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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
Indications for dialysis
**AEIOU ** - acidosis pH < 7.1 - electrolyte abnormalities k+ > 6.5 - Intoxication (SLIME) - Oedema (fluid overload) - Urea ***Slime *** - salicylates - lithium - isopropanolol - methanol - ethylene glycol
26
Why may decreased potassium lead to hepatic encephalopathy ?
- decreased potassium - leads to ***hyperammonaemia*** - hepatic encephalopathy
27
Name of criteria for diagnosis of MS (2)
- Poser 1983 - Macdonald Multiple sclerosis - demyelinating lesions in the central nervous system - disseminated in time and space
28
What features may you see on the MRI of someone with MS?
Dawsons fingers
29
3 main types of MS presentations
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
Medical management for relapsing MS
5 days of 500mg Methyl prednisolone
31
Features of low vs high ICP
Raised - papillodema - valsalva may help Low - severe, throbbing headache - lie down and fluids needed
32
UMN vs LMN
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
Cerebrum functions
- vision - hearing - fine control - touch - emotions
34
Brainstem fuctions
- breathing - vomiting - swallowing - body temp - sleep cycles - digestion
35
Cerebellum functions
- coordinate muscle movement - posture - balance
36
Epilepsy treatment: Tonic clonic
M - sodium valproate F- Lamotrigine (VG[Na] inhibitor) O in lamotrigine O in tonic clonic
37
Epilepsy treatment: Generalised tonic clonic
M - sodium valproate F - lamotrigine / levetiracetam
38
Epilepsy treatment: Focal seizures
1st line - Lamotrigine or Leve 2nd line - carbamazepine Beware carbamazepine can cause absent seizures
39
Epilepsy treatment: absent
1st line - Ethosuximide 2nd line: M = sodium valproate F = lamotrigine or Leve
40
Epilepsy treatment: myoclonic seizures
M - sodium valproate F - leve
41
Summarise Parkinson's treatment
**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
Name a drug which prevents reuptake of dopamine at synapses
Amantidine - increases exocytosis and release of dopamine
43
3 core features of parkinsons
- tremor - bradykinesia - cogwheel rigidity
44
Summarise extrapyramidal side effects
**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
Key features of neuroleptic malignant syndrome
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
What may cause parkinsonian type features?
**1. Parkinsons disease** **2. Parkinson plus syndromes** - multisystem atrophy - progressive supranuclear palsy - lewy body dementia - corticobasal degeneration **3. Drug induced** - lithium - antipyschotics
47
Medical prevention of tumour lysis syndrome
allopurinol
48
Examples of non-Hodkgin lymphoma
**1. Malt lymphoma** - associated with H-pylori **2. Burkit lymphoma** - associated with EBV - very bad
49
Describe features of Ann Arbour staging
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
What might be found in urine with a patient with myeloma
bence jones protein
51
Movicol is what type of laxative
bulk forming
52
Constipation management
**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
Management of pericarditis
1. Ibuprofen (NSAID) 2. colchicine 3. PPI cover
54
What type of cells is chronic lymphocytic leukaemia associated with
NOT ASSOCIATED WITH BLAST CELLS associated with --> **smudge cells** worm CLL - more common in adults
55
What is the name given when chronic lymphocytic leukaemia turns into lymphoma
Richter transformation
56
Acute myeloid leukaemia is associated with what:
auer rods AML - older patients
57
Acute lymphocytic leukaemia is associated with what genetic condition
Downs syndrome
58
Most common type of leukaemia found in children
acute lymphocytic leukaemia
59
What biologic can be given for CML treatment
Imantinib
60
What is the Philadelphia chromosome
- 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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