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Bitemedicine Flashcards

1
Q

Symptoms of hyperviscousity

A

Headache, blurred vision, flushing, palmar erythema, itching after a bath, burning pain in extremities, increased risk of thrombosis

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2
Q

Medication in patients with polycythaemia vera

A

Aspirin

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3
Q

EPO levels in polycythaemia vera

A

Low (negative feedback)

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4
Q

Mutation in 95% of patients with polycytaemia vera

A

JAK2

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5
Q

Management of polycythaemia vera

A

Weekly phlebotomy
Aspirin
Hydroxyurea (in patients at very high risk of thrombosis e.g. older age)

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6
Q

Symptoms of polycythaemia vera

A

Headache, blurred vision, flushing, palmar erythema, itching after a bath, burning pain in extremities, increased risk of thrombosis

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7
Q

Pathophysiology of essential thrombocytosis

A

Proliferation of megakaryocytes increases platelet count

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8
Q

Symptoms of essential thrombocytosis

A

Bleeding (platelets dysfunctional)

Clotting (more platelets)

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9
Q

Mutation seen in 50% of patients with essential thrombocytosis

A

JAK2

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10
Q

Bone marrow biopsy in essential thrombocytosis

A

Increased megakaryocytes

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11
Q

Management of essential thrombocytosis

A

Aspirin

Hydroxyurea

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12
Q

Which haematological malignancy is gum hypertrophy most associated with?

A

AML

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13
Q

What condition does myelodysplasia predispose to?

A

AML

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14
Q

Translocation associated with AML

A

t(15;17)

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15
Q

Features of the acute promyelocytic leukaemia subtype of AML

A

Younger patients (around 45yrs)
Associated with DIC
t(15;17) translocation
Good prognosis

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16
Q

What is myelodysplasia?

A

Neoplastic proliferation of immature myeloid cells with evidence of dysplasia
30% progress to AML

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17
Q

Bone marrow biopsy in myelodysplasia

A

Blast cells raised but less than 20%

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18
Q

Blood film in AML

A

Immature myeloid cells

Auer rods

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19
Q

Bone marrow biopspy in AML

A

More than 20% myeloblasts

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20
Q

Genetics of CML

A

Philadelphia chromosome common (causes BCR-ABL gene)

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21
Q

Blood film in CML

A

Raised granulocytes, but most of these aren’t blasts

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22
Q

Bone marrow biopsy in CML

A

Raised granulocytes, but most of these aren’t blasts

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23
Q

Blast cell count in chronic phase CML

A

Less than 10% blast cells

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24
Q

Blast cell count in accelerated phase CML

A

Less than 20% blast cells

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25
Blast cell count in blast phase CML
Over 20% blast cells
26
What is myelofibrosis?
Myeloproliferative condition whereby there is neoplastic proliferation of mature myeloid cells, particularly megakaryocytes, leading to marrow fibrosis
27
Risk factors for myelofibrosis
Older age | Radiation
28
Mutation seen in around 50% of patients with myelofibrosis
JAK2
29
Teardrop RBCs of blood film
Myelofibrosis
30
FBC in myelofibrosis
Anaemia, others are low or variable
31
Bone marrow aspirate and biopsy in myelofibrosis
"dry tap" on aspirate | marrow fibrosis on biopsy
32
Management of myelofibrosis
Chemotherapy
33
What age does polycythaemia vera tend to onset?
50-70
34
What are actinic keratoses?
Pre-malignant scaly spots on the skin Dues to sun exposure May develop into squamous cell carcinoma
35
SCC prognosis
Good
36
Risk factors for malignant melanoma
``` Older age (not so significant as BCC or SCC Sun exposure Previous skin cancer Family history of skin cancer Fair skin Multiple / atypical moles Immunosuppression ```
37
What is the most common type of melanoma?
Superficial spreading
38
Characteristics of superficial spreading melanoma
Grows horizontally before deepe Younger patient Back, chest, arms, legs Flat, large, irregularly pigmented
39
Characteristics of nodular malignant melanoma
Rapidly growing Middle aged Sun exposed areas Pigmented nodule may bleed and ulcerate
40
Symptoms of malignant melanoma
``` Large size Dark Uneven boarders Sensory changes eg itching Crusting/ bleeding Systemic symptoms ```
41
Management of malignant melanoma
Excision Topical adjuvant chemotherapy Lymph node clearance (if involved) Systemic adjuvant chemotherapy (if high grade)
42
First line in PE
Rivaroxaban
43
Management of asymptomatic primary PE <2cms
Disacharge and review in clinic
44
Management of symptomatic or >2cms primary PE
aspirate with 16-18G cannula
45
Management of unsuccessful aspiration of primary Pneumothorax
Chest drain and admit
46
Management of secondary PE <1cm
Admit for high flow O2 and observe
47
Management of secondary PE 1-2 cm
aspirate with 16-18G cannula
48
Management of unsuccessful aspiration of secondary PE
Chest drain and admit
49
Management of secondary Pneumothorax >2cms
Chest drain and admit
50
Management of undisplaced intracapsular hip fracture without significant comorbidities
Internal fixation with dynamic hip screw
51
Management of undisplaced intracapsular hip fracture with significant comorbidities
Hemiarthroplasty
52
Management of displaced intracapsular hip fracture without significant comorbidities
Total hip replacement
53
Management of displaced intracapsular hip fracture with significant comorbidities
Hemiarthroplasty
54
Management of intertrochanteric hip fracture
Internal fixation with dynamic hip screw
55
Management of subtrochanteric hip fracture
Internal fixation with intermedullary nail
56
Organism that causes pneumonia with red sputum
Klebsiella
57
Gender more common in PSC
Males
58
Gender more common in PBC
Female
59
Treatment of cluster headaches
High flow O2 and SC or nasal triptan
60
Which haematological malignancy is associated with gum hypertrophy
AML
61
Risk factors for PBC
Middle aged female | Other autoimmune conditions
62
Risk factors for PSC
Middle aged male | IBD
63
Presentation of PSC
``` Often asymptomatic Fatigue Pruritis Jaundice Hepatomegaly ```
64
Presentation of PBC
``` Often asymptomatic Fatigue Pruritis Jaundice Hepatomegaly ```
65
Antibodies in PBC
Anti-mitochondrial antibodies (AMA)
66
Antibodies in PSC
pANCA
67
Imaging in PBC
Abdo US
68
Imaging in PSC
ERCP
69
Management of PBC
Ursodeoxycholic acid Cholestyramine Replace fat soluble vitamins Liver transplant if end stage
70
Management of PSC
Cholestyramine Replace fat soluble vitamins Liver transplant if end stage
71
Management of high risk HPV but no cell changes on cervical screening
Repeat HPV smear in a year. If no high risk HPV then return to routine screening. If high risk HPV then look for cell changes. If cellular changes, refer to colposcopy. If no cell changes then further smear in 2 years and refer to colposcopy if still positive for HPV
72
Management of inconclusive smear
Repeat in 3 months. If still inconclusive refer for colposcopy
73
Management of asymptomatic gallstones
Reassurance
74
Tumour marker to monitor pancreatic cancer
CA19-9
75
First line in peripheral arterial disease
Supervised exercise programme
76
First line in acne vulgaris
Topical retinoids or topical clindamycin with or without topical benzoyl peroxide Mental health screen and education
77
Second line in acne vulgaris
Oral doxycycline or COCP
78
First line in mild acne rosacea
Topical abx
79
First line in moderate / severe acne rosacea
Oral abx
80
Symptoms of acne rosacea
Papules / pustules Telangiectasia Flushing
81
Medications to avoid in acne rosacea
Vasodilator meds
82
Symptoms of seborrheic dermatitis
Redness over nose that may spread | Dandruff
83
First line in seborrheic dermatitis
Anti-fungal shampoo and cream
84
Symptoms of pityriasis rosea
Initial oval herald patch followed by widespread rash
85
Management of pityriasis rosea
Reassurance. May offer symptom relief e.g. creams
86
Symptoms of lichen planus
Purple itchy rash on the wrists with oral involvement
87
Management of lichen planus
Topical steroids
88
Demographic of bullous pemphigoid
Older
89
Management of bullous pemphigoid
Oral steroids
90
Management of pemphigus vulgaris
Oral steroids
91
When to check urate in gout
4-6 weeks after attack
92
Key antibodies in Sjogren's syndrome
anti-Ro, anti-La
93
Treatment for Sjogren's syndrome
Symptomatic e.g. eyedrops | DMARDs
94
Symptoms of dermatomyositis
Proximal muscle aches and weakness Rash (typically purple rash on eyelids) Papules over finger joints Oedema
95
Creatinine kinase in dermatomysitis
Raised
96
Management of dermatomyositis
Steroids | Avoid sun exposure and topical steroids for rash
97
Features of scleroderma
``` Calcinosis Raynauds Oesophageal dysmotility Tight skin Telangiectasia ```

Progress Tests (17 decks)

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