3 Flashcards
what is the unhappy triad
MCL injury, ACL rupture, medial meniscus tear (usually from a valgus force )
what is another name for Jacks test
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
how is the bone affected in osteoporosis
quantitiative defect of bone
how is the bone affected in osteomalacia
qualitative defect in bone with abnormal softening of bone due to deficient mineralisation of osteoid (immature bone)
what is an osteoid osteoma
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
what type of drug is latanoprost
prostaglandin
what does latanoprost do
can be used to treat ocular hypertension and open angle glaucoma
how does latanoprost work
it increases the uveoscleral outflow
what should eye pressures be below
21mmhg
what is scleritis associated with
50% have systemic disease eg RA, GPA
give the appearance of scleritis
large injected vessels, may have headache or photophobia, very painful ocular movements, eye is very painful
how do you treat scleriits
NSAIDS and very high dose steroids
how is endopthalmitis treated
intravitreal amikacin and vancomycin
how is bacterial keratitis treated
ofloxacin
how often does keratitis need to be treated
need admission so that hourly drops can be administered
what does keratitis look like
white area on the cornea-hypopyon usually
what does a viral keratitis have
a dendritic ulcer
what are the symptoms of open angle glaucoma
there are no symptoms, non painful but can get gradual progressive visual field loss
duct of stenson connects to what gland
parotid
what type of cells does small cell lung cancer come from
neuroendocrine cells
what does the flatter upper part of the oxyhaemoglobin curve mean
that a moderate fall in alveolar PO2 will not much affect oxygen loading
what does a steep lower part
means peripheral tissue gets a lot of O2 for a small drop in capillary po2
what does the bohr effect do
facilitates the removal of o2 from haemoglobin at tissue level by shifting the o2-hb dissociation to the right
what is residual volume
the min volume of air remaining in lungs even after maximal expiration
what is functional residual volume
volume of air left in lungs after passive expiration
what forms from the first pouch
Eustachian tube, middle ear, tympanic membrane
what forms from the first cleft
external auditory meatus
what are the otic placodes
thickenings of the ectoderm, one on each side overlying the hindbrain-rhombencephalon
what does the utricular portion give rise to
the semicircular canals
what does the saccular portion give rise to
the cochlea
what is the difference in erythema and purpura
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
what is petechial defined as
micro-haemorrhage 1-2mm in diameter
what is littles area
where the anterior ethmoidal, sphenopalatine and facial arteries anastomose
pencil in a cup deformity
psoriatic arthritis
what are the symptoms of glaucoma
asymptomatic until visual field are badly impaired
what are the risk factors for glaucoma
black race, family history, increasing age and hypertension and diabetes
what type of vision predisposes to chronic open angle glaucoma
myopic
what type of vision predisposes to closed angle glaucoma
hypermetropic
what are some of the complications of glaucoma
vision loss, central retinal artery or vein occlusion and repeated episodes in either eye
what are the causes of central retinal vein occlusion
glaucoma, polycythaemia, hypertension
what is MEN I
parathyroid hyperplasia, pituitary adenoma, pancreatic tumours
what type of tumours are in MENIIA
parathyroid hyperplasia, phaeochromocytoma, medullary thyroid cancer
what type of tumours are in MEN IIB
phaeochromocytoma, medullary thyroid cancer, mucosal neuroma
when examining the eyes what 5 things do you do/check
(inspect the eyes) visual acuity visual fields external eye movements fundi pupils
what is the presentation of bacterial keratitis
rapid onset of pain, photophobia and decreased vision
what does gluteus maximus do
extend the hip
what does gluteus medius and minimus do
ABduct and medially rotate the hip
what does the deep muscles of the hip do
laterally rotate the thigh and hip
what is the nerve supply to the posterior thigh and what are its nerve roots
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
what is the nerve supply to the hamstring part of the adductor magnus
tibial nerve -L5,S1,S2
what is the nerve supply to the short head of biceps
the common fibular nerve
what are the nerve roots of the deep fibular nerve
L4,L5
what are the nerve roots of the superficial fibular nerve
L5,S1,S2
how do superficial lymph from the lower limb drain
follow saphenous veins, drain to superficial inguinal lymph nodes then to external iliac lymph nodes
how do deep lymphatics from the lower limb drain
follow deep veins (popliteal lymph nodes) to deep inguinal nodes to external to common iliac to lumbar lymphatics
what are the hip joint ligaments
iliofemoral, pubofemoral, ischiofemoral
they spiral from pelvis to femur
what is the course of the obturator nerve
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
what is the neurovascular bundle superficial to deep
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
what does the ACL help prevent against
anterior displacement of the tibia on the femur and hyperextension of the knee joint
also resists internal rotation
what does PCL prevent against
posterior displacement of the tibia on the femur and helps prevent against hyperflexion of the joint
what does genu varum increase the risk of
medial OA
what separates the anterior and lateral compartments of the leg
the ANTERIOR intermuscular septum
where does the fibularis longus attach distally
the fibularis longus passess beneath the sole of the foot to reach the bases of the 1st metatarsal
where does the fibular brevis attach distally
base of the 5th metatarsal
what forms the anterior wall of the axilla
pec major
what is the axillary vein a continuation of
the brachial vein, it becomes the axillary vein at the lower border of teres major
what is an eponychium
cuticle
how do you treat hyperkalaemia
10mls of 10% calcium gluconate ASAP
where is the quadrangular membrane
between vestibular ligament and epiglottis
where is the conus elasticus
between cricoid and vocal ligament
what is serostitis
inflammation of a serous membrane eg lungs, or pericardium
what is there an accelerated risk for in SLE
IHD
what can steroids cause in relation to the eye
cataracts and glaucoma
what are the thyroid function results in sick euthyroid
everything may be low TSH, T3 and T4 (or TSH may be normal)
where do amiloride and triamtere act
they block luminal Na channels on the apical membrane in late distal tubule and collecting ducts
how do spironolactone and eplerenone wor
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
what are aquaretics/vaptans
vasopressin receptor antagonists
what do aquaretics/vaptans cause
an electrolyte free aquaresis, decrease urine osmolality
increase serum sodium
used in SIADH, CHF, cirrhosis
where are Askanazy/Hurtle cells found
in Hashimotos thyroiditis and follicular thyroid cancer
what is the gold standard test for acromegaly
GTT
what does aldosterone cause excretion of
potassium
what can malignant hyperparathyroidism cause
PThrP is formed by malignant squamous cell carcinomas, it mimics PTH resulting in decreased PTH, increased calcium and increased phosphate
what is the issue with pseudohypoparathyroidism
it is PTH resistant
what cancer is associated with SIADH
small cell lung cancer
