Cardiovascular Flashcards
1
Q
What can cause chest discomfort?
A
MI
Angina
Pericarditis
Aortic dissection
Oesophageal spasm
Pneumothorax
MSK pain
2
Q
What causes breathlessness
A
HF
Valvular disease
Angiona
PE
Pulomary hypertension
Respiratory disease
Anaemia
Obiestu
Anxiety
3
Q
What causes palpitiations?
A
Tachyarrhythmias
Ectopic beats
Anxiety
Hyperthyroidism
Drugs
4
Q
What causes syncope/presyncpe
A
Arrhytmias
Postural hypotension
Aortic stenosis
Hypertrophic cardiomyopathy
Atrial muxoma
Simple faints
Epilepsy
Anxiety
5
Q
What causes oedema?
A
HF
Constrictive pericarditiiss
Venous stasis
Lymphoedema
Nephrotic syndrome
Liver disease
Drugs
Immobiliyy
6
Q
What does chest pain due to MI feel like?
A
Dull discomfort
Tight or pressing band like sensation
7
Q
What is stable angina?
A
Episodes of pain percipitated by exertion and may occur more readily when walking in cold or windy weather
8
Q
What is unstable angina?
A
Abrupt onset of worsening chest pain
Minimal exertion or at rest
9
Q
What are these for angina
A
10
Q
What are these for MI?
A
11
Q
What are these for aortic dissection
A
12
Q
What are these for pericardial pain
A
13
Q
What are these for oesophageal pain?
A
14
Q
What causes reduced ventricular contractility (systolic dysfunction)?
A
MI
Dilated cardiomyopathy
Myocarditisi
15
Q
What causes impaired ventricular filling (diastolic dysfunction)
A
Left ventricular hypertrophy
Constrictive pericarditis
Hypertrophic or restrictive cardiomyopathy
16
Q
What causes increased metabolic and cardiac demand (rare)
A
Thyrotoxicosis
Atriovenous distulae
Paget’s disease
17
Q
What are causes valvular or congenital lesions?
A
Mitral and/or aortic valve disease
Tricuspid and/or pulmonary valve disease
Ventricular septal defect
Patent ductus arteriosus
18
Q
Whagt should be asked about in acute dysponea?
A
Durationof onset
Background symptoms of exertion dysponea and usual exercise tolerance
Associated symptoms: chest pain, syncope, palpitation or respiratory symptom
19
Q
What is the SOCRATES for extrasystoles?
A
20
Q
What is the SOCRATES for sinus tachycardia?
A
21
Q
What is the SOCRATES for supraventricular tachycardia?
A
22
Q
What is the SOCRATES for atrial fibrillation?
A
23
Q
What is the SOCRATES for ventricular tachycardia?
A
24
Q
What are ectioic beats?
A
Benign cause of palpiation at rest and are abolished by exercise
25
What does supraventricular tachycardia produce?
Sudden paroxysms of rapid, regular palpitation that can sometimes be terminated ith vagal stimulation using valsalva breathing manoeuvres or carotid sinus pressure
26
High risk features that increase the likelihood of life threatening arrhytmioa such as ventricul;ar tachycardoa include?
Previous MI or cardiac surgery
Associated syncope or severe chest pain
FH of sudden death
WPW syndrome
Signicianet heart disease such as hypertrophic cardiomyopathy or aortic stenosis
27
In patients with syncope ask about
Circumstances
Duration of LOC
Time to recovery
Driving status
28
What medication causes angina?
Aggravated by thyroixine or durg induced anaemia
29
What medication causes dysponea?
BB in patients with asthma
Exacerbation of HF with BB some Calcium channel antagonists
NSAIDS
30
What medication causes palpitation?
Tachycardia
Arrhytmia from thyroixne
Beta stimulants
Hypokalemia from diurectic
Tricyclic antidepressantsS
31
What medication causes syncope/presynctope?
Vasodilators
Brachycardia from rate limiting agents
32
What medication causes oedema?
Glucocorticoids, NSAIDS, calcium cha nnel antagondists
33
What is oedema?
Excess fluid in the intersitital space
34
What are the baseline symptoms, major events, investigations and procedures for ischemic heart disease?
Baseline symptoms- Exertional anaemia? If so ascertain functional limiations/response to GTN spray
Major events- Previous MI/ unstable angina
Investigations- Cornorary angiography, exercise electrocardiogram, exercise capacity
Procedures- PCI, coronary artery bypass graft surgery
35
What are the baseline symptoms, major events, investigations and procedures for heart failure?
Baseline symptoms- Dysponea, fatihue, ankle swelling, record usual functional status
Major events- Hospitalisation for decompensated HF, ventricular arrhytmias
Investigations- ECG, left ventricular sizem wall thickness and systolic function, valvular disease, RVF
Procedures- Implantable cardioverdefinbrillator, cardiac resynchronization therapy
36
What are the baseline symptoms, major events, investigations and procedures for ischemic valvular disease
Baseline symptoms- Often asymptomatic, exertuonal dysponea, chest pain or syncope
Major events- IE or previous rheumatic fever
Investigations- ECG: nature and severity of valve lesions, ventricular size and function
Procedures- Surgical valve repair or replacement, transcatheter valve procedures
37
What are Janeway lesions?
Painless, blanching red macules on the thenar/hypithenar eminences
38
What are osler nodes?
Painful raised erythematous lesions, typically on the pads of the fingerts
39
What is normal capillary refill time?
2 seconds or less
40
What do splinter haemorrhages be found?
IE
Some vasculitic disorders
41
What are petichial rash?
Most often present on the legs and conjunctivae is a transient finding in endocarditis and can be confused with the rash of meningococcal disease
42
What are tendon xanthomata are a sign of?
Sign of familial hypercholesterolaemia, a genetic disorder associated with severe elevations in serum cholesterol and premature coronary artery disease
43
What is xanthelmasta?
Creamy yellow plaques found periorbitally and on the medial aspect of the eyelids
44
What is corneal arcus?
Creamy yellow discolouration at the boundary of the iris and cornea
45
When taking a pulse asssess
Rate- number of pulses occuring per minute
Rhythm- The pattern of regularity of pulses
Volume- The perceived degree of pulsation
Character- AN impression of the pulse waveform shape
46
How to detect collapsing pulse?
Lift arm up vertically overhead. First ask if have any patin
47
What are sinus rhythm causes of fast rate?
Exercise
Pain
Excotement/anxiety
Fever
Hyperthyroidism
Medication
Sympathomimetics
Vasodilators
48
What are arrhytmia causes of fast rate?
AF
Atrial flutter
Supraventricular tachycardia
Ventricular tachycardia
49
What are sinus rhythm causes of slow rate?
Sleep
Athletic trainning
Hypothyroisism
BB
Digoxin
Verampamil, diltiazem
50
What are arrhytmias causes of fast rate?
Carotid sinus hypersensitivity
Sick sinus syndrome
Second degree heart block
Complete heart block
51
What are sinus rhythm causes of irregular pulse?
Sinus arrhytmia
Atrial extrasystoles
Ventricular extrasystoles
52
What are arrhytmias causes of irregular pulse?
Atrial fibrillation
Atrial flutter with variable response
Second degree heart block with variable response
53
What happens to pulse during inspiration?
Accelerates
54
What happens to pulse during expiration?
Slows
55
What haoppens to systolic blood pressure during inspiration?
Falls (up to 10mmHg)
56
What happens to systolic blood pressure during expiration?
Rises
57
What happens to jugular venous pressure during inspiration?
Falls
58
What happens to jugular venous pressure during expiration?
Rises
59
What happens to second heart sounds during inspiration?
Splits
60
What happens to second heart sound during expiration?
Fuses
61
When does a collapsing pulse occur?
Severe aortic reguargitation
62
What are the causes of widesprad vascular disease and renal bruit?
Renovascular disease, including renal artery stenosis
63
What are the causes of episodes of sweating, headache and palpitation?
Phaeochromocytoma
64
What are the causes of hypokalaemai?
Primary aldosteronism
65
What are the causes of cushinoid faces, central obseity, abdominal striae, proximal muscle weakness, chronic glucocorticoid use
Cushing's syndrome
66
What are the causes of low bolume femoral pulses with radiofemoral delay?
Voarctation of thr aorta
67
What are the causes of bilateral palpable kindeys?
Adult polycystic kidney disease
68
69
What are the difference betwen the carotid and jugular pulsation?
70
What is the abnormality with heart failure?
Elevation, sustainaed abdomino-jugular reflux over 10 seconds
71
What is the abnormality with pulmonary embolism
Elevation
72
What is the abnormality with pericardial effusion
Elevation
Prominent Y descent
73
What is the abnormality with pericardial constructuo?
Elevation
Kussmaul's sign
74
What is the abnormality with superior vena cava obstruction?
Evelation
Loss of pulsation
75
What is the abnormality with atrial fibrillatiob?
Absent A waves
76
What is the abnormality with tricuspid stenosis?
Giant a waves
77
What is the abnormality with tricuspid regurgitation?
Goant v or cv waves
78
What is the abnormality with common heart block?
Common waves
79
What are a waves?
Corresponds to right atrial contraction
Occurs just before the first heart sound
80
What are v waves?
Atrial filling during ventricular systole when the tricuspid valve is closed
81
What is Kussamaul's sign?
Paradoxcal rise of JVP on inspiration that is seen in pericardial constriction, severe RVF and restrictive cardiomyopathy
82
What sounds are heard in the cardiac apex?
First heart sound
Third and fourth heart sounds
Mid diastolic murmur of mitral stenosis
83
What sounds are heard in the lower left sternal border?
Early diastolic murmurs of aortic and tricuspid reguargitation
Opening snap of mitral stenosis
Pansystolic murmur of ventricular septal defect
84
What sounds are heard in the upper left sternal border
Second heart sound
Pulmonary valve murmurs
85
What sounds are heard in the upper right sternal border?
Systoilic ejection murmurs
86
What sounds are heard in the left axilla?
Radiation of the pansystolic murmur of MR
87
What sounds are heard in the below left clavicle?
Continous machinery murmur of a persistent patent ductus arteriosus
88
What is pectus excavatum?
Posterior displacement of the lower sternum
89
What is pectus carinactum?
Displace the heart and affect palpatipn and auscultation
90
What does a midline sternotomy scar indicates?
Previous valve replacement or coronary artery bypass surgery
91
What is a left submammary scar?
Result of mitral valvotomy or transapical transcatheter aortic valve implantation
92
Whem are infraclavicular scars seen?
Seen after pacemaker of defribbator implanation and the bulge of the device may be obvious
93
What does a normal apical impusle do?
Briefly lifts your fingers and is localised
94
What is seen in detocardia with the cardiac apex?
Palpable om tje rigjt side but this is uncommon
95
What does left ventricular hypertrophy cause?
Forceful but undisplaced apical impusle
Imululses over left parasternal area indicates RVH
96
What is ther most common thrill?
Aortic stenosis
Usually palpable over the upper giht sternal border
97
What are the quiet abnormalities of the first heart sound?
Low cardiac output
Poor LVG
rheumatic mitral regurgitation
LOng P R interval
98
What are the loud abdnormalities of the first heart sound?
Increased CO
Large stroke volume
Mitral stenosis
Short PR interval
Atrial myxoma
99
What are the variable abnromalities of the intensity of the first heart sound?
Atrail fibrillation
Extrasystoles
Complete heart block
100
What are ejection clicks?
High pitched sounds
101
What is higher pitched aortic regurgitation or mitral stenosis?
Aortic regurgitation
102
What are the grades of instensity of murmurs?
103
What are examples of ejection systolic murmurs?
Increased flow through normal valves: Severe anaemia, feverem athletes, pregnancy, atrial septal defect, other causes of flow murmurs
Normal or reduced flow through a stenotic valve: AS and Pulmonary stenosis
Subvalvular obstruction: Hypertrophic obstructive cardiomyopathy
104
What are examples of pansystolic murmurs?
Mitral regurgitation
Tricuspid reguargitation
Ventricular septal defect
Leaking mitral or tricupid prothesios
105
What is the most common cause of continuous murmurs?
PDA
106
What is the medical rsearch council breathlessness scale?
Degree of breathlessness related to activities
107
What is stridor?
Haesh, granting respiratory sound is caused by the vibration of the walls on the trachea or major bronchi
108
What is excessive daytime sleepiness may be due?
Obstructive sleep aponea
109
What are some drugs that cause bronchoconstriction?
Beta blockers
Opiods
Non steroidal anti inflammatory drugs
110
What are some drugs that cause cough?
Angiotensin converting enzyme inhibitors
111
What are some drugs that cause bronchiolotitis obliterans
Penicillamine
112
What are some drugs that cause diffuse parencymal lung disease?
Cytotoxic agents: Bleomcin, methotrexate
Anti inlfmamatory agents: Sulfasalazine, penicillamine gold salts and aspirin
Cardiovascular drugs: Amiodarone, hydralazine
Antibiotics: nitrofuratonin
IV drug misuse
113
What are some drugs that cause parenchymal thromboembolism?
Oestrogen
114
What are some drugs that cause pulmonary hypertension?
Oestrogens
Dexfenfluramine
Fenfluramine
115
What drugs causes pleural effusion?
Amiodarone
Nitrofuratonin
Phenytoin
Methotrexate
Pergolide
116
What are some drugs that cause respiratory depression?
Opiods
Benzodiazepines
117
When is jugular venous pressure raised?
In patients with pulmonary hypertension
118
What happens to the trachea in a tension pneumothorax?
Tracheal deviation away from the affected side
119
What are the suggestive features on history of infection?
Fever
120
What are the suggestive features on history of acute bronchitis?
Wheeze
Cough
Sputum
121
What are the suggestive features on history of exacerbation of chronic obstructive pulmonary disease
Acute on chronic dysponea
122
What are the suggestive features on history of pneumonia
Pleuritic pain, rusty sputum, righors
123
What are the suggestive features on history of malignancy?
Insidious onset, weight lossm, persisting pain or cough
124
What are the suggestive features on history of progressive fibrodis
Progressive dysponea
125
What are the suggestive features on history of pulmonary effusion?
Progressive dysponea
126
What are the suggestive features on history of large pulmonary embolism
Sudden
Severe dysponea
127
What are the suggestive features on history of medium PE
Epusodes of pleural pain
Haemoptysis
128
What are the suggestive features on history of multiple small PE
Progressive dysponea
129
What are the suggestive features on history of asthma?
Atopy
Hay fever
Pet ownership
Variable wheezw
Disturbance of sleep
130
What are suggestive features on examination for acute bronchitis
Wheee
131
What are suggestive features on examination for exacerbation of COPD
Hyperinflation
132
What are suggestive features on examination for pneumonia
If lobar, dull to percusion and bronchial breathing
133
What are suggestive features on examination for malignancy
Cervical lymphadenopathy
Clubbing
Signs of lobar/lung collapse and effusion
134
What are suggestive features on examination for pulmonary fibrosis?
Tachyponea
Inspiratory fine crackles at bases
Cyanosis
135
What are suggestive features on examination for pulmonary effusion?
Unilateral basal fullness and reduced breath sounds
136
What are suggestive features on examination for large PE
Normal breath sounds
137
What are suggestive features on examination for medium PE
Pleural rub, swollen leg if DVT, crackles if infarct
138
What are suggestive features on examination for multiple small PE
Raised jugular venous pressure, right ventricular heave
Loud pulmonary second sound
139
What are suggestive features on examination for asthma
Polyphhonic expiratory wheeze
Eczema
140
What is the position of the liver?
Upper border: fifth right intercosal space on full expiration
Lower border: At the costal margin in the mid clavicular line on full inspiration
141
What is the position of the spleen?
Underlies left ribs 9-11, posterior to the mid axillary line
142
What is the position of the gallbladder
At the intersection of the right lateral vertical plane and the costal margin
143
What is the position of the pancreas?
Neck of the pancreas lies at the level of L1
Head lies blow and right
Tail lies above and left
144
What is the position of the kidneys?
Upper poles lies deep to the 12th rib posteriorly
7cm from the midline
The right is 2-3cm lower than the left
145
What are causes of painful mouth?
Deficiencies, including iron, folate, vitmain B12 or C
Dermatological disorders, including lichen planus
Chemotherapy
Aphthous ulcers
Infective stomatitis
IBC and coelaic disease
146
What is the socrates of heartburn?
Chest pain is burning
Radiates upwards
Perciciptated by lying flat or bending foward
Associated symptoms: Waterbrash, taste of acid appearing in the mouth
147
What is used to classify dyspepsia?
Reflux like dyspepsia
Ulcer like dyspepsia
Dysmotility like dyspepsia
148
What is odynophagia?
Pain on swallowing
149
What is the SOCRATES for peptic ulcer?
150
What is the SOCRATES for biliary colic
151
What is the SOCRATES for acute pancreatitis
Site is the epigastrum/left hypochondrium
Onset is sudden
Character is constant
Radiation is into back
Associated sym,ptoms is non specific
Frequenct attacks can be enumerated
Special times- After heavy drinking
Duration is more than 24 hours
Exacervating- Alcohol and eating
Relieving is sitting upright
Severe
152
What is the SOCRATES for renal colic
S- Loin
O- Rapid increasing
C- Constant
R- Into genitalia and inner thigh
A- Non specific
Frequency- Usually a discrete period
Special times- Following periods of dehyration
T- 4-24 hours
E
S- Severe
153
What are the history symptoms of acute apendicitis?
Nausea
Vomiting
Abdominal pain that later shifts to right iliac fossa
154
What are the history symptoms of perforated pelvic ulcer with acute peritonitis?
Vomiting at onswt associated with severe acute onset abdominal pain
Previous history of dysphagia
Ulcer disease
NSAIDS
Glucocorticoid therapy
155
What are the history symptoms of acute pancreatitis
Anoreixa
Nausea
Vomiting
Constant severe epigastric pain
Previous alcojol abuse/choleithiasis
156
What are the history symptoms of ruptured aortic anyerusm
Sudden onset of severe tearing back/loin/abdominal pain
Hyoitension and past history if vascular disease
High BP
157
What are the history symptoms of acute mesenteric ischemia?
Anorexia
Nausea
Vomiting
Blood diarrhoea
Constant abdominal pain
Previous history of vasciaular disease
High BP
158
What are the history symptoms of intestinal obstruction
Colicky central abdominal pain
Nausea
Viomutunbg and constipation
159
What are the history symptoms of ruptured ectopic pregnancy?
Premenopausal female
Delayed or missed menstral period
Hypotension
Unilateral iliac fossa pain
Oleuritic shoulder tip pain
Prune juice like vaginal dischare
160
What are the history symptoms of pelvic inflammatory disease?
Sexually active young female
Previous history of SRI
Recent gynaecological procedure
Pregancny
Pregnancy
use of IUD
Dyspaneuria
Lower of central abdominal pain
Backache
Pleuritic chest pain
161
What are the examinations of the acute appendicitis?
Fever
Tenderness
Guarding or palpable mass in right iliac fossa
Pelvic peritonitis on rectal examination
162
What are the examinations of the perforated peptic ulcer with acute peritonitis?
Shallow breathing with minimal abdo,omal witrh movement
Abdomional tenderness and guarding board like rigitdity
Abdominal distenstion and absent bowel sounds
163
What are the examinations of the acute pancreatitis?
Fever
Periumbiliacal or loin bruising
Epigastric tenderness
Variable guaridng
Reduced or absent bowel sounds
164
What are the examinations of the rupture aortic aneurysm?
Shock and hypotemsion
Puslatile, tender, abdominal mass
Asymmetrical femoral pulses
165
What are the examinations of the acute mesenteric ischemia
AF
HF
Asymmetrical peropheral pulses
Absent bowel sounds
Variable tenderness an guarding
166
What are the examinations of the intestinal obstruction?
Surgical scars
Hernias
Mass
Distension
Visible peristalsis
Increased bowel sounds
167
What are the examinations of the ruptured ectopic pregnancy?
Suprapubic tenderness
Periumbilical brusing
Pain and tenderness on vaginal exmaintion
Swelling/fullness in fornix on vaginal examination
168
What are the examinations of the PID?
Fever
Vaginal discharge
Pelvic peritnonitis causing tenderness on rectal exmaintion
RUQ tenderness
Pain/tenderness on vaginal examination
Swlling/fullness in fornix on vaginal examination
169
What drugs cause weight gain?
Oral glucocorticoids
170
What drugs cause dyspepsia and GI bleeding?
Aspirtin
NSAIDS
171
What drugs cause nausea?
Many drugs
Including SSRIs
172
What drugs cause diarrhoea?
Antibiotics
PPIs
173
What drugs cause concstipation?
Opioids
174
What drugs cause jaundice hepatitis?
Paracetemol
Pyrazinamide
Rifampicin
Isoniazid
175
What drugs cause jaundice cholesttic?
Flucloxacillin
Chloropromazine
Co-amoxiclav
176
What drugs cause liver fibrosis?
Methotrextaee
177
What is an indirect inguinal hernia?
Bulges through internal ring and follows course of inguinal canal
178
What is a direct inguinal hernia?
At the sit of muscle weakness in posterior wall of inguinal canal
179
What is the cause of abnomrally pale stool?
Biliary obstruction
180
What is the cause of abnomrally pale and grassy stoool?
Steatorrhoea
181
What is the cause of black and tarry
Bleeding from upper gi tract
182
What is the cause of grey/black
Oral iron or bismuth therapy
183
What is the cause of silver
Steatorrhoea pul upper gi bleeding
184
What is the cause of fresh blood in or on stool
Large bowel, rectal or anal bleeding
185
What is the cause of stool mixed with pus
Infective colitis or IBD
186
What is the cause of rice water stool
Cholera
187
What are the vasovagal syncope triggers, prodome, duration of unconciousness, convulsion, colour, injuries and revovery
Triggers- Tyoucally pain, illness, emotion
Prodome- Feeling faint/lightheaded, nausea, tinnitus, vision dimming
Duration of unconsioussness- Less then 60 seconds
Convulsions- May occyr but usually brief myoclonic jerks
Colour- Pale/grey
Injuries- Uncommon. Sometimes biting tip of tongue
Recovery- Rapid, no confusion
188
What are the seizure triggers, prodome, duration of unconciousness, convulsion, colour, injuries and revovery
Triggers- Often none
Prodome- Focal onset
Duration of unconsioussness- 1-2 minutes
Convulsions- Usual tonic clinic. 1-2 minutes
Colour- Flushed/cyanosed, may be pale
Injuries-lateral tongue biting, headache, generalised myalgia, back pain
Recovery- Gradual over 30 minutes
189
What are the clinical features of GCA
Painless loss of vision
More than 50 years
Weight loss
Loss of aptitie, fatigue
Jaw or tongue claudication
Temporal headach
Pale or swollen optic disc
RAPD
190
What are the clinical features of vitreous haemorrhage?
Painless loss of vision
Risk in poligerative diabetic retinopathy
Hisotry of flashing lights or floaters may precede haemorrhage in posterior vitreous attachment
Poor fundus view on examination
Reduction or loss of red reflex
191
What are the clinical features of central retinal vein occlusion?
Acute painless loss of vision
May have RAPD if severe
Greater risk if hypertensive
Haemorraheg exudates and tortuous retainal veins
192
What are the clinical features of wet age related acular defeneration?
Sudden painless loss of central vision
Age more than 55
Increased risk in smokers
Haemorrhages at the macula
193
What are the clinical features of retinal detachment?
Painless loss of vision
Associated with flashing lights or floaters
History of curtain coming across vision
Myopuv patients at greater risk
RAPD if macula is involved
Pale raised retiana usually with a retinal tear
194
What are the clinical features of anterior ischemic optic neuropathy?
Painless loss of upper or lower visual field
Increaased risk of vasculopaths
Examination may reveal optic disc swelling
195
What are the clinical features of central retinal arterial occlusion
Acute, painless loss of visin
Carotid bruit may be ehatd
Increased risk in vasculopaths
Examination: Pale retina with a cherry red spot at the fovea
196
What are the clinical features of optic neuritis/retrobular neuritis
Visual reduction over hours
20-50
Pain exacerbated by eye movement
RAPD
Reduced colour sensitivity
Swollen optic disc in optic neuritis
197
What are the clinical features of corneal disease
Usual association with pain
Foreign body sesnation
Corneal opacity may be visible
198
What are the clinical features of amaurosis fungax?
Painless loss of vision for minutes
History of CVD
May have association AF or carotid bruit
Normal ocular examination
199
What are the clinical features of refractive error
No associated symptoms
Normal ocular examination
Vision can be improved by pinhole
200
What are the clinical features of glaucoma
Usually bilateral but asymmetrical los of visual feild
Cupped optic discs on examination
201
What are the clinical features of cataract
Gradual clouding of vision
May be associated with glare
Seen in elderly
Examintion clouding of the pupil and altered red reflex
202
What are the clinical features of diabetic maculopathy
Histroy of diabetes
Central vision reduced or distorted
Haemorrhages and exudates at the macula on examination
203
What are the clinical features of compressive optic neuropathy
Gradual unilateral loss of vision
Pale optic disc
204
What are the clinical features of retinitis pigmentosa
Gradual bilateral symmetrical loss of poeripheal visual field
Nuctalopia
FH
Bone spicule fundus, attenuated blood vessels and waxy optic disc
205
What are the clinical features of dry age related macular degeneration
Gradual loss of central vision
Bilateral
Examintion: Drusen, atrophy and pigmentation of the macula
206
What do flashers and floaters result from?
Disturbance of the vitreous and the reinsa, occurring most commonly in posterior vitreous detachment
207
What are the clinical features of blocked gland on lid?
Pain on lid
Tenderness to touch
Occular examination: redness and swelling of lid
208
What are the clinical features of corneal foreign body
Foreign body sensation
Watery eye
Photpphobia
Ocular examination
209
What are the clinical features of corneal infection
Foreign body sensation
Photophobia
Red eye
Ulcer on cornea which can be highlighted with fluorescien stainning
Ocular examination: white infiltrate may be visible
210
What are the clinical features of scleritis
Severe pain that keeps the patient awake at night
Soreness of the eye to touch
Association with recent infection, surgery or rheumatic disease
Ocular examination: sclera injection
211
What are the clinical features of angle closure glaucoma
Constant pain around eye
Acute reduction in vision
Possibly haloes seen around lighyd
Asssociated with nausea and vomiting
Ocular examination: fixed mid dilated pupil, hazy cornea and usually a cataract
212
What are the clinical features of conjunctivitis?
increased clear or purulent discharge
Ocular examination: red eye
Vision is usually unaffected
213
What are the clinical features of uveitis
Floaters
Blurry vision
Photophobia
Ocular examination: ciliary flush
214
What are the clinical features of optic neuritis?
Reduction in vision
Reduction in colour sensitivity
Constant pain worsened by eye movement
Ocular examination: swolen disc in optic neuritis
Normal disc in retrobulbar neutiritds
215
What are the clinical features of orbital cellulitis
Constant ache around the eyes
Reduced vision
Double vision
Associated with a recent viral infection
Ocular examintion- conjunctival chemosis and injection, restrictive eye movement in severe cases visual reduction with RAPD
216
What are the clinical features of thyroid eye disease?
Symptoms of hyperthyrodisim
Sore, gritty eyes
Double vision
Ocular eamointion: lid retraction, proptosis, restricted eye movements and conjunctival injection, conjunctival chemosis
217
What are monocular causes of double vision?
High astigmatism
Cornal opacity
Abnormal lens
Iris defect
218
What are binocular causes of double vision?
Myaesthenia gravis
VI, IV, III nerve palsy
Internuclerar opthalmoplegoa
Thyroid eye disease
Complex or combined palsy
Severe orbital cellulitis or orbital inflammation
219
What are causes of increased discharge from the eyes?
Bacterial conjunctiitis
Viral conjunctivitis
Blocked tear duct
Foreign body
Allergic conjunctivitis
Blepharitis
Poor tear film/dry eyes
220
What are the common causes of periorbital swelling?
Infective
Inflammatory
Neoplastic
Systemic
Vascular
Pseudoproptosis
221
What are the associated distinguishing features of horner's syndrome?
Ptosis
Miosis
Eye movement spared
222
What are the associated distinguishing features of cranial nerve III palsy
Dilated pupil
Eye movement affected
223
What are the associated distinguishing features of myotonic dystrophy?
Frontal balding, sustained handgrip
224
What are the associated distinguishing features of chronic progressive external opthalmoplegia
Bilateral ptosis and impairment of eye movements
Often without diplopia
Sparing of pupil reflexes
225
What are the associated distinguishing features of oculopharyngeal dystrophy?
History of swallowing abnormalities
226
What are the associated distinguishing features of myasthenia gravis?
History of variable muscular failure
227
What are the associated distinguishing features of eyelid tumour?
Evident on inspecrion
228
What are the associated distinguishing features of eyelid inflammation/infection
Evident on inspection
229
What are the associated distinguishing features of trauma of eyelid?
Scarring/history of trauma
230
What are the associated distinguishing features of levator aponeuorisis degeneration?
Often unilateral, eye mvoement normal
231
What are the associated distinguishing features of long term contact lens wear
History of contact lens use
232
What are the causes of dilated pupil?
Cranial nerve III pa;sy
Physiological
Pharmacological treatment with a dilating agent
Post surgival
Adie's tonic pupil
233
What are some causes of constricted pupil?
Horner's syndrome
Mechnaical
Physiological
Late stage Adie's tonic pipil
Pharmacological treatment with a constricting agent
234
What are the causes of the unilateral optic disc swelling??
Optic neuritis
Anterior ischemic optic neuropathy
Syphilis
Lyme disease
Bartonella
Sarcoidosis
Leukemia
Optic nerve glioma
Secondary metastases
235
What are the causes of the bilateral optic disc swelling
Papilloeema
Pseudopapilloedemia in hypermetropes
Optic disc drusen
Diabetic papillitis
Hypersensitve papillopathy
236
What are the differential diagnosis of optic disc pallor?
Inherited- congenital optic atrophy including leber's and behr's
End stage glaucoma
Trauma
Compressive- Orbital neoplasm, Thyroid eye disease and Orbital cellulitis
Neurological- End stage papilloedema, devic's disease
Metabolic- Nutritional deficiency, ethambutol, dm
Vascular- Central retianl artery occlusion, GCA
Inflammatory- Meningitis, post optic neuritis
237
What are the clinical features of acute otitis external?
Pain worse on touching outer ear, tragus
Swelling of ear canal
Purulent discharge and itching
238
What are the clinical features of acute otitis media?
Severe pain, red, bulging tympaninic membrane, purulent discharge if tympanic membernae perforation preset
239
What are the clinical features of perichondritis
Erythmeanous, swollen pinna
240
What are the clinical features of trauma fo the ear?
Pinna haematoma, pinna laceration, haemotympanum, CSF leak of facial nerve pasly may be present
241
What are the clinical features of herpes zoster?
Vesicles in ear canal, facialn nerve palsy may be present, vertigo in common
242
What are the clinical features of ear malignancy?
Mass in ear canal or on pinna
243
What are the clinical features of tonsillitis and peritonsillar abscesses
Sore throat, tonsil inflammation
Trismus, soft palate swelling in peritonisllar abscess
244
What are the clinical features of tmj dysfunction?
Tenderness
Clicking of joint on jaw opening
245
What are the clinical features of dental disease?
Toothache
246
What are the clinical features of cervical spine disease?
Neck pain/tenderness
247
What are the clinical features of cancer of the pharynx or larynx
Associated sore throat, hoarseness, dysphagia, weight loss and neck lump
248
What are causes of conductive hearing loss?
Wax
Otitis externa
Middle ear effusion
Trauma to the tympanic membrane/ossicles
Otosclerosis
Chronic middle ear infection
Tumours of the middle ear
249
What are the clinical features of sensorineural hearing loss?
Genetic
Prenatal infeciton
Birth injury
Infection
Trauma
Menieres disease
Degenerative
Occuptation
Acousitc neuroma
Idiopathic
250
What are the duration, hearing loss, tinnotis, aural fullness, episodic triggers of benign paroxysmal positional vertigo
duration- Seconds
hearing loss- no
tinnotis- no
aural fullness- no
episodic- yes
triggers- lying on affected ear
251
What are the duration, hearing loss, tinnotis, aural fullness, episodic triggers of vestibular neuritis
duration- days
hearing loss- no
tinnotis- np
aural fullness- no
episodic- rarely
triggers- possible presence of upper respiratory symptoms
252
What are the duration, hearing loss, tinnotis, aural fullness, episodic triggers of menieres disease
duration- hours
hearing loss0 yes
tinnotis- yes
aural fullness- yes
episodic- Recurrent vertigo, persistent tinnitus and progressive sensorineural deafness
triggers- None
253
What are the duration, hearing loss, tinnotis, aural fullness, episodic triggers of central vertigo
duration- Hours- migrane. Days and weeks- MS. Long term- cerebrovascular accident
hearing loss- No
tinnotis- no
aural fullness- no
episodic- migrane- recurs. CNS demage- usually some recovery but often persistent
triggers- drugs
254
What is nystagmus?
Involuntaru rhytmic oscillation of the eyes
255
What are the clinical pathology and characteristics of peripheral nystagmus
Clinical- SSC, vestibular nerve
Unidirectional
Not suppressed by optic fixation
Patient too dizzy to walk
Dix halpike fatigue on repetition
Away from affected side
256
What are the clinical pathology and characteristics of central nystagmus?
Brainstem, cerebellum are affected
Bidirectional
Suppressed by optic fixation
Patient can walk
Dix hallpike persists
To either side is nyastmus
257
What are the clinical pathology and characteristics of dysconjugate nystagmus
Interconnectons of III, IV and VI nerves are affected
Typically affects the abducting eye
Maximal on looking to either side
258
What are the clinical pathology and characteristics of pendular nystagmus type?
Eyes are effect
No fast phase
Looks straight ahead
259
What are the features of congenital abnormalities of dysphonia?
Larynfomalacia
More common in preterm neonates
Associated stridor due to immature larynx folding in on indpsiration
260
What are the features of neurological disorder in dyshonia
Vocal cord palsy
Unilareral causing weak
Breathy cry
Bilateral may cause stridor and airway obstruction
261
What are the features of croup?
Barking cough
Stridor
Hoarse voice
262
What are the features of laryngitis?
Bacterial or viral
263
What are the features of voice abuse?
History of voice abuse
264
What are the features of upper respiratory tract infection and laryngitis?
Associated features of upper respiratory tract infection
265
What are the features of trauma of dysphonia?
Mechanical or chemical injury
Cigarette smoking
GORD
266
What are the features of dysphonia in lung cancer?
Vocal cord paralysis
Breatrhy voice
267
What are the features of dysphonia in vocal cord nodules
Prologned vocal straon
Rough voice
Reduced vocal range
Vocal fatigue
268
What are the features of dysphonia in neurological disorder?
Weak, wet or dysarthric voice
269
What are the features of dysphonia in cancer of the larynx
Rough voice
Constant progressive often affects smokers
Associated with dysphagia, odynophagia and otalgia
270
What are the clinical features of a thyroglossal cyst
Smooth, round, cystic lymp that moves when patient sticks out tongue
271
What are the clinical features of a submental lymph nodes?
Associated infectipn of lower lip, floor of mouth, tip of tongue or cheek skin
272
What are the clinical features of a thyroid isthmus swelling
Lump moves on swallowing
273
What are the clinical features of a dermoid cyst
Small, non tender, mobile subcutanous lump
274
What are the clinical features of a thyroid lobe swelling
Lump moves with swallowing but not on tongue protrusion
275
What are the clinical features of a submandibular gland swelling?
Swelling below the angle of the mandible
Can be felt bimanually
276
What are the clinical features of a parotid gland swelling
Swelling in the preauricular area or just below the ear
277
What are the clinical features of a parotid gland mass
Hard, fixed mass with facial nerve weakness suggests a malignant tumour of the parotid gland
278
What are the clinical features of a brachial cyst
Smooth, non tender, fluctuant mass
Not translucent
Slowly enlarging may increase after URTI
279
What are the clinical features of a malignant lymph nodes?
Large
Hard
Fixed
Matted
Painless mass suggests malignancy
280
What are the clinical features of lymph nodes during infection?
Lymph nodes can be reactive to infectio and are usually smooth, firmly, mobile and tender
281
What are the clinical features of carotid body tumour?
Firm, rubbery, pulsatile neck mass, fixed verticully due to attachment to bifurcation of common carotid
Bruit may be predent
282
What are the clinical features of carotid artery aneurysm?
Rare, present as pulsatile neck mass
283
What are the clinical features of cystic hygroma
Soft, fluctuant, compressible and transilluminable mass, usually seen in children
284
What are the clinical features of cervical ribs
Hard, bony mass
285
What are the clinical features of supraclavicular lymphadenopathy?
Left supraclavicular node may suggest gastric malignancy
286
What is the differential diagnosis of tiredness
Hypothyroidism
Hyperthyrodism
DM
Hypopituitarism
287
What is the differential diagnosis of weight gain
Hypothyroidism
PCOS
Cushings syndrome
288
What is the differential diagnosis of weight loss
Hyperthyrodisim
DM
Adrenal insufficiaency
289
What is the differential diagnosis of diarrhoea
Hyperthryodism
Gastrin producing tumour
Carcinoid
290
What is the differential diagnosis of diffuse neck swelling
Simple goitre
Graves disease
Hashimotos thyroiditis
291
What is the differential diagnosis of polyuria?
DM
DI
Hyperparathyroisidm
Conn's syndrome
292
What is the differential diagnosis of hirsutism
Idiopathic
PCOS
Congenital adreanl hyperplasia
Cushings syndrome
293
What is the differential diagnosis of funny turns or spells
Hypoglucemia
Phaeochromocytoma
Neuroendocrine tumour
294
What is the differential diagnosis of sweating
Hyperthryodism
Hypogonadism
Acromegaly
Phaeochromocytoma
295
What is the differential diagnosis of flushing
Hypogonadism
Carcinoid syndromes
296
What is the differential diagnosis of resistant hypertension
Conns syndrome
Cushings syndrome
Phaeochromocytoma
Acromegaly
297
What is the differential diagnosis of amenorrhoea/oligomenorrhea
PCOS
Hyperprolactinaemia
Thyroid dysfunction
298
What is the differential diagnosis of erectile dysfunction
Primary or secondary hypogonadism
DM
Non endocrine systemic disease
Medication induced
299
What is the differential diagnosis of muscle weakness
Cushings syndrome
Hyperthyrodism
Hyperparathyrodisms
Osteomalacia
300
What is the differential diagnosis of bone fragility and fractures?
Hypogonadism
Hyperthyrodism
Cushings syndrome
Primary hyperparathyrodism
301
What is the SOCRATES of uterine pain
S- Midline
O- Builds up before periods
C- Cramping
R- Lower back and upper thighs
A- Bleeding from vagina
T- With menstration
E
S- Variable in spasms
302
What is the SOCRATES of ovarian pain
S- Left or right iliac fossa
O- Sudden, intermittent
C- Gripping
R- Groin, if free fluid to shoulder
A- Known cyst, pregnancy, irregular cycle
T- May be cyclical
E- Positional
S- Intense
303
What is the SOCRATES of adhesions or pelvic infection
S- Generalised lower abdomen. More on one side
O- Builds up, acute on chronic
C- Shooting, gripping
R- None
A- Discharge, fever, past surgery
T- Acute, may be cyclical
E- Movement, examination
S- Intense in waves
304
What is the SOCRATES of endometriosis
S- Variable
O- Builds up, sudden
C- Shooting, cramping
R- None
A- Infertility
T- Builds up during period
E- Intercourse, cyclical
S- Variable
305
What is dyspanunia?
Pain during intercourse
306
What should you ask about dyspanunia?
Is it around vaginal entrance or deep
307
What is vaginismus?
Pain due to involuntary spasm of muscles at the vaginal entrance
308
When does stress incontinence occur?
Occurs on excretion, coughing, laughing or sneezing
309
What is urge incontience?
Overwhelming desire to urinate when the bladder is not full due to detrusor muscle dysfunction
310
What is tamoxifen?
Has oestrogenic effects in postmenopausal women
311
What is the routine examination sequence for a pregnancy checkup
Calculate MI
MSSU
BP
Physical exam
312
When should an MSSU be done and what does it do?
Booking. always sent
Detects asymptomatic bacteruria
313
When should an urinalysis be done and what does it do?
Every visit
Trace or proteinuria: Send MSU, ask about symptoms or UTI
Lots of proteinuria. Consider pre-eclampsia or, rarely underlying renal disorder
Glycosuria: Consider random blood glucose or glucose tolerance test
314
When should an FBC be done and what does it do?
Booking, 28 weeks, 36 weeks
If haemoglobin is less than 105, treat; consider checking haematinic
315
When should an haemoglobin electrophoresis be done and what does it do?
Booking. To check for sickle cell disease and thalaseemia
316
When should a blood group and antibody screen be done and what does it do?
Bookig, 28 weeks
More often if advised by labratory
317
When should an hep B be done and what does it do?
Booking
If the patient is a previous intravenous drug absuer or is known to be HIV or hep B positive also carry out hep C screening
318
When should an HIV screening be done and what does it do?
Booking
Unless the patient opts out
319
When should an syphilis screening be done and what does it do?
Booking
320
When should an plasma glucose screening be done and what does it do?
Booking
321
When should an carbon monoxide level screening be done and what does it do?
Every visit for smpkers
Advice and referral for cessation, growth scans
322
When should a combined biochewmical screening and nuchal translucency measurement for trisomy 21 be done and what does it do?
11-14 weeks
Detects 80-90% of affected pregnancies
323
When should an first trimester US screening be done and what does it do?
6-13 weeks
Viability, gestational age more or less than 7 days
Fetal number
Some major anomalies
324
When should an detailed US scan be done and what does it do?
18-22 weeks
Detects 90% of major congenital abnormalities and placental site
325
When should a placental site check be done and what does it do?
If low at 20 weeks, recheck later at 34 weeks
If there is an anterior placenta in a woman who has had a previous C section, recheck the scan at 28 weeks to consider the risk of placenta acreta
326
When should a growth scan be done and what does it do?
After 24 weeks; can be as often as 2-4 weekly
Previous growth restricted baby. other risk factors, measurement of a small for dates baby, reduced fetal movements
327
When should an presentation scan be done and what does it do?
After 36 weeks
If there is concern that presentation is not cephalic
328
When should an amniocentesis be done and what does it do?
15 weeks onwards
For fetal karyotype; 0.5-1% risk of miscarriage
329
When should an free fetal DNA maternal test be done and what does it do?
End of first triemster
To detect trisomy: current guidance advocates use of screening test only
330
What happens to the size of the uterus during pregnancy?
Increases
At 20 weeks the uterine fundus is at the umbilicus
By 36 weeks it reaches the xiphisternum
331
When should vaginal examination not be done?
In pregnancy unless there is a specific indication. Never perform a vaginal examination after 20 weeks unless the placental location is known not to be low
332
What do diuretics cause?
Contribute to urinary symptoms
333
What can alpha blockers cause?
Retrograde ejaculation
334
What can antihypertensive agents cause?
Erectile dysfunction
335
What can vasoactive agents cause?
Such as alprostadil, may result in a prolonged erection
336
What can antidepressants or antipsychotics cause?
May affect sexual function
337
What is variocele?
Dilation of the veins of the pampiniform plexus and feels like a bag of worms
338
What is a hydrocele?
Swelling caused by fluid in the tunica vaginalis.
Usually idiopathic but may be secondary to inflammatory conditions or tumours
339
What is epididymal cysts?
Swelling of the epididymis that are felt to be completely separate from the body of the testis are epididymal cysts
Transilluminate and are never malignant
340
What are testicular tumours?
Painless, hard swelling of the body of the testis
341
What are epididymitis?
Inflammation of the epididymis produces painful epidiymal swellig, most often caused by an STI in young men, or a coliform urinary infection in the eldarly
342
What is testicular torsion?
Retracted or high lying testicle, accompanies by acute pain and swelling
Occurs in testicular torsion
343
What are the extra articular signs of rheumatoid arthritis?
Rheumatoid nodules
Palmar erythema
Episcleitis
Dry eyes
Intertsitial lung disease
Pleural witjh or withoput perciardial effusion
SMall vessel vasculitis
Raynud's phenomenon
Low grade fever
Weight loss
Lymphadenopathy
Splenomegaly
Leg ulcers
344
What are the extra articular signs of psoriatic arthrisi
Psoriasis
Nail pitting
Onycholysis
Enthesititis
Dactylitis
345
What are the extra articular signs of reactive arthritis
Urethritis
Mtuh and or genital ulcers
Conjuncittis
Iritis
Enthesitis
346
What are the extra articular signs of axial spondyloartheitis
IBD
psoriasis
Enthesititis
Iritis
Aortic regurgitiation
Apical intersittial fibrosis
347
What are the extra articular signs of septic arthtitis
Fever
Malaise
Source of sepsis
348
What are the extra articular signs of gout
Tphi
Signs of renal failure of alcoholic liver disease
349
What are the extra articular signs of sjorgrens syndrome
Dry eyes
Xerostomia
Salivery gland enlargement
Raynaud's phenomenon
Neuropathy
350
What are the extra articular signs of SLE
Photosenstivie rash
Mucucotaneous ulcers
Alopecia
Fever
Pleural with or without pericardial effusion
Diaphragmatic paralysis
Pulmonary fiboris
Raynaud's phenomenon
Lymphopenia
351
What are the extra articular signs of systemic sclerosis?
Skin tightening
Telangievtasia
Raynaud's phenomonenon
Calcifiec deposits in fingers
Dilated nail-fold capullaries
Pulmonary fibrosis
352
What are the extra articular signs of adult- onsent Still's disease?
Rash, fever, hepatomegaly, splenomegaly
353
What are the adverse musculoskeletal effects of glucocricoids
Osteoporosis
Myopathy
Osteonecrosis
Infection
354
What are the adverse musculoskeletal effects of statins?
Myalgia
Myositis
Myopahty
355
What are the adverse musculoskeletal effects of ACEI
Myalgia, arthralgia, postivie antinuclear antibody
356
What are the adverse musculoskeletal effects of antiepilaptoics
Osteomalacia
Arthraliia
357
What are the adverse musculoskeletal effects of immunosuppressants
Infections
358
What are the adverse musculoskeletal effects of quinolones
Tendinopathy
Tendon rupture
359
What is the defenition of abscess
A collection of pus, often associatied with signs and symptoms of inlammation
360
What is the defenition of angioedema
Deep swelling (oedema) of the dermis and subcutis
361
What is the defenition of annular?
Ring like
362
What is the defenition of arcurate
Curved
363
What is the defenition of atrophy
Thinning of on eor more layers of the skin
364
What is the defenition of blister
A liquid filled lesion
365
What is the defenition of bulla
Large blister
366
What is the defenition of burrow
Track left by burrowing scabies mite
367
What is the defenition of callus
Thicekened area of skin that is a response to repeated friction or pressure
368
What is the defenition of circinate
Circular
369
What is the defenition of comedo
Blackhead
370
What is the defenition of crust
A hard, adherent suface change caused by leakage and drying of blood, serum or pus
371
What is the defenition of cyst?
Fluid filled papular lesion that fluctanes and transillumionates
372
What is the defenition of discoid
Disc like
373
What is the defenition of ecchymosis
Deep bleed in skin
374
What is the defenition of erosion
Superficial loss of skin, involving the epidermis, scarring is not normally a result
375
What is the defenition of erythma
Redness of the skin that blanches on pressure
376
What is the defenition of erythroderma
Any inflammatory sjkin disease thart affects more than 80% if the body surface
377
What is the defenition of exanthem
Rash
378
What is the defenition of excoriation
Scratch mark
379
What is the defenition of fissure
A split, usually extending from the skin surface through the epidermis to the dermis
380
What is the defenition of freckle
An area of hyperpigmentation that increases in the summer months and. decreases during winter
381
What is the defenition of furuncle
A boil
382
What is the defenition of gyrate
Wave like
383
What is the defenition of haematoma
Swelling caused by a collection of blood
384
What is the defenition of horn
Hyperkeratotic projection from the skin surface
385
What is the defenition of hyperkeratosis
Thickening of the stratum corneum
386
What is the defenition of ichthyosis
Very dry skin
387
What is the defenition of keratosis
Lesion characterised by hyperkeratosis
388
What is the defenition of lentigo
Area of fixed hyperpigmentation
389
What is the defenition of lichenification
Thickening of the epidermis, resulting in accentuation of skin markings. Usually indicative of a chronic eczematous process
390
What is the defenition of macule
Flat colour change
391
What is the defenition of millium
Keratin cyst
392
What is the defenition of naevus
Localised development defect
393
What is the defenition of nodule
Large papule
394
What is the defenition of nummular
Coin shaped
395
What is the defenition of onycholysis
Seperation of the nail plate from the nail bed
396
What is the defenition of papilloma
Benign growth projecting from the skin surface
397
What is the defenition of papule
Elevated lesion, arbitrarily less than 0.5 cm in diameter
398
What is the defenition of patch
Large macule
399
What is the defenition of pedunculate
Having a stalk
400
What is the defenition of petechiae
Pin head sized macular purpura
401
What is the defenition of pigmnetation
Change in skin colour
402
What is the defenition of plaque
A papule or nodule that in cross sectional profile is plateau shaped
403
What is the defenition of poikiloderma
A combination of atrophy, hyperpigmentation and telangiectasia
404
What is the defenition of purpura
Non blachable redness
405
What is the defenition of pustule
A papular lesion containing turbid purulent material
406
What is the defenition of reticulate
Net like
407
What is the defenition of scale
A flake on the skin surface, composed of stratum corneum cells, shed together rather than individually
408
What is the defenition of scar
The fibrous tissue resulting from the healing of a wound, ulcer or certain inflammatory conditions
409
What is the defenition of serpiginous
Snake like
410
What is the defenition of striae
A strethc mark
411
What is the defenition of targetoid
Target like
412
What is the defenition of telangiectasia
Dilated blood vessels
413
What is the defenition of ulcer
A deep loss of skin, extending into the dermis or deeper, usually results in scarring
414
What is the defenition of umbilication
Depression at the centre of a lesion
415
What is the defenition of verrucous
Wart like
416
What is the defenition of vesicle
Small blister
417
What is the defenition of wheal
A transient, itchym elevated area of skin resulting from dermal oedema that characrises urticaria
418
What is the defenition of xerosis
Mild/moderate dryness of the skin
