8 Flashcards
what does electromyography in likely MND show
a decrease in number of action potentials with increase in amplitude
is chronic inflammation usually primary or secondary
usually primary
describe the main features of chronic inflammation
angiogenesis predominates, macrophages, plasma cells and lymphocytes
healing by fibrosis
when could you get splenic atrophy
coeliac disease
in terms of peritoneum where is spleen located
almost entirely covered in peritoneum which adheres firmly to its capsule
recesses of greater sac separate it from the stomach and kidney
what is most associated with early onset alz
presenilin 1
what type of cells are seen in CLL
smear cells
what is the mutation in sickle cell disease
point mutation in B chain and predisposes haemoglobin to polymerisation resulting in sickled cells and decrease RBC survival
what are hereditary thrombophilias caused by
Factor V Leiden, antithrombin III deficiency, protein C deficiency, protein S deficiency
what can female cells show
Barr bodies-inactivated condensed X chromosome
where is the substantia gelatinosa and what does it do
pain and temperature in posterior horn
describe pathway of anterior corticospinal tract (also called ventral)
the neurones converge and descend through the internal capsule
they remain ipsilateral, decussate and terminate in ventral horn of cervical and upper thoracic
describe pathway of lateral corticospinal tract
neurones converge and descend through internal capsule, decussate in medulla and then terminate in the ventral horn
what are the 2 parts of corticospinal tract and spinothalamic tract
both have anterior and lateral parts
what does anterior spinothalamic tract carry
sensory modalitites of pressure and crude touch
what does lateral spinothalamic tract carry
pain and temperature
what do the 1st order neurones in spinothalamic tract do
arise from sensory receptors in periphery-enter spinal cord, ascend 1-2 vertebral levels and synapse in tip of dorsal horn-substantia gelatinosa
what do second order neurones in spinothalamic tract do
from substantia gelatinosa to thalamus, they decussate within the cord and form 2 tract
what 2 tracts does spinothalamic form
anterior and lateral
where can ovarian tumours be derived from
surface epithelium, sex cord/stromal tumours, germ cell tumours
name the types of germ cell ovarian tumours
teratoma, dysgerminoma, choriocarcinoma, yolk sac tumour
name the types of sex cord/stromal tumours
fibroma, thecoma-granulosa, sertoli-leydig
what are the main features of brenner tumour
usually benign, contain Watthard cell rests
typically coffee bean nuclei
what is the other name for alemtuzumab
lemtrada
how does lemtrada work
it acts against T cells in relapsing-remitting MS
what is other name for Tysabri
natalizumab
how does natalizumab/Tysabri work
acts against VLA-4 receptors that also allow immune cells
what is the precursor to squamous cervical cancer
Cervical Intraepithelial Neoplasia-CIN
what is the precursor to adenocarcinoma cervical cancer
Cervical Glandular Intraepithelial Neoplasia-CGIN
when is a burst fracture typically seen
In young patients with trauma
there is involvement of the posterior elements
when do you get a wedge fracture
typically in thoracic spin in patients with osteoporosis, metastatic disease (bony mets) and osteogenesis imperfect
link between MND and FTD is because of
C90RF hexanucleotide repeat expansions
wasting of thenar eminence is present in
MND
what are the muscles of thenar eminence
Opponens pollicis Abductor pollucis brevis flexor pollicis brevis
what are the muscles of thenar eminence supplied by
median nerve
describe type I fibres
slow oxidative
ATP from oxidative phosphorylation
slow contraction and relaxation-fatigue resistant
red fibres=high myoglobin content
describe type II fibres
2 categories-type IIA=oxidative phosphylation-fast contraction and relaxation, fatigue resistant
type IIB=ATP from glycolysis, fast contraction but NOT FATIGUE RESISTANT, pale in colour and poorly vascularised
where are Golgi tendon organs forund
at the junction of muscle and tendon
what do Golgi tendon organs do
monitor changes in muscle tension
what is the relation to Golgi tendon organs and extrafusal fibres
in series with extrafusal fibres (intrafusal fibres in parallel with extrafusal fibres)
what are Golgi tendon orgnas innervated by
Ib sensory afferents (these are myelinated and slightly slower conducting than 1a)
most important prognostic indicator in VIN
spread to inguinal lymph nodes
what is the motor neurone pool
collection of alpha motor neurones that innervate a single muscle
side effects of carbamazepine
leucopenia, diplopia, blurred vision, impaired balance, drowsiness, mild generalised rash, SIADH
side effects of lamotrigine
SJS, TEN, diplopia, blurred vision, photosensitivity, tremor, agitation, vomiting, aplastic anaemia
side effects sodium valporate
VALPORATE-alopecia, liver failure-watch LFTs, pancreatitis, oedema, ataxia, teratogenicity, tremor, thrombocytopaenia, encephalopathy (due to increased ammonia)
side effects for phenytoin
nystagmus, diplopia, tremor, dysarthria, ataxia, decreased intellect, depression, corase facial features, acne, gum hypertrophy, polyneuropathy, gum dyscrasis
dacrocytes are typical of
myelofibrosis
how do you test for complement deficiency
normal IgG and vaccine response but symptoms of primary immunodeficiency disease
main test is CH50 and AP50 test
describe paroxysmal hemicranias
typically in the elderly
women>men
shorter duration and more frequent than cluster
severe unilateral headache, autonomic features
10-30mins
1-40 a day
absolute response to INDOMETHACIN
what is first line treatment for trigeminal neuralgia
carbamazepine
what is the typical position of the uterus in endometriosis and why
fixed retroverted from scar tissue which forces uterus out of its normal position
which TCAs are the most dangerous in overdose
dosulepin and amitriptyline
what is Uhthoffs phenomenon
worsening of vision following increase in body temperature
Lhermitte’s syndrome
paraesthesia in limbs on neck flexion
what is a straddle fracture
fracture to all 4 pubic rami
what does prothrombin time look at
TF/VIIa
extrinsic system
the extrinsic pathway is looked at by what
prothrombin time
what does intrinsic pathway measure
APTT
what is hairy leukoplakia caused secondary to
EBV
