Cards

Question 1

What electrolyte disorder is common in myleoma

Answer 1

hypercalcaemia

Question 2

what are the presenting features of myeloma

Answer 2

Older adults - median age 60 years; male more than female
Anaemia
Bone pain - most common in the back or ribs; may present as a pathologic fracture following minimal trauma, especially of the femoral neck
Infection - commonly with encapsulated organisms such as Streptococcus pneumoniae, Haemophilus influenzae; due to suppression of antibody production and neutropenia
Hypercalcaemia - nausea, fatigue, confusion, polyuria, constipation
Weight loss is common
Hyperviscosity.

Question 3

What is a common cause of post operative foot drop

Answer 3

pressure on the common peroneal nerve during anaesthesia

ensure padding on the fibula head during operations

Question 4

why is a central neurological cause unlikely to result in foot drop

Answer 4

would not cause a well defined peripheral nerve lesion

Question 5

give common causes of hypercalcaemia

Answer 5

primary hyperparathyroidism 
hypercalcaemia of malignancy 
paraneoplastic syndrome
lymphoma 
thyrotoxicosis

Question 6

what blood features might you find in severe boughts of prolonged vomiting

Answer 6

high serum aldosterone
hypochlorydia
hypokalaemia
tetany (caused by metabolic acidosis)

Question 7

would you expect high or low bicarb in a metabolic acidosis

Answer 7

low (this is not compensation)

Question 8

what are the functions of aldosterone

Answer 8

steroid hormone that retains sodium

Question 9

what is the opposite of aldosterone

Answer 9

atrial naturetic peptide

Question 10

what is a strain pattern on an ECG?

Answer 10

left ventricular hypertrophy
large voltages in the chest leads
ST depression and T wave inversion

with hypertension suggests end organ damage

Question 11

what is the inheritance pattern of haemophillia A

Answer 11

X linked recessive

Question 12

will the son of a haemophilliac have haemophillia

Answer 12

no because they inherit the X chromosome from their mother

Question 13

what artery originates from the left posterior aortic sinus

Answer 13

left coronary artery

Question 14

what artery supplies the AV node

Answer 14

right coronary artery

Question 15

what vessel opens into the right atrium

Answer 15

coronary sinus

Question 16

what artery supplies the apex of the heart

Answer 16

LAD

Question 17

what artery lies in the anterior atrioventricular groove

Answer 17

right coronary artery

Question 18

what artery runs in the posterior AV groove

Answer 18

circumflex

Question 19

what are the commonest causes of optic atrophy

Answer 19

glaucoma 
MS
compression due to aneurysms
Pagets disease
tumours

Question 20

what conditions are associated with blue sclerae

Answer 20

osteogenesis imperfecta
ehlers danlos syndrome
marfans syndrome
chronic corticosteroid use
Fe deficiency anaemia 

due to underlying choroidal veins showing through the thin sclera

Question 21

what is cushings disease

Answer 21

pituitary dependent cushings syndrome

Question 22

what are the features of TTP

Answer 22

pupura, fever, haemolytic anaemia, microvascular thrombosis, renal failure, mild stroke, fragmented red cells

Question 23

what can cause TTP

Answer 23

cytotoxic drugs
SLE
pregnancy 
oral contraceptive use 
usually no known cause

Question 24

what is haemolytic uraemic syndrome

Answer 24

haemolytic anaemia
acute kidney failure
thrombocytopaenia

Question 25

what are the features of scurvy

Answer 25

``` occurs in people with poor nutrition perifollicular skin bleeding prolonged bleeding time vit C deficiency weakness tiredness sore arms and legs gum disease hair changes ```

Question 26

what are features of EDS

Answer 26

``` abnormal velvety hyperelastic skin poor skin healing hyperextensible joints purpura psuedotumours from organisations of haematomas from injuries hydrarthrosis repeated falls ```

Question 27

what is henloch schonlein pupura

Answer 27

``` arthritis colicky abdo pain arthritis polyarthritis purpura melaena haematemesis obstruction intussusception glomerulonephritis ```

Question 28

what investigation should you give patients on warfarin with a history of a loss of consciousness

Answer 28

CT head

Question 29

what is a mallory weiss tear

Answer 29

occurs following episodes of vomiting following alcohol or gastroenteritis they require no intervention

Question 30

how can you lower portal pressure

Answer 30

beta blockers

Question 31

what can cause a small pupil

Answer 31

``` horners syndrome old age pontine haemorrhage argyll robertson pupil drugs opiates ```

Question 32

what causes dilated pupils

Answer 32

``` holmes adie pupil third nerve palsy drugs atropine CO ethylene glycol ```

Question 33

what is a holmes adie pupul

Answer 33

dilated pupil that reacts more to accomodation than light | infection to cilliary ganglion (psymp)

Question 34

what are the features of turners syndrom

Answer 34

``` abnormal breast development coarctation of the aorta increased incidence of bone fractures infantile lymphodema primary amenorrhoea hypertension facies fold of skin on neck elbow deformity brown nevi widely spaced nipples shield shaped thorax low hairline webbing of neck ```