Amir Sam's conditions Flashcards
A patient presents with an ataxic gait, failure to abduct the right eye and is very confused. What is the likely diagnosis?
Wernicke’s encephalopathy
TRIAD: confusion + ataxia + opthalmoplegia (nystagmus + LR palsy)
Wernicke’s encephalopathy presents with what distinctive lab result?
Reduced red cell transketolase
A known alcoholic patient presents confusion, ataxia and opthalmoplegia. He is also noted to be slightly hypoglycaemic. In what order do you provide treatment options for this patient.
IV thiamine (Pabrinex) BEFORE giving glucose.
Glucose metabolism uses up thiamine so precipitates an acute worsening of any Wernicke’s
Definition of dementia
Global impairment of higher cortical function in clear consciousness.
ICD-10 definition
Decline in:
- memory
- other cognition: planning, organising, problem solving
Absence of clouded consciousness
Change in emotion, personality or behaviour
Most common organism that causes Septic arthritis
Staph aureus
Cause of septic arthritis in a young, sexually active person
Neisseria gonococcus
Initial choice of antibiotics in septic arthritis
IV Vancomycin and 3rd generation cephalosporin: cefotaxime.
Change once culture and sensitivities tested.
A patient presents with a shooting radicular pain in the C7 distribution. Below this level he is complaining of increasing loss of sensation and weakness.
The patient is known to have lung cancer.
What are you most worried about in the acute setting?
Acute cord compression = neurosurgical tumour.
Probably due to bony mets.
Cancers that spread to bone: Breast Prostate Lungs Thyroid Kidneys Testes
Definition of erythroderma
Exfoliative dermatitis involving >90% of the skin
What are the 4 types of sickle cell crisis?
1) Thrombotic painful crisis
2) Sequestration crisis
3) Aplastic crisis
4) Haemolytic crisis (rare)
What are the 3 main medical options for smoking cessation
Nicotine replacement therapy
Varenicline
- nicotine R partial agonist
- CI in depression and pregnancy
Bupropion
- NA + DA reuptake inhibitor, nicotine antagonist
- CI in epilepsy and pregnancy
Treatment for Torsades des pointes
IV MgSO4 2g over 10 mins
A patient presents with a severe headache and a fixed dilated,oval-shaped pupil. What is the diagnosis?
Acute glaucoma
6 Stages of Death verification
1) Unresponsive to voice or pain
2) No palpable carotid pulse
3) No heart sounds - 2 minutes
4) No breath sounds - 2 minutes
5) Pupils fixed & dilated - unresponsive to light
6) Document in notes.
3 types of autopsy
1) Consented autopsy
- Appropriate consent allowing for teaching, audit and/or research
2) Coronial autopsy
- Coroner instructs pathologist to take tissue samples to determine cause of death within the balance of probability.
3) Forensic autopsy
- Police involvement to determine cause of death beyond reasonable doubt.
5 types of psoriasis
1) Chronic plaque psoriasis
2) Flexural
3) Guttate
4) Pustular - generalised or palmo-plantar
5) Erythroderma
5 types of psoriatic arthritis
Asymmetrical oligoarthritis (
Large vessel vasculitis in a 30 year old Japanese lady in whom you cannot feel the pulse
Takayasu arteritis
55 year old lady with jaw pain on eating, scalp tenderness and reducing vision
Giant cell arteritis
A gentleman with a history of HBV infection has angiography that reveals microaneurysms
Polyarteritis nodosa
A man with a saddle nose, haemoptysis and haematuria.
Granulomatosis with polyangitis = Wegener’s
Patient with asthma and vasculitis
Eosinophilic granulomatosis with polyangitis = Churg-Strauss
Urine osmolality expected in Diabetes insipidus
> 200 mmol
Painful asymmetrical wasting of the quadriceps muscles in T2DM associated with weight loss and autonomic failure.
Diabetic amotrophy
Chondrocalcinosis visible on Xray is associated with which cause of arthritis?
Pseudogout
1st line treatment for Ank Spond
NSAIDs + spinal exercises
Which is painful polymyositis or polymyalgia rheumatica
Polymyalgia rheumatica
Shirmer’s Test
Test for Sjogren’s
Filter paper on lower eyelid to measure tear production.
Behcets triad
Oral ulcers + genital ulcers + anterior uveitis
Anion Gap calculation
= (Na + K) - (Cl + HCO3)
3 Phases of CML
Chronic phase: 10% blasts
Blast phase: >20% blasts
Gout and massive splenomegaly are associated with which haematological malignancy
CML
Evan’s Syndrome =
AIHA + ITP
Associated with CLL
Richter transformation
Transformation of CLL → DLBCL
Smear cells
CLL
Staging system in CLL
Binet staging
Stage A: 3 enlarged lymph nodes
Stage C: anaemia or thrombocytopenia
BM aspirate findings in multiple myeloma
> 10% plasma cells
>30 g/L paraprotein
BM aspirate findings in MGUS
BM aspirate findings in Smouldering myeloma
> 10% plasma cells
30 g/L paraprotein
= Same as multiple myeloma but NO CRAB
Prognostic factors in Myeloma
B2 microglobulin and albumin
