritis

A

large injected vessels, may have headache or photophobia, very painful ocular movements, eye is very painful

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12
Q

how do you treat scleriits

A

NSAIDS and very high dose steroids

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13
Q

how is endopthalmitis treated

A

intravitreal amikacin and vancomycin

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14
Q

how is bacterial keratitis treated

A

ofloxacin

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15
Q

how often does keratitis need to be treated

A

need admission so that hourly drops can be administered

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16
Q

what does keratitis look like

A

white area on the cornea-hypopyon usually

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17
Q

what does a viral keratitis have

A

a dendritic ulcer

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18
Q

what are the symptoms of open angle glaucoma

A

there are no symptoms, non painful but can get gradual progressive visual field loss

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19
Q

duct of stenson connects to what gland

A

parotid

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20
Q

what type of cells does small cell lung cancer come from

A

neuroendocrine cells

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21
Q

what does the flatter upper part of the oxyhaemoglobin curve mean

A

that a moderate fall in alveolar PO2 will not much affect oxygen loading

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22
Q

what does a steep lower part

A

means peripheral tissue gets a lot of O2 for a small drop in capillary po2

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23
Q

what does the bohr effect do

A

facilitates the removal of o2 from haemoglobin at tissue level by shifting the o2-hb dissociation to the right

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24
Q

what is residual volume

A

the min volume of air remaining in lungs even after maximal expiration

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25
Q

what is functional residual volume

A

volume of air left in lungs after passive expiration

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26
Q

what forms from the first pouch

A

Eustachian tube, middle ear, tympanic membrane

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27
Q

what forms from the first cleft

A

external auditory meatus

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28
Q

what are the otic placodes

A

thickenings of the ectoderm, one on each side overlying the hindbrain-rhombencephalon

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29
Q

what does the utricular portion give rise to

A

the semicircular canals

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30
Q

what does the saccular portion give rise to

A

the cochlea

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31
Q

what is the difference in erythema and purpura

A

purpura is due to the extravasation of blood so it will not blanche but erythema is due to vascular dilatation so it will blanche on pressure

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32
Q

what is petechial defined as

A

micro-haemorrhage 1-2mm in diameter

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33
Q

what is littles area

A

where the anterior ethmoidal, sphenopalatine and facial arteries anastomose

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34
Q

pencil in a cup deformity

A

psoriatic arthritis

35
Q

what are the symptoms of glaucoma

A

asymptomatic until visual field are badly impaired

36
Q

what are the risk factors for glaucoma

A

black race, family history, increasing age and hypertension and diabetes

37
Q

what type of vision predisposes to chronic open angle glaucoma

A

myopic

38
Q

what type of vision predisposes to closed angle glaucoma

A

hypermetropic

39
Q

what are some of the complications of glaucoma

A

vision loss, central retinal artery or vein occlusion and repeated episodes in either eye

40
Q

what are the causes of central retinal vein occlusion

A

glaucoma, polycythaemia, hypertension

41
Q

what is MEN I

A

parathyroid hyperplasia, pituitary adenoma, pancreatic tumours

42
Q

what type of tumours are in MENIIA

A

parathyroid hyperplasia, phaeochromocytoma, medullary thyroid cancer

43
Q

what type of tumours are in MEN IIB

A

phaeochromocytoma, medullary thyroid cancer, mucosal neuroma

44
Q

when examining the eyes what 5 things do you do/check

A 
(inspect the eyes) 
visual acuity 
visual fields 
external eye movements
fundi 
pupils
45
Q

what is the presentation of bacterial keratitis

A

rapid onset of pain, photophobia and decreased vision

46
Q

what does gluteus maximus do

A

extend the hip

47
Q

what does gluteus medius and minimus do

A

ABduct and medially rotate the hip

48
Q

what does the deep muscles of the hip do

A

laterally rotate the thigh and hip

49
Q

what is the nerve supply to the posterior thigh and what are its nerve roots

A

all supplied by the tibial division of sciatic nerve (L5,S1,S2) apart from short head of biceps femoris which is supplied by common fibular division of sciatic

50
Q

what is the nerve supply to the hamstring part of the adductor magnus

A

tibial nerve -L5,S1,S2

51
Q

what is the nerve supply to the short head of biceps

A

the common fibular nerve

52
Q

what are the nerve roots of the deep fibular nerve

A

L4,L5

53
Q

what are the nerve roots of the superficial fibular nerve

A

L5,S1,S2

54
Q

how do superficial lymph from the lower limb drain

A

follow saphenous veins, drain to superficial inguinal lymph nodes then to external iliac lymph nodes

55
Q

how do deep lymphatics from the lower limb drain

A

follow deep veins (popliteal lymph nodes) to deep inguinal nodes to external to common iliac to lumbar lymphatics

56
Q

what are the hip joint ligaments

A

iliofemoral, pubofemoral, ischiofemoral

they spiral from pelvis to femur

57
Q

what is the course of the obturator nerve

A

the obturator nerve, artery and vein enter the medial compartment of the thigh via the obturator foramen of the hip bone
the nerve then divides into anterior and posterior at the upper border of adductor brevis

58
Q

what is the neurovascular bundle superficial to deep

A 
tibial nerve (from sciatic) 
popliteal vein (posterior tibial)
popliteal artery (continuation of femoral)
lymphatics-popliteal lymph nodes are located along the popliteal vein in the fossa
59
Q

what does the ACL help prevent against

A

anterior displacement of the tibia on the femur and hyperextension of the knee joint
also resists internal rotation

60
Q

what does PCL prevent against

A

posterior displacement of the tibia on the femur and helps prevent against hyperflexion of the joint

61
Q

what does genu varum increase the risk of

A

medial OA

62
Q

what separates the anterior and lateral compartments of the leg

A

the ANTERIOR intermuscular septum

63
Q

where does the fibularis longus attach distally

A

the fibularis longus passess beneath the sole of the foot to reach the bases of the 1st metatarsal

64
Q

where does the fibular brevis attach distally

A

base of the 5th metatarsal

65
Q

what forms the anterior wall of the axilla

A

pec major

66
Q

what is the axillary vein a continuation of

A

the brachial vein, it becomes the axillary vein at the lower border of teres major

67
Q

what is an eponychium

A

cuticle

68
Q

how do you treat hyperkalaemia

A

10mls of 10% calcium gluconate ASAP

69
Q

where is the quadrangular membrane

A

between vestibular ligament and epiglottis

70
Q

where is the conus elasticus

A

between cricoid and vocal ligament

71
Q

what is serostitis

A

inflammation of a serous membrane eg lungs, or pericardium

72
Q

what is there an accelerated risk for in SLE

A

IHD

73
Q

what can steroids cause in relation to the eye

A

cataracts and glaucoma

74
Q

what are the thyroid function results in sick euthyroid

A

everything may be low TSH, T3 and T4 (or TSH may be normal)

75
Q

where do amiloride and triamtere act

A

they block luminal Na channels on the apical membrane in late distal tubule and collecting ducts

76
Q

how do spironolactone and eplerenone wor

A

compete with aldosterone for binding to intracellular receptors causing decreased gene expression and reduced synthesis of a protein mediator that activated Na channels in apical

77
Q

what are aquaretics/vaptans

A

vasopressin receptor antagonists

78
Q

what do aquaretics/vaptans cause

A

an electrolyte free aquaresis, decrease urine osmolality
increase serum sodium
used in SIADH, CHF, cirrhosis

79
Q

where are Askanazy/Hurtle cells found

A

in Hashimotos thyroiditis and follicular thyroid cancer

80
Q

what is the gold standard test for acromegaly

A

GTT

81
Q

what does aldosterone cause excretion of

A

potassium

82
Q

what can malignant hyperparathyroidism cause

A

PThrP is formed by malignant squamous cell carcinomas, it mimics PTH resulting in decreased PTH, increased calcium and increased phosphate

83
Q

what is the issue with pseudohypoparathyroidism

A

it is PTH resistant

84
Q

what cancer is associated with SIADH

A

small cell lung cancer

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