Clinical Cases Flashcards

1
Q

how do you define an aneurysm?

A
  • bulging of artery that causes it to enlarge
  • 1.5x
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2
Q

what causes an aneurysm? (4)

A
  • cardiovascular disease
  • atherosclerosis
  • smoking
  • trauma
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3
Q

why do AAAs normally appear at the bottom of the aorta and not higher up?

A

find it coincidentally

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4
Q

at which vertebral level would you palpate to examine the aortic pulse?

A
  • L1-L5 but it bifurcates at L2
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5
Q

what is atherosclerosis?

A

narrowing of artery due to plaque

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6
Q

what are the main risk factors of atherosclerosis? (2)

A
  • smoking
  • high fat diet
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7
Q

what causes chest pain in atherosclerosis?

A

angina caused by reduced blood flow to the heart

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8
Q

what are healthy levels of cholesterol?

A
  • 5mmol/L or less
  • under 200mg
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9
Q

how might a myocardial infarction occur?

A

when blood can’t flow to the heart

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10
Q

what is the most common method of coronary artery bypass?

A
  • coronary artery bypass graft (CABG)
  • then stent
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11
Q

it is harder to diagnose pneumonia in elderly individuals compared to those under 65, why is this?

A

symptoms may differ

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12
Q

why is pneumonia particularly concerning in older adults?

A

comorbidities lead to weakened immune systems

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13
Q

how does covid-19 develop in a patient?

A
  • immune system attacks an infection of the SARS-CoV-2 virus in lungs
  • alveoli swell
  • leaks fluids
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14
Q

how is pneumonia treated?

A
  • antibiotics, oxygen
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15
Q

what is a pneumothorax?

A
  • collapsed lung
  • air fulls pleural space
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16
Q

what is the difference between a tension pneumothorax and a spontaneous pneumothorax?

A
  • tension - caused from penetrating chest trauma, more you breathe the worse it gets, can cause mediastinal shift
  • spontaneous - no real cause, blebs just ruptur
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17
Q

what are the common causes of a pneumothorax? (5)

A
  • chest pain
  • tachycardia
  • history of trauma
  • cyanosis
  • low BP
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18
Q

which lifestyle choices lead to gastric ulceration? (5)

A
  • smoking
  • medication
  • spicy food
  • stress
  • alcohol
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19
Q

which symptoms would be experienced after eating with a gastric ulcer vs duodenal ulcer?

A
  • eating improves pain of duodenal ulcer but worsens pain of gastric ulcers
20
Q

what causes blood and ‘grit’ in vomit?

A
  • ulcer bleeding
  • digested blood that looks like coffee grounds
21
Q

why does a patient with gastric ulcers have to attend regular endoscopies?

A

to check the ulcer has healed

22
Q

how is a colonoscopy performed?

A
  • long, thin tube with a camera on the end inserted up rectum and into stomach
  • allows doctors to clearly see the inside of your colon
23
Q

what anatomical feature has been lost with a patient demonstrating a ‘lead pipe colon’?

A

Haustre

24
Q

what impact might have UC have on a patient’s life? (3)

A
  • pain
  • toilet more frequently
  • j-pouch can lead to fertility problems
25
Q

what is a J-pouch? What else can be offered for UC?

A
  • colon and rectum removed and small intestine attached to form passage and rectum
  • medications
26
Q

what might cause swelling in the abdomen and feet/ankles?

A
  • body attempts to compensate for this pressure by diverting blood flow into other veins
27
Q

why does the skin and eyes appear yellow in cirrhosis & portal hypertension?

A
  • excess bilirubin in blood
28
Q

what can portal hypertension result in?

A
  • splenomegaly
  • caput medusae
29
Q

what is splenomegaly and caput medusae?

A
  • splenomegaly- enlarged spleen
  • caput medusae- distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen
30
Q

what would happen if a patient continued drinking alcohol with liver cirrhosis?

A
  • need a liver transplant
31
Q

what is the difference between a rectocele, cystocele and uterine prolapse?

A
  • all caused by weakening of the pelvic floor muscles
  • rectocele - rectum protrudes into vaginal wall
  • cystocele - bladder drops from normal position into vaginal wall
  • uterine prolapse - uterus drops from normal position to vaginal wall
32
Q

what are the risks and benefits involved with a midline episiotomy? (3)

A
  • less bleeding
  • less pain
  • increased risk of perineal body damage
33
Q

how does a midline episiotomy compare to a mediolateral episiotomy?

A
  • medio-lateral is at a 45 angle
  • less risk of damage to perineal body
  • more painful and bleeding
34
Q

how are pelvic organ prolapses prevented and treated? (5)

A
  • lifestyle changes
  • pelvic floor exercises
  • hormonal treatment
  • vaginal pessaries
  • surgery
35
Q

what is epididymitis?

A
  • a tube (epididymis) at the back of the testicles become swollen and painful
  • caused by infection
  • treated with antibiotics
36
Q

what is the route of infection from the tip of the penis to the epididymis? (6)

A
  • spongy urethra
  • membranous uretha
  • prostatic urethane
  • through hole into ejactulatory duct
  • vas deferent
  • epididymis
37
Q

why are UTI’s less common in men compared to women?

A
  • men have longer, thinner urethra that is further from the rectum
38
Q

what is a differential diagnosis?

A
  • when symptoms match more than one condition and additional tests are necessary before making an accurate diagnosis
39
Q

how would you determine if a patient has epididymitis and not testicular torsion? (3)

A
  • blood tests
  • bacterial culture of urine
  • testicular torsion is more acute onset
40
Q

what is cancer?

A
  • disease caused when cells divide uncontrollably and spread into surrounding tissues
41
Q

what is the difference between radiotherapy and chemotherapy?

A
  • radiotherapy is a treatment where radiation is used to kill cancer cells
  • chemotherapy is a cancer treatment where medicine is used to kill cancer cells
42
Q

explain why difficulty urinating is a symptom of prostate pathology

A
  • you might get urinary problems if the cancer is pressing on your urethra or has spread around the prostate eg. urethra & bladder
43
Q

what is locally advanced prostate cancer?

A
  • cancer that has started to break out of the prostate, or spread to the area just outside the prostate
44
Q

how does locally advanced prostate cancer differ from ‘normal’ prostate cancer and advanced prostate cancer?

A
  • advanced cancer has spread outside the prostate to other parts eg. lymph nodes, bones, liver, lungs
  • normal hasn’t spread yet
45
Q

what is a prostatectomy and what are the consequences?

A
  • surgical procedure for the partial or complete removal of the prostate
  • may cause erectile dysfunction or incontinence