Additional Stuff Missed Flashcards
Which layer of the skin is reduced in psoriasis?
Stratum granulosum
Define Osteomalacia and give some causative reasons for it:
Softening of the bone secondary to decreased mineralization of the bone matrix
Causes:
- Low Vit D = Low Ca2+
Outline pathogenesis behind Non- radiographic axial spondyloarthritis:
Gut flora + HLA B27 + Abnormal biomechanics
= IL-23
this promotes:
- IL17 = inflammation and bone loss
- IL- 22 = Osteoproliferation
List some places that are at risk of avascular necrosis:
Femoral head
Scaphoid
Tarsal navicular
Outline the stages of OA on radiograph:
Stage 0 = nothing seen
stage 1 = minor joint space narrowing +/- small osteophytes
Stage 2 = Definitive Osteophytes + joint space narrowing
Stage 3 = Multiple Osteophytes + Definitive joint space narrowing
+/- Deformity
Stage 4 = Large osteophytes, marked reduction in joint space + deformity + scloerosis
Who get’s urine cultures done when there is a UTI:
3< children
What is the diagnostic criteria for RA?
Number of joints: Max 5 points
Serology:
Synovitis
ESR or CRP
List some complications of AKI:
Hyperkalamia
Pulmonary edema
Acidosis
Toxin build up
Define Pyuria and if it present without bacteria in the urine, what are some likely diagnoses?
Pyuria: Pus in the urine
If without bacteria consider:
- TB
- Chlamydia
What is the most common type of prostate cancer and how is it graded?
Adenocarcinoma
Gleason’s grading
What is the staging of prostate cancer and where does it often spread to?
T1 - local involvement
T2 - Diffuse throughout Prostate
T3 - eroded out of prostate
T4 - invading neighbouring structures
*levi rectal muscle often involved
Things that can raise PSA:
Size of prostate
Acute illness
Age - increases with age
List some causes of Down’s syndrome with some features you expect to see and how is down’s diagnosed?
Nondisjunction
Robertsonian translocation
Mosaicism
Phenotype features:
- epicanthal folds
- flat facial profile
- tetralogy of fallot
- one palmar crease
- macroglossus
- Chorionic villus sampling
- Amniocentesis
- use karyotyping
List several things that go wrong with valves and the apparatus:
Valves:
- Calcification
- Thickening
- Degeneration
- Prolapse
Annular: - Dilation - Calcification - tethering/ rupture -
Systemic diseases associated with aortic regurgitation:
Marfan’s syndrome
SLE
Ankylosing spondylitis
Valve replacement: compare and contrast mechanical valves and tissue valves:
Mechanical:
- life long durability
- anti-coagulation is needed
- increased risk of infection
- haemolytic anaemia
Tissue:
- limited life expectancy
- free from anticoagulation
List some complications of mitral stenosis:
AF
Pulmonary hypertension with right sided heart failure
Dysphagia as it compresses on the esophagus
Stroke formation - due to the AF
There are two types of mitral regurgitation - what are they?
Mitral valve prolapse
- pansystolic
Mitral regurgitation
- mid systolic click followed by pansystolic
Which murmur is associated with IVDUs?
Tricuspid regurgitation
Whats the most important diagnostic factor for leukaemia which will guide treatment:
Cytogenetics of the cancer
What is the treatment for ALL?
and what is an extremeley bad prognostic for ALL?
Young:
- High dose Chemo
- Clinical Trials
- Supportive management
- Stem cell transplant - if relapse, refractory, Good performance
Bad prognostic:
- t9;22
What is the treatment for AML?
<60: High dose chemo + Stem Cell Transplant
> 60: Low dose Chemo
Comorbidities or very old: Supportive measures
What may have hypercellularity but present with pancytopenia?
Myelodysplastic syndrome
May progress to AML
*Refractory Anaemia with blast cell = most at risk of doing this
Symptoms of GvHD:
Jaundice
Diarrhea - bloody
Rash
Hepatosplenomegaly
What can cause Cold type haemolytic syndrome?
Mycoplasma infections
EBV infection
Common drug used for haemophilic disorders:
Desmopressin
Management of Immune thrombocytopenia purpura?
Intravenous immunoglobulins
Name the drug used to mimic mineralocorticosteroids and when is it used?
Fludrocortisone
In adrenal insufficiency
Outline how Adenosine works and list some side effects:
MOA:
Causes transient heart block across the AVN:
A1 receptors activation which reduces cAMP. This stimulates efflux of K+ - causing hyperpolarization of the node, blocking Ca2+ from entering and depolarising.
this causes a break in the re-entry circuit of the AVN. Allowing the SA node to resume sinus rhythm over the heart.
Side effects:
- transient heart block
- breathlessness
- sense of impeding doom as the heart stops
*should not be used in coronary heart disease due to the coronary steal syndrome
