3 December #2 Flashcards
What are symptoms of cataracts?
Gradual progressive loss of visual acuity/blurring of vision
Fading colour vision esp blues
Glares and halos around lights
Impaired night vision
What are findings/investigations for cataracts?
Leukocoria- grey/white discolouration of pupil
Loss of red reflex
Slip lamp exam to visualise
What are features of depression
Low mood
Anhedonia- loss of enjoyment
Weight change
Difficulty concentrating
Sleep disturbance
Irritability
What are causes of lower zone pulmonary fibrosis?
Asbestosis
Connective tissue disorder e.g. SLE
Idiopathic pulmonary fibrosis
Drugs e.g. amiodarone, methotrexate, nitrofurantoin
What are causes of upper zone Fibrosis?
Coal works
Hypersensitivity pneumonitis
Ankylosing spondylitits
TB
Sarcoidosis
What is the management of idiopathic pulmonary fibrosis?
Nintendanib or Pirfenidone if FVC 50-80%
Otherwise supportive, e.g., pulmonary rehab, LTOT, transplant
What investigations should be done in Idiopathic pulmonary fibrosis?
Gold standard High resolution CT- honeycombing/ground glass
Spirometry- restrictive picture (low FVC, high FEV1:FVC)
Low TLCO
What are features of Mortons neuroma?
Thickening of the common digital plantar nerve
Forefoot pain- sharp or burning
Altered sensation in toes (3rd intermetatarsal space)
Worse on activity
Stone in shoe feeling
=ve mulders click
What are clinical features of digoxin toxicity?
Confusion
N&V
Yellow-green vision
Bradycardia
Hypokalaemia
Treat with digibind
What is the management in acute mania?
1- oral antipsychotic
2- if not effective try alternative
3- add lithium
What is the management of post partum depression?
Mild- self help
Moderate/severe- CBT
2nd line medication- SSRI/SNRI/TCA (if breastfeeding, then paroxetine or sertraline
What are features of drug hypersensitivity syndrome?
High temp
Rash- morbilliform- target lesions or blisters
Organ involvement e.g. hepatitis or AKI
High eosinophils, leukocytosis
Treat with steroids
What antibodies are found in autoimmune hepatitis?
type 1- Anti-smooth muscle (adults and kids
2- Anti liver kidney microsomal antibodies (kids only)
3- Anti soluble liver antigen antibodies- middle aged adults
What are symptoms of autoimmune hepatitis?
Jaundice
Derranged LFTs- ALT/AST 5-10x upper limit
Features of CLD
INR high
What investigations findings are present in encephjalitis?
LP- lymphocytosis, raised protein, PCR- HSV
MRI- temporal and frontal lobe inflammation and oedema
If T2 weighted MRI- increased signal in temporal or frontal lobes
What is the management of PID?
If OP
1) Im ceftriaxone, PO doxy, PO metro 14 days
2) PO ofloxacin and PO metro 14 days
3) PO moxifloxacin 14 days
If admitted
1) IV cef and IV doxy
Or IV clindamycin and IV gent
What are features of Lambert Eaton Syndrome
Due to antibodies against voltage gated Ca channels due to cancer e.g. small cell/ovarian/breast
Symptoms
- hyporeflexia
- waddling gait
- muscle weakness
What is the management of absence seizures?
1) Ethosuximide
2) Valproate
What is the management of tonic clonic?
1) Valproate
2) Lamotrigine or keppra (women)
What is the management of myoclonic seizures?
1) Valprotate
2) Keppra
What is the management of focal seizures?
1) Lamotrigine or keppra
What are features of Osgood Schlatter disease?
Inflammation of patellar ligaent at tibial tuberosity
Affects children/teens
Progressive knee pain worst over tibial tuberosity
Worse after sports
Pain on palpation of tibial tuberosity
Pain reproduced on knee extension against resistance
What are clinical features of Psittacosis?
Die tp Chlamydia Psittaci
Transmitted from birds
Flu like symptoms
Atypical pneumonia- dry non productive cough
Hepatosplenomegaly
Fever with no tachycardia
Treat with doxy or clarithromycin
What are features of orbital cellulitis?
Often due to URTI or sinusitis
Acute severe ocular pain
Opthalmoplegia with diplopia
Lid oedema and erythema
CT with contrast
IV abx
