Buzzwords Flashcards by Gillian Miller

Inflammatory myopathy with poor response to steroids

Inclusion body myositis

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Leg symptoms and midline shift

Falcine herniation

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Back pain worse on coughing

Slipped disc

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Headache worse on coughing

Posterior fossa issue

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Pleocytosis on CSF

Rules out bacterial meningitis (pleocytosis = increase in lymphocytes)

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Migraine prophylaxis

1st line: propanolol, topiramate or amitryptiline

2nd line: valproate, pizotifen, gabapentin or pregabalin (if one drug does not work by 3/12, try another)

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Injury to the upper brachial plexus

Erb’s palsy (waiters tip)

More common, associated with shoulder dystocia)

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Injury to lower brachial plexus

Klumpke’s palsy (claw hand)

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+ve simmonds test

Achilles tendon rupture

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Anti-acetylcholine receptor antibody

Myasthenia gravis

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Mesocortical dopamine hypoactivity

Negative and cognitive symptoms in schizophrenia

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Subcortical dopamine hyperactivity

Psychosis

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Tuberoinfundibular dopamine pathway

Prolactin release

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Nigrostriatal dopamine pathway

Extra pyramidal movements

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Subcortical and mesocortical dopamine pathways

(sometimes known as mesolimbic system)

Motivation and reward

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What is the mesolimbic system responsible for?

Motivation and reward

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Mesolimbic DA blocakde

Depression

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Mesolimbic DA agonism

Psychosis

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Drugs which cause weight gain

Olanzapine and clozapine cause loads of weight gain

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When can you prescribe clozapine?

Need to have tried 2 other drugs and be a consultant to prescribe it

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Limbic system functions?

M2OVE
Motivation
Memory
Olfaction
Visceral afferents
Emotion

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Brain changes in schizophrenia

Reduced frontal lobe volume (and grey matter)
Enlarged lateral ventricles
Reduced grey matter in the TEMPORAL CORTEX

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Pressure of thought: varied ideas in abundance

Characteristic in mania but can be seen in schizphrenia

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Flight of ideas and knights move thinking

Quickly moving from one topic to another but there is a link, unlike knights move thinking where there does not appear to be a link between point A and point B
-seen in bipolar in manic phase

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Treatment for EPSE

Procyclidine

Involved in normal response to threat

Amygdala

What does the PFC do?

Dampens down amygdala response to threat (fewer connections = less effective)

Management of OCD

1) SSRI 2) SSRI 3) TCA or SSRI 4) SSRI or TCA (TCA used is chlomipromine) so essentially an SSRI If there is a partial response at any time of those points, consider CBT as an adjunct

Becks triad

Negative feelings about self, world and future

Problems with NMDA antagonists

Produce psychotic symptoms

NMDA receptor antagonists

Ketamine Dextromethorphan Phencyclidine (remember these can produce psychotic symptoms)

Alcohol withdrawal

Use chlordiazepoxide | 30mg qds, 25mg qds, 20mg qds, 15mg qds, 10mg qds, 10mg tds, 10mg bd, 10mg OD nocte

Eosinophilic inclusions

Lewy bodies (LBD and PD)

What could trigger a hypertensive crisis with MAOIs

Interactions with tyramine containing foods, nasal congestants, TCA's, pethidine

How do you treat hypertensive crisis?

Phentolamine infusion

Which patient should you avoid TCA's in?

Patients with cardiac problems or patients with suicidal intent

Cherry red spot on macula

Central retinal artery occlusion

Tear drops or blood level in sinus

Blow out fracture

Failure to adduct

Internuclear opthalmoplegia - issue with medial longitudinal fasciculus

Pain on movement

Optic neuritis, most commonly caused by MS

Painful loss of vision at 1ks

Optic neuritis

Curtain coming down

Amurosis fugax

Curtain coming down (partial) longer than five minutes

Retinal detachment

Flashes and floaters

Retinal detachment

Photophobia

Anterior uveitis

Gritty eyes

Bacterial conjunctivitis or sub-tarsal foreign body

Watery and pain and preaurciular lymph nodes

Viral conjunctivitis

Silver/copper wiring

HTN eye disease

Loss of red reflex, red eye on opthalmoscopy

Haemorrhage

New vessels and haemorrhage

Wet ARMD

Follicular conjunctivits

Chlamydia

Pinpoint pupils

Pontine issue

Dilated pupils

Trans-calcarine fracture

Different sized pupils

Damage to CN III (or sympathetic chain in horners)

Down and out, not dilated

Diabetes

Down and out, dilated

CNIII damage

Roth spots

Infective endocarditis

Brushfield spots

Down syndrome

Scrambled egg / egg yolk appearance of macula

Best disease

Antepartum haemorrhage in patient with succenturiate lobe or velamentous inseration

Vasa praevia

Maternal blood and no fetal distress

Placenta praevia | MUST BE EXCLUDED BEFORE VAGINAL EXAMINATION

Fetal blood and sudden fetal distress

Vasa praevia

Placenta accreta "doughy abdomen"

Insertion into myometrium post endometrial ablation --> C section and hysterectomy - always give contraception!

Fetal distress and loss of engagement, previous C section or surgery

Uterine rupture

PPH followed by pituitary failure

Sheehan's syndrome

Strawberry cervic

Trichomonas vaginalis

Prolapse and back pain

Uterine prolapse

Large tense uterus "woody abdomen", bleeding and pain

Placental abruption

"fluid level behind drum" "retracted drum", "dull colour"

Otitis media with effusion

Loss of corneal reflex (+ sensorineural hearing loss, vertigo and tinnitus)

``` Acoustic neuroma (vestibular schwannoma) Associated with NFII ```

Battle sign

Mastoid process of temporal bone fractures

Pearly white on otoscopy and foul, cheesy discharge

Cholesteatoma

Saddle nose

Wegeners

ADHD triad

Hyperactive Inattention Impulsive

Treatment for ADHD

Methylphenidate

Triad of autism

Social communication, language, repetitive behaviour

What is aspergers

Form of autism where there is only a problem with social communication

Statin interacts with ...

Grapefruit juice

Metronidazole interacts with ...

ALCOHOL !!

Warfarin interacts with ...

Grapefruit juice

Calcium and thyroxine leads to what?

Decrease absorption from GIT

Warfarin and NSAID

Bleed

ACEi and spironolactone

Hyperkalaemia

Digoxin and verapamil

Digoxin toxicity

Fluoxetine and phelezine

Serotonin syndrome

When are triptans contraindicated?

In IHD, uncontrolled hypertension, concurrent use of LITHIUM, SSRI or ergot derivative drugs (such as cabergoline in PD)

"stuck on" appearance

Basal cell papilloma (seborrhoaic keratosis)

Picket fence pearly border

Basal cell carinoma

Dermatitis herpetiformis

Coeliac disease

Erythema nodosum

Commonly sarcoidosis, also UC and TB

Erythema bullseye lesion

Erythema migrans --> lime disease

Silver scales, extensor surfaces

Psoriasis

Cauliflower appearance

Plantar warts

Flaccid blisters that can be burst easily to form erythematous erosions

Pemphigus vulgaris

Large tense bullae that cannot be burst

Bullous pemphigoid

Heliotrope rash and scaly knuckles

Dermatomyositis

Fish scale skin

Ichthyosis

Schistocytes

Intravascular haemolysis

Pepper pot skull

Myeloma

Reed sternberg cells

Hodgkin's lymphoma

9:22 location

Philadelphia chromosome (CML)

Atypical lymphocytes

EBV (mononucleosis)

Auer rods

Acute myeloid leukaemia

Itchy after a hot bath

Polycythemia rubra vera

Translocation 8:14

Burkitt's lymphoma

African kid with a history of EBV and tumour in face/jaws

Burkitt's lymphoma

Haemarthrosis

Hodgkin's lymphoma

Bleeding into joint

Problem with seconday haemarthrosis

Young boy with reduced levels of factor VIII and an increased APTT

Haemophilia A

Reduced levels of factor IX with Christmas disease

Haemophilia B

Patient has fever and pleuritic chest pain that is relieved by sitting up and leaning forward

Pericarditis

ECG saw tooth baseline + 150 bpm

Atrial flutter

Raised JVP / hepatojugular

Right-sided heart failure

Saddle shaped ST elevation

Pericarditis

Broad complex tachycardia

Ventricular problem

Mid diastolic murmur with a tapping, undisplaced apex

Mitral stenosis

Broad QRS with slurred upstroke on R wave (delta wave)

Wolff parkinson white syndrome

Patient gets pericarditis 4-6 weeks post MI

Dressler's syndrome

Blurred yellow vision headache

Digoxin toxicity

Crescendo decrescendo murmur

Aortic stenosis

Systolic murmur, radiates to the neck

Aortic stenosis

Ground glass appearance on x-ray

Pulmonary fibrosis and respiratory distress syndrome of the newborn

Miliary TB spread through pulmonary artery

Dissemination in lungs

Miliary TB spread through pulmonary vein

Dissemination to liver, spleen and kidneys

Positive anti-glomerular basement membrane antibodies

Goodpastures

Tall, thin young man who indulges in marijuana

Pneumothorax

Bronchiolar wider than neighbouring arteriole (on CT) (signet ring sign)

Bronchiectasis

D sign on x-ray

Empyema

"Steeple" sign on x-ray

Laryngotracheobronchitis / croup

Pneumocystis pneumonia

HIV (treat with co-trimoxazole [and prednisolone if severe])

Klebsiella pneumonia

Alcoholic/danger of aspiration pneumonia

Mucoid sputum

Chlamydia psittaci

Red jelly sputum

Klebsiella pneumonia

Rusty sputum

Pneumococal pneumonia

Morning headache

Hpercapnia or side effects of organic nitrates

ACTH secreting lung tumour

SMALL CELL CARCINOMA

PTH secreting lung tumour

SQUAMOUS CELL CARCINOMA

Increased ACE and Ca2+

Sarcoid

Neuroendocrine, highly malignant and may be associated with ectopic endocrine syndromes

Small cell carcinoma

Egg shell calcification at hilar regions

Silicosis

"heart failure cells" seen in alveolar spaces

Macrophages that have absorbed haemosiderin - found in chronic pulmonary oedema and associated (severe) left ventricular hypertrophy Also seen in long standing pulmonary hypertension

Ghon focus

Area of infection and caseous necrosis at the periphery of the lung, beneath the pleura - found in TB infection

Assman focus

Apical lesion of secondary tuberculosis infection

Bird beak appearance (and distended oesophagus)

Achalasia; if in lower GI imaging, is a sign of bowel obstruction

GET SMASHED

``` Acute pancreatitis causes: Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion bites/stings Hyperlipidemia/hyperthermia/hypercalcemia ERCP Drugs ```

Murphy's sign positive

Cholecystitis

Pale stools, jaundice, abdo pain

Biliary obstruction

Pyoderma gangrenosum, erythema nodosum

Crohn's/UC

Tinkling bowel sounds

Bowel obstruction

Vesicular rash and weight loss

Crohn's

Urea breath test

H pylori

13 C breath test

Bacterial overgrowth

Rice water like stools

Vibrio cholera

AMA

Primary biliary cirrhosis

ASMA

Autoimmune hepatitis

Alpha feto protein assay

Hepatocellular carcinoma (or teratoma)

Diuretic for ascites (due to cirrhosis)

Spironolactona

Corkscrew oesophagus on barium swallow

Diffuse oesophageal spasm

Severe abdo pain and diarrhoea after raw milk

Campylobacter

Russels sign

Self induced vomitting

Mallory hyalins bodies

Alcoholic liver disease (acute hepatitis) and chronic active hepatitis

Onion skinning fibrosis

Primary sclerosing cholangitis

Thumb printing on x-ray, commonly seen at splenic flexure

Ischaemic colitis

Charcots triad

Acute cholangitis i.e. | Fever, jaundice and abodminal pain

Increased shoe size, spade hands, wedding ring too tight

Acromegaly

Signs of hyperthyroidism plus any eye changes, gritty eyes, smooth velvety skin

Graves disease

Orphan annie nuclei

Papillary thyroid cancer

Anosmia and GnRH deficiency

Kallmann syndrome

Troussea sign, chvostek sign and QT prolongation on ECG

Hypocalcemia

Brachydactyly of 4th metacarpal

Pseudohypoparathyroidism

Wrist drop

Radial nerve palsy

Dinner fork or swan's neck deformity

Displaced colles fracture

Feels like walking on pebbles

Advanced rheumatoid arthritis in the feet- subluxation of the metatarsophalangeal joints

Hanging rope sign

AVN

Positive anterior drawer test

ACL tear/rupture

Pain in internal rotation and extension of the knee at ninety degrees

Lateral meniscus tear

Dry eyes, mouth, vagina, bronchitis

Sicca syndrome

Locked knee

Bucket handle/meniscal tear

Shortened led and externally rotated

Displaced fracture neck of femur

Shortened leg and internally rotated

Dislocated femoral head

Onion peel sign

Ewing's sarcoma

Sunray spiculation

Osteosarcoma

Popcorn calcifiaction

Chondrosarcoma

Soap bubble appearace

Giant cell tumour (benign)

Rosary bead sign

Polyarteritis nodosa

Sea anenoma

Transitional cell carcinoma on cystoscopy

UTI and travel to india

Carbapenase-producing klebsiella (resistant to all antibiotics)

UTI with foul smelling urine and renal calculi

Proteus

Bleeding of renal artery

Fibromuscular dysplasia

RBC casts in urine

Proves haematuria is glomerular

Muddy brown casts of epithelial cells

Acute tubular necrosis

Potato appearance

Testicular seminoma