Conditions Flashcards
Name 4 pre-syncopal signs/symptoms
- Sweating
- Pallor
- Light-headedness
- Blurred vision
Describe the normal baroceptor reflex
Name 2 types of syncope that are caused by a default in this reflex
Low BP leads to low stretch of the baroreceptors (stretch receptors) at the aortic arch and carotid sinus. CN 9 detects this from the baroreceptors at the carotid sinus and CN 10 detects this from the baroreceptors at the aortic arch and relays the information to the medulla. The medulla reduces its parasympathetic input into CN 10 and increases its sympathetic input into the sympathetic nerves exiting it. These sympathetic nerves increase SAN impulse release, HR and ventricular contractility so BP increases.
Postural hypotension and Reflex hypotension
Name 4 drug groups that commonly induce drowsiness
Benzodiazepines
Antipsychotics
Analgesias
Anti-depressants
Why do elderly patients tend to bruise easily?
Thin skin as dermis lacks collagen + elastin and hypodermis lacks subcutaneous fat
and
Fragile subcutaneous vessels
What is the name for the inability to retract the prepuce/foreskin
Phimosis
Paraphimosis definition
Inability to pull the foreskin forward, over the glans
Balanitis definition
Inflamed penile glans
What is the name for inflamed prepuce (foreskin)
Posthitis
Name 2 causes of painful testicles
Testicular torsion
Epididymo-orchitis
What is Epididymo-orchitis and name 3 causes
Inflammation of the epididymis and testicle due to a UTI, STI or Mumps (all infections)
What is a rare complication of Epididymo-orchitis, that can lead to death in 50% of cases?
What is it?
Fournier’s gangrene - necrotic scrotal skin tissue
Hydrocoele definition
Production of fluid is greater than the reabsorption of fluid in the layer between the tunica vaginalis and tunica albuginea
Name 2 testicular deformities that transilluminate
Spermatocele/Epididymal cysts (separate from testis) and Hydrocoeles (not separate from testis)
(Pro-tip: Varicoceles DO NOT transilluminate)
What is a varicocele?
NOT tender
Enlargement of the veins in the pampiform plexus, above the testis, in the scrotum, due to valve impairment, preventing the flow of venous blood.
How would a patient with a varicocele complain about?
Painless ache at the end of the day
On examination, what would you see in a patient will a varicocele?
A bag of worms, above the testis, in the scrotum
Discuss 2 treatments for BPH
- Tamsulosin, an alpha adrenoceptor blocker relaxes the smooth muscle of the prostate and bladder, so the urethra is wider
- Finasteride, a 5-a reductase inhibitor, shrinks the prostate by depriving it from androgens, so urethra is wider
Name some factors of frailty
Delirium
Falls
Incontinence and UTIs
Immobility and pressure sores
Discuss the Kubler-Ross model
Shock. Denial. Anger. Bargaining. Depression. Acceptance.
Discuss what Fitzpatrick skin types shows
Type 1 (pale white) to Type 6 (dark black):
The darker you are, the less you burn and the more easier it is for you to tan
Regarding dermatology, what is SCAM used for?
What does each letter stand for?
Skin complaints:
Site and distribution for rashes/Size and shape for lesions
Colour
Associated skin changes
Morphology
Regarding dermatology, what is ABCD used for?
What does each letter stand for?
Pigmented lesions
Asymmetry
Border - irregular or blurred
Colour
Diameter
Name 4 skin functions : PTSD
Protection from environmental insult
Temperature regulation
Sensation
Vit D synthesis
What 4 cell types are present in the Epidermis?
What are their functions?
Keratinocytes - protection
Langerhans - APC
Melanocytes - produce melanin which provides pigment and protects cell nuclei from UV DNA damage
Merkel cells - nerve endings for sensation
What is the epidermal turnover time?
30 days
What are the layers of the epidermis?
Stratum corneum (horny layer)
Stratum lucidum (palms and soles)
Stratum granulosum
Stratum spinosum
Stratum basale
‘come get some bread’
What glands regulate temperature?
Where are they found?
Apocrine glands are found in the axilla, genitals in the dermal layer (become active after puberty)
Eccrine glands are widespread (throughout the body) and are also found in the dermal layer
(Both glands are sweat glands)
What are the 3 types of hair?
- Lanugo
- Vellum
- Terminal
Where are the erythemous and crusting vesiculations, in eczema, found on
A) infants
B) children/adults
A) face and extensors
B) flexors (inner elbow, behind knee)
Regarding sepsis risk, high results of this sign will indicate a higher risk
Lactate is more sensitive (than BP)
HIGH LACTATE over 2- GIVE FLUID BOLUS
Why are lactate levels high in sepsis?
Poor perfusion leading to anaerobic respiration
What is the paediatric sepsis 6 bundle?
- Give O2
- Find iv access and take bloods
- Give iv antibiotics
- Give fluids to treat high lactate
- Consult senior
- Consider giving peripheral inotropes - Warm shock give Noradrenaline, Cold shock give Adrenaline
What antibiotics can be given to …. to treat sepsis
A) <1 yo
B) 1-3 yo
C) >3 yo
A) Gentamicin, Amoxicillin, Cefotaxime
B) Amoxicillin, Ceftriaxone
C) Ceftriaxone
20% of breast cancers have what receptor present?
What does this receptor encode for?
What drug specifically targets this receptor?
Her2-R
Encodes for a transmembrane tyrosine kinase receptor
Trastuzumab
Name and describe a stromal tumour that occurs in female breasts in < 30’s
Fibroadenomas, localised hyperplasia of stromal and epithelial tissue, macroscopically they are white/grey and rubbery
What 3 pathological changes occur in Fibrocystic change in the breasts?
This is a benign epithelial change in the breast and it is the commonest breast lesion.
- Fibrosis of connective tissue
- Cyst formation
- Apocrine metaplasia
With Leidig testicular tumour cells, how are the hormone levels?
High testosterone
Low/normal:
FSH and LH
What breast malfunction, in men, can liver cirrhosis cause and why?
Gyaenecomastia due to reduced oestrogen metabolism
What is Paget’s disease?
What do you see?
A ductal carcinoma in situ that has invaded the nipple skin but not the basement membrane
See flaky, eczema, crusting nipple
What type of breast cancer is a precursor to an invasive carcinoma?
Ductal carcinoma in situ
What breast cancer can spread to the peritoneum?
Invasive lobular carcinoma
What is intraductal papilloma?
A unilateral benign growth in a mammary duct, leading to the secretion of discharge from the nipple
Name a drug that can given for short term treatment of severe resistant inflammatory skin conditions (e.g. psoriasis, recalcitrant eczema)
Also give its trade name.
Clobetasol propionate
Dermovate
Use 2 words to describe a Pseudomonas skim infection
Green and smelly.
Gentamicin can be used to treat a Pseudomonas skin infection. Ciprofloxacin can also be used to treat Pseudomonas skin infection but why isn’t it first line?
It causes a Clostridium difficile infection (so get diarrhoea)
What are the 6 stages in the transtheoretical (Stages of Change) model?
- Pre-contemplation
- Contemplation
- Determination/Preparation
- Action
- Maintenance
- Relapse
Balanitis treatment
Fusidic acid cream 4x day for 1 week
Give 6 possible causes of haematospermia
- Inflammation: Prostatitis, Urethritis
- Prostate biopsy
(1-3 are the most common reasons) - UTI Calculi
- Chlamydia
- Schistosomiasis
- Severe hypertension
