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Osce Prep > Diseases > Flashcards

Diseases Flashcards

1
Q

Pathology of DKA

A

Hyperglycaemia but no insulin so cells enter starvation like state
Fat is metabolised into free fatty acids -> metabolic acidosis

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2
Q

DKA triggers

A

Infection, medication compliance, surgery, pancreatitis, antipsychotics

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3
Q

Specific care for diabetes

A

Lifestyle (especially diet - low glycemic index food)
Statin - if high cholesterol
Acei / AR2 blockers
Footcare - use a mirror
If prone to hypoglycaemia you need to inform dvla

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4
Q

What level do you want HbA1c to be at

A

Below 6.5%

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5
Q

Treat hypoglycaemia

A

Oral sugar
Dextrose
Glucagon injection

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6
Q

Causes of meningitis

A

NHS
N meningitidis
Haem influenzae
Strep pneumoniae

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7
Q

How does MS work

A

Autoimmune T cell mediated plaques of demylienation -> axon loss
Heals but not completely -> relapsing and remitting

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8
Q

Needed for diagnosis of MS

A

2 events lasting over 1 hour separated by at least 30mins

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9
Q

Ms risk factors

A

Female, 30,white

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10
Q

Symptoms of ms

Usual presentation is

A

Cerebellar, brain stem, unilateral optic neuritis, limb tingling / weakness, sudden onset weakness
Mono symptomatic

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11
Q

Ms link to

A

Trigeminal neuralgia

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12
Q

2 Ms signs

A

Utoffs - heat exacerbates

Lermettes - flex neck -> electric shock down spine

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13
Q

How is ms diagnosed

A

Clinically
Can use lumbar puncture to look for olyclonal bands of IgG
Evoked potential

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14
Q

Where else other then ms would olyclonal bands of IgG be found ?
How to differentiate

A

SLE

Do a blood test and Ms would not have olyclonal in blood

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15
Q

Treatment of MS

A

Acute relapse - methylprednisolone
Regular - b interferons
Natafluzamab - monoclonal antibody against T cells

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16
Q

Risk with giving immunosuppressants

A

Infections

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17
Q

ms symptoms ?

Treatment

A 
Spasticity - diazepam , baclofen 
Tremor - Botox 
Incontinence 
Dysphagia
Constipation 
Diplopia 
Truncal and limb ataxia (need protection from falls)

Keep happy, de stress, inform DVLA

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18
Q

Where do UMN fibres run from -> to

A

Pre central gyrus -> anterior horn cells

19
Q

Where do LMN run from to

A

Anterior horn cell - peripheral nerve

20
Q

Usual cause of MND

A

Idiopathic

Genetic link

21
Q

What is never affected in MND

A

Sensory, eye, sphincter

22
Q

What happens in MND

A

Loss of motor neurones in motor cortex, CN nuclei, anterior horn cells
(Depending on type)

23
Q

Most common type of MND

A

Amyotrophic lateral sclerosis

24
Q

AML signs and symptoms

A 
UMN and LMN 
Wasting, fasiculations, pronator drift 
Brisk reflexes 
Emotional liability 
Whole muscle groups affected
25
Q

Bulbar palsy affects

A

CN 9-12 LMN
Normal jaw jerk
Tongue fasiculations, swallowing difficulty, speech problems

26
Q

Pseudo bulbar palsy affects

A

UMN
No fasiculations, jaw jerk is brisk, slow speech and tongue
Emotional Incontinence

27
Q

Muscular atrophy affects

A

LMN only - anterior horn cells

Distal muscles affected first

28
Q

PLS is

A

Pseudobulbar palsy and spastic leg weakness
UMN
Loss of betz cells in motor cortex

29
Q

Risk factors for MND

A

Over 40, male

30
Q

Symptoms of MND

A 
Stumbling gait 
Weak abduction of shoulders (hair washing) 
Weak grip 
Foot drop
Aspiration pneumonia 
Drooling - amytriptiline 
Dysphagia 
Spasticity - diazepam 
Breathing difficulty
31
Q

Symptoms of DKA

A

Reduced consciousness, dehydration, abdo pain, cusmal breathing, sweet smelling breath

32
Q

What is coeliac disease

A

Autoimmune T cell mediated destruction of (usually) terminal ileum

33
Q

What HLA in coeliac

34
Q

What happens in coeliac

A

Gliardin is demylenated by tissue transglutamase

-> stimulates inflammation

35
Q

How to test for coeliac

A

Biopsy of terminal ileum

Need to be eating gluten for 6 weeks prior

36
Q

What’s seen in a coeliac biopsy

A

Decreased duodenal folds
Vilous atrophy
Crypt hyperplasia

37
Q

Why do you have a blood test with coeliac

A

Risk of b12 deficiency

38
Q

Symptoms of coeliac

A

Steatorrhoea
Abdo pain, distension
Anaemia
Weight loss

39
Q

Complications of coeliac

A 
Osteoporosis- vit d deficient 
Ataxia - b12 deficient 
Mouth ulcers - iron deficiency 
Infertility 
Lymphoma 
Dermatitis on extensor surfaces 
Secondary lactose intolerance
40
Q

Treatment of coeliac

A

Gluten free diet

Wheat barley need to be excluded

41
Q

Eg of coeliac diet

A 
Foods with gluten free stamp 
meat
fish
fruit and vegetables
rice
potatoes
lentils.
42
Q

What to do if coeliac symptoms get bad by a ccidently eating gluten

A

Keep hydrated

If severe speak to GP

43
Q

How to limit coeliac malabsorption problems

A

Supplements

44
Q

Causes of confusion in elderly

A

Any infection eg pneumonia / uti
Hepatic encephalopathy
Raised urea (jaundice / ckd)

Osce Prep (9 decks)

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