All Flashcards by Em C

Hand inspection of any exam

Janeway lesions

Non tender eryhtematous macuilpapular lesions (contain bacteria) on palms/pulps of fingers in IE

How well did you know this?

Not at all

Perfectly

Hand inspection of any exam

Janeway lesions

Non tender eryhtematous macuilpapular lesions (contain bacteria) on palms/pulps of fingers in IE

How well did you know this?

Not at all

Perfectly

Hand inspection of any exam

Janeway lesions

Non tender eryhtematous macuilpapular lesions (contain bacteria) on palms/pulps of fingers in IE

How well did you know this?

Not at all

Perfectly

Hand inspection of any exam

Oslers nodes
- Raised tender palpable nodules on the pulps of fingers/toes or thenar/hypothenar eminence.
Assoc w/ IE

How well did you know this?

Not at all

Perfectly

Hand inspection of any exam

Oslers nodes
- Raised tender palpable nodules on the pulps of fingers/toes or thenar/hypothenar eminence.
Assoc w/ IE

How well did you know this?

Not at all

Perfectly

Hand inspection of any exam

Oslers nodes
- Raised tender palpable nodules on the pulps of fingers/toes or thenar/hypothenar eminence.
Assoc w/ IE

How well did you know this?

Not at all

Perfectly

Eye exam of any exam

Xanthelasma - most common xanthoma.
Plane xanthoma usually around the medial canthus of the upper eyelid (but upper and lower eyelids can be affected symmetrically.)

Presents as soft, yellow or orangey macules, papules, or plaques.
Deposits of lipid (often at normal levels)
Assoc w/

FH
Type II hyperlipoproteinaemia,
primary biliary cirrhosis

How well did you know this?

Not at all

Perfectly

Eye exam of any exam

Xanthelasma - most common xanthoma.
Plane xanthoma usually around the medial canthus of the upper eyelid (but upper and lower eyelids can be affected symmetrically.)

Presents as soft, yellow or orangey macules, papules, or plaques.
Deposits of lipid (often at normal levels)
Assoc w/

FH
Type II hyperlipoproteinaemia,
primary biliary cirrhosis

How well did you know this?

Not at all

Perfectly

Eye exam of any exam

Xanthelasma - most common xanthoma.
Plane xanthoma usually around the medial canthus of the upper eyelid (but upper and lower eyelids can be affected symmetrically.)

Presents as soft, yellow or orangey macules, papules, or plaques.
Deposits of lipid (often at normal levels)
Assoc w/

FH
Type II hyperlipoproteinaemia,
primary biliary cirrhosis

How well did you know this?

Not at all

Perfectly

Cardiac

Tendon xanthomas

subcutaneous nodules usu Achilles tendon or over the knuckles.

smooth, firm to palpation, and mobile.
Overlying skin colour is normal. T

Assoc w/ FH (& T2 Hyperlipidaemoa)

How well did you know this?

Not at all

Perfectly

Achilles exam of any exam

Tendon xanthomas

subcutaneous nodules usu Achilles tendon or over the knuckles.

smooth, firm to palpation, and mobile.
Overlying skin colour is normal. T

Assoc w/ FH (& T2 Hyperlipidaemoa)

How well did you know this?

Not at all

Perfectly

Hand exam of any exam

Tendon xanthomas

subcutaneous nodules usu Achilles tendon or over the knuckles.

smooth, firm to palpation, and mobile.
Overlying skin colour is normal. T

Assoc w/ FH (& T2 Hyperlipidaemoa)

How well did you know this?

Not at all

Perfectly

Hand exam of any exam

Tendon xanthomas

subcutaneous nodules usu Achilles tendon or over the knuckles.

smooth, firm to palpation, and mobile.
Overlying skin colour is normal. T

Assoc w/ FH (& T2 Hyperlipidaemoa)

How well did you know this?

Not at all

Perfectly

Cardiac

Eruptive Xanthomata

Yellow papules in crops of 2–5 mm w/ red rim over extensor surfaces (elbow, knee, can be buttocks or shoulders, also check inside the mouth).

May be tender and usuy itchy.

Occurs at Trigs >11 mmol/L (any cause but type III hyperlipid)

How well did you know this?

Not at all

Perfectly

Cardiac

Eruptive Xanthomata

Yellow papules in crops of 2–5 mm w/ red rim over extensor surfaces (elbow, knee, can be buttocks or shoulders, also check inside the mouth).

May be tender and usuy itchy.

Occurs at Trigs >11 mmol/L (any cause but type III hyperlipid)

How well did you know this?

Not at all

Perfectly

Cardiac

Eruptive Xanthomata

Yellow papules in crops of 2–5 mm w/ red rim over extensor surfaces (elbow, knee, can be buttocks or shoulders, also check inside the mouth).

May be tender and usuy itchy.

Occurs at Trigs >11 mmol/L (any cause but type III hyperlipid)

How well did you know this?

Not at all

Perfectly

Cardiac

Eruptive Xanthomata

Yellow papules in crops of 2–5 mm w/ red rim over extensor surfaces (elbow, knee, can be buttocks or shoulders, also check inside the mouth).

May be tender and usuy itchy.

Occurs at Trigs >11 mmol/L (any cause but type III hyperlipid)

How well did you know this?

Not at all

Perfectly

Mouth exam - any exam
- What is this & associations?

High arched palate in Marfans

assoc w/ AR (aortic root dilatation), MR (MVP)

How well did you know this?

Not at all

Perfectly

Mouth exam - any exam
- What is this & causes?

Mucosal petichiae

IE
Trauma (vomiting)
Haem: platelet abnormalities, clotting factor deficiencies
defects in vascular integrity.

Hand exam of any exam
- What is this & causes?

Splinter haemorrhages
Causes:
1) Local trauma
2) Infective endocarditis
3) Other: Sepsis, Vasculitis, Psoriatic nail disease

Hand exam of any exam
- What is this & causes?

Palmar erythema (vasodilation & should be symmetrical)
- Epo infusion in pulm HTN
- Can be primary (hereditary, idiopathic or PREGNANCY 2⁰ oestregen)
- Liver dis: cirrhosis, Wilson, haemochromatosis
- AI: RA (>60%)
- Endocrine/nutritional: Thyrotoxicosis, DM
- Drug induced (also related to liver functioning)
- Others: smoking, malignancy, COPD, atopic dermatitis, infections

Ix with FBC, LFT, Iron, TSH, Glucose +/- anti CCP, ANA, SSA/SSB, Ceruloplasmin, albumin, (CXR, BM Bx, MRI, CTCAP)

Hand exam of any exam
- What is this & causes?

Koilonychia
Causes
1) Malnutrition/IDA
2) Rheumatic fever

Hand exam of any exam
- What is this & causes?

Leuconychia
Causes
1) Trauma
2) Hypoalbuminaemia
3) Chemo

Hand exam of any exam
- What is this & causes?

Onycholysis
- white discolouration 2* nail bed separating nail plate
Causes
1) Trauma
2) Psoriasis (Linchen Planus, dermatitis)
3) Systemic: Sarcoid, Ank Spond, Cancer, Endocrine
4) Infection (Scabies, dermatophytes)

Neuro exam
(left eye not dilating in dim light)

Horner’s syndrome
- oculasympathetic palsy
- Myosis, Ptosis (tarsal mm), Anhydrosis
IPSILATERAL side:
1st order (Anh+): Central
2nd order (Anh+): preganglionic upto bifurcation ICA/ECA (mediastinal/pancoast/cervical rib)
3rd order (Anh- as nerve to facial sweat glands exits): Carotid artery dissection, otitis media
(also trauma at any point, differentiate with anhidrosis)

Eye exam - unilateral visual loss (monocular)

where is lesion>??

Pre-chiasm
including retina & optic nerve before optic chiasm on IPSILATERAL side
Can be complete or partial (eg nasal hemianopsia)

Eye exam - binocular outside visual loss
- name
- where is lesion
- causes

Bitemporal hemaniopia
OPTIC CHIASM
1) Pituitary adenoma (acromegaly)
(2 - Meningioma
3 - ACA aneurysm compressing from above)

Eye exam - same (half) VF loss in both eyes
- name
- where is lesion
- aetiology

Homonymous hemianopsia

CONTRALATERAL (if Rt VF loss in both eyes, lesion = LEFT POST-CHIASM optic tract

Macular innvervated by MCA + PCA so can be spared if lesion in occiput in 1 artery.
Otherwise likely optic tract (pre-division)

?RAPD

Eye exam - same (quadrant) VF both eyes
- name
- where is lesion
- aetiology
- other assoc fx

Contralateral optic tract
E - inferior Rt quadrantinopia = Lft parietal
F - superior Rt quadrantinopia = Lft temporal
Cause - mass lesion
Consider - other lobe fx
Temporal: Aphasia, hallucinations
Parietal: Gerstmans (agraphia, acalculia, R/L confusion), contralat neglect,

Eye exam
- name
- where is lesion
- aetiology

Macular sparing homonymous hemianopsia
Occiput lobe
Macular innvervated by MCA + PCA so can be spared in occiput if lesion only on 1 artery

Which nerves open & close eyes?

What conditions will these be abN?

CN7: closes eye (hooks closed)
CN3: opens eye (3 pillars hold open)

Horner’s: oculasympathetic - normal but ptosis
CN3 palsy: closure normal but ptosis
CN7 palsy: weak (can’t wink/smile)
Myopathy/MG: weak closure AND ptosis

Eye exam - rest (can’t look up or in at nose)

Condition
Aetiology
Other tests

Look for ptosis +/- mydriasis (no light reflex) “down & out”
3rd nerve palsy (oculomotor)
Vascular/ischaemia (DM/HTN) + tumour
+ CT-A ?ANEURYSM (Post Com art)
Brainstem lesion: CVA, tumour, demyelination
Sphenoid wing meningioma
Cav sinus lesion/thrombosis

Pupil sparing in ischaemia (DM/HTN) as occurs in middle artery (parasympathetic fibres are outer) -Blown pupil #1 sign of compressive lesion

Eye exam - when looking right
(may be normal with slight head tilt @ rest)
- Condition
- Aetiology
- Other tests

4th nerve / Trochlear palsy
“UP & IN” hypertropia may normalise w/ headtilt
Left eye cant look down to nose on H (Superior oblique impaired)

Vascular, tumour
Congenital & trauma

Eye exam - at rest

Condition
Aetiology
Other tests