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Y4 - Finals Edition > CBL notes > Flashcards

CBL notes Flashcards

1
Q

Staging system for Hodgkin Lymphoma

A

Ann Arbour

Hodgkin lymphoma
- reed Sternberg cells
- lymphadenopathy
- pain on alcohol consumption

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2
Q

Criteria for PCOS

A

Rotterdam criteria
1. Polycystic ovaries on USS
2. Oligomenorrhoea / anovulation
3. Hyperandrogenism features (biochemical or chemical)

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3
Q

Examples of two nephrotic syndromes that cause proteinuria

A
  1. Minimal change disease
  2. Focal glomerulonephritis
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4
Q

MEN 1 syndromes

A
  1. Parathyroid
  2. Pituitary
  3. Pancreatic

due to MEN 1 link gene mutation

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5
Q

MEN 2a syndromes

A

due to RET proto oncogene mutation

Pheochromocytoma
Parathyroid
Medulla

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6
Q

Men 2b syndromes

A

due to RET proto oncogene mutation

Pheochromocytoma

Mucosal neuromas

Medullary thyroid carcinoma

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7
Q

Features of prolactinoma

A
  • low libido
  • galactorrhoea
  • fatigue
  • amenorrhoea
  • infertility
  • erectile dysfunction
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8
Q

Treatment of prolactinoma

A

dopamine agonist
- e.g. bromocriptine

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9
Q

Causes of microcytic anaemia

A

TAILS

T-thalassaemia
A-anaemia of chronic disease
I- Iron deficiency anaemia
L- lead poisoning
S- sideroblastic anamia

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10
Q

Management of heavy menstrual bleeding

A

1st line = IUS
2nd line = COCP
3rd line = POP

Tranexamic acid - for bleeding
Mefenamic acid - for pain

**Surgical **
- endometrial ablation
- hysterectomy

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11
Q

Myeloproliferative disorders associated with what gene mutation

A

JAK 2 mutation

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12
Q

Features associated with myeloma

A

CRAB
C-high calcium
R- renal failure
A- anaemia
B - bony disease

Pepperpot skull

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13
Q

Normocytic anaemia causes

A
  • anaemia of chronic disease
  • renal failure
  • acute bleeding
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14
Q

Normocytic anaemia causes

A
  • anaemia of chronic disease
  • renal failure
  • acute bleeding
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15
Q

Macrocytic anaemia causes

A

Megaloblastic
- due to b12 and folate def

Non-megaloblastic
- alcohol

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16
Q

Causes of optic neuritis (3)

A

Multiple sclerosis

Diabetes

Syphilis

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17
Q

Features of optic neuritis

A
  • unilateral
  • decreased visual acuity
  • red desaturation
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18
Q

High risk babies are given what for prevention of RSV causing bronchiolitis

A

Palvizumab

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19
Q

Mutations to know about in cystic fibrosis (2)

A

Phe(delta)508del
- abnormal protein folding

F(delta)508del
- amino acid fucks off so cannot stay in 3D shape

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20
Q

How does ivacaftor work?

A
  • opens up CFTR protein channels
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21
Q

Important gene associated with cystic fibrosis

A

CYP2D6

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22
Q

two types of age related macular degeneration

A

Wet vs Dry

Wet
- WORSE PROGNOSIS
- choroidal neovascularisation
- leakage of serous fluid
- rapid visual loss

Dry
- atrophic
- drusen
- subacute

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23
Q

Classification used for AKI

A

K-DIGO classification

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24
Q

Otitis externa management

A

Management

  1. **Topical acidifiers **
    - acetic acid (ear carlm)

**2. Topical Abx **
- ciprofloxacin
- or gentamicin and hydrocortisone

**3. Oral antiboiotics **
- flucloxacillin
- ciprofloxacillin

or metronidazole if anaerobic

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25
Q

Indications for dialysis

A

**AEIOU **
- acidosis pH < 7.1
- electrolyte abnormalities k+ > 6.5
- Intoxication (SLIME)
- Oedema (fluid overload)
- Urea

**Slime **
- salicylates
- lithium
- isopropanolol
- methanol
- ethylene glycol

26
Q

Why may decreased potassium lead to hepatic encephalopathy ?

A
  • decreased potassium
  • leads to hyperammonaemia
  • hepatic encephalopathy
27
Q

Name of criteria for diagnosis of MS (2)

A
  • Poser 1983
  • Macdonald

Multiple sclerosis
- demyelinating lesions in the central nervous system
- disseminated in time and space

28
Q

What features may you see on the MRI of someone with MS?

A

Dawsons fingers

29
Q

3 main types of MS presentations

A
  1. Relapsing remitting
    - most acute attack and then period of remission
  2. Secondary progressive
    - relapsing / remitting
    - patients are deteriorating
    - may have gait and bladder disturbance
  3. Primary progressive
    - progressive deteriorating from the start
30
Q

Medical management for relapsing MS

A

5 days of 500mg Methyl prednisolone

31
Q

Features of low vs high ICP

A

Raised
- papillodema
- valsalva may help

Low
- severe, throbbing headache
- lie down and fluids needed

32
Q

UMN vs LMN

A

Upper motor neuron
- increased tone
- increased reflexes
- positive babinski
- disuse atrophy

Lower motor neuron
- decreased tone
- decreased reflexes
- negative babinski
- severe muscle atrophy
- fasciculations

33
Q

Cerebrum functions

A
  • vision
  • hearing
  • fine control
  • touch
  • emotions
34
Q

Brainstem fuctions

A
  • breathing
  • vomiting
  • swallowing
  • body temp
  • sleep cycles
  • digestion
35
Q

Cerebellum functions

A
  • coordinate muscle movement
  • posture
  • balance
36
Q

Epilepsy treatment: Tonic clonic

A

M - sodium valproate
F- Lamotrigine (VG[Na] inhibitor)

O in lamotrigine O in tonic clonic

37
Q

Epilepsy treatment: Generalised tonic clonic

A

M - sodium valproate
F - lamotrigine / levetiracetam

38
Q

Epilepsy treatment: Focal seizures

A

1st line - Lamotrigine or Leve

2nd line - carbamazepine

Beware carbamazepine can cause absent seizures

39
Q

Epilepsy treatment: absent

A

1st line - Ethosuximide

2nd line:
M = sodium valproate
F = lamotrigine or Leve

40
Q

Epilepsy treatment: myoclonic seizures

A

M - sodium valproate

F - leve

41
Q

Summarise Parkinson’s treatment

A

1. L-Dopa + carbidopa (prevent breakdown of L-dopa before reaching BBB)

2. MAOB-i
- e.g. Rasagiline
- note selegiline lots of side effects
—-> hallucinations
—-> confusion
—-> insomnia

3. COMT-i
- e.g. entarcapone (increase dopamine getting to BBB)

4. Dopamine agonist
- bromocriptine
—-> Non-ergot
- cabergoline
—-> ERGOT based –> pulmonary fibrosis

42
Q

Name a drug which prevents reuptake of dopamine at synapses

A

Amantidine

  • increases exocytosis
    and release of dopamine
43
Q

3 core features of parkinsons

A
  • tremor
  • bradykinesia
  • cogwheel rigidity
44
Q

Summarise extrapyramidal side effects

A

1. Acute dystonia’s
- torticolis (lateral neck rotation)
- retrocolis (neck extension)
- trismus (fixed jaw closing)
- opisthotonus (arching of posture)
- oculogyric crisis (forceful eye deviation)

2. Tardive dyskinesia
- lip smacking
- uncontrollable movements of face

3. Akathisia (restlessness)

4. Parkinsonsism features

45
Q

Key features of neuroleptic malignant syndrome

A
  1. Muscle rigidity
  2. Fever
  3. Unstable BP
  4. Myoglobinuria

Autonomic instability
- fever
- tachy
- diaphoresis (sweating lots)
- dilation of pupils
- elevated or unstable BP

46
Q

What may cause parkinsonian type features?

A

1. Parkinsons disease

2. Parkinson plus syndromes
- multisystem atrophy
- progressive supranuclear palsy
- lewy body dementia
- corticobasal degeneration

3. Drug induced
- lithium
- antipyschotics

47
Q

Medical prevention of tumour lysis syndrome

A

allopurinol

48
Q

Examples of non-Hodkgin lymphoma

A

1. Malt lymphoma
- associated with H-pylori

2. Burkit lymphoma
- associated with EBV
- very bad

49
Q

Describe features of Ann Arbour staging

A

Stage 1 - in one region

Stage 2 - more than one region but same side of diaphragm

Stage 3 - above and below diaphragm

Stage 4 - widespread in non lymphatic areas too

50
Q

What might be found in urine with a patient with myeloma

A

bence jones protein

51
Q

Movicol is what type of laxative

A

bulk forming

52
Q

Constipation management

A

1st Line
- Senna (stimulant)
- Lactulose (osmotic)

2nd Line
- if caused by opiates give naloxogel

3rd line
- if non-opiate related then give a macrogol (osmotic) e.g. movicol

4th line
- enema

53
Q

Management of pericarditis

A
  1. Ibuprofen (NSAID)
  2. colchicine
  3. PPI cover
54
Q

What type of cells is chronic lymphocytic leukaemia associated with

A

NOT ASSOCIATED WITH BLAST CELLS

associated with –> smudge cells
worm

CLL
- more common in adults

55
Q

What is the name given when chronic lymphocytic leukaemia turns into lymphoma

A

Richter transformation

56
Q

Acute myeloid leukaemia is associated with what:

A

auer rods

AML
- older patients

57
Q

Acute lymphocytic leukaemia is associated with what genetic condition

A

Downs syndrome

58
Q

Most common type of leukaemia found in children

A

acute lymphocytic leukaemia

59
Q

What biologic can be given for CML treatment

A

Imantinib

60
Q

What is the Philadelphia chromosome

A
  • abnormality of chromosome 22 which part of chromosome 9 is transferred to it
  • often found in CML

Y4 - Finals Edition (40 decks)

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