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DIAGNOSIS 3 > Conditions > Flashcards

Conditions Flashcards

1
Q

Type 1 diabetes

A

Aka: juvenile diabetes or insulin dependent diabetes
-Body’s immune system destroys insulin producing cells in the pancreas.
-Chronic condition
-Occurs in childhood/adolescence
-Pancreas makes little to no insulin.
-S/S:
Thirsty
Frequent urination
Hunger
Loss of weight unintentionally
Irritable mood swings
Blurred vision

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2
Q

Type 2 diabetes

A

-AKA: Adult onset diabetes, obese diabetes.
-Pancreas does not produce enough insulin to keep blood sugar levels within a healthy range.
-Cells in muscle, fat and liver become resistant to insulin->cells don’t make enough sugar.

-S/S:
Thirsty
Hungry
Fatigue
Blurred vision
Diabetic neuropathy
Slow healing sores

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3
Q

Malaria

A

-Disease caused by a parasite-> mosquito
-infects the liver—> blood cells—>mosquito bites and transmits.
S/S:
Fever
Chills/Shivering
Diarrhea
Muscle and joint px
Tachycardia

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4
Q

Cellulitis

A

-Bacterial skin infection
-Occurs when a break in the skin allows bacteria to enter.
-if left untreated it can spread to lymph nodes( life threatening)
-MC in the lower leg
-S/S:
Swollen
Expanding
Warm
Blister

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5
Q

Hyperthyroidism

A

Primary:
-Over production of thyroid hormone by thyroid gland.(thyrotoxytocis)

Secondary :
-Thyroid is overproducing due to TSH(d/t hypothalamus or pituitary overproduction)

S/S:
-Anxiety/irritability
-weight loss
-fatigue
-tachycardia w palpitations
-sexual dysfunction
-frequently loose stools
-thinning of hair
-goiter

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6
Q

Graves’ disease

A

Graves’ disease: mimic TSH which binds to TSH receptor antibodies- stimulating increased thyroid gland production.
-Exopthalamus (bulged eyed d/t Graves.

S/s:
-exopthalamus
-goiter
-pretibial myxedema(fat nodules)
- unintentional weight loss
-erectile dysfunction
-change in menstrual function

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7
Q

Hypothyroidism

A

Underactive thyroid:
-causes:
-MC form hashimotos thyroditis a autoimmune condition attacks thyroid gland.
-Iodine deficiency.
-treatment for hyperthyroidism can lead to hypothyroidism.

S/S:
-Dry skin
-Coarse hair/hair loss
-weight gain
- amenorrhea(period stops unexpectedly)
-fluid retention(oedema, pleural effusion, ascites)
-constipation
-fatigue/muscle ache
-depression

Check:
Tsh levels or high
T4 and T3

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8
Q

Hyperparathyroidism

A

4 glands posterior
-Produce PTH when there are low levels of calcium in blood.
-when PTH is released it increases absorption of Ca2+ from intestines, kidneys and increases osteoclastic activity.

Causes:
Tumor
Low Vit D
Hyperplasia

S/S:
Fatigue
Depression
Polyuria
Constipation

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9
Q

Cushing’s syndrome

A

When there is an increase in cortisol-> alarms ACTH(adrenocorticotrophic hormone) and CRH(corticotrophin releasing hormone) to stop production of cortisol.

Excessive cortisol s/s:
-Lowers immune system
-Inhibits bone formation
-Raises blood glucose
-Increases metabolism
-Increases alertness

Causes of Cushings;
-too much steroids
-Cushings disease- pituitary adenoma producing acth-> excessive cortisol.
-adrenal Cushings-d/t adenoma

S/S:
Moon face
Buffalo hump
Pink striae
Depression
Excessive fat in stomach and chest
Later stages-> type 2diabetes, osteoporosis, high bp

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10
Q

Polymyalgia rheumatica

A

-Affects Female >50y/o
-Caucasian
Features:
-bilateral shoulder pain
-bilateral pelvic pain
-worse with movement
-interferes with sleep
-morning stiffness
Strongly associated with giant cell arteritis.

DDX:
-OA
-RA
-Fibromyalgia

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11
Q

Sarcoidosis

A

-MC in female 20-40y/o
-with shortness of breath/dry cough and nodules on their shins.
-granuloma formation in the lungs.
S/S:
-Erythema nodosum in shins
-Joint pain
-Bilateral hilar lymphadenopathy-dry cough and dyspnoea
Other:
Liver nodules
Optic neuritis
Conjunctivitis
Uveitis

Ddx:
TB
HIV
Pneumonia

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12
Q

Stable Angina

A

-Caused by atherosclerosis reducing blood flow to the myocardium.
-during exercise there is a high demand of blood supply being constricted.
-Relieved by rest!

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13
Q

Pericarditis

A

Inflammation of the pericardium.
Patho:
Pericardium is the lubricating sac around the hear to prevent friction.
MC- idiopathic or viral(TB, HIV,Epstein Barr)
S/S:
-chest pain sharp and worse with inspiration, laying down
-low grade fever
Investigation:
Elevated inflammatory markers

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14
Q

Infective endocarditis

A

Causes:
Staphylococcus aureus
Or staphylococcus
S/S
New/changing heart murmur
Splinter hemorrhages
Oslers nodes
Rotting teeth

Risk factors:
Hx of IE
intravenous drug use
Chronic kidney disease

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15
Q

Cardiovascular disease

A

Atherosclerosis
MC in male
Plaques result in;
Stiffness
Stenosis
Plaque rupture

Risk factors:
Smoking
High cholesterol LDL
Older age
Family Hx
Poor diet
Obesity
Sedentary life
Stress

Atherosclerosis results in:
Angina
MI
TIA
STROKE
Peripheral artery disease

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16
Q

Bradycardia

A

Causes:
Beta blockers
Heart block
Sick sinus syndrome(idiopathic degenerative fibrosis of the sino atrial node)

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17
Q

Hypertension

A

Primary hypertension
Secondary is caused by:
R-renal disease
O-obesity
P-pregnancy
E-endocrine
D-Drugs- alcohol, steroids,NSAID

Complications:
Angina
Stroke
Hypertensive retinopathy or neuropathy
Heart failure

Medications to treat HT:
A- ace inhibitors
A- angiotensin 2 receptor block
B- beta blockers
C- calcium channel blockers
D- thiazide diuretics

Ps:
ARBs are recommended if person does not tolerate ACE inhibitors d/t dry cough. These should not be used together.

Thiazide diuretic are used as an alternative if the patient does not tolerate calcium channel blockers due to Odema.

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18
Q

Chronic/Congestive Heart Failure

A

Dysfunction of left ventricle to pump blood to the body.
D/t left atrial regurgitation
Left atrium, pulmonary veins and lungs experiencing increase volume in pressure of blood leaking fluid, resulting in pulmonary edema.

Causes:
Most common cause is bilateral heart failure
Right sided heart failure is caused by left sided heart failure
ischemic, heart disease
Aortic stenosis
Hypertension
Atrial fibrillation

Presentations:
Dyspnea
Cough- frothy pink sputum
Peripheral edema
Fatigue
orthopnea- dyspnea when laying flat.
Paroxysmal nocturnal dyspnea-when patients wake up at night with severe shortness of breath, a cough and wheeze.

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19
Q

Diabetes insipidus

A

Lack of anti diuretic hormone
Lack of response to antidiuretic hormone.

-ADH is produced in the hypothalamus and secreted by the posterior pituitary gland
-Also known as vasopressin.
-ADH stimulates water reabsorption from the collecting ducts in the kidneys.

Presentation:
D/t kidneys inability to reabsorb water and concentrate urine:
-Polyuria
-Polydipsia
-Dehydration
-Postural hypotension

Treatment:
Thiazide diuretics
NSAIDs

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20
Q

Liver Cirrhosis

A

Chronic inflammation of liver cells causing fibrosis

Causes:
Alcoholism
Fatty liver disease
Hep B and C

Signs:
Spider naevi
Jaundice
Hepatomegaly
Splenomegaly
Palmar erythema
Ascites
Easily bruised
Caput medusae-d/t portal hypertension

Investigation:
ALT, AST, ALP, bilirubin are deranged.
-Endoscopy
-Liver biopsy

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21
Q

Hepatitis

A

Inflammation of the liver
Causes :
Alcoholic hep
Fatty liver disease
Viral hepatitis
Autoimmune hep
Drug induced(paracetamol overdose)

Presentation:
May be asymptomatic
-abdominal px
Fatigue
Pruritis
Muscle/jt px
Nausea/vomiting
Jaundice
Fever(viral hep)

Markers:
Liver Function Test(LFT)
-elevated transaminases (AST/ALT)

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22
Q

Hep A

A

Mc viral hepatitis
Transmitted via oral-faecal route usually by contaminated water/food.

Presentation:
Nausea
Vomiting
Anorexia
Jaundice
Hepatomegaly
Dark urine
Pale stools

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23
Q

Hep B

A

DNA vírus
Spread:
-direct contact with blood or bodily fluids
-vertical transmission during pregnancy.

Presentation:
Fatigue
Jaundice
Pruritis
Abdominal pain
Loss in appetite

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24
Q

Hep C, D

A

RNA (ribonucleic acid) virus
Spreads:
Blood and bodily fluids
Complications:
Liver cirrhosis
Hepatocellular carcinoma

HepD
RNA virus
Can only get D if you’ve had B

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25
Q

Hep E

A

RNA virus
Rare
Spread:
Faecal oral route
Presentation:
Mild illness

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26
Q

Haemochromatosis

A

High levels of Iron storage disorder
-HFE located on chromosome 6

Presentation:
Chronic fatigue
Joint px
Pigmentation bronze
Hair loss
Memory/mood disturbance

Complications:
Type 1 diabetes
Cardiomyopathy
Pseudogout

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27
Q

Wilson’s disease

A

Excessive copper in body
May lead to hepatitis or cirrhosis
Affects nervous system-> Parkinson’s
Presentation:
Kayser Fleischer rings in cornea
Osteopenia
Anemia
Renal tubular damage

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28
Q

Peptic ulcers

A

Ulceration of stomach mucosa or duodenum.
Causes:
Excessive steroid/NSAIDs
Helicobacter pylori

Presentation:
Epigastric px
Nausea/vomiting
Dyspepsia
Anemia- blood in vomiting
Peritonitis

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29
Q

GORD

A

Presentation:
Heartburn
Acid regurgitation
Bloating
Hoarse voice
Epigastric px

Red flags:
Dysphagia
Over 55
Low haemoglobin
Nausea and vomiting

Treatment:
Omeprazole

Barrett’s esophagus:
Chronic gord
Monitored for adenocarcinoma

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30
Q

IBD

A

Crohns:
Diarrhea
Abdominal pain
Passing blood
Weight loss

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31
Q

IBS

A

Affects young adults women
Presentation:
Bloated
Constipated
Abdominal pain
Worse after eating
Improved by opening bowels

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32
Q

Lung cancer

A

3rd most common cancer after breast and prostate.

Histology:
Mc-Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma

Presentation:
Dyspnoea
Cough with blood
Finger clubbing
Recurring pneumonia
Weight loss
Lymphadenopathy- supraclavicular

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33
Q

Pneumonia

A

Inflammation of lung tissue causing consolidation

Cause:
Streptococcus pneumoniae
Influenza

Presentation:
Shortness of breath
Cough productive sputum
Fever
Cough with blood
Sharp pain on inspiration
Sepsis
Late stage: delirium

Sepsis secondary presents with:
Tachycardia/pnoea
Hypoxia
Fever
Confusion

Signs in examination:
Coarse crackles
Bronchial breath sounds-LOUD
Dullness when percussing

Inflammatory markers:
High WBC and CRP

34
Q

Asthma

A

Chronic inflammation of the bronchioles causing bronchoconstriction

Triggers:
Exercise
Smoke
Night/early morning
Dust
Animals
Cold/damp

Presentations:
Episodic
Worse at night
Dry cough with wheeze and dyspnoea
Family Hx
Hx of atopic conditions

35
Q

Interstitial Lung Disease

A

Umbrella term for conditions that affect the lung tissue causing inflammation and fibrosis—> stiffness

Idiopathic pulmonary fibrosis:
Insidious onset of dyspnoea and dry cough >3 months.
->50y/o
-finger clubbing
-inspiratory crackles

PF may be drug induced:
-Amiodarone

36
Q

Pleural effusion

A

A collection of fluid in the pleural cavity
High protein count= exudative
Low protein count= transudative

Exudative leads to:
Pneumonia
Lung Ca
RA
TB

Transudative:
CHF
Hypothyroidism
Hypoalbuminemia

Presents with:
Dyspnoea
Dullness to percussion
Reduced breath sounds-
Tracheal deviation AWAY from effusion

37
Q

Pneumothorax

A

When air gets stuck into pleural space.

Causes:
Spontaneously
Secondary-trauma
Lung infection- asthma or COPD

Presentation:
Young thin male presents with sudden dyspnoea and pleuritic chest px whilst exercising.

Tension pneumothorax- d/t trauma creating a one way valve letting air in and not out—> cardiorespiratory arrest if not treated.
Signs of tension pneumothorax:
Tracheal deviation away
Increase resonance in percussion.
Tachycardia
Hypotension

38
Q

Pulmonary hypertension

A

An increase in resistance and pressure of blood in the pulmonary arteries.

Causing right ventricular hypertrophy! And dilated pulmonary arteries.
Causes:
SLE
MI/ systemic hypertension
COPD
PE

S/S:
Dyspnoea - main complaint
Syncope
Raised JVP
Peripheral oedema

39
Q

Sepsis

A

Systemic inflammation

The bacteria or other pathogens are recognised by macrophages, lymphocytes and mast cells. These cells release vast amounts of cytokines like interleukins and tumor necrosis factor to alert the immune system of an invader. These cytokines activate other parts of the immune system. This immune activation leads to further release of chemicals such as nitrous oxide that causes vasodilation. This full immune response causes inflammation throughout the body.

Severe sepsis is defined when sepsis is present and results in organ dysfunction, for example:
Hypoxia
Acute Kidney Injury
Thrombocytopenia
Coagulation dysfunction
Hypotension

Risk Factors:
Very young or old patients <1 or >75
Chronic conditions such as COPD and diabetes
Chemotherapy, immunosuppressants or steroids

Presentation:
Temperature
Heart rate
Respiratory rate
Oxygen saturations
Blood pressure
Consciousness level

40
Q

Septic arthritis

A

Cause:
Staphylococcus aureus is the most common causative organism.

Presentation:

In a young patient presenting with a single acutely swollen joint always think of gonococcus septic arthritis until proven otherwise.

The patient may have urinary or genital symptoms to trick you into thinking of reactive arthritis but remember that it is important to exclude gonococcal septic arthritis first as this is the more serious condition.

Hot, red, swollen and painful joint
Stiffness and reduced range of motion
Systemic symptoms such as fever, lethargy and sepsis

41
Q

Gastroenteritis

A

Viral is MC
D/t:
E.coli
Campylobacter jejuni
Salmonella
Shigella

Presentation:
Nausea
Vomiting
Diarrhea

42
Q

Tuberculosis

A

Caused by mycobacterium tuberculosis
Presentation:
-common exam question involves a patient coughing up sputum that grows acid-fast bacilli that stain red with Zeihl-Neelsen staining. This is mycobacterium tuberculosis and the diagnosis is TB.

Lethargy
Fever or night sweats
Weight loss
Cough with or without haemoptysis
Lymphadenopathy
Erythema nodosum
Spinal pain in spinal TB

43
Q

HIV

A

Human immunodeficiency virus:
AIDS—>late stage HIV
-The virus enters and destroys the CD4 T helper cells.

Transmission:
Anal, vaginal or oral sex
Vertical transmission-pregnancy
Blood or bodily fluids

44
Q

Anaemia

A

Low levels of hemoglobin in blood
Normal- hemoglobin levels
Men= 130-180 g/l
Women=120-165 g/l

Microcytic anemia causes: small RBCs.
Thalassemia
Lead poisoning
Iron deficiency

Normocytic Anaemia causes: normal sized RBCs.
Acute blood loss
Anemia of chronic disease
Hypothyroidism

Macrocytic anemia causes: abnormally large RBC d/t improper breakdown.
B12 deficiency
Folate deficiency

Presentation:
Fatigue
Dyspnoea
Dizziness
Palpitations

Signs:
Pale
Conjunctival pallor
Tachycardia
Raised respiratory rate
Koilonychia- spoon nails
Jaundice- hemolytic anemia
Bone deformity-thalassemia

45
Q

Leukemia

A

Cancer of the stem cells in bone marrow.
A genetic mutation in one of the percursor cells in bone marrow leading to abnormal white blood cells.
Causing a suppression in other type cells,
Low:
RBC- anemia
WBC- leukopenia
Platelets- thrombocytopenia

Presentation:
Fatigue
Fever
Failure to thrive
Pallor due to anemia
Lymphadenopathies
Hepatosplenomegaly
Abnormal bruising d/t thrombocytopenia

46
Q

Lymphoma

A

Cancer in the lymph nodes
Risk factors:
HIV
Epstein-Barr virus
Family history
Rheumatoid arthritis and sarcoidosis
Presentation:
Night sweats
Unexpected weight loss
Fever

Hodgkin’s lymphoma
Reed Stenberg positive
Local

Non-Hodgkin’s lymphoma
Diffuse
Reed Stenberg negative

47
Q

Myeloma

A

Myeloma is a cancer of the plasma cell. These are type B lympasis that produce antibodies.

The cancerous plasma cells invade the bone marrow, causing anemia, neutropenia, and thrombocytopenia.

Myeloma bone disease as a result of increased osteoclast activity and suppressed osteoclast activity .

Presentation:
Elevated calcium
Renal failure
Anemia
Bone lesion and pain

48
Q

DVT

A

Deep venous thrombosis:
once a thrombus has developed, it can travel from deep veins, through the right side of the heart, and into the lungs, where I can block pulmonary arteries, causing a pulmonary embolism.

Risk factors:
Periods of immobility?
Recent Surgery
Long haul flights

Presentation:
Unilateral edema(bilateral indicates CHF and liver cirrhosis)
Calf or leg swelling
Varicose veins
Tenderness to the calf
Edema
Color changes to the leg

49
Q

Osteoarthritis

A

Degenerative joint disease, it is not inflammatory, unlike rheumatoid

Risk factors :
Obesity, age, occupation, trauma, and being female .

Presentation:
Joint pain and stiffness
Stiffness is worse with activity unlike inflammatory (better with activity)
Hands- heberdenes(DIP), Bouchards(PIP) with weak grip.

Are common joints affected are:
Hips
Sacro iliac joint
Cervical spine
Knee

50
Q

Rheumatoid arthritis

A

An auto immune condition that causes chronic inflammation of the synovial lining of joints, tendon, sheaths, and bursa.

Presentation:
Pain, swelling, and stiffness
Fatigue
Weight loss
Muscle ache and weakness
Improves with activity
Swan neck, boutonnières
Ulnar deviation of fingers at MCP

Joints affected:
PIP
MCP
Wrist and ankle
Cervical spine

51
Q

Reactive arthritis

A

Also known as Reiters syndrome

The obvious differential diagnosis is septic arthritis.
The most common infections that trigger our gastroenteritis and STI‘s. Chlamydia is the most common STI.

Presentation:
Single affected joint
HLA B27
Warm, swollen, painful joint
Knee is the MC
Bilateral conjunctivitis/uveitis
(Can’t see, pee or climb a tree)

52
Q

Ankylosing spondylitis

A

An inflammatory condition, mainly affecting the spine, causing progressive stiffness and pain.
HLA B27(sero-negative)

Key joints affected:
SI and all vertebrae

Presentation:
Young adult male in their late 20s presenting with low back pain and stiffness and sacroiliac pain. The pain is worse with rest and improves with movement. The pain is worse at night and morning. Takes 30min for stiffness to resolve in the morning.

Chest pain
Uveitis
IBS
Achilles tendinitis
Inflamed costosternal
Plantar fasciitis

53
Q

Unstable Angina

A

Unstable angina occurs due to atherosclerosis plus a blood clot on top of it.
Causing heart not to get enough blood flow and oxygen
May lead to a heart attack
Not better with rest!
S/S:
Chest pain- may also go into the shoulder, jaw and neck.
-squeeze, crushing
-dyspnoea
-sweating

Variant angina- vasospasm
S/s:
Intermittent, chest pain.
Palpitations- rapid, irregular,skipped heat beat
Orthostatic Hypotension
Dyspnoea

54
Q

Systemic Lupus Erythmatosus

A

An inflammatory autoimmune connective tissue disease. Typical Red malar rash in the face.
More common in women.
Antinuclear antibodies present.

Presentation:
Hair loss
Malar rash
Dyspnoea
Splenomegaly
Joint pain
Lymphadenopathy
Myalgia

Complications-SLE affects many organs in the body.

Investigation:
Full blood count- normocytic anemia
Decreased C3 and C4 levels
CRP and ESR elevated
Protein uria present d/t lupus nephritis

55
Q

Giant cell arteritis

A

Strong link with polymyalgia rheumatica
White Female >50 y/o
Often irreversible
If untreated or too late—> vision loss.
S/s:
Sever unilateral headache
Jaw clarification
Diplopia
Complete blindness

Investigation:
Raised esr
Temporal artery biopsy- multinucliated giant cells

Medications:
Steroids
Aspirin- decreases visual loss
Protein pump inhibitor for gastric prevention on steroids

56
Q

Polymyositis and dermatomyositis

A

Both auto immune disorders that inflame the muscles
Presentation :
Muscle pain, fatigue, and weakness
Occurs bilaterally
Mostly affect, shoulder and pelvic girdle
Develops over weeks
Dermatomyositis -gottron lesions (scaly patches in all joints in the hands)

57
Q

Sjögren’s syndrome

A

Condition that affects the exocrine glands leading to symptoms of dry mucous membranes.
Presentation:
Dry mouth
Dry eyes
Dry vagina

58
Q

Systemic vasculitis

A

Inflammation of blood vessels.
Categorized by affecting small, medium or large vessels.

Presentation:
Purpura- purple colored spots diffuse spread
Joint and muscle pain
Peripheral neuropathy
Renal impairment
Hypertension
Anterior uveitis

Tests:
Inflammatory markers are raised
Anti neutrophil cytoplasmic antibodies blood test

59
Q

Gout

A

A crystal arthrophy associated with chronically high blood uric acid levels. Do you write crystals are deposited in the joint, causing it to become hot, swollen, and painful.
Male are more common
Risk Factors:
Male
Obesity
High meat and seafood diet
Alcohol
Diuretics
Family hx
Presentations :
Gouty tophi are uric acid deposit crystals, usually affecting small joints in the hand, elbows and ears.
Most common joints affected are the base of the big toe
base of the MCJ in the wrist
base of the thumb

Tests:
Fluid aspiration is done to differentiate with septic arthritis.

60
Q

Osteoporosis

A

The condition where there’s a reduction in bone density. I subpoena refers to less severe reduction in bone density.
Risk factors
Older age
Female >65, men less common but >75
Alcoholic or smoker
Rheumatoid arthritis
Low BMI
Postmenopausal women do to estrogen being protective against osteoporosis.

Treatment:
Dexa scan is used

61
Q

Paget’s disease

A

Bone disorder which causes excessive activity of osteoclasts and osteoblasts, leading to patchy areas of high density, sclerosis and low density lysis.

This results in enlarged and misshapen bones with structural problems, that increase pathological fractures, and particularly affects the axial skeleton .

Presentation:
Bone pain
Bone deformation
Fractures
Hearing loss if it affects the bones in the ear

Complications :
Spinal stenosis and spinal cord compression

62
Q

Osteomalacia

A

Defective Bone mineralization, causing soft bones, this is a result from insufficient vitamin D in children it’s called rickets disease.

Presentation:
Weak bones
Bone pain
Muscle weakness
Fractures
Looser zones -fragility fractures

63
Q

Chronic Kidney disease

A

Chronic reduction in kidney function, which tends to be permanent and progressive

causes :
Diabetes
Hypertension
Glomerulonephritis
Polycystic kidney disease

Risk factors :
Old age
Hypertension
Diabetes
Smoking

Presentation :
Pruritis
Loss of appetite
Edema
Muscle cramps
Pallor
Hypertension

Tests:
Urine dipstick
Proteinuria
Glomerular filtration rate

64
Q

Renal dialysis

A

Dialysis is a method for performing the filtration of kidneys artificially in patients with late stage renal failure. This is done to remove excess fluid, solutes, and waste products.

65
Q

Hyper kalemia

A

Hyperkalemia, is a high serum potassium. The main complication is cardiac arrhythmia, such as ventricular fibrillation, and it may be fatal.

Causes
Acute kidney injury
Chronic kidney disease
Adrenal insufficiency
Tumor

Tests :
Urea and electrolytes blood test
Glomerular filtration rate

S/S:
Chest px
Heart palpitations
Muscle pain
Nausea
Fatigue

66
Q

Polycystic kidney disease

A

Disease that is genetic where the kidneys develop multiple fluid filled cysts where it impairs kidney function.

Presentation:
High bp
LBP
Haematouria
Headaches
Kidney stones

There are two types :
Most common is autosomal

Test:
Ultrasound

67
Q

Diabetic Retinopathy

A

This is a condition where blood vessels in the retina are damaged by how long exposure to high blood sugar levels, causing a progressive deterioration in the health of the retina.

Nonproliferative type:
Mild-aneurysms
Moderate-micro, aneurysms, hard exudates,cotton wool spots
Severe-blood hemorrhages plus Michael aneurysms, venous, beating , blot hemorrhages

Proliferative:
Neovascularization
Vitreous hemorrhage

Complications :
Retinal detachment
Vitreous hemorrhage
Optic neuropathy
Cataracs

68
Q

Cataracts

A

This is when the lens of the eye becomes, cloudy and opaque, reducing visual acuity with the amount of light that enters the eye.

Risk factors
Smoking
Aging
Alcohol
Diabete
Steroids
Hypocalcemia

Presentation :
Very slow, reducing In Vision
Progressive blurring
Starburst around lights
Loss of read reflex, which appears grey or white
Grey cloud cover pupil and iris

69
Q

Conjunctivitis

A

Inflammation of the conjunctiva, which is the layer that covers the eye.
Three types :
Bacterial
Viral
Allergic

Presentation :
Unilateral or bilateral
Red eyes
Bloodshot
Itchy sensation
Discharge from the eye

DDX :
Episcleritis
Glaucoma
Trauma to the eye

70
Q

Retinal detachment

A

Presentation:
Peripheral vision loss , like a shadow coming across the vision.
Blurred or distorted vision
Flashes and floaters

Risk factors :
Diabetic retinopathy
Trauma to the eye
Aging
Family history

71
Q

Glaucoma

A

Optic nerve damage caused by intraocular pressure due to a blockage in aqueous humor.

Open Angle:
Most common form of glaucoma, drainage angle, formed by the iris, and the cornea remains open. The other draining systems don’t drain properly.

Angle closure glaucoma:
The iris bulges, which completely blocks the drainage angle as a result pressure increases.

Presentations
Halo around lights
Blurred vision
Intensify pain
Nausea and vomiting
Grey cloud cover only pupil region not iris.

72
Q

Orthostatic hypotension causes?

A

Age related changes in the autonomic nervous system.
Drug induced(diuretics)
Arterial stiffness
Sedentary/immobility
Heart disease
Hypovolemia

73
Q

Atopic triad

A

Eczema
Asthma
Allergies- hay fever

74
Q

Diabetes insipidus

A

Very watery Polyuria, not sweet unlike Mellitus
5-20l of urine are passed a day
Thirsty-> drink a lot (polydypsia)
2types of insipidus:
Pituitary- produces ADH ->allowing more glomerular filtration to occur and lowering the amount of filtrate in the nephrons. Although in this case it doesn’t produce enough ADH.—>polyuria

Nephrotic- kidneys do not respond to ADH-> treatment with thiazides

75
Q

Pancreatitis

A

Inflammation of the pancreas
Either chronic or acute
-Acute presents with rapid onset of inflammatory symptoms .
-Chronic involves longer-term inflammation that progresses and deteriorates pancreatic function.
Causes:
Gallstones MC in women
Alcohol MC in men
Post-ERCP

Presentation:
Severe epigastric pain
Radiating through the back
Emesis
Abdominal tenderness
Malaise -fever

76
Q

Appendicitis

A

Inflammation of Appendix
10-20yo peak incidence
Patho:
Arrises from cecum part of the large bowel.
Pathogens may obstruct the valve and cause it to swell and rupture into the peritoneal cavity.->peritonitis

Presentation:
Abdominal pain firstly general then in the RIF.
Loss in appetite
Nausea and vomiting
Low grade fever
Rosving sign(LIF palp. =px RIF)
Guarding

Ddx: ectopic pregnancy, ovarian cyst, diverticulitis
Rebound tenderness( px on release)

77
Q

Ectopic pregnancy

A

Fertilized egg settles and grows outside the inner lining of the uterus.
Mc occurs in fallopian tube
Leads to death of the embryo or internal bleeding
Causes:
STD
Previous ectopic pregnancy
Abdominal surgery
Smoking

S/S:
Breast discomfort
Vaginal excess bleeding
Lower abdominal pain
Pelvic pain
Dizziness/Fatigue (anemia)

78
Q

Varicose veins

A

> 3 mm
Telangiectasia-small red blood vessels <1mm
Patho:
Veins squeeze blood back up into the heart. When the veins become incompetent the blood back flows and pools via perforating veins into the superficial veins. Causing dilatation-varicose.
Associated with chronic venous insufficiency.(skin changes and ulcers)

Risk factors:
Old age
Obesity
Prolonged standing
DVT
Pregnancy

S/S:
May be asymptomatic
Ache, itching or burning in the legs
Oedema
Muscle cramps
Restless legs
Large blood loss with trauma

Tests:
-DVT squeeze
-Feel for a thrill in saphenofemoral junction and tap the varicose veins in the lower leg. (May be hear with a cough)
-Can be seen with ultrasound

79
Q

Chronic venous insufficiency

A

blood, not efficiently, draining due to incompetent valve.
causes :
Age
Immobility
Obesity
Prolong standing
DVT

When blood pools it causes venous hypertension.
Most commonly seen in “gaiter area” -shin area and calf
Can lead to:
Cellulitis
Skin changes
Skin ulcers
Pain
Common in older patients
Occurs bilaterally compared to cellulitis which presents unilaterally.
S\S:
-Haemosiderin staining-hemoglobin leaking
-Varicose eczema-dt chronic inflammatory response.
-Lipodermatosclerosis- hardening of the skin/tightening with narrowing in the shins causing a inverted champagne bottle look
-atrophy Blanche-smooth white patches surrounded by hyper pigmentation

80
Q

AAA

A

Sudden severe LBP/flank/abdo pain
Syncope
Tachycardia
Hypotension
Palpable mass larger than 3cm of width
Normal size- 2.3cm

RF:
Smoker
Obese
Family hx
>65yo
Male
Atherosclerosis

81
Q

Hypothyroid myopathy S/S

A

Muscle cramps
Fatigue
Muscle weakness
Myoedema
Acute compartment syndrome

DIAGNOSIS 3 (8 decks)

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