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Progress Tests > Bitemedicine > Flashcards

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
Q

Blast cell count in blast phase CML

A

Over 20% blast cells

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26
Q

What is myelofibrosis?

A

Myeloproliferative condition whereby there is neoplastic proliferation of mature myeloid cells, particularly megakaryocytes, leading to marrow fibrosis

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27
Q

Risk factors for myelofibrosis

A

Older age

Radiation

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28
Q

Mutation seen in around 50% of patients with myelofibrosis

A

JAK2

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29
Q

Teardrop RBCs of blood film

A

Myelofibrosis

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30
Q

FBC in myelofibrosis

A

Anaemia, others are low or variable

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31
Q

Bone marrow aspirate and biopsy in myelofibrosis

A

“dry tap” on aspirate

marrow fibrosis on biopsy

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32
Q

Management of myelofibrosis

A

Chemotherapy

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33
Q

What age does polycythaemia vera tend to onset?

A

50-70

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34
Q

What are actinic keratoses?

A

Pre-malignant scaly spots on the skin
Dues to sun exposure
May develop into squamous cell carcinoma

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35
Q

SCC prognosis

A

Good

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36
Q

Risk factors for malignant melanoma

A 
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
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37
Q

What is the most common type of melanoma?

A

Superficial spreading

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38
Q

Characteristics of superficial spreading melanoma

A

Grows horizontally before deepe
Younger patient
Back, chest, arms, legs
Flat, large, irregularly pigmented

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39
Q

Characteristics of nodular malignant melanoma

A

Rapidly growing
Middle aged
Sun exposed areas
Pigmented nodule may bleed and ulcerate

40
Q

Symptoms of malignant melanoma

A 
Large size
Dark
Uneven boarders
Sensory changes eg itching
Crusting/ bleeding
Systemic symptoms
41
Q

Management of malignant melanoma

A

Excision
Topical adjuvant chemotherapy
Lymph node clearance (if involved)
Systemic adjuvant chemotherapy (if high grade)

42
Q

First line in PE

A

Rivaroxaban

43
Q

Management of asymptomatic primary PE <2cms

A

Disacharge and review in clinic

44
Q

Management of symptomatic or >2cms primary PE

A

aspirate with 16-18G cannula

45
Q

Management of unsuccessful aspiration of primary Pneumothorax

A

Chest drain and admit

46
Q

Management of secondary PE <1cm

A

Admit for high flow O2 and observe

47
Q

Management of secondary PE 1-2 cm

A

aspirate with 16-18G cannula

48
Q

Management of unsuccessful aspiration of secondary PE

A

Chest drain and admit

49
Q

Management of secondary Pneumothorax >2cms

A

Chest drain and admit

50
Q

Management of undisplaced intracapsular hip fracture without significant comorbidities

A

Internal fixation with dynamic hip screw

51
Q

Management of undisplaced intracapsular hip fracture with significant comorbidities

A

Hemiarthroplasty

52
Q

Management of displaced intracapsular hip fracture without significant comorbidities

A

Total hip replacement

53
Q

Management of displaced intracapsular hip fracture with significant comorbidities

A

Hemiarthroplasty

54
Q

Management of intertrochanteric hip fracture

A

Internal fixation with dynamic hip screw

55
Q

Management of subtrochanteric hip fracture

A

Internal fixation with intermedullary nail

56
Q

Organism that causes pneumonia with red sputum

A

Klebsiella

57
Q

Gender more common in PSC

A

Males

58
Q

Gender more common in PBC

A

Female

59
Q

Treatment of cluster headaches

A

High flow O2 and SC or nasal triptan

60
Q

Which haematological malignancy is associated with gum hypertrophy

A

AML

61
Q

Risk factors for PBC

A

Middle aged female

Other autoimmune conditions

62
Q

Risk factors for PSC

A

Middle aged male

IBD

63
Q

Presentation of PSC

A 
Often asymptomatic
Fatigue
Pruritis
Jaundice
Hepatomegaly
64
Q

Presentation of PBC

A 
Often asymptomatic
Fatigue
Pruritis
Jaundice
Hepatomegaly
65
Q

Antibodies in PBC

A

Anti-mitochondrial antibodies (AMA)

66
Q

Antibodies in PSC

A

pANCA

67
Q

Imaging in PBC

A

Abdo US

68
Q

Imaging in PSC

A

ERCP

69
Q

Management of PBC

A

Ursodeoxycholic acid
Cholestyramine
Replace fat soluble vitamins
Liver transplant if end stage

70
Q

Management of PSC

A

Cholestyramine
Replace fat soluble vitamins
Liver transplant if end stage

71
Q

Management of high risk HPV but no cell changes on cervical screening

A

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
Q

Management of inconclusive smear

A

Repeat in 3 months. If still inconclusive refer for colposcopy

73
Q

Management of asymptomatic gallstones

A

Reassurance

74
Q

Tumour marker to monitor pancreatic cancer

A

CA19-9

75
Q

First line in peripheral arterial disease

A

Supervised exercise programme

76
Q

First line in acne vulgaris

A

Topical retinoids or topical clindamycin with or without topical benzoyl peroxide
Mental health screen and education

77
Q

Second line in acne vulgaris

A

Oral doxycycline or COCP

78
Q

First line in mild acne rosacea

A

Topical abx

79
Q

First line in moderate / severe acne rosacea

A

Oral abx

80
Q

Symptoms of acne rosacea

A

Papules / pustules
Telangiectasia
Flushing

81
Q

Medications to avoid in acne rosacea

A

Vasodilator meds

82
Q

Symptoms of seborrheic dermatitis

A

Redness over nose that may spread

Dandruff

83
Q

First line in seborrheic dermatitis

A

Anti-fungal shampoo and cream

84
Q

Symptoms of pityriasis rosea

A

Initial oval herald patch followed by widespread rash

85
Q

Management of pityriasis rosea

A

Reassurance. May offer symptom relief e.g. creams

86
Q

Symptoms of lichen planus

A

Purple itchy rash on the wrists with oral involvement

87
Q

Management of lichen planus

A

Topical steroids

88
Q

Demographic of bullous pemphigoid

A

Older

89
Q

Management of bullous pemphigoid

A

Oral steroids

90
Q

Management of pemphigus vulgaris

A

Oral steroids

91
Q

When to check urate in gout

A

4-6 weeks after attack

92
Q

Key antibodies in Sjogren’s syndrome

A

anti-Ro, anti-La

93
Q

Treatment for Sjogren’s syndrome

A

Symptomatic e.g. eyedrops

DMARDs

94
Q

Symptoms of dermatomyositis

A

Proximal muscle aches and weakness
Rash (typically purple rash on eyelids)
Papules over finger joints
Oedema

95
Q

Creatinine kinase in dermatomysitis

A

Raised

96
Q

Management of dermatomyositis

A

Steroids

Avoid sun exposure and topical steroids for rash

97
Q

Features of scleroderma

A 
Calcinosis
Raynauds
Oesophageal dysmotility
Tight skin
Telangiectasia

Progress Tests (17 decks)

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