4 Flashcards by Erin Prentice

what does membranous look like on light microscopy

spike and dome

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what does diffuse proliferative look like on LM

wire loop

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what complication is associated with RTA type 1

renal stones

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what complication is associated with RTA type 2

osteomalacia and coeliac disease

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what is alports syndrome associated with

splitting of lamina densa

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what is Bartters syndrome

defect in the Na/K/Cl cotransporter

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what is Fanconi syndrome

generalised disorder of renal tubular transport in the PCT

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what causes apple green birefringence on congo red staining

amyloidosis

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what is renal cell carcinoma associated with

smoking, VHL syndrome, tuberous sclerosis

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what is filtered load

GFR x plasma conc

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where are the desmosomes

in the prickle cell layer

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where are the hemidesmosomes

dermo-epidermal junction

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where is the dorsalis pedis artery felt

lateral to the EHL tendon

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what nerve roots does the knee jerk test

L3,L4

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what type of drug is latanoprost

prostaglandin analogue

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how does latanoprost work

it increases the uveascleral outflow

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how do B blockers such as timolol work

they reduce the aq production

should be avoided in heart block and asthmatics

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how do carbonic anhydrase drugs work

they decrease the aq production

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give an example of a carbonic anhydrase drug

dorzolamide

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what virus causes dendritic ulcers

Herpes simplex

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how do you treat a dendritic ulcer

3% eye ointment of acyclovir 5x a day

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how do you treat a herpes zoster virus that involves the cornea

oral aciclovir

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how do you treat anterior uveitis

refer to opthamology

cyclopegics-eg atropine, cyclopenate

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what muscle does froments test test

looking for ulnar nerve palsies

ADDUCTOR pollicis

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what are langherhans cells

they are antigen presenting cells

where are Langerhans cells made

in the bone marrow

where are the hemidesmosomes found

in the basal layer

where are the desmosomes found

prickle cell layer

A 3 year old boy presents on a sunny day in June. His mother reports he keeps crying and rubs at his skin when playing outside and this has been going on for a few weeks. His skin is sometimes a bit red, but there is never a rash and his skin is clear on examination now. He is skin type 1 with a few freckles evident, generally well, on no medication and there is no family history of skin problems.

erythropoeitc protoporphyria

what happens in catagen phase

it is the involuting phase

what happens in telogen phase

resting phase

which layer are the odland bodies found in

the granular layer

describe mucosal membranes

they are highly specialised for function, Mucosal membranes are often affected by skin disease e.g. blistering diseases. They aren’t keratinised, have many sensory functions e.g. taste, and often contain glands e.g. lacrimal glands, sebaceous glands

where are the filaments in the prickle cell layer

the filaments are Intercellular

where are melanocytes found

in the basal layer

where does nuclei loss happen

starts in the granular layer and is complete in the keratin layer

what is the mediator for type IV hypersensitivity reactions

TH1

58 year old man presents in July with blisters on the dorsal aspect of his hands which have been appearing over the last few months, crust over and heal leaving scarring. He works as a joiner and is aware that his skin has also been more fragile than usual. You notice that he has a lot of hair growing on his cheeks. He is generally well and on no medication What is the most likely diagnosis?

porphyria cutanea tarda

what do the sebaceous glands do

they maintain the skin barrier

whats the most common causal organism for dermatophyte infections

trichophyton mentagraphytes | around 70%

what is erysipelas

a more superficial cellulitis and typically more raised and demarcated than cellulitis caused by group A strep

when should you suspect necrotising fasciitis

when there is little to see on the surface but there is SEVERE pain

describe what staph looks like

gram positive cocci in clusters

for psoriasis which topical treatment is the most clean and least smelly

vitamin D analgogue, it is easy to apply, non greasy and non smelly

what is the first line treatment for rosacea

topical metronidazole

what happens to the sebaceous glands in rosacea

there is sebaceous glans hyperplasia but sebum excretion is normal

how to you treat arterial ulcers

DONT USE COMPRESSION BANDAGING keep the ulcer clean and covered adequate analgesia and vascular reconstruction

what is mycosis fungoides

commonest T cell lymphoma | it progresses from well defined itchy red scales and plaques to red-brown infiltrated plaques and ulcerating tumours

which embryological layer is the epidermis formed from

ectoderm

what embryolocical layer is the dermis formed from

mesoderm

what type of cells are melanocytes

dendritic cells

where are Langerhans cells found

in the prickle cell layer and also in dermis and lymph nodes

what are birbeck grnaules

found in Langerhans cells

what genetic mutations are found in melanomas

50% melanomas have an activating B raf mutation | genetic markers eg CDKNA mutations

where is filaggrin found

in the granular layer | large keratohyalin grnaules, contain structural filaggrin and involucrin proteins

what is an arthus reaction

a localised type III hypersensitivity reaction

mutations in which gene is associated with BCC

PTCHI

what damage does benign hypertension do to the kidneys

firbointimal thickenening and luminal narrowing | atrophy and ischaemia of the nephrons

what does malignant hypertension do to kindeys

fibrinoid necrosis

what does diabetes do to the kidneys

widespread ischaemic atrophy secondary to atheroma of renal arteries, arteriolar hyalinosis and luminal narrowing diffuse and nodular glomerulosclerosis

what are sympathomimetics

used in open angle glaucoma, usually when topical B blocker is inappropriate eg brimonidine

what is tocilizumab

IL6 receptor blocker

what is abatercept

t CELL FUNCTION DISRUPTION

what causes eczema herpeticum

herpes simplex virus

what is keratoderma

cutaneous manifestation of reiters disease

what causes exacerbation of psoriasis

B blocker, lithium, chloroquine and hydroxychloroquine, NSAIDs and ACEI and infliximab

describe helicobacter

gram negative bacteria

how is H pylori eradicated

PPI, amoxicillin, clarithromycin

management of heart failure

1st line ACEI and Bblocker 2nd line aldosterone antagonist, hydralazine and nitrate 3rd line cardiac resynchronisation therapy or digoxin

how do you treat dyspepsia without any alarm features and not on any medication

test and treat for h pylori or advise on lifestyle factors and then full dose PPI for one month and reassess

how do you give oxygen to COPD patients

28% venture mask at 4l/min and aim for o2 sats of 88-92% adjust target if pco2 is normal

what is Blatchford score

used at first assessment of a GI bleed

what is Rockall score

used after endoscopy

what is characteristic about hypokalaemia

U waves, small or absent T waves,prolong PR interval, ST depression, long QT

how is heart rate calculated

if the heart rate is regular then it is calculated by 300 divided by the number of large squares between beats

how is an irregular heart rate calculated

count the number of QRS complexes in 30 large squares and multiple by 10

how do you treat a displaced fracture of olecranon

tension wire band