Conditions Flashcards

Question

Hep E

Answer 1

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

Answer 2

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

Answer 3

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

Answer 4

Ulceration of stomach mucosa or duodenum. Causes: Excessive steroid/NSAIDs Helicobacter pylori Presentation: Epigastric px Nausea/vomiting Dyspepsia Anemia- blood in vomiting Peritonitis

Answer 5

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

Answer 6

Crohns: Diarrhea Abdominal pain Passing blood Weight loss

Answer 7

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

Answer 8

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

Answer 9

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

Answer 10

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

Answer 11

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

Answer 12

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

Answer 13

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

Answer 14

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

Answer 15

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

Answer 16

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

Answer 17

Viral is MC D/t: E.coli Campylobacter jejuni Salmonella Shigella Presentation: Nausea Vomiting Diarrhea

Answer 18

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

Answer 19

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

Answer 20

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

Answer 21

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

Answer 22

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

Answer 23

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

Answer 24

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

Answer 25

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

Answer 26

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

Answer 27

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)

Answer 28

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

Answer 29

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

Answer 30

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

Answer 31

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

Answer 32

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)

Answer 33

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

Answer 34

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

Answer 35

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.

Answer 36

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

Answer 37

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

Answer 38

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

Answer 39

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

Answer 40

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.

Answer 41

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

Answer 42

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

Answer 43

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

Answer 44

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

Answer 45

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

Answer 46

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

Answer 47

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.

Answer 48

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

Answer 49

Eczema Asthma Allergies- hay fever

Answer 50

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

Answer 51

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

Answer 52

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)

Answer 53

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)

Answer 54

>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

Answer 55

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

Answer 56

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

Answer 57

Muscle cramps Fatigue Muscle weakness Myoedema Acute compartment syndrome