All Over Essentials Flashcards
What is nephrotic syndrome? (3 main points)
- Proteinuria
- Hypoalbuminaemia
- Oedema
Give the main triggers of migraines?
CHOCOLATE Cheese/chocolate Hangovers Oral Contraceptive Pill Caffeine Orgasms Lie-ins Alcohol Travel Exercise
What are the symptoms of Benign Prostatic Hyperplasia?
Frequency Urgency Hesitancy Incomplete Bladder Voiding Post-void dribbling
What can cause Peripheral Neuropathy? (5)
DAVID Diabetes Alcohol Vitamin B12 Deficiency Infection Drugs (Isoniazid)
What will be seen in the CT scan of somebody with a subdural haemorrhage? (2 marks)
Crescent Shaped Mass
Midline Shift
Which neutrons are affected in Huntington’s chorea?
GABA and Cholinergic neurons
Which cancer most commonly metastasises to the brain?
Lung
Name an inhibitory neurotransmitter?
GABA
60 year old female, new onset headache - doesn’t go away with painkillers, tenderness when brushing hair and pain in jaw when eating. What is the diagnosis and what is the treatment - how urgent?
Giant Cell Arteritis - Needs urgent high dose steroids such as IV Methylprednisolone - can cause permanent blindness
What are the signs of bacterial meningitis?
Fever, Positive Kernigs Sign, Non blanching rash
What is the ethology of multiple sclerosis?
Chronic Autoimmune Disorder of the CNS
Plaques of Demyelination - common sites are optic nerves, brainstem, cervical spinal cord
What is Amaurosis Fugax ?
In a TIA , emboli passes into retinal artery and forms ‘a curtain descending over field of vision’
What organisms commonly cause pyelonephritis? What drugs would be used to treat it?
E. coli, Klebsiella, Proteus
Use Empirical Antibiotics - Ciprofloxacin or co-amoxiclav
How is Parkinson’s disease treated pharmacologically? (2)
Levodopa and dopa-decarboxylase inhibitor
What can trigger a tension headache?
Fumes/Smells
Stress
Noise
Concentrated Visual Effort
What are the three criteria for Acute Kidney Injury?
- Rise in creatinine of more than 26micromol/l in 48 hours
- Rise in creatinine of more than 1.5 x baseline
- Urine output of more than 0.5 ml/kg/h for more than 6 consecutive hours
What are the symptoms of raised intracranial pressure (3 marks)?
Headache
Seizures
Vomiting
What kind of inheritance pattern does Polycystic Kidney Disease follow?
Autosomal Dominant
What investigations would be performed if you suspect a subarachnoid haemorrhage, what would you see?
CT Head - White star shape
Lumbar Puncture - Xanthochromia (yellow)
What are the 4 main traits of Parkinsons Disease?
Tremor
Rigidity
Bradykinesia
Postural Instability
Where are the three most common places for renal calculi to get stuck?
Pelviureteric Junction
Pelvic Brim
Vesicoureteric Junction
What is nephritic syndrome? (4 main points)
- Haematuria (more blood in urine than nephrotic, red cell casts, podocytes develop large pores so blood and protein can escape into urine)
- Proteinuria
- Hypertension
- Low Urine Volume
Which organisms commonly cause meningitis?
Viral: Herpes Simplex Virus, Epstein Barr Virus, HIV, Mumps
Bacterial: Neisseria Meningitides, Streptococcus Pneumoniae, Listeria Monocytogenes
What are the contraindications for thrombolysis? (4 marks)
Surgery in last three months
Patient on warfarin
History of active malignancy
Platelets (less than 100,000/mm3)
How are Ischaemic Strokes managed? (4 marks)
Thrombolysis - IV Alteplase must be given within 4.5 hours
2nd line - aspirin 300mg for 2 weeks, then clopidogrel
Rehabilitation: Physio, OT, SALT
Risk Factor Management
A Man presents with muscle weakness in both of his legs. The weakness started in his feet and is now spreading to his thighs. You see in his GP notes he recently attended with glandular fever. What could be hi diagnosis?
Guillan Barré Syndrome
Which organism most commonly causes urinary tract infections?
E. coli
In what condition will the scrotum feel like a ‘bag of worms’?
Varicocoele
Name three causes of Subarachnoid Haemorrhages?
Berry Aneurysm
Arteriovenous Malformations
Idiopathic
What is the commonest type of primary brain tumour?
Astrocytoma
What are the two classes of drug given to treat BPH? Give examples of each.
Alpha Blockers - Tamsulosin
5-alpha reductase inhibitors - Finasteride
How is Bacterial Meningitis treated?
Treat first, investigate later
Benzylpenicillin in community
Cefotaxime in hospital
Contact Tracing
How are urinary tract infections managed?
Plenty of Fluids - urinate often
Can use trimethoprim or nitrofurantoin
40 year old male smoker - sudden excruciating pain around one eye - 5 episodes in last week and wakes him from sleep - what is diagnosis? What is the treatment?
Cluster Headaches
Treat with 100% O2 and sumatriptan at onset
Prevent with Verapamil
What are the four types of multiple sclerosis?
Relapsing Remitting
Primary Progressive
Secondary Progressive
Progressive Relapsing
How are TIA’s managed?
Control of Risk Factors: hypertension, hypercholesterolemia, stop smoking
1st line: Clopidogrel (PY12 Inhibitor)
What treatment can slow the progression of Motor Neurone Disease?
Riluzole (Sodium Channel Blocker)
How is epilepsy treated?
Focal - With Carbamazepine which inhibits sodium channels or lamotrigine which inhibits glutamate release
Generalized: Sodium Valproate or Lamotrigine
How do brain tumours present?
Headache (+ Papilloedema)
Seizures
Progressive Neurological Deficit
Which article is most commonly affected in an extradural haemorrhage?
Middle Meningeal Artery
What is used to treat Encephalitis?
High dose IV Acyclovir
Which haemorrhage is caused most commonly by trauma, how soon is the onset?
Subdural haemorrhage - days to weeks
What is often described as the ‘worst headache ever’ or a ‘thunder-clap headache’ with photophobia, seizures, nausea/vomiting?
Subarachnoid Haemorrhage
Which investigations should be performed when extradural haemorrhage is suspected?
CT Head - Lentiform shaped mass
X Ray may show fracture
NEVER LUMBAR PUNCTURE
What are the four features of the gait of somebody with Parkinson’s ?
Reduced arm swing on one side
Shuffling
Stooped Posture
Difficulty Starting
How long after a trauma would subdural and extradural haemorrhages present?
Subdural - days to weeks later
Extradural - about 12 Horus later (Think of that Natasha woman)
What would be seen on microscopy of the blood of somebody experiencing acute inflammation?
Neutrophil Polymorph
Define granulomatous inflammation?
An aggregate of epithelioid histocytes with or without giant cells
What is a granuloma?
Epithelioid Macrophages surrounded by mature lymphocytes
Name the two types of granuloma and give examples of each?
Caseating (with necrosis) - TB
Non-caseating (without necrosis) - Crohns Disease
Name an anti-viral medication?
Acyclovir
Which gene is associated with apoptosis?
P53
Name 4 of the Wilson Junger screening criteria? (9 in total)
- the condition should be an important health problem
- the natural history of the condition should be understood
- there should be a recognisable latent or early symptomatic stage
- there should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific
- there should be an accepted treatment recognised for the disease
- treatment should be more effective if started early
- there should be a policy on who should be treated
diagnosis and treatment should be cost-effective
case-finding should be a continuous process
What are the three cancer screening programmes available in the UK?
Cervical
Breast
Bowel
How are Venous and Arterial Thrombi differentiated?
Venous: Statis, Fibrin, Low Pressure, Treated with Anticoagulants (Warfarin, Heparin) and Direct Acting Oral Anticoagulants (Rivaroxiban)
Arterial: Platelets, High Pressure, Anti-Platelet Medication such as Clopidogrel and Aspirin
What is the adenoma-carcinoma sequence?
APC, RAS, P53
How is an acute Migraine immediately managed?
Sumatriptan
What is the most common cause of Bacterial Meningitis in Neonates?
Group B Streptococcus
What would be seen in the blood of somebody suffering with Bacterial Meningitis?
Raised Protein, Low Glucose
What are the features of the Tetralogy of Fallot?
Ventricular Septal Defect (VSD)
Pulmonary Stenosis
Right Ventricular Hypertrophy
The aorta overrides the ventricular septal defect, accepting right heart blood.
