Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Diseases And Conditions > Flashcards

Diseases And Conditions Flashcards

1
Q

What is anaemia?

A

Low Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is polycythaemia?

A

High Hb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is leukopenia?

A

Low WCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is leukocytosis?

A

High platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is pancytopenia?

A

All cells reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the origin or red blood cells and platelets?

A

Myeloid origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the normal Hb levels in a male?

A

130-180g/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the normal Hb levels in a female?

A

115-165 g/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the normal RCC in a male?

A

4.5-6.5 x10^12 /L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the normal RCC in a female?

A

3.8-5.8 x10^12 /L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the normal WCC?

A

4.0-11.0 x10^9/ L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the normal MCV?

A

80-100 fL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the normal HCT?

A

27-32 pg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the normal PLT?

A

150-450 x10^9 /L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the three haemantinics?

A

Iron, vitamin b12, folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the three haemantinics?

A

Iron, vitamin b12, folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the sources and losses of iron?

A

Sources: meat, green leafy veg, supplements
Losses: achlorhydria, IBD, bowel cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the sources and losses of vitamin b12?

A

Sources: milk, meat
Losses: lack of intake, lack of intrinsic factor, Crohn’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the sources and losses of folic acid?

A

Sources: green veg, legumes
Losses: lack of intake, absorption failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the therapeutic INR:

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a dangerous INR?

A

> 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the definition of lymphoma?

A

Clonal proliferation of lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the symptoms of lymphoma?

A

Fever
Face/neck swellings
Lump in neck/armpits
Excessive night sweats
Weight loss
Loss of appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the clinical presentation of Hodgkin lymphoma?

A

Fever
Night sweats
Itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the clinical presentation of Non-Hodgkin Lymphoma?

A

Extra nodal disease
Symptoms of marrow failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the features of Hodgkin Lymphoma?

A

Peak age 15-40 years
2M:1F
Stage I&II: 90% cure
Stage III&IV: 50-70% cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the features of Non-Hodgkin Lymphoma?

A

Peak age: any age
85% affects B cells
15% affects T cells
>50% relapse rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the investigations for lymphoma?

A

Physical exam
Biopsy
Blood tests
Scanning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the treatment for lymphoma?

A

Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the definition of multiple myeloma?

A

Malignant proliferation of plasma cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the clinical presentation of multiple myeloma?

A

Monoclonal paraprotein in blood and urine
Lytic bone lesions
Excess plasma cells in bone marrow leading to marrow failure
Anaemia
Hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the symptoms of leukaemia ?

A

Fever/chills
Persistent fatigue
Frequent infections
Weightloss
Swollen nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the symptoms of multiple myeloma?

A

Bone pain
Fatigue
Weight loss
Repeated infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the investigations for multiple myeloma?

A

CT/MRI scans
Bone marrow biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the treatment for multiple myeloma?

A

Anti-myeloma medicines
Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the definition of leukaemia?

A

Group of cancers of the bone marrow which prevents normal manufacture of the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the clinical features of leukaemia?

A

Anaemia
Neutropenia
Thrombocytopenia
Lymphadenopathy
Splenomegaly
Bone pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the features of Acute lymphoblastic leukaemia (peak age, % cured, prognosis m vs f)

A

Peak age: 4 years
80% children cured
Better prognosis in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the features of acute myeloid leukaemia? (Peak age, cure rate under 60, cure rate over 70)

A

Peak age: elderly
30-40% under 60s cured
10% over 70 cured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the features of chronic lymphocytic leukaemia (peak age, M:F, what it is)

A

Peak age: 70 years
2M:1F
B-cell clonal lymphoproliferative disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the features of chronic myeloid leukaemia (peak age, effect on neutrophils, presentation)

A

Peak age: 50-70 years
Increase in neutrophils and their precursors
Fatigue, weightloss and sweating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What chromosome is associated with chronic myeloid leukaemia?

A

Philadelphia chromosome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the risk factors of leukaemia?

A

Previous cancer treatment
Genetic disorders
Smoking
Family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the investigations for leukaemia?

A

Blood tests
Bone marrow tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the treatment for leukaemia?

A

Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is poryphyria?

A

An abnormality of haem metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the presentation of porphyria?

A

Photosensitive rash
Hypertension
Tachycardia
Neuropsychiatric disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the signs of anaemia?

A

Pale
Tachycardia
Enlarged liver/spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are the symptoms of anaemia?

A

Tired
Dizzy
Shortness of breath
Palpitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are the causes of anaemia?

A

Reduced production: reduced haemantinics
Increased loss: bleeding, autoimmune, thalassaemia, sickle cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the investigations for anaemia?

A

History
Full blood count
Faecal occult bloods
Endoscopy
Bone marrow examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the treatment for anaemia?

A

Haematinic replacement
Transfusion/eryththropoetin (in production failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the effect of anaemia on GA?

A

Reduced O2 capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the effect of anaemia on the oral cavity?

A

Mucosal atrophy
Candidiasis
Recurrent ulceration
Sensory changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the definition of Macrocytic?

A

> 100 fL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the definition of Microcytic?

A

<80 fL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the definition of normocytic?

A

80-100 fL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is Macrocytic anaemia associated with?

A

Vit b12 deficiency
Folate deficiency
Drug induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is Microcytic anaemia associated with?

A

Iron deficiency
Chronic inflammatory disease
Thalassaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is normocytic anaemia associated with?

A

Haemolytic anaemia
Blood loss
Bone marrow disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What are the four stages in the process of haemostasis?

A

Vasoconstriction
Platelet plug
Coagulation Cascade
Fibrin plug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are the stages in the process of platelet plug formation?

A

ECM releases cytokines and inflammatory markers
Platelets adhere to each other
Platelet plug forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What mediators do platelets release?

A

ADP
Serotonin (maintains vasoconstriction)
Prostaglandins and phospholipids (maintain vasoconstriction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the intrinsic pathway in the coagulation cascade?

A

XII -> XIIa
XI -> XIa (via XII)
IX -> IXa (via XIa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the extrinsic pathway in the coagulation cascade?

A

VII -> VIIa (via III)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the extrinsic pathway in the coagulation cascade?

A

VII -> VIIa (via III)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is the common path in the coagulation cascade?

A

Prothrombin -> thrombin (via Va)
Fibrinogen -> fibrin (via thrombin)
Fibrin -> cross-linked fibrin clot (via XIIa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is the definition of haemophillia?

A

Rare inherited condition that affects the body’s ability to form clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What are the clinical features of mild haemophilia?

A

Bleeding occurs after injury, surgery or extraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are the clinical features of moderate haemophilia?

A

Bleeding into joints and muscles after mild injury or spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are the clinical features of severe haemophilia?

A

Spontaneous bleeding into joints and muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the cause of haemophilia A?

A

Low clotting factor VIII (8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the cause of haemophilia B?

A

Low clotting factor IX (9)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What are the investigations for haemophilia?

A

Blood test
Clotting screen
Genetic test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the treatment of severe and moderate haemophilia A?

A

Recombinant factor VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the treatment of mild haemophilia A and carriers?

A

DDAVP (desmopressin)
Transaeximic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the treatment for haemophilia B?

A

Recombinant factor IX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the definition of Von Willebrand’s disease?

A

Deficiency of Von Willebrand’s factor resulting in reduction of factor VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What are the clinical features of Von Willebrand’s disease?

A

Large/easy bruising
Frequent nose bleeds
Bleeding gums
Heavy periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What kind of mutation causes Von Willebrands disease?

A

Autosomal dominant mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What are the investigations for Von Willebrand’s disease?

A

Blood test
Genetic test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is the treatment for severe and moderate Von willebrands disease?

A

DDAVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is the treatment of mild Von Willebrand’s disease and carriers?

A

Transexaemic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is Thrombophilia?

A

Increased risk of blood clot development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What are the causes of Thrombophilia?

A

Protein s/c deficiency
Antithrombin 3 deficiency
Factor V Leiden variant
Cancer
Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is the minimum platelet count for primary care?

A

100 x10 ^9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What is the minimum platelet count for hospital care?

A

50 x10 ^9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What are the irreversible risk factors for CVD?

A

Age
Sex
Family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What are the reversible risk factors of CVD?

A

Smoking
Obesity
Diet
Exercise
Hypertension
Hyperlipidaemia
Diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is the primary preventions for CVD?

A

Exercise
Diet
Not smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What are the secondary preventions for CVD?

A

Medical treatments to reduce risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are the four features of Stable angina?

(Cause, ischaemic/infact, ECG, troponins)

A

Pain due to increased demand due to atherosclerotic plaque
Demand ischaemia, not infarction
Normal ECG
Normal troponins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are the four features of unstable angina?
(Cause, ischaemic/infact, ECG, troponins)

A

Plaque ruptures, thrombus formation, partial occlusion of vessel, pain at rest
Supply ischaemia, no infarct
ECG: normal, inverted T waves or ST depression
Normal troponins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What are the four features of an NSTEMI?

(Cause, ischaemic/infact, ECG, troponins)

A

Plaque ruptures, thrombus formation, partial occlusion of vessel, subendocardial myocardium infarction
Subendocardial infarct
ECG: normal, inverted T waves or ST depression
Elevated troponins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What are the four features of a STEMI?

(Cause, ischaemic/infact, ECG, troponins)

A

Complete occlusion of blood vessel lumen, transmural injury and infarction to myocardium
Transmural infarct
ECG: hyperacute T waves or ST elevation
Elevated troponin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is cyanosis?

A

5g/dL or more deoxygenated Hb in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What is a cause of central cyanosis?

A

Congenital heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is a cause of peripheral cyanosis?

A

Cold environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the definition of angina?

A

Reversible ischaemia of the heart muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What are the symptoms of angina?

A

Central crushing chest pain
May radiate to arm/back/jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What are the investigations of angina?

A

ECG
Angiography
Echocardiogram
Isotope studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What are the treatment options for angina?

A

Reduce O2 demands
Increase oxygen delivery
Modify risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

How can you reduce O2 demands in angina?

A

Reduce hypertension
Reduce heart filling pressure/dilate coronary vessels
Emergency Tx: GTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What medication can be used to reduce hypertension?

A

Diuretics
Ca Channel agonists
ACE inhibitors
Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What medications can be used to reduce heart filling pressure/dilate coronary vessels?

A

Nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What can be done to increase oxygen delivery?

A

Angioplasty
Coronary artery bypass graft (CABG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What can be done to increase oxygen delivery?

A

Angioplasty
Coronary artery bypass graft (CABG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What is the definition of peripheral vascular disease?

A

Angina of the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What are the clinical features of peripheral vascular disease?

A

Ateroma in femoral/popilteal vessels
Claudication pain in limbs during exercise
Poor wound healing
Limited function
May lead to necrosis and gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What are the clinical features of peripheral vascular disease?

A

Ateroma in femoral/popilteal vessels
Claudication pain in limbs during exercise
Poor wound healing
Limited function
May lead to necrosis and gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What is the definition of myocardial infarction?

A

Infarction of the coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What are the clinical features of a myocardial infarction?

A

Pain
Nausea
Sweaty
‘Going to die’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What are the investigations for a myocardial infarction?

A

History
ECG
Biomarkers (troponin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What are the treatment options for a myocardial infarction?

A

Get patient to hospital
Analgesia
Aspirin
BLS if needed
Open blood flow by angioplasty/ stent (up to 3 hours) Thrombolysis (up to 6 hours)
Bypass obstruction: CABG, fem/pop bypass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Which medications are used for prevention of myocardial infarction?

A

Aspirin
Beta blockers
ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What is Bradyarrhythmia?

A

Slowed heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What is the investigation for bradyarrythmia?

A

Prolonged p-q interval on ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What is the treatment for Bradyarrythmia?

A

Cardiac pacemakers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What is tachyarrhythmia?

A

Increased heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

How does atrial tachycardia present on an ECG?

A

Narrow QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

How does ventricular tachycardia present on an ECG?

A

Broad QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

What are the risk factors of infective endocarditis?

A

Prosthetic heart valve
Congenital heart disease
Damaged heart valves
Previous endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

What are the symptoms of infective endocarditis?

A

High temperature
Chills
Headache
Joint and muscle pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What are the causes of infective endocarditis?

A

Bacteria enters system and adheres to damaged endothelium and microthrombi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What is the duke criteria for infective endocarditis diagnosis?

A

Positive blood cultures (3x over 24 hours)
Evidence of endocardia involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

What is the treatment for infective endocarditis?

A

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What dental procedures put a patient at risk of bacteraemia?

A

Extractions
Periodontal therapy
Gingival surgery
Implants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

What is the definition of heart failure?

A

Output of heart is incapable of meeting demands of tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

What are the clinical features of left heart failure?

A

Lungs and systolic effects
Dysponea
Tachycardia
Low BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

What are the clinical features of right heart failure?

A

Venous pressure elevation
Swollen ankles
Aceites
Raised jugular vein pressure
Tender enlarged liver
Poor GI absorption
Pitting oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

What are the causes of high output heart failure?

A

Demands of system increased beyond heart capacity
Anaemia
Thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What are the causes of low output heart failure?

A

Heart is failing and not strong enough to force blood around the body
Cardiac defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

What are the investigations for heart failure?

A

Blood test
ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

What is the treatment for acute heart failure?

A

Emergency hospital management
Oxygen
Morphine
Frusemide (for fluid removal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

What is the treatment of chronic heart failure?

A

Community based management
Improve myocardial function (treat underlying disorders)
Reduce compensation effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

What is hypertension?

A

Increased blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What are the clinical features of hypertension?

A

Systolic >140mmHg
Diastolic >90mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

What are the clinical features of hypertension?

A

Systolic >140mmHg
Diastolic >90mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

What are the risk factors of hypertension?

A

Age
Race
Obesity
Stress
Drugs (steroids, oral contraceptives)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

What are the causes of hypertension?

A

Environment
Genes
Gene and environment interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

What are the investigations for hypertension?

A

3 separate measurements: sitting, rested
Urinalysis: serum biochemistry/lipids
ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

What is the treatment for hypertension?

A

Modify risk factors
Single daily drug dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

What are the causes of valve disease?

A

Congenital abnormality
Rheumatic fever
Myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

What is the treatment for valve disease?

A

Valve replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

What are the features of a mechanical valve?

A

Longer life (up to 30 years)
Ticking noise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

What are the features of a porcine valve?

A

Short life <10 years
Silent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

What are the two components of respiration?

A

Ventilation
Gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

What are the features of ventilation?

A

Airway patency
Active muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

What are the features of gas exchange?

A

Adequate alveoli
No alveolar wall fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

What is type1 respiratory failure?

A

Inadequate gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

What is type 1 respiratory failure associated with?

A

Thickening of alveolar walls
Inadequate alveolar number
V-Q mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

What is a V-Q mismatch?

A

A mismatch between where air goes into lungs and blood going into lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

What is type 2 respiratory failure?

A

Inadequate ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

What is the definition of asthma?

A

Reversible airflow obstruction
Bronchial hyper reactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

What are the clinical features of asthma?

A

Cough
Wheeze
Shortness of breath
Diurnal variation
Difficulty breathing out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

What are the triggers of asthma?

A

Infections
Environmental stimuli (dust, smoke, chemicals)
Cold air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

What is the asthma triad?

A
  1. Bronchial smooth muscle constriction
  2. Bronchial smooth muscle oedema
  3. Excessive mucous secretion into airway lumen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

What is the investigation for asthma?

A

Peak expiratory flow rate (PEFR) to track airway resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

What are the 5 stages of treatment for asthma?

A
  1. Short acting b-agonist
  2. Low dose inhaled corticosteroid
  3. High dose inhaled corticosteroid
  4. Long acting b-agonist
  5. Adjuvant therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What are the adjuvant therapy options for asthma?

A

Regular montelukast
Pulsed oral steroid (prednisolone)
Biologic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

What is chronic obstructive pulmonary disease (COPD)?

A

Emphysema and chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

What is the risk factor of COPD?

A

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

What are the symptoms of COPD?

A

Increased breathlessness
Persistent productive cough
Frequent chest infections
Persistent wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

What does type 1 COPD result in?

A

Hypoxaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

What does type 2 COPD result in?

A

Hypercapnia
Ventilation failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

What is the PaO2 for type 1 COPD?

A

PaO2 <8.0 kPa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

What is the PaCO2 for type 2 COPD?

A

PaCO2 >6.7 kPa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

What are the investigations for COPD?

A

Spirometry
Chest x-ray
Blood test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

What is the treatment for COPD?

A

Smoking cessation
Long acting bronchodilator
Inhaled steroid
Oxygen support
Pulmonary rehabilitation therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

What is cystic fibrosis?

A

Inherited defect in cell chloride channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

What are the clinical features of cystic fibrosis?

A

Production of excess sticky mucous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

What are the symptoms of cystic fibrosis?

A

Troublesome cough
Repeated chest infections
Prolonged diarrhoea
Poor weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

What can cystic fibrosis progress to?

A

Liver dysfunction
Osteoporosis
Diabetes
Reduced fertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

What mutation is associated with cystic fibrosis?

A

CFTR gene mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

What are the different investigations for cystic fibrosis?

A

Prenatal screening: if sibling +ve
Perinatal testing: blood spot test on day 5 of life
Sweat test: suspected +ve, measures salt content of sweat
CTFR gene testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

What are the treatment options for cystic fibrosis?

A

Physiotherapy (10-60 mins/day: to remove mucous in lungs)
Medication:
Lungs: bronchodilators (open airways), antibiotics (chest infection), steroids (airway inflammation)
Digestive system: pancreatic enzyme replacement, nutritional supplements
CFTR modulators
Stem cell treatment
Exercise (for lung function and physical strength)
Transplantation (heart, lung)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

What are the types of lung cancer?

A

Small cell or non-small cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

What are the symptoms of lung cancer?

A

Cough
Haemoptysis
Pneumonia
Metastasis (bone, liver brain)
Dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

What are the causes of lung cancer?

A

Smoking
Genetics
Air pollution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

What are the investigations for lung cancer?

A

Radiographs
Biopsy
Biomarkers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

What are the treatment options for lung cancer?

A

mAbs
Platinum based doublet therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

What is sleep apnoea?

A

Airway obstruction during sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

What are the treatment options for sleep apnoea?

A

Mandíbular advancement appliance
Continuous positive airway pressure
Positional therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

What are the symptoms of bowel cancer?

A

Anaemia
Rectal blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

What are the A B C D stages of bowel cancer?

A

A- submucosal (80% 5YS)
B- muscularis (65% 5YS)
C- lymph nodes (45% 5YS)
D- liver (5% 5YS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

What are the causes of bowel cancer?

A

Genetics- p53 (75%)
Ulcerative colitis
Intestinal polyps
Diet low in fibre and veg and high in fat and meat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

What are the investigations for bowel cancer?

A

Screening - adults >50 every two years
Endoscopy if +ve screening
CT/MRI
Carcinoembryonic antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

What are the treatment options for bowel cancer?

A

Surgery
Hepatic metastases
Radiotherapy
Chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

What is the definition for coeliac disease?

A

Sensitivity to alpha-gliaden component of gluten

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

What are the clinical features of coeliac disease?

A

Subtotal villus atrophy of the jejunum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

What are the symptoms of coeliac disease?

A

Weightloss
Lassitude
Weakness
Abdominal swelling
Diarrhoea
Oral aphthae
Malabsorption of iron, folate, vit b12, fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

What are the risk factors of coeliac disease?

A

Family history
Environmental factors
Comorbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

What are the investigations for coeliac disease?

A

Autoantibody tests (serum transglutaminase TTG, anti-gliadin/anti-endomyseal antibodies)
Jejunal biopsy
Faecal fat (increased due to malabsorption)
Haemantinics (low b12, folate, ferritin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

What are the investigations for coeliac disease?

A

Autoantibody tests (serum transglutaminase TTG, anti-gliadin/anti-endomyseal antibodies)
Jejunal biopsy
Faecal fat (increased due to malabsorption)
Haemantinics (low b12, folate, ferritin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

What is the treatment for coeliac disease?

A

Gluten free diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

What are the dental aspects of coeliac disease?

A

Oral ulcers and blisters due to malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

What is pernicious anaemia?

A

Anaemia caused by vitamin b12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

What are the clinical features of pernicious anaemia?

A

Diarrhoea
Lightheaded
Loss of appetite
Shortness of breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

What are the causes of pernicious anaemia?

A

Lack of b12 in diet
Disease of gastric parietal cells (autoimmune)
Crohn’s disease
Bowel cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

What are the investigations for coeliac disease?

A

Blood tests
Schilling test/serological markers
Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

What is the treatment for pernicious anaemia?

A

Increase b12 in diet
Supplements
Vitamin b12 injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

What are the symptoms of Crohn’s disease?

A

Colonic disease: diarrhoea, abdominal pain, rectal bleeding
Small bowel disease
Orofacial granulamatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

What are the ratios for Crohn’s disease in male/female and white/black

A

M>F
W>B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
204
Q

What are the features of Crohn’s disease?

A

Discontinuous
Rectum involved 50%
Anal fissures 75%
Ileum involved 30%
Mucosa cobbled and fissured
Non vascular
Serosa inflammed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
205
Q

What is the microscopic appearance of Crohn’s disease?

A

Transmural
Oedematous
Granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
206
Q

What is the presentation of necrotising ulcerative gingivitis/periodontitis?

A

Marginal gingival ulceration with loss of interdental papillae
Grey sloughing on surface of ulcers
Halitosis
Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
207
Q

What are causative factors of NUG/NUP?

A

Anaerobic fusospirochatal bacteria
Smoking
Stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

What is used to treat NUG/NUP?

A

Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
209
Q

What are the functions of the skin?

A

Anatomical barrier
Sensory input
Heat regulation
Stores liquids and water
Drug absorption and waste excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
210
Q

What is the impact of oily skin?

A

Increased sebaceous gland secretion
Increased bacterial colonisation
Increased spots and pimples
Skin is heavier and thicker
Increased pore blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
211
Q

What are comedones?

A

Black heads
Buildup of keratin and sebum
The pores oxidise leading to a black colour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
212
Q

What are bacterial infections that affect the skin?

A

Furuncles and carbuncles
Acne
Erysipelas
Impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
213
Q

What is a group of furuncles called?

A

Carbuncle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
214
Q

What is a furuncle?

A

Infection of the skin leading to pus filled pockets
Red, painful and swollen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
215
Q

What bacteria causes furuncles?

A

Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
216
Q

What does acne consist of?

A

Comedones, papeles, pustules, nodules and inflammatory cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
217
Q

What age groups are most commonly affected by acne’s?

A

13-18 years
25-40 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
218
Q

What are some causes of acne?

A

Follicular sensitivity to testosterone
Propionibacteruym acne’s overgrowth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
219
Q

What five things can worsen acne?

A

Contraceptives
Greasy skin cleansers
Systemic steroid treatment
Anticonvulsants
Squeezing spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
220
Q

What is the local management of acne?

A

Reduce excess skin oil
Antibacterial agents: benzoyl peroxide, retinoids, antibiotic lotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
221
Q

What is the systemic management of acne?

A

Antibiotics; tetracycline based (minocylin)
Retinoids: isotretinoin
Hormone manipulation: anti androgens (cyproterone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
222
Q

What bacteria causes erysipelas?

A

Streptococcus pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
223
Q

What do erysipelas present as?

A

Defined, sharp raised border; may blister and peel
Systemic symptoms: fever, rigors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
224
Q

What is the management of erysipelas?

A

Systemic antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
225
Q

What is the progression of erysipelas?

A

Necrotising fasciitis
Septic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
226
Q

What is impetigo?

A

Highly infectious skin disease
Presents as red, crusty blisters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
227
Q

What bacteria is associated with impetigo?

A

Straphlococcal
Streptococcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
228
Q

What is the management of impetigo?

A

Topical antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
229
Q

What are some examples of viral skin infections?

A

Herpes simplex
Shingles (herpes zoster)
Mulluscum contagiosum
Warts
Measles
Rubella
Fifth disease
Hand foot and mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
230
Q

What is herpes simplex virus activated by?

A

Trauma
Physical
Chemical
UV
Stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
231
Q

What is the management of herpes simplex virus?

A

Aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
232
Q

What is the cause of shingles?

A

Recurrent herpes zoster virus that affects single dermatones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
233
Q

What is the management of shingles?

A

High dose aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
234
Q

What is mulluscum contagiosum caused by?

A

Pox virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
235
Q

Who is mostly affected by mulluscum contagiosum?

A

Infants and small children
Children with atopic eczema
Adults with HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
236
Q

What is the presentation of mulluscum contagiosum?

A

Clusters of small papules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
237
Q

What is the presentation of mulluscum contagiosum?

A

Clusters of small papules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
238
Q

What conditions are warts associated with?

A

HPV1-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
239
Q

What is the treatment for warts?

A

Keratosis is
Cryosurgery
Excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
240
Q

What are some examples of fungal skin infections?

A

Athletes foot (tines pedis)
Nail infections (oncycholysis)
Ringworm
Intertrigo
Pityriasis versicolour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
241
Q

What is the treatment for athletes foot?

A

Keep skin clean, dry and damage free
Antifungal/antibacterial cream: miconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
242
Q

What is onycholysis?

A

Associated with tinea unguium infection
Nail becomes malformed, thick and crumbly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
243
Q

What is ringworm in feet associated with?

A

Tinea cruris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
244
Q

What is ringworm in the body associated with?

A

Tinea corporis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
245
Q

What is ringworm in the scalp associated with?

A

Tinea capitius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
246
Q

What is intertrigo?

A

Fungal infection due to chafing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
247
Q

What is the treatment for intertrigo?

A

Topical antifungal
Clotrimazole
Miconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
248
Q

What is pityriasis versicolor caused by?

A

Pityrosporum orbiculare
Cradle cap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
249
Q

What is the presentation of pityriasis versicolor?

A

Patchy skin pigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
250
Q

What is the treatment of pityriasis versicolour?

A

Topical or systemic antifungal
Topical ketoconazole (shampoo/wash)
Systemic itraconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
251
Q

What are two examples of skin infestations?

A

Scabies
Lice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
252
Q

What is scabies?

A

Infection with scabies mite (sarcoptes scabiei)
Burrow into skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
253
Q

What is the presentation of scabies?

A

Itching
Rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
254
Q

What is the treatment of scabies?

A

Chemical insectides:
Benzoyl benzoate
Permethrin
Malathion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
255
Q

What are the three types of lice and how are they transmitted?

A

Head, pubic, body
Transmitted by close contact and shared items

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
256
Q

What is the treatment for lice?

A

Personal clothing and hygiene
Chemical insectides: permethrin, malathion, phenothrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
257
Q

What are examples of inflammatory skin disease?

A

Eczema
Occupational dermatitis
Psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
258
Q

What is eczema?

A

Inflammation of skin
Itchy, dry, flaky

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
259
Q

What are the types of eczema?

A

Atopic
Contact
Seborrhoeic
Discoid
Gravitational

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
260
Q

What type of surfaces does eczema affect?

A

Flexor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
261
Q

What are the features of atopic eczema?

A

Develops in childhood
Improves with age and runs in families
Associated with hay fever and asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
262
Q

What are the features of contact eczema?

A

Adult onset
Contact with allergen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
263
Q

What are the features of seborrhoeic eczema?

A

Affects scalp and eyelashes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
264
Q

What are the features of gravitational eczema?

A

Related to poor circulation in legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
265
Q

What are some triggers of eczema?

A

Stress
Menstruation
Illness
Weather

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
266
Q

What is the management of eczema?

A

Cotton clothing
Emollients: oily and prevent the drying of irritated skin, apply after bath
Soap substitutes
Corticosteroids: remove inflammation and allow skin to return to normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
267
Q

What is occupational dermatitis and how is it treated?

A

Reaction to an environmental agent
Results in a rash, immediately or 72 hours after
Treated with topical steroids and removal of stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
268
Q

What is psoriasis?

A

Inflammatory skin disease affecting 2% pop
Dysregulated epidermal proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
269
Q

What surfaces are affected by psoriasis?

A

Extensor surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
270
Q

What are the treatments for psoriasis?

A

Emollients
Topical steroids
Tar
Dithranol
Vitamin A derivatives
PUVA (psoralen UV light A)

Systemic: methotrexate, cyclosporine, aitretin, inflixamab, etanercept

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
271
Q

What are examples of blistering immunological skin conditions?

A

Pemphigoid
Pemphigus
Epidermolysis bullosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
272
Q

What are some examples of immunological connective tissue diseases?

A

Scleroderma
Dermatomyositis
Raynaulds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
273
Q

How do immunological skin conditions lead to blisters?

A

Auto-antibodies attack skin components causing a loss of cell-cell adhesion
‘Split’ forms in skin which fills with inflammatory exudate, forms vesicle/blister

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
274
Q

What is pemphigoid?

A

Sub epithelial antibody attack
Leads to thick walled blisters: clear or blood filled
Can have oral and skin lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
275
Q

What is the treatment of pemphigoid?

A

Steroids or steroid sparing drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
276
Q

What does pemphigus affect?

A

Affects mucosa and skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
277
Q

What are the signs and symptoms of denture induced stomatitis?

A

Inflammed mucosa
Burning sensation
Discomfort
Bad taset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
278
Q

What are the types of dementia?

A

Alzheimers
Vascular
Dementia with Lewy bodies
Fronto temporal
Korsakoff syndtome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
279
Q

What are the signs of late stage dementia?

A

Unaware of time and place
Difficulty in recognising faces
Increased need for self care help
Difficulty walking
Behaviour changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
280
Q

What are examples of cognitive tests for dementia?

A

Mini Mental State Exam
Blessed Dementia Scale
Montreal Cognitive Assessment
Single test: clock draw, delayed word recall, category fluency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
281
Q

What are the risk factors for head and neck cancer?

A

Smoking
Oral Hygiene
Alcohol
Betel chewing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
282
Q

What is a stroke?

A

An acute focal neurological deficit due to cerebrovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
283
Q

What are the risk factors for stroke?

A

Smoking
Alcohol
Hypertension
Hyperlipodemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
284
Q

What are the types of stroke?

A

Haemorrhage
Infarction
Embolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
285
Q

What are the signs/symptoms of stoke?

A

Face drooping
Arm weakness
Speech difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
286
Q

What are the methods of stroke prevention?

A

Antiplatelets (aspirin)
Statins (reduce cholesterol)
Stop smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
287
Q

What are the complications of stroke?

A

Sensory/motor loss
Dysphagia
Dysphonia
Cognitive impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
288
Q

What is epilepsy?

A

Recurrent seizures associates with reduced GABA levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
289
Q

What are the types of epilepsy?

A

Generalised tonic-clonic seizures
Partial/Focal seizures
Myoclonic seizures
Tonic seizures
Atonic seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
290
Q

What is an aura?

A

Abnormal sensation that a seizure may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
291
Q

What is tonic associated with?

A

Muscle tensing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
292
Q

What is clonic associated with?

A

Muscle jerking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
293
Q

What is a post-ictal period?

A

Post seizure
Person is confused, tired, irritable and low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
294
Q

How does a partial/focal seizure present?

A

Occurs in isolated areas
Affects hearing, speech, memory and emotions
Awake during simple, Unconscious during complex
Symptoms: deja vu, strange smell/tastes, unusual emotions/behaviours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
295
Q

What is an acute febrile convulsion?

A

A fit or seizure occurring in children 6 months - 6 years when they have a high fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
296
Q

What are the causes of epilepsy?

A

Idiopathic
CNS disease
Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
297
Q

What are the precipitators of epilepsy?

A

Illness
Stress
Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
298
Q

What is the treatment for epilepsy?

A

Anti-convulsants
Anti-epileptics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
299
Q

What is the emergency treatment for epilepsy?

A

Protect head, clear area
Give O2
>5minutes: buccal midazolam
Post-seizure reassurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
300
Q

What information should you gather in a fit history?

A

Last 3 fits
Medications and compliance
When fits are most likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
301
Q

What is status epilepticus?

A

Single epileptic seizures lasting more than 5 minutes or 2 or more within a 5 minute period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
302
Q

What is multiple sclerosis?

A

Progressive demyelination of axons leading to reduced nerve conductivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
303
Q

How does multiple sclerosis present?

A

Intention tremor
Muscle weakness
Paraesthesia
Visual disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
304
Q

What is motor neurone disease?

A

Degeneration of spinal cord affecting bulbar motor nuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
305
Q

What are the tests for bleeding disorders?

A

Prothrombin test
Platelet count
Activated partial prothrombin time
Thrombin time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
306
Q

What drugs are associated with xerostomia?

A

Benzodiazepines
Antidiuretics
Antidepressants
Anticholinergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
307
Q

What is the definition of delusion?

A

False, fixed beliefs which dominate the person’s mind and are contrary to education and culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
308
Q

What are the dental implications of alcohol use disorder?

A

Xerostomia
Poor oral hygiene
Erosion and toothier
Increased caries risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
309
Q

What is schizophrenia?

A

Encompasses a number of symptoms associated with significant alterations to a person’s perception, thoughts, moods and behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
310
Q

What are the dental implications of schizophrenia?

A

Hypersalivation
Tardive Dyskinesia
Xerostomia
Increased oral cancer risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
311
Q

What is tardive dyskinesia most commonly caused by?

A

Typical antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
312
Q

What are the side effects of atypical antipsychotic clozapine?

A

Agranulocytosis
Neutropenia
Hypersalivation
Plasma levels can be influenced by tobacco withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
313
Q

What are the dental implications of cannabis use?

A

Increased dietary carbohydrates
Can induce tachycardia and widespread vasodilation
Use can be a contraindication to dentist led sedation
Xerostomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
314
Q

What is the safest LA to use on patients with advanced liver disease?

A

Articaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
315
Q

What analgesia is best used for patients with liver cirrhosis?

A

Paracetamol

316
Q

What is the liver responsible for producing?

A

Clotting factors 1,2,7,9,10,11
Thrombopoietin

317
Q

What is the minimum UKLED score for a transplant?

A

49

318
Q

What is cirrhosis?

A

Liver cell necrosis and inflammation followed by replacement with fibrotic tissue and regenerating nodules of hepatocytes and vascular derangement

319
Q

What type of RNA does hepatitis D have?

A

Circular

320
Q

What is the main route of hepatitis A transmission?

A

Faeco-oral

321
Q

What is used for the treatment of hepatitis A

A

Sofosbuvir

322
Q

What are the cardinal signs of Parkinson’s?

A

Postural instability
Muscle rigidity
Resting tremor
Bradykinesia

323
Q

What are the oral health implications of Parkinsons?

A

Oral hygiene deteriorates
Poor access
Dry mouth
Lack of muscle control

324
Q

What are the signs of dental pain in a non-verbal patient?

A

Pulling at face and mouth
Refusal to eat
Disturbed sleep
Increased restlessness

325
Q

What is Parkinsons?

A

Degenerative brain disease: loss of dopaminergic neurone in the substantial Niagara

326
Q

What is xerostomia?

A

Dry mouth
1/2 the amount of normal unstimulated flow rate
Clinically <3ml/min

327
Q

What medications are associated with xerostomia?

A

Tricyclic antidepressants
Anticholinergics
Antipsychotics
Beta blockers
Antihistamines
Diuretics
Benzodiazepines

328
Q

What are the causes of xerostomia?

A

Sjögren’s syndrome
Anxiety
Surgical removal
Head and neck radiotherapy
Dehydration
Stress

329
Q

What is the peak age for Acute Lymphoblastic Leukaemia?

A

0-4 years

330
Q

What medications are associated with gingival hyperplasia?

A

Calcium channel blockers (nifedipine)
Immunosuppressants (cyclosporine)
Anticonvulsants (phenytoin)

331
Q

How many cases of Acute Lymphoblastic Leukaemia occur annually?

A

440

332
Q

What are the symptoms of Acute Lymphoblastic Leukaemia?

A

Breathlessness
Pale
Fatigue
Easy bleeding/bruising
Increased temperature
Increased infections
Swollen lymph nodes
Irritable
Bone pain
Decreased appetite
Fullness in stomach
Swollen testicles

333
Q

Examples of MDT for Acute lymphoblastic leukaemia:

A

Paeds Oncologist
Paeds Haematologist
Paeds Dentist
GP
Paeds Cancer Nurse
Play Specialist
Psychologist
Social Worker

334
Q

What are the management options for Acute Lymphoblastic Leukaemia?

A

Chemotherapy
Stem cell or bone marrow transplant

335
Q

What oral problems are associated with Acute Lymphoblastic Leukaemia?

A

Increased infection during treatment
Oral and pharyngeal mucositis
Xerostomia
Increased caries
Gingival hyperplasia
ORN, MRONJ
Trismus

336
Q

What are the dental considerations to be made for an Acute Lymphoblastic Leukaemia patient?

A

Prevention
Timing of appointments
Immunosuppressant and bleeding risk
Anxiety
Fatigue
Wider social and family circumstances

337
Q

What is the presentation of diabetes?

A

Polyuria (Toilet)
Excessive Thirst
Lethargy (Tired)
Weight Loss (Thinner)

338
Q

What is the MDT associated with diabetes in Paeds?

A

Paediatric Endocrinologist
Paeds diabetes specialist nurse
Paeds dietician
Clinical psychologist

339
Q

What is the diagnostic value for diabetes in mmol/litre glucose?

A

11.1

340
Q

What is type 1 diabetes managed with?

A

Insulin

341
Q

What dental problems are associated with type 1 diabetes?

A

Increased perio risk
Decreased saliva flow
Increased caries
Candidiosis
Increased infection

342
Q

What considerations should be made for the treatment of type 1 diabetes patients?

A

Prioritise prevention (high risk)
Timing of appointment (early/mid morning)
GA (liase with endocrinologist, may need overnight monitoring due to fasting)
Anxiety
Fatigue with care: fed up of tx

343
Q

What is the ratio of autism M:F

A

3M:1F

344
Q

What are the four cardinal signs of Parkinson’s disease?

A

Postural instability (impaired gait and falls, impaired use of upper limbs)
Resting tremor
Bradykinesia (slow movement and slow initiation of movement)
Rigidity (Increased muscle tone)

345
Q
A
346
Q

How may a Parkinson’s patient present?

A

Mask-like face
Slow speech
Difficulty swallowing
Abnormal posture
Difficulty walking
Memory problems

347
Q

What are the dental issues associated with a Parkinson’s patient?

A

Difficulty accepting treatment
Tremor at rest
Lack of control of muscles of mastication
Dry mouth

348
Q

What is xerostomia in Parkinson’s patients associated with?

A

Anticholinergic effect of drugs (benzotropine)
Increased drug interactions

349
Q

How may pain display in a Parkinson’s patient?

A

Fighting
Pacing
Repetitive motions
Refusal to eat
Crying
Groaning and refusal to co-operate

350
Q

What are the facial signs in a Parkinson’s patient in pain?

A

Frowning
Grimacing
Teeth clenching
Biting
Rubbing area

351
Q

What are the behavioural signs of a Parkinson’s patient in pain?

A

Aggression
Depression
Isolation
Sleep disturbance
Withdrawal

352
Q

What is the difference in tremors in Parkinson’s and Cerebral Palsy?

A

Parkinsons is a resting tremor
Cerebral palsy is an intention tremor

353
Q

What are some management techniques for xerostomia?

A

Sucking on ice cubes
Frequent sips of water
Avoiding alcohol containing mouthwashes
Avoiding dry foods and caffeine

354
Q
A
355
Q

What is Alzheimer’s?

A

Reduction in the cortex size, severe in the hippocampus
Presence of plaques which are deposits of protein fragments of beta-amyloid that builds up in the space between the nerve cells and the tangles (twisted fibres of tau protein build up in cell)

356
Q

What is vascular dementia caused by?

A

Reduced blood flow to the brain which damages and eventually kills brain cells

357
Q

What is dementia with Lewy bodies?

A

Deposits of abnormal protein- Lewy bodies inside of brain cells

358
Q

What is fronto-temporal dementia?

A

The frontal lobe has an associated ubiquitous associated protein linked with TDP-43

359
Q

What are examples of rarer types of dementia?

A

HIV-related
Corticobasal degenerative
Parkinson’s
Multiple Sclerosis
Niemann-Pick disease
Creutz-feld Jacob

360
Q

What is the presentation of early stage dementia?

A

Short term memory loss
Confusion
Poor judgement/decisions
Anxiety, agitation or distress over changes
Inability to manage everyday tasks
Communication problems
Declines in talking, reading and writing

361
Q

What is early stage dementia often attributed to?

A

Stress
Bereavement
Ageing

362
Q

What is early stage dementia often attributed to?

A

Stress
Bereavement
Ageing

363
Q

What is the presentation of mid stage dementia?

A

More support required to eat, wash, dress
Increasingly forgetful, may fail to recognise people
Distress, aggression, anger, mood changes
Wandering and getting lost
May behave inappropriately
May experience hallucinations/throwback memories

364
Q

What is the presentation of late stage dementia?

A

Inability to recognise familiar objects, surroundings or people
Increased physical frailty
Difficulty eating and swallowing, weight loss
Associated incontinence
Loss of speech
Symptoms are progressive and irreversible

365
Q

What are the three types of Von Willebrand disease?

A

Hereditary
Acquired
Psuedo/platelet type

366
Q

What are the three types of Von Willebrand disease?

A

Hereditary
Acquired
Psuedo/platelet type

367
Q

What are some examples of rarer blood disorders?

A

Haemophilia carriers
Factor XIII deficiency
Factor X deficiency
Factor V deficiency
Glandsman Disease

368
Q

What is thrombocytopenia?

A

Abnormally low levels of thrombocytes

369
Q

What is the reference value for thrombocytopenia?

A

<150x10^9/L

370
Q

What is the reference value for thrombocytopenia?

A

<150x10^9/L

371
Q

What are examples of blood tests?

A

Full blood count
Coagulation screen
Prothrombin time
Partial thromboplastin time
Activated partial thromboplastin time (APTT)
APTT ratio
INR
D-dimer
Fibrogen

372
Q

What does the INR determine?

A

How long it takes for blood to clot

373
Q

What is INR=1

A

Equal to a person not on warfarin

374
Q

What is INR>1

A

Longer clotting time

375
Q

What is INR <4?

A

Allows treatment without interruption

376
Q

What are the risk factors of oral cancer?

A

Tobacco use
Increased sun exposure
Gender (M>F)
Poor OH
Weakened immune system
Alcohol use
Human papilloma virus (HPV)
Increased age
Poor diet and nutrition

377
Q

What are the physical features of Down’s Syndrome?

A

Macroglossia
Class II occlusion
Hypodontia
Short neck

378
Q

What are the physical features of Down’s Syndrome?

A

Macroglossia
Class II occlusion
Hypodontia
Short neck

379
Q

Why are Down’s syndrome patients at increased Perio risk?

A

Immunocompromisation
Poor OH

380
Q

Why are Down’s syndrome patients at increased Perio risk?

A

Immunocompromisation
Poor OH

381
Q

What is the definition of NUG/NUP?

A

Painful ulceration and blunting of interdental papilla
Associated with grey/yellow necrotic slough

382
Q

What are the signs/symptoms of NUG/NUP?

A

Malodour/halitosis
Interproximal necrosis
Gingivitis
Pain, swelling, bleeding
Metallic taste
Bleeding

383
Q

What are the risk factors for NUG/NUP?

A

Poor OH
Immunocompromised
Stress
Smoking

384
Q

What is an abscess?

A

Localised collection of dead and dying neutrophils

385
Q

What are the signs/symptoms of a dental abscess?

A

TTP in lateral direction
Pain
Swelling
Redness
Pus drainage
Bleeding

386
Q

What are the types of abscess?

A

Gingival
Periodontal
Pericoronal
Periapical
Perio-endo

387
Q

What is atrial fibrillation (AF)?

A

Electrical impulses in atria fire irregularly and chaotically

388
Q

What are the symptoms of atrial fibrillation?

A

Irregular and fast heartbeat

389
Q

What are the risks associated with atrial fibrillation?

A

Risk of blood clot formation- stroke

390
Q

What are the three types of diabetes?

A

Type 1
Type 2
Gestational

391
Q

What are the associated side effects of diabetes?

A

Hypoglycaemic episodes
Increased periodontal disease risk
Xerostomia
Oral dysaesthesia (burning mouth syndrome)
Decreased wound healing
Increased infection risk
Parotid gland enlargement

392
Q

What is hypertension>

A

Increased blood pressure

393
Q

What are the risks associated with hypertension?

A

Heart attack
Stroke
Kidney failure
Sight problems
Vascular dementia

394
Q

What are the primary risk factors for hypertension?

A

Genetics
Black
Smoking
Lack of exercise
SIMD
Increased alcohol
Increased weight
Increased salt intake

395
Q

What are the secondary causes of hypertension?

A

Increased adrenal hormone
Kidney disease
Diabetes
Medications

396
Q

What is neurosis?

A

Contact with reality maintained

397
Q

What are two examples of neurosis?

A

Anxiety
Phobias

398
Q

What is psychosis?

A

Contact with reality lost

399
Q

What are examples of anxiety disorders?

A

Generalised Anxiety Disorder
Phobic Anxiety
Panic Disorders

400
Q

What is generalised anxiety disorder?

A

Free-floating anxiety in many/all situations

401
Q

What is phobic anxiety?

A

Intense anxiety/panic in specific situations

402
Q

What is panic anxiety?

A

Unpredictable extreme anxiety

403
Q

What is somatosomal disorder?

A

Repeated presentation of physical symptoms and persistent requests for medical investigations in spite of negative findings and reassurance that the symptoms have no physical basis

404
Q

What are psychological treatments for mental disorders?

A

Psycho-education
Anxiety management techniques
Cognitive behaviour therapy

405
Q

What are examples of anxiolytic drugs?

A

Alcohol
Benzodiazepines (diazepam, midazolam, temazepam)
Antidepressants (tricyclics, mirtazepione, SSRIs)

406
Q

What is the dental presentation of anxiety?

A

TMD and parafunction
Oral dysaethesia
Denture intolerance

407
Q

What are adjustment disorders?

A

Maladaptive responses to severe past or continuing stress/trauma

408
Q

How are adjustment disorders managed?

A

Psychological intervention

409
Q

What is the dental presentation of mood disorders?

A

Face pain
Dysaethesias

410
Q

What is the occurrence of mood disorders based on gender?

A

3F1M

411
Q

What are examples of depressive mood disorders?

A

Major depressive disorder
Persistent depressive disorder
Bipolar depression
Post-partum depression
Pre-menstrual dysphoria
Seasonal affective disorder
Atypical depression

412
Q

What are the symptoms of depression?

A

Low mood
Lethargy
Appetite disturbance
Loss of confidence/ self esteem
Unreasonable self reproach and guilt
Anxiety
Reduced interest/motivation
Sleep disturbance
Poor concentration
Recurrent thoughts of suicide

413
Q

What are the two types of bipolar?

A

Mania
Cyclothermia and Hypomania

414
Q

What are the symptoms of cyclomania and hypomania?

A

Increased productivity and feeling of wellbeing
Reduced need for sleep
Gradual reduction in social/occupational function
Increase in reckless behaviour, followed by period of depression

415
Q

How does an euphoric mood disorder present?

A

Upbeat
Talkative
Inflated self esteem
Feels that anything is possible

416
Q

How does a dysphoric mood disorder present?

A

Irritable
Agitated
Aggressive
Restless
Rage

417
Q

What are the treatment options for mood disorders?

A

Psychological: cognitive therapy, interpersonal psychotherapies
Physical: exercise, phototherapy, ect
Drugs: antidepressants, mood stabilising

418
Q

What are examples of acute phase antidepressants?

A

Selective Serotonin Reuptake Inhibitors (SSRIs)
Venalfaxine/Mirtazepine
Tricylic Antidepressants (TCA)
Monoamine Oxidase Inhibitor (MAOI)

419
Q

What are examples of mood stabilising drugs?

A

Lithium
Carbamazepine
Valproate
Lamotrigine

420
Q

What are uses of antidepressants?

A

Treating depression/anxiety
Pain relief
Helps psychological treatments

421
Q

What are examples of conditions with perceptual abnormalities?

A

Manic depression
Schizophrenia
Korsakoff’s Psychosis
Alcohol induced brain degeneration

422
Q

What is schizophrenia?

A

Fundamental and characteristic distortions of thinking and perception
Various types of delusions
Auditory hallucinations
Relapsing and remitting periods of acute psychosis

423
Q

What causes schizophrenia?

A

Multifactorial abnormality of dopaminergic neurotransmission

424
Q

What is schizophrenia associated with?

A

Genetic susceptibility
Environmental: perinatal risk factors
Drug abuse; cocaine, amphetamines, ecstasy, opiates

425
Q

What is the prevalence of schizophrenia?

A

1-2%

426
Q

How is schizophrenia managed?

A

Psychological therapy: CBT, cognitive remediation, family intervention
Drug therapy: dopamine antagonist drugs (extrapyramidal effects), atypical antipsychotics

427
Q

How are the extrapyramidal effects of antipsychotics treated?

A

Use an atypical antipsychotic
Beta-adrenergic blockers
Antichlolinergics

428
Q

What is borderline personality disorder?

A

Instability in interpersonal relationships, self image, marked impulsivity

429
Q

What is antisocial personality disorder?

A

Disregard for and violation of rights of others

430
Q

What is histrionic personality disorder?

A

Excessive emotionality and attention seeking

431
Q

What is narcissistic personality disorder?

A

Grandiosity, need for admiration, lack of empathy

432
Q

What is avoidant personality disorder?

A

Social inhibition, feelings of inadequacy, hypersensitivity to negative evaluations

433
Q

What is a dependent personality disorder?

A

Submissive and clinging behaviour

434
Q

What is shizoid personality disorder?

A

Detachment from social relationships and restricted range of emotional expression

435
Q

What is the presentation of necrotising stomatitis?

A

Bone denudation
Osteitis and bone sequestrum

436
Q

What is the management of orofacial granulomatosis?

A

Oral hygiene support
Symptomatic relief as per ulceration
Dietary exclusion
Topical steroids
Topical tacrolimus
Short courses of oral steroids
Intralesional corticosteriods
Surgical intervention

437
Q

What is the management of orofacial granulomatosis?

A

Oral hygiene support
Symptomatic relief as per ulceration
Dietary exclusion
Topical steroids
Topical tacrolimus
Short courses of oral steroids
Intralesional corticosteriods
Surgical intervention

438
Q

What is the treatment of necrotising periodontal disease?

A

Debridement and chlorhexidine mouthwash rinse 0.2% twice daily
If systemic effects use metronidazole 400mg

439
Q

What are the signs and symptoms of primary herpetic gingivostomatitis?

A

Fluid filled vesicles: rupture to painful, ragged ulcers on gingival, tongue, lips, buccal and palatal mucosa
Severe oedematous marginal gingivitis
Fever
Malaise
Headache
Cervical lymphadenopathy

440
Q

What is the NICE recommendation for patients with acute sinusitis that do not respond to first line treatments within 48 hours?

A

Referral to ENT specialist

441
Q

What factors increase the risk of complications from acute sinusitis?

A

People with pre-existing co-morbidites: cystic fibrosis, immunosuppression, significant heart, liver, lung or renal disease

People with acute cough >65 years with two of the following RF or >80 with one: hospitalisation in the previous year, type 1/2 diabetes, congestive heart failure, current use of oral corticosteroids

442
Q

What is the treatment for primary herpetic gingivostomatitis?

A

Bed rest
Hydration
Soft diet
Paracetamol
Antimicrobial gel or mouthwash
Topical acyclovir

443
Q

What can be done for osteoporosis prevention?

A

Exercise : to increase peak bone mass
Bisphosphonates

444
Q

What is gout?

A

Monoarthropathy affecting a single joint such as the big toe

445
Q

What is the cause of gout?

A

Deposit of uric acid crystaks

446
Q

How does gout present?

A

Pain
Swelling

447
Q

How does gout present?

A

Pain
Swelling

448
Q

What is osteoarthritis?

A

Swelling of joints

449
Q

What is osteoarthritis?

A

Swelling of joints

450
Q

What does rheumatoid arthritis affect?

A

Synovial joints

451
Q

How does rheumatoid arthritis present on the hands?

A

Z-thumb deformity
PIP joint extension
Ulnar deviation at MCP
Symmetrical synovitis of PIP, DIP and MCP

452
Q

What is z-thumb deformity?

A

Ulnar deviation of the fingers at MCP

453
Q

What is PIP joint extension?

A

Symmetrical synovitis affecting PIP, DIP, MCP

454
Q

What are the dental implications of rheumatoid arthritis?

A

Atlanto axial instability
Sjogrens syndrome

455
Q

What are the suprahyoid muscles?

A

Mylohyoid
Anterior belly of digastric
Stylohyoid
Geniohyoid

456
Q

What are the suprahyoid muscles?

A

Mylohyoid
Anterior belly of digastric
Stylohyoid
Geniohyoid

457
Q

How soon does an extradural haemorrhage present?

A

24 hours

458
Q

How soon does an extradural haemorrhage present?

A

24 hours

459
Q

What is affected by an extradural haemorrhage?

A

Pterion

460
Q

When does a subdural haemorrhage present?

A

A long time after injurt

461
Q

What vessels are affected by a subdural haemorrhage?

A

Cerebral veins

462
Q

When does a subarachnoid injury present?

A

Sudden loss of consciousness

463
Q

What vessel is affected by a subarachnoid haemorrhage?

A

Cerebral artery

464
Q

What is the Philadelphia chromosome?

A

9 and 22 translocation

465
Q

What is the Philadelphia chromosome associated with?

A

Chronic lymphoid leukeamia

466
Q

What type of virus is HIV?

A

RNA

467
Q

What is the role of matrix metalloproteins?

A

Inflammatory cells that cause breakdown of the ECM

468
Q

What type of virus is Hep B?

A

DNA

469
Q

What type of virus is Hep C?

A

RNA

470
Q

Where are erythrocytes produced?

A

Bone marrow

471
Q

What virus is associated with lymphoma?

A

Epstein barr viruse

472
Q

What are the causes of thrombophillia?

A

Genetic susceptibility
Protein S/C deficiency
Anti-thrombin III deficiency
Factor V leiden variant

473
Q

What is the normal Hb range for females?

A

120-265g/l

474
Q

What is the normal Hb range for males?

A

130-180g/l

475
Q

What is the normal platelet count?

A

150-450/L

476
Q

What is the normal RCC range for females?

A

3.8-5.8 x10^12/L

477
Q

What is the normal RCC range for males?

A

4.5-6.5x10^12/L

478
Q

What is the size of a microcytic blood cell?

A

<80fl

479
Q

What is the size of a normal blood cell?

A

80-100fl

480
Q

What is the size of a macrocytic blood cell?

A

> 100fl

481
Q

What do the alpha cells of the islet of langerhans produce?

A

Glucagon

482
Q

What do the beta cells of the islet of langerhans produce?

A

Insulin

483
Q

What do the delta cells of the islet of langerhans produce?

A

Somatostatin

484
Q

What do the PP cells of the islet of langerhans produce?

A

Pancreatic peptide

485
Q

What are the metastatic route of cancer?

A

Lymphatic
Haematogenous
Transcoelomic

486
Q

Where does prostate cancer usually metastasise to?

A

Bone via lymphatics

487
Q

What are the clinical classifications of cancer?

A

Benign
Malignant

488
Q

What are the histological classification of cancer?

A

Epithelial
Mesenchyme

489
Q

What are the features of benign tumours?

A

Slow rate of growth
Do not metastasise
Does not recur if removed
Does not impinge on surrounding structures
Tumour margins not well defined

490
Q

What are the features of malignant tumours?

A

Fast rate of growth
Invasive
Recur if removed
Can metastasize
Margins well defined

491
Q

What are two examples of benign tumours?

A

Chondroma: cartilage
Lipoma: fat

492
Q

What are two examples of malignant tumours?

A

Lymphoma
Carcinoma

493
Q

What are the effects of cystic fibrosis?

A

Diabetes (pancreatic enzymes decreased: decreased insulin)
Productive cough
Difficulty breathing
Failure to thrive

494
Q

What are the tests for cystic fibrosis?

A

Pre-natal (at risk/suspected)
Peri-natal (all babies at 5 days old)
Sweat test (increased salt concentration)
Genetic testing for CFTR mutation

495
Q

What is the gold standard test for cystic fibrosis?

A

Sweat test

496
Q

What are the features of Addisons crisis?

A

Hypotension
Vomiting
Eventual coma

497
Q

What is the role of TSH, T3 and T4 in primary hyperthyroidism?

A

Decreased TSH
Increased T3
Increased T4

498
Q

What is the role of TSH, T3 and T4 in secondary hyperthyroidism?

A

Increased TSH
Increased T3
Increased T4

499
Q

What are the symptoms of hyperthyroidism?

A

Excessive sweating
Heat intolerance
Palpatations
Diahorrea
Anxiety/irritability
Weight loss

500
Q

What is the role of TSH, T3 and T4 in primary hypothyroidism?

A

Increased TSH
Decreased T3
Decreased T4

501
Q

What is the role of TSH, T3 and T4 in secondary hypothyroidism?

A

Decreased TSH
Decreased T3
Decreased T4

502
Q

What are the symptoms of hypothyroidism?

A

Cold intolerance
Constipation
Fatigue
Weight gain

503
Q

What are possible causes of hypothyroidism?

A

Hashimotos thyroiditis
Non-functional pituitary tumour

504
Q

What is the proportion of small vs non-small cell lung cancers?

A

20% small cell lung cancer
80% non small cell lung cancer

505
Q

What are examples of non-small cell lung cancers?

A

Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma

506
Q

What is the cause of atherosclerosis?

A

Hyperlipademia
Chronic inflammation followed by healing response
Leads to the formation of atheroma

507
Q

What are the risk factors for atheroscelosis?

A

Age
Gender
Genes (familial hypercholestraemia)

508
Q

How are atheroma formed?

A

Chronic inflammation phase
Endothelial cells change surface cell receptors, increased lipid permeability
Increased cell adhesion

509
Q

What happens during the healing phase of atheroma?

A

Smooth muscle proliferation
Fibrous tissue formation
Plaque is formed- central mass of lipid and necrotic tissue

510
Q

What follows chronic endothelial cell injury?

A

Chronic endothelial cell injury
Increased permeability (lipid deposited)
Macrophages increase: foam cells, fatty streaks
Smooth muscle proliferation: macrophages activate T cells, increase in inflammatory cells
Fibrous tissue formation

511
Q

What are the effects of atherosclerosis?

A

Decreased blood supply
Occlusion leading to infarction
Thrombosis
Embolism

512
Q

What are examples of tumours of blood vessels?

A

Hamartomas
Kaposi sarcoma
Angiosarcoma

513
Q

What are examples of cardiac tumours?

A

Myoma
Angiosarcoma

514
Q

What is calcific aortic stenosis?

A

Calcium deposits as a result of chronic endothelial injury

515
Q

What are ascoff bodies?

A

Nodules of heart characteristic of rheumatoid issue

516
Q

What does SOCRATES stand for?

A

Site
Onset
Character
Radiation
Association
Time
Exacerbating
Severity

517
Q

What are the features of a medical history?

A

o Cardiovascular
o Respiratory
o Endocrinology
o Gastrointestinal
o Neurological
o Musculoskeletal
o Blood Disorders
o Other (p. surgery/hospital admissions, other med conditions)

518
Q

What medications are notable in a medical history?

A

Anticoagulants
Antiplatelets
Bisphosphates
Steroids within last 2 years

519
Q

What are the features of a medical history?

A

C/O
HPC
Pain history
Past medical history
Medications
Allergies
Past dental history
Social history
Family history

520
Q

What can decrease the INR?

A

Carbamazepine
Alcohol

521
Q

What can increase the INR?

A

Antibiotics
Alcohol (liver disease)
NSAIDS

522
Q

What are examples of complications with blood transfusions?

A

Incompatibility
Fluid overload
Infection transmission

523
Q

What is the definition of lymphoma?

A

Clonal proliferation of lymphocytes

524
Q

What is the clinical presentation of hodgekins lymphoma?

A

Lymphadenopathy (fluctuates with alcohol)
Fever
Night sweats
Itching

525
Q

What is the clinical presentation of non-hodgkins lymphoma?

A

Lymphadenopathy (widely disseminated)
Extra nodal disease
Symptoms of marrow failure

526
Q

What are the symptoms of lymphoma?

A

Fever
Face/neck swelling
Lump in neck/armpit
Excessive night sweats
Weight loss
Loss of appetite

527
Q

What is factors are associated with non-hodgekin lymphoma?

A

Microbial factors
Autoimmune disease
Immunosuppresion

528
Q

What is the peak age of Hodgkin lymphoma?

A

15-40 years

529
Q

What gender is most affected by Hodgkin lymphoma?

A

2M:1F

530
Q

What is the cure rate of hodgekin lymphoma?

A

Stage I&II: 90%
Stage III&IV: 50-70%

531
Q

What is the peak age of non hodgekin lymphoma?

A

Any age

532
Q

What proportion of non-hodgekin lymphoma is B vs T cell?

A

B cell: 85%
T cell: 15%

533
Q

What is the % relapse in non-hodgekin lymphoma?

A

> 50%

534
Q

What investigations can be carried out for suspected non-hodgekin lymphoma?

A

Physical exam
Biopsy
Blood tests
Scanning

535
Q

What is the treatment for non-hodgekin lymphoma?

A

Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

536
Q

What is leukaemia?

A

Group of cancers of the bone marrow which prevent normal manufacture of the blood

537
Q

What is the clinical presentation of leukaemia?

A

Anaemia
Neutropenia
Thrombocytopenia
Lymphadenopathy
Splenomegaly
Bone pain

538
Q

What are the symptoms of leukaemia?

A

Fever/chills
Persistent fatigue
Frequent infection
Weight loss
Swollen nodes

539
Q

What are the types of leukaemia?

A

Acute lymphoblastic leukaemia
Acute myeloid leukaemia
Chronic lymphocytic leukaemia
Chronic myeloid leukaemia

540
Q

What are the features of acute lymphoblastic leukaemia?

A

Peak age: 4 years
80% cured
Better prognosis in females

541
Q

What are the features of acute myeloid leukaemia?

A

More common in elderly
30-40% of under 60s cured
10% over 70s cured

542
Q

What are the features of chronic lymphocytic leukaemia?

A

Peak age 70
2M:1F
B cell clonal lymphoproliferative disease

543
Q

What are the features of chronic myeloid leukaemia?

A

Peak age 50-70 years
Increase in neutrophils and their precursors

544
Q

What is chronic myeloid leukaemia associated with?

A

Philadelphia chromosome

545
Q

What are the risk factors of leukaemia?

A

Previous cancer treatments
Genetic disorders
Smoking
Family history

546
Q

What are the investigations for leukaemia?

A

Blood tests
Bone marrow tests

547
Q

What are the treatments for leukaemia?

A

Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

548
Q

What is porphyria?

A

Abnormality of haem metabolism

549
Q

What is severe sepsis?

A

Sepsis and acute organ dysfunction

550
Q

What is the definition of septic shock?

A

Sepsis in which the underlying circulatory and cellular and/or metabolic abormalities are marked enough to substantially increase mortality

551
Q

What are the features of septic shock?

A

Persisting hypotension that requires vasopressors to maintain mean arterial pressure at >=65mmHg with a mean serum lactate concentration of >2mmol l-1

552
Q

What does qSOFA stand for?

A

Quick Score for Sepsis

553
Q

What are the components of qSOFA?

A

Respiratory; >= 22 breaths/ min
Altered Mentation; GCS <15
Systolic Blood Pressure; <=100mmHg

554
Q

What does the Glasgow Coma Score assess?

A

Eye opening
Verbal response
Motor response

555
Q

What is the immunopathogenicity of sepsis?

A

Innate Immunity
Complement System
Vascular Endothelium
Coagulation System
Adaptive Immunity

556
Q

What is peptic ulcer disease?

A

Ulcers affecting any acid affected site in the gastrointestinal tract due to gastric inflammation

557
Q

What are the causes of peptic ulcer disease?

A

High acid secretion (duodenal)
Normal acid secretion (stomach) but reduced protective barrier and high h.pylori involvement
Drugs: NSAIDs, steroids

558
Q

What is helicobactor pylori?

A

Bacterium associated with peptic ulcers

559
Q

What is the triple therapy for h.pylori?

A

2 antibiotics (amoxycillin and metronidazole)
Proton pump inhibitor (omeprazole)

560
Q

What is the treatment for peptic ulcers?

A

Lifestyle changes
Diet changes
Ulcer healing drugs
Surgical repair/endoscope which complications occur

561
Q

What is the presentation of peptic ulcers?

A

Epigastric burning pain: worse before/after food, at night

562
Q

What are the investigations for peptic ulcers?

A

Endoscopy
Radiology
FBC and FOB (anaemia)
Pylori testing: breath, antibiotics, mucosa

563
Q

What are complications associated with peptic ulcers?

A

Local: perforation, haemorrhage, stricture, malignancy
Systemic: anaemia

564
Q

What is coeliac disease?

A

Autoimmune disease in which exposure to gluten causes an autoimmune reaction leading to inflammation of the small bowel

565
Q

What is the allergy in coeliac disease?

A

Beta-gliaden

566
Q

What is polyphria?

A

Abnormality of Haem metabolism

567
Q

How does polyphria present?

A

Photosensitive rash
Hypertension
Tachycardia
Neuropsychiatric disturbances

568
Q

What happens during vasoconstriction (in haemostasis)

A

Damaged vessel –> Vascular spasm –> Vasoconstriction

569
Q

What are the steps of the formation of a platelet plug?

A

ECM releases cytokines and inflammatory markers –> Platelet adhesion –> Platelet plug formation

570
Q

What do platelets release?

A

ADP
Serotonin (maintains vasoconstriction)
Prostaglandins and phospholipids (maintains vasoconstriction)

571
Q

What is haemophilia?

A

Rare inherited condition that affects the body’s ability to form blood clots

572
Q

What are the clinical features of mild haemophilia?

A

Bleeding occurs after injury, surgery or extraction

573
Q

What are the clinical features of moderate haemophilia?

A

Bleeding into joints and muscles after minor injury or spontaneously

574
Q

What are the clinical features of severe haemophilia?

A

Spontaneous bleeding into joints and muscles

575
Q

What type of genetic predisposition is assoicated with haemophilia?

A

Sex linked recessive
Defective gene on X chromosome

576
Q

What clotting factor is deficient in haemophilia A?

A

8

577
Q

What clotting factor is deficient in haemophilia B?

A

9

578
Q

What are the investigations for haemophilia?

A

Blood test
Clotting screen
Genetic test

579
Q

What is the treatment of severe and moderate haemophilia A?

A

Recombinant factor VII

580
Q

What is the treatment of mild and carriers of haemophilia B?

A

DDVAP (desmopressin)
Transaxemic acid

581
Q

How common is haemophilia A?

A

1 in 10,000

582
Q

How common is haemophilia B?

A

1 in 50,000

583
Q

What is the treatment for haemophilia B?

A

Recombinant factor IX

584
Q

What dental treatments should be cautioned in patients with haemophilia?

A

LA: lingual infiltration, posterior superior alveolar nerve block, IDB
Extractions
Minor/Periodontal surgery
Biopsies

585
Q

What is Von Willebrand’s Disease?

A

Deficiency of Von Willebrand factor (which reduces factor 8 levels)

586
Q

What are the clinical features of VWD?

A

Large/easy bruises
Frequent nose bleeds
Bleeding gums
Heavy periods

587
Q

What is the genetic predisposition of VWD?

A

Autosomal dominant mutation

588
Q

What investigations can be carried out for VWD?

A

Blood test
Genetic tests

589
Q

What is the treatment for severe and moderate VWD?

A

DDAVP

590
Q

What is the treatment for mild and carriers of VWD?

A

Transaxemic acid

591
Q

What is thrombophilia?

A

Increased risk of blood clot development

592
Q

What are the causes of thrombophilia?

A

Inherited: protein S/C deficiency, antithrombin 3 deficiency, factor V Leiden variant
Acquired: cancer, pregnancy

593
Q

What is a potential treatment of thrombophilia?

A

Anti-thrombin

594
Q

What is thrombocytopenia?

A

Reduced platelets

595
Q

What are causes of thrombocytopenia?

A

Idiopathic
Drug related

596
Q

What is qualitative platelet disorders?

A

Normal platelet count but abnormal function

597
Q

What are the causes of qualitative platelet disorders?

A

Inherited: Bernard Soulier Syndrome, Hermansky Pudlak, Glanzmann’s Thrombasthenia

Acquired: cirrhosis, drugs, alcohol, cardiopulmonary bypass

598
Q

What are the investigations for qualitative platelet disorders

A

Blood test

599
Q

What are irreversible risk factors for CVDs?

A

Age
Sex
Family history

600
Q

What are reversible patient risk factors for CVDs?

A

Smoking
Obesity
Diet

601
Q

What are reversible medical risk factors for CVDs?

A

Hypertension
Hyperlipidaemia
Diabetes

602
Q

What are examples of primary preventions for CVDs?

A

Exercise
Diet
No smoking

603
Q

What are examples of secondary prevention for CVDs?

A

Medical treatment to reduce risk: control cholesterol, hypertension, antiplatelet drugs

604
Q

What are the 4 acute coronary syndromes?

A

Stable angina
Unstable angina
NSTEMI
STEMI

605
Q

What are the features of stable angina?

A

Pain due to increased demand due to atherosclerotic plaque
Demand ischaemia, no infarct
Normal ECG
Normal troponins

606
Q

What are the features of unstable angina?

A

Plaque ruptures, thrombus formation, partial occlusion of the vessel, pain at rest
Supply ischaemia, no infection
Normal, inverted T waves or ST depression (ECG)
Normal troponins

607
Q

What are the features of NSTEMI?

A

Plaque ruptures, thrombus formation, partial occlusion of vessel, subendocardial myocaridal infarction
Subendocardial infection
Normal, inverted T waves or ST depression (ECG)
Elevated troponins

608
Q

What are the features of STEMI?

A

Complete occlusion of blood vessel lumen, transmural injury and infarction to myocardium
Transmural infarct
Hyperacute T waves or ST elevation (ECG)
Elevated troponin

609
Q

What is cyanosis?

A

5g/dl or more deoxygenated Hb in blood

610
Q

What are the causes of central cyanosis?

A

Congenital heart disease

611
Q

What are the causes of peripheral cyanosis?

A

Cold environment

612
Q

What are the symptoms of ulcerative colitis?

A

Colonic disease (diarrhoea, abdominal pain, pr bleeding)

613
Q

What are the symptoms of ulcerative colitis?

A

Colonic disease (diarrhoea, abdominal pain, pr bleeding)

614
Q

What demographic factors are most affected by ulcerative colitis?

A

F>M
W>B

615
Q

How does ulcerative colitis present?

A

Continuous
Rectum always involved
Anal fissures 25%
Ilium involved 10%
Mucosa granular and ulcerated
Vascular
Serosa normal

616
Q

How does ulcerative colitis present microscopically?

A

Mucosal
Vascular
Mucosal abscesses

617
Q

What risk is associated with ulcerative colitis?

A

Carcinoma

618
Q

What investigations can be carried out to diagnose ulcerative colitis?

A

Blood tests (anaemia, C-reactive protein, erythrocyte sedimentation rate)
Faecal cal protein
Endoscopy
Leukocyte scan
Barium studies
Bullet endoscopy

619
Q

What investigations can be carried out for bowel bleeding/inflammation?

A

Biopsy
Faecal occult blood test (FOBT)
Colonoscopy

620
Q

What treatments are carried out for ulcerative colitis?

A

Immunosuppressants: systemic steroids (prednisolone), local steroids (rectally administered), anti-inflammatory drugs (5-ASA based; pentasa, mesalazine), non-steroid immunosuppressants (azathioprine), anti-TNF alpha therapy: infliximab, adalimumab

621
Q

What gender is most affected by crohns/ulcerative colitis?

A

Crohns: male
Ulcerative colitis: female

622
Q

What race is most affected by crohns and ulcerative colitis?

A

White

623
Q

What is the pattern of crohns and ulcerative colitis?

A

Crohns: discontinuous
Ulcerative colitis: continuous

624
Q

What % rectum involvement in crohns and ulcerative colitis?

A

50% crohns
100% UC

625
Q

What is the % of anal fissures in crohns and ulcerative colitis?

A

Crohns: 75%
UC: 25%

626
Q

What is the % ileum involvement in Crohns and UC?

A

Crohns: 30%
UC: 10%

627
Q

What is the mucosa in crohns and ulcerative colitis?

A

Crohns: cobbled
UC: granular

628
Q

What is the vascular role in crohns and ulcerative colitis?

A

Crohns: non-vascular
UC: vascular

629
Q

What is the serosa like in crohns vs ulcerative colitis?

A

Crohns: inflammation
Ulcerative colitis: normal

630
Q

What is the association between iron deficient anaemia and inflammatory bowel disease?

A

Due to inflammation and bleeding in intestines
Inflammation can affect RBC productions
Can affect iron absorption (irons/protein production affected)
Medications such as NSAIDs and corticosteroids can affect iron absorption

631
Q

Why can iron deficient ananemia lead to fatigue?

A

Lack of oxygen to tissues and organs

632
Q

What is dysphagia?

A

Difficulty swallowing

633
Q

What are the clinical features of dysphagia?

A

Food sticking

634
Q

What are the causes of dysphagia?

A

External compression (lungs, aorta, atrial enlargement, cervical spine)

Dysmotility disorders (fibrosis- scleroderma, acid related fibrosis)

Neuromusclar dysfunction (Parkinson’s, diabetes, achalasia)

635
Q

What are the clincial features of gastrointestinal reflux disease?

A

Epigastric burning (worse when lying down)
Dysphagia
GI bleeding
Severe pain

636
Q

What are the causes for GORD?

A

Defective lower oesophageal sphincter
Impaired lower cleaning
Impaired gastric emptying

637
Q

What is the treatment of GORD?

A

Smoking cessation
Weight loss
Antacids
H2 blockers
Proton pump inhibitors

638
Q

What are the clinical features peptic ulcer disease?

A

Asymptomatic
Epigastric burning pain before/after meals
Local complication: perforation, haemorrhage stricture
Systemic: anaemia

639
Q

What are the causes of peptic ulcer disease?

A

High acid secretion: duodenal

Normal acid: stomach (helicobacter pylori involvement)

Drugs: NSAIDs

640
Q

What are the causes of peptic ulcer disease?

A

High acid secretion: duodenal

Normal acid: stomach (helicobacter pylori involvement)

Drugs: NSAIDs

641
Q

What are the investigations for peptic ulcer disease?

A

Endoscopy
Radiology
Anaemia symptoms: fbc, fob, h.pylori (breath, antibodies, mucosa)

642
Q

What are the medical treatments options for peptic ulcer disease?

A

Smoking cessation
Small regular meals
Ulcer healing drugs
Eradication therapy

643
Q

What are the surgical treatments for peptic ulcer disease?

A

Endoscope
Surgical repair
Vagotomy

644
Q

What is bilroth 1?

A

Lower stomach removed
Duodenum attached to top stomach

645
Q

What is bilroth 2?

A

Lower stomach removed
Duodenum stitched up
Top stomach attached to small bowel

646
Q

What is jaundice?

A

Accumulation of bilirubin in the skin

647
Q

What are the clinical features of jaundice?

A

Yellow/orange pigmentation in skin and sclera of eye
Conjugated bilirubin excreted in urine and faeces

648
Q

What are the causes of pre-hepatic jaundice?

A

Increased harm load (autoimmune, spleen, abnormal RBCs)
Excessive quantities of rbc breakdown products

649
Q

What are the post-hepatic causes of jaundice?

A

Liver cell failure (cirrhosis, hepatitis)
Prevents metabolism of rbc breakdown products

650
Q

What are the post-hepatic causes of jaundice?

A

Liver cell failure (cirrhosis, hepatitis)
Prevents metabolism of rbc breakdown products

651
Q

What are the post-hepatic causes of jaundice?

A

Biliary, gall bladder and pancreatic disease
Obstruction to bile outflow
Gallstones can block biliary tree, cause inflammation and move out to biliary tree, causing pain in shoulder tip, RHS of abdomen (fatty foods)

652
Q

What are the neonatal causes of jaundice?

A

Blood infection, difficult birth, hypoxia, abo and rhesus incompatibility
Poor liver function in neonate
Risk of kernicterus

653
Q

What are the investigations for jaundice?

A

Ultrasound (detect dilated bile channels)
Plain radiographs (show gall stones)
Endoscopic Retrograde Cholangio Pancreatography (contrast radiograph of biliary tree)

654
Q

What is the treatment of pre-hepatic jaundice?

A

Identify and treat cause

655
Q

What is the treatment of post hepatic jaundice?

A

Remove obstruction (biliary tree stent)

656
Q

What is the treatment of neonatal jaundice?

A

Phototherapy

657
Q

What is the management of jaundice?

A

Remove gall bladder (cholescystectomy)
Prevent build up of bile acid (urodeoxycholic acid, low cal/cholesterol diet)
Prevent bile acid resorption for git (colestyramine)

658
Q

What is the definition of liver failure?

A

Loss of liver function

659
Q

What are the clinical features liver failure?

A

Loss of synthetic function: plasma proteins, clotting factors
Loss of metabolic function: drug metabolism (affects first pass), detoxication, conjugation of rbc products

660
Q

What are the effects of liver failure?

A

Fluid retention
Raised INR
Portal hypertension
Inability to remove toxins (causes encelopathy)
Jaundice

661
Q

What are the causes of acute liver failure?

A

Paracetamol poisoning
Rapid death due to bleeding
Encephalopathy (brain damage)

662
Q

What are the causes of chronic liver failure?

A

Cirrhosis
Primary/secondary liver cancer

663
Q

What are the investigations for liver failure?

A

Hepatic cell enzyme levels (alt, ggt (increase in liver inflammation)
INR levels

664
Q

What is the treatment of acute liver failure?

A

Liver transplant

665
Q

What is MARS?

A

Molecular Adsorbent Recirculaitng System (MARS)

666
Q

What are the dental implications of liver failure?

A

Prolonged effect of sedatives
Drug doses may need to be reduced
NSAIDs increase bleeding risk
Reduced blood clotting

667
Q

What is cirrhosis?

A

Mixture of damage, fibrosis and regeneration of liver structure

668
Q

What are the clinical features of cirrhosis?

A

Often none
Acute bleeding (portal hypertension)
Jaundice
Oedema
Ascites (abdominal fluid)
Encelopathy
Spider naevi
Palmar erythema

669
Q

What are the causes of cirrhosis?

A

Alcohol
Primary biliary cirrhosis
Viral disease
Autoimmune chronic hepatitis
Cystic fibrosis
Haemachromatosis

670
Q

What are the investigations for cirrhosis?

A

Blood tests
Scans
Liver biopsy

671
Q

What hormones does the anterior pituitary gland produce?

A

Thyroid stimulating hormone (TSH)
Adrenocorticotrophic hormone (ACTH)
Growth hormone (GH)
Lutenising hormone (LH)
Follicle stimulating hormone (FSH)
Prolactin

672
Q

What is the pathway of production of thyroid stimulating hormone?

A

Hypothalamus
Thyroid releasing hormone (TRH)
Anterior pituitary
TSH
Thyroid gland
T3/4
Target tissue
(Negative feedback control)

673
Q

What is the pathway of adrenocorticotropic hormone (ACTH)?

A

Hypothalamus
Corticotropin releasing hormone (CRH)
Anterior pituitary
ACTH
Adrenal cortex
Cortisol/Aldosterone/Androgens
Target tissue

674
Q

What is the pathway of growth hormone?

A

Hypothalamus
Growth hormone releasing hormone- somatostain reduction
Anterior pituitary
Growth hormone
Liver and target tissues
Insulin like growth hormone

675
Q

What is the pathway for LH and FSH?

A

Hypothalamus
Gonadotropin-releasing hormone
Anterior pituitary
LH, FSH
Gonads
Sex hormone release

676
Q

What hormones are produced by the posterior pituary gland?

A

Antidiuretic hormone
Oxytocin

677
Q

What is the pathway of antidiuretic release?

A

Hypothalamus
Posterior pituitary
ADH
Kidney

678
Q

What are the parts of the adrenal gland?

A

Zona glomerulosa (cortex)
Zona fascularis
Zona reticular is

679
Q

What are the parts of the adrenal gland?

A

Zona glomerulosa (cortex)
Zona fascularis
Zona reticularis (medulla)

680
Q

What does zona glomerulosa produce?

A

Aldosterone

681
Q

What is aldosterone responsible for?

A

Salt and water retention (inc na+ resorption and k+ loss)
Inhibited by ACE inhibitors and AT2 blockers

682
Q

What does zona fasularis produce?

A

Cortisol

683
Q

What is cortisol?

A

Natural glucocorticoid
Physiological steroid effects- antagonist to glucose, lowers immune reaction, raises bp, inhibits bone synthesis

684
Q

What is the zona reticularis responsible for?

A

Adrenal androgens

685
Q

What is the effect of pituitary hypofunction due to pituitary failure?

A

Low ACTH
Low cortisol
Increased synACTHen

686
Q

What is the effect of adrenal hypofunction due to gland destruction?

A

High ACTH
Low cortisol
Decreased synACTHen

687
Q

What is the 5YS of thyroid cancer in young?

A

5%

688
Q

What is the 5YS of thyroid cancer in older people?

A

80%

689
Q

What is the definition of acromegaly?

A

Excess growth hormone

690
Q

What are the clinical features of acromegaly?

A

30-50 years
Coarse features
Enlarged hands and mandible
T2D
CVD (ischaemic heart disease, acromegaly cardiomyopathy)
Enlarged supra-orbital ridges
Broad nose
Thickened lips and soft tissues

691
Q

What are the causes of acromegaly?

A

Associated with MEN1
Increased GH after bone plate fusion
Pituitary adenoma

692
Q

What are the investigations for acromegaly?

A

Blood tests for growth hormone

693
Q

What are the treatments for acromegaly?

A

GH production reduction (drugs)
Surgical removal of tumour

694
Q

What are the dental aspects of acromegaly?

A

Enlarged tongue
Interdental spacing
Reverse over bite
Shrunk dentures

695
Q

What is addisons disease?

A

Primary adrenal hypofunction
Affects cortisol

696
Q

What are the symptoms of addisons disease?

A

Weakness
Anorexia
Body hair loss

697
Q

What are the signs of addisons disease?

A

Postural hypertension
Vitiligo
Hyperpigmentation (more common in primary)
Weightloss
Lethargy

698
Q

How does Addisons disease present?

A

Hypotension
Vomiting
Eventual coma

699
Q

What are the causes of Addisons disease?

A

Tb association
Autoimmune adrenalitis (organ specific autoimmune disease)

700
Q

What would the investigation results for Addisons disease be like?

A

High ACTH
Negative synACTHen test (no plasma cortisol rise in response to ACTH injection)

701
Q

What is the treatment of Addisons disease?

A

Hormone replacement (fludrocortisone)

702
Q

What are the dental aspects of Addisons disease?

A

Steroid precautions- may need increased dose for dental treatment due to stress to prevent adrenal crisis

Oral pigmentation

703
Q

What are the two types of corticosteroids?

A

Mineralcorticosteroids
Glucocorticosteroids
Inhaled

704
Q

What do mineralcorticosteroids do?

A

Regulate salt and water balance (aldosterone)

705
Q

What is an example of mineralcorticosteroids?

A

Fludrocortisone

706
Q

What do glucocorticosteroids do?

A

Reduce inflammation and suppress immune system (cortisol)

707
Q

What are examples of glucocorticosteroids?

A

Prednisone
Dexamethasone
Hydrocortisone

708
Q

What are examples of glucocorticosteroids?

A

Prednisone
Dexamethasone
Hydrocortisone

709
Q

What do inhaled corticosteroids do?

A

Treat respiratory conditions

710
Q

What are examples of inhaled corticosteroids?

A

Fluticasone
Budesonide

711
Q

What is the definition of Cushing syndrome?

A

Adrenal gland hyper function (cortisol)

712
Q

What are the symptoms of Cushing syndrome?

A

Poor infection resistance
Osteoporotic changes (back pain, bone fractures)
Psychiatric disorders (depression, emotional lability, psychosis)
Hirsuitism (female hair growth)
Skin and mucosal pigmentation (due to similarities between ACTH and melanostimulating hormone)

713
Q

What are the signs of Cushing syndrome?

A

Centripetal obesity (moon face, buffalo hump)
Hypertension
Thick skin
Púrpura
Muscle weakness

714
Q

What is the cause of primary Cushings?

A

Adrenal tumour

715
Q

What is the cause of secondary cushings?

A

Pituitary tumour

716
Q

What are the investigations for cushings?

A

High 24 hour urinary cortisol excretion
Abnormal dexamethasone suppression tests
CRH tests

717
Q

What is the treatment for Cushings disease?

A

Detect cause
Surgery (pituitary or adrenal)

718
Q

What are the dental aspects of cushings?

A

Candidiasis
Oral pigmentation

719
Q

What is conns syndrome?

A

Adrenal hyperfunction (aldosterone)

720
Q

What are the clinical features of conn’s syndrome?

A

Excessive thirst
Fatigue
Frequent urination
Headache

721
Q

What are the causes of conn’s syndrome?

A

Tumours of the adrenal gland
Low blood potassium
High blood pressure

722
Q

What are the investigations for conn’s syndrome?

A

Aldosterone levels in blood

723
Q

What is the treatment for Conn’s syndrome?

A

Drugs that block aldosterone
Exercise
Alcohol reduction
Stop smoking

724
Q

What is hyperthyroidism?

A

Increased thyroid production

725
Q

What are the symptoms of hyperthyroidism?

A

Hot and excess sweating
Weight loss
Diarrhoea
Palpitations
Muscle weakness
Irritable
Manic
Anxious

726
Q

What are the signs of hyperthyroidism?

A

Warm
Moist skin
Tachycardia
Atrial fibrillation
Increased blood pressure
Heart failure
Tremor
Palpitations
Eye retraction
Lid lag

727
Q

What is the cause of hyperthyroidism?

A

Graves’ disease (70-80%),, proptosis of eye
Toxic multinodular goitre, toxic adenoma, pituitary tumour
Family history of autoimmune disease

728
Q

What are the investigations for hyperthyroidism?

A

Blood tests for TSH, T3, T4,
Ultrasound/radioisotope imaging
Fine needle aspirate/biopsy

729
Q

How would pituitary cause hyperthyroidism present in investigations?

A

High TSH
High T3

730
Q

How would graves/adenoma caused hyperthyroidism present in investigations?

A

Low TSH
High T3

731
Q

What is the treatment of hyperthyroidism?

A

Carbimazole
Beta blockers
Radioiodine-1311
Partial thyroidectomy

732
Q

What are the dental aspects of hyperthyroidism?

A

Pain anxiety
Psychiatric problems
May have to postpone treatment

733
Q

What is hypothyroidism?

A

Decreased thyroid hormone production

734
Q

What are the symptoms of hypothyroidism?

A

Tired
Cold intolerance
Weight gain
Constipation
Hoarse voice
Goitre
Puffed face and extremities
Angina
‘Slow’
Poor memory
Hair loss

735
Q

What are the causes of primary hypothyroidism?

A

Autoimmune thyroiditis (hashimotos) (90%)
Idiopathic atrophy
Radioiodone treatment
Thyroidectomy
Carbimazole
Iodine deficiency
Congenital

736
Q

What does hashimotos present as and who is mainly affected?

A

Goitre and hypothyroidism features
Middle aged and elderly women

737
Q

Who does idiopathic atrophy affect and what is its cause?

A

Increases with age
10F:1M
Autoimmune cause

738
Q

What are the causes of secondary hypothyroidism?

A

Hypothalamic/pituitary disease

739
Q

What are the investigations for hypothyroidism?

A

Blood tests for TSH, T3, T4
Ultrasound/radioisotope imaging
Fine needle aspirate/biopsy

740
Q

How may pituitary cause hypothyroidism present in investigations?

A

Low TSH, Low T4
(Rare)

741
Q

How may gland failure hypothyroidism present?

A

High TSH, Low T4

742
Q

What is the treatment of hypothyroidism?

A

T4 tablets (thyroxine)

743
Q

What are the dental aspects of hypothyroidism?

A

Avoid sedative use

744
Q

What is the definition of multiple endocrine neoplasia?

A

Disorders of the endocrine system that increase an individuals likelihood of developing endocrine tumours

745
Q

What are the clinical feature of MEN1?

A

Tumours of parathyroid, pituitaty, pancreas and adrenal

746
Q

What are the clincial features of MEN2a?

A

Medullary thyroid cancer (young adult)
Pheochromocytoma (adrenal)
Hyperparathyroidism
Cutaneous lichen amyloidosis (itchy skin)

747
Q

What are the clinical features of MEN 2b?

A

Medulary thyroid cancer (early childhood)
Pheochromocytomas
Tall, slender
Benign tumours on lips and tongue
Eyelid and lip thickening
Spine curvature

748
Q

What is the cause of MEN1?

A

Mutation of MEN1 TSG

749
Q

What is the cause of MEN2?

A

Mutation of RET gene

750
Q

What is the definition of T1DM?

A

Inability to produce insulin

751
Q

How does T1DM present?

A

Increased thirst and urination
Fatigue
Weightloss

752
Q

How does T1DM present in young?

A

Keroacidosis

753
Q

What are acute complications of T1DM?

A

Hypoglycaemia

754
Q

What are chronic complications of T1DM?

A

Cardiovascular
Infection
Neuropathy (weakness and wasting of muscles, bladder/bowel dysfunction)

755
Q

What are large vessel complications of T1DM?

A

Atheroma

756
Q

What are small vessel complications of T1DM?

A

Poor wound healing
Wound infections
Renal disease
Eye disease (cataract, diabetic retinopathy)

757
Q

What are the causes of T1DM?

A

Autoimmune reaction to pancreatic beta cells
Familial

758
Q

What are the investigations for T1DM?

A

Blood test
Glucose toleraance test
Random plasma glucose

759
Q

What are the diagnostic results on a blood test for T1DM?

A

HbA1c >48mmol/mol

760
Q

What are the diagnostic results of a glucose tolerance test for diabetes?

A

Before test (fasting plasma glucose) (mmol/L)
<6.1 normal
6.1-7.0 impaired
>7.0 diabetes

2 hours after load (75g)
<7.8 normal
7.8-11.1 impaired
>11.1 diabetes

761
Q

What are the diagnostic results of a glucose tolerance test for diabetes?

A

Before test (fasting plasma glucose) (mmol/L)
<6.1 normal
6.1-7.0 impaired
>7.0 diabetes

762
Q

What is the diagnostic result for random plasma glucose test?

A

> 11.1 mmol/l on two occasions

763
Q

What are the targets of T1DM treatment?

A

Preprandial (before meals): 4-6mmol/L
Bedtime: 6-8mmol/L

764
Q

What is the treatment of T1DM?

A

Insulin injections
Glucose monitoring

765
Q

What are two examples of insulin regimes?

A

Basal bolus
Split mixed

766
Q

What is the difference between basal bolus and split mixed insulin regime?

A

Basal bolus: more injections, better control
Split mixed: fewer injections, poorer control

767
Q

What is the difference between basal bolus and split mixed insulin regime?

A

Basal bolus: more injections, better control
Split mixed: fewer injections, poorer control

768
Q

What is the dental relevance of T1DM?

A

Effect of hypoglycaemia
Managing diabetic complications

769
Q

What is T2DM?

A

Insulin resistance

770
Q

What are the clinical features of T2DM?

A

Increased thirst and urination
Fatigue

771
Q

What are the acute complications of T2DM?

A

Hypoglycaemia

772
Q

What are the chronic complications of T2DM?

A

Cardiovascular disease
Infection
Neuropathy (weakness and wasting of muscles,
Bladder/bowel complications

773
Q

What are the large vessel complications of T2DM?

A

Atheroma

774
Q

What are the small vessel complications of T2DM?

A

Poor wound healing
Wound infections
Renal disease
Eye disease (cataract, diabetic retinopathy)

775
Q

What are the causes of T2DM?

A

Obesity
High sugar diet
Lack of exercise
Familial

776
Q

What are the medical treatments for T2DM?

A

Metformin
DDP-4 inhibitors
GLP-1 mimentics
Sulphonylureas

777
Q

What is the patient focused treatment of T2DM?

A

Lifestyle changes: exercise, diet
Patient education
Plasma glucose monitoring
Gastric band

778
Q

What is atherosclerosis?

A

Narrowing of large blood vessels

779
Q

What are the modificable risk factors for atherosclerosis?

A

Hyperlipidaemia
Smoking
Obesity
Lack of exercise
Diet

780
Q

What are the non-modifiable risk factors for atherosclerosis?

A

Increased age
M>F
Genes (familial hypercholesterolaemia, mutation of LDL receptor)

781
Q

What are the non-modifiable risk factors for atherosclerosis?

A

Increased age
M>F
Genes (familial hypercholesterolaemia, mutation of LDL receptor)

782
Q

What is arteriosclerosis?

A

Age related changes in small blood vessels

783
Q

What are the stages of Atheroma formation?

A

Cholesterol deposition in blood vessel walls
Chronic inflammatory response
Healing response
Atheroma formation

784
Q

What happens during the chronic inflammatory response phase?

A

Endothelial cells change cell receptor
Increased permeability to lipids, cell adhesion changes to allow monocyte attachment

785
Q

What happens during the chronic inflammatory response phase?

A

Endothelial cells change cell receptor
Increased permeability to lipids, cell adhesion changes to allow monocyte attachment

Finals (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions