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TCD Cases > Clinical Situations - Additional Reading > Flashcards

Clinical Situations - Additional Reading Flashcards

1
Q

Approximately what % of hospital admissions can be linked to some form of non-adherence?

A

10-25%

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2
Q

Suggest 4 common causes of metabolic acidosis

A
  1. DKA
  2. Lactic acidosis
  3. Renal failure
  4. Chronic diarrhoea
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3
Q

Pneumonia is likely to cause what type of acid-base disturbance?

A

Respiratory acidosis

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4
Q

Define pyloric stenosis

A

Narrowing of the opening between the stomach and the first part of the duodenum (i.e. constriction of the pyloric antrum and sphincter)

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5
Q

What is the principle symptoms of pyloric stenosis

A

Projectile vomiting (that does not contain bile) after feeding

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6
Q

Excluding salbutamol, name 3 other short acting beta- 2 agonists

A
  1. Terbutaline
  2. Levalbuterol
  3. Perbuterol
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7
Q

Give 2 potential causes of a mixed respiratory and metabolic acidosis

A
  1. Cardiac arrest

2. Multi-organ failure

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8
Q

Give 3 potential causes of a mixed respiratory and metabolic alkalosis

A
  1. Liver cirrhosis with diuretic use
  2. Hyperemesis Gravidarum
  3. Excessive ventilation in COPD
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9
Q

Suggest 5 potential causes of excessive renal hydrogen ion loss (leading to a metabolic alkalosis

A
  1. Loop and thiazide diuretics
  2. Heart Failure
  3. Nephrotic syndrome
  4. Cirrhosis
  5. Conn’s syndrome
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10
Q

Define nephrotic syndrome

A

A collection of symptoms that indicate kidney damage

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11
Q

What are the key characteristics associated with nephrotic syndrome?

A
  1. Proteinuria
  2. Hypoalbunemia
  3. Hyperlipidaemia
  4. Oedema
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12
Q

When recalling the clinical manifestations of hypercalcaemia, the phrase ‘stones, bones. groans and psychiatric overtones’ referees to what symptoms?

A
  1. Nephrolithiasis
  2. Bone pain
  3. Abdominal pain
  4. Depression, anxiety, confusion
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13
Q

What are the 4 principle clinical manifestations associated with hypercalcemia?

A
  1. Dehydration
  2. Renal insufficiency
  3. Nephrogenic diabetes insipidus
  4. Type 1 (distal) RTA (renal tubule acidosis)
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14
Q

What is the most common cause of primary hyperparathyroidism?

A

Parathyroid adenoma

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15
Q

What are the 3 possible aetiologies of primary hyperparathyroidism?

A
  1. Adenoma
  2. Diffuse Hyperplasia
  3. Carcinoma
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16
Q

What are the 3 major side effects associated with the use of bisphosphonates?

A
  1. AKI
  2. Osteonecrosis of the jaw
  3. MSK pain
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17
Q

Suggest 5 causes of a normocytic anaemia

A
  1. Anemia of chronic disease
  2. Chronic kidney disease
  3. Aplastic anemia
  4. Haemolytic anemia
  5. Acute blood loss
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18
Q

Describe the type of anemia characteristically seen in patients with liver disease

A

Macrocytic (normoblastic anemia)

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19
Q

Give 6 potential causes of a macrocytic normoblastic anemia

A
  1. Alcohol
  2. Liver disease
  3. Hypothyroidism
  4. Pregnancy
  5. Reticulocytosis
  6. Myelodysplasia
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20
Q

What are the 5 potential causes of a microcytic anemia?

A
  1. Iron deficiency anemia
  2. Thalassaemia
  3. Congenital sideroblastic anemia
  4. Anemia of chronic disease (although more commonly seen as a normocytic anemia)
  5. Lead poisoning
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21
Q

What is the most common form of leukaemia seen in adults?

A

Chronic lymphocytic leukaemia

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22
Q

Define a ‘Richter’s transformation’

A

The transformation of a chronic lymphocytic leukaemia into a high-grade lymphoma

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23
Q

What are the 4 principle complications associated with chronic lymphocytic leukaemia?

A
  1. Anemia
  2. Hypogammaglobulinaemia
  3. Warm autoimmune haemolytic anemia in 10-15% of patients
  4. Richter’s transformation
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24
Q

Suggest 2 conditions that can cause osteomalacia

A
  1. Coeliac disease

2. Type 2 renal tubular acidosis

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25
Q

What are the characteristic cell types associated with B cell lymphoma?

A

Giant B cells with bilobed nuclei that have prominent eosinophilic inclusions

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26
Q

Give the 5 potential causes of intravascular haemolysis

A
  1. Mismatched blood transfusion
  2. G6PD deficiency
  3. Red cell fragmentation
  4. Paroxysmal nocturnal haemoglobinuria
  5. Cold autoimmune haemolytic anemia
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27
Q

Suggest 4 potential causes of red cell fragmentation intravascularly

A
  1. Prosthetic heart valves
  2. TTP
  3. DIC
  4. HUS
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28
Q

What is TTP?

A

Thrombotic thrombocytopenic purpura

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29
Q

What is HUS?

A

Haemolytic-uremic syndrome

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30
Q

What are the 3 principle characteristics of haemolytic-uremic syndrome?

A
  1. Low RBC count
  2. Acute kidney failure
  3. Low platelets
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31
Q

Name the 4 causes of extracellular haemolysis

A
  1. Haemoglobinopathies
  2. Hereditary spherocytosis
  3. Haemolytic disease of the new-born
  4. Warm autoimmune haemolytic anemia
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32
Q

Heinz bodies present on a blood film is indicative of what condition?

A

Thalassaemia

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33
Q

What are the 3 blood film abnormalities associated with Thalassaemia?

A
  1. Heinz bodies
  2. Basophilic stripping
  3. Target cells
34
Q

What is the underlying aetiology of Haemophilia A?

A

Deficiency of factor VIII

35
Q

What is the underlying aetiology of haemophilia B?

A

Deficiency of factor IX

36
Q

Reticulocytes differentiate from which cell type?

A

Myeloid progenitor cells found in the bone marrow

37
Q

Name 3 hormones that can increase the differentiation of myeloid progenitor cells into reticulocytes

A
  1. EPO
  2. Thyroid hormones
  3. Androgens
38
Q

Give 3 causes of a microcytic anemia

A
  1. Iron deficiency
  2. Chronic inflammatory disease
  3. Thalassemia
39
Q

Suggest 2 causes of a normocytic anemia with a raised reticulocyte count

A
  1. Haemolytic anemia

2. Blood loss

40
Q

What is the primary cause of a normocytic anemia with a low reticulocyte count?

A

Bone marrow disorders e.g. aplastic anemia

41
Q

Suggest 3 causes of a megaloblastic macrocytic anemia

A
  1. Vitamin B12 deficiency
  2. Folate deficiency
  3. Drug induced
42
Q

What are the 2 main characteristics features of a megaloblastic anemia seen on blood film?

A
  1. Immature large RBC’s (megaloblasts)

2. Hypersegmented neutrophils

43
Q

Suggest 3 potential causes of a non megaloblastic macrocytic anaemia

A
  1. Alcohol abuse
  2. Hypothyroidism
  3. Pregnancy
44
Q

Give the 4 main causes of intravascular haemolysis

A
  1. DIC
  2. TTP
  3. HUS
  4. Mechanical heart valves
45
Q

Give 3 possible causes of extravascular haemolysis

A
  1. Hypersplenism
  2. Inherited haeomolytic anemia
  3. Acquired haemolytic anemia
46
Q

Name an infection that can induce haemolytic anemia

A

Malaria

47
Q

Name 2 types of inherited haemolytic anemia

A
  1. Sickle cell

2. Hereditary spherocytosis

48
Q

Pernicous anemia is an example of what type of hypersensitivity reaction?

A

Type II hypersensitivity reaction

49
Q

Which vitamin deficiency is likely to cause a sideroblastic anemia?

A

Deficiency in vitamin B6

50
Q

Recall the components of the mnemonic TOP CaRS for remembering the sections of a neurological examination

A 
TO - Tone 
P - Power 
C - Co-ordination 
R - Reflexes 
S - Sensation
51
Q

Name 3 types of primary headache

A
  1. Migraine
  2. Cluster
  3. Tension
52
Q

Give 5 causes of secondary headache

A
  1. SAH
  2. Acute glaucoma
  3. Raised ICP
  4. Temporal arteritis
  5. Meningitis
53
Q

The red flag symptom: ‘thunder clap headache’ is associated with what condition?

A

SAH

54
Q

The red flag symptom: ‘headache worse on lying down’ is indicative of what condition?

A

Raised ICP

55
Q

Scapulas tenderness is associated with which cause of secondary headache?

A

Temporal arteritis

56
Q

What is the normal duration range associated with migraine?

A

4-72 hours

57
Q

Approximately what % of migraine patients experience an aura?

A

25%

58
Q

What symptom is associated with a somatosensory aura?

A

Paraesthesia

59
Q

What 2 symptoms are associated with a visual aura?

A
  1. Scotoma

2. Hemianopia

60
Q

What 2 symptoms are associated with a motor aura?

A
  1. Dysarthria

2. Ataxia

61
Q

What is the mainstay treatment for an acute migraine attack?

A

NSAIDS + Paracetamol + oral triptan

62
Q

Suggest 3 potential options for the long term prophylaxis of migraine

A
  1. Topiramate
  2. Propanolol
  3. Amitryptaline
63
Q

Give 4 potential treatments for the management of chronic tension headaches

A
  1. Antidepressants
  2. Relaxation training
  3. CBT
  4. Myofascial trigger massage
64
Q

What are the 3 major causes of subarachnoid haemorrhage?

A
  1. Berry aneurysms
  2. Trauma
  3. Arterovenous malformations
65
Q

What other condition has a strong association with Berry aneurysms?

A

Autosomal dominant polycystic kidney disease

66
Q

During investigation of a subarchnoid haemorrhage, what are you looking for on a head CT?

A

Blood in the basal cisterns

67
Q

What is the use of an LP in investigating a subarachnoid haemorrhage?

A
  1. Look for Xanthochromia

2. Culture the sample for a potential infective agent

68
Q

Name the 4 major complications associated with SAH

A
  1. Rebleeding
  2. Cerebral ischaemia
  3. Hydrocephalus
  4. Hyponatremia
69
Q

What 2 signs on fundoscopy are associated with raised ICP?

A
  1. Venous congestion

2. Inflammation of the cup

70
Q

Name 5 symptoms/ clinical manifestations that can be associated with giant cell arteritis

A
  1. Headache
  2. Temporal scalp tendereness
  3. Jaw claudication
  4. Amaurosis fugax
  5. Symptoms of polymyalgia rheumatica
71
Q

Give 7 side effects associated with long term steroid use

A
  1. Cushingoid appearance
  2. Osteoporosis
  3. Reduced immunity
  4. Gastric damage
  5. Hyperglycaemia
  6. Hypertension
  7. Cateracts
72
Q

Name the 3 most common causative agents of meningitis

A
  1. Neisseria Meningititis
  2. Strep Pneumonia
  3. Listeria monocytogenes
73
Q

Give the 4 principle signs of an UMN lesion

A
  1. Spasticity
  2. Hypertonic
  3. Positive babinski sign
  4. Generalised weakness
74
Q

What causes Wallenberg’s syndrome

A

A stroke in the vertebral or posterior cerebellar arteries supplying the brainstem.

75
Q

Define Weber’s syndrome

A

Form of stroke characterised by an ipsilateral oculomotor nerve palsy and controlateral hemiparesis

76
Q

Give 10 potential complications of MI

A
  1. Cardiac arrest
  2. Cardiogenic shock
  3. Chronic heart failure
  4. Tachyarythmia
  5. Bradyarrythmia
  6. Pericarditis
  7. Left ventricular aneurysm
  8. Left ventricular free wall rupture
  9. Ventricular septal defect
  10. Acute mitral regurgitation
77
Q

AV block is most common after which form of MI?

A

An inferior MI

78
Q

What are the 4 characteristics of Dressler’s syndrome on clinical presentation?

A
  1. Fever
  2. Pleuritic pain
  3. Pericardial effusion
  4. Raised ESR
79
Q

Define myelofibrosis

A

Myeloproliferative neoplasm, in which the proliferation of an abnormal clone of haematopoietic stem cells in the bone marrow and other sites results in fibrosis or the replacement of the marrow with scar tissue.

80
Q

Suggest 2 haematological causes of secondary myelofibrosis

A
  1. Polycythaemia vera

2. Essential thrombocythaemia

TCD Cases (25 decks)

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