4 Flashcards
what does membranous look like on light microscopy
spike and dome
what does diffuse proliferative look like on LM
wire loop
what complication is associated with RTA type 1
renal stones
what complication is associated with RTA type 2
osteomalacia and coeliac disease
what is alports syndrome associated with
splitting of lamina densa
what is Bartters syndrome
defect in the Na/K/Cl cotransporter
what is Fanconi syndrome
generalised disorder of renal tubular transport in the PCT
what causes apple green birefringence on congo red staining
amyloidosis
what is renal cell carcinoma associated with
smoking, VHL syndrome, tuberous sclerosis
what is filtered load
GFR x plasma conc
where are the desmosomes
in the prickle cell layer
where are the hemidesmosomes
dermo-epidermal junction
where is the dorsalis pedis artery felt
lateral to the EHL tendon
what nerve roots does the knee jerk test
L3,L4
what type of drug is latanoprost
prostaglandin analogue
how does latanoprost work
it increases the uveascleral outflow
how do B blockers such as timolol work
they reduce the aq production
should be avoided in heart block and asthmatics
how do carbonic anhydrase drugs work
they decrease the aq production
give an example of a carbonic anhydrase drug
dorzolamide
what virus causes dendritic ulcers
Herpes simplex
how do you treat a dendritic ulcer
3% eye ointment of acyclovir 5x a day
how do you treat a herpes zoster virus that involves the cornea
oral aciclovir
how do you treat anterior uveitis
refer to opthamology
cyclopegics-eg atropine, cyclopenate
what muscle does froments test test
looking for ulnar nerve palsies
ADDUCTOR pollicis
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
