ENDO/RENAL/MSK MIX 6.6.23 Flashcards
What are the two potential heart complications of Ehlers Danlos?
Mitral valve prolapse
Aortic regurgitation
What is ehlers danlos
Genetically inherited
Occurs due to defect in synthesis of collagen => hyperextensibility of skin , recurrent joint problems , repeat dislocations
What type of haemorrhage is associated with ehlers danlos
Subarachnoid haemorrhage
What are berry aneurysms
Precursor to a subarachnoid haemorrhage
What are the two acute complications that must be monitored doses in toxic epidermal necrolysis
Fluid loss and electrolyte derangement
What are all acute complications of toxic epidermal necrolysis
Volume loss
Electrolyte derangement
Hypothermia
Secondary infection
What are the known drugs that cause TEN
Allopurinol
Phenytoin
Sulphonamides
Penicillins
Carbamazepine
NSAIDs
What is first line for TEN is now commonly used
IV immunoglobulins
What muscle of forearm inserts/attaches into radial tuberosity
Biceps brachii
What innervates the trapezius
Spinal accessory
Injury to the spinal accessory nerve affects which movement
Upward rotation of the scapula
What complication of acute severe hyponatraemia causes severe headaches, nausea, vomiting and confusion
Cerebral oedema
Low sodium level disturbs the body’s osmotic balance - acute means that the brain does not have enough time to adjust
As a result water shifts rapidly from the extracellular space into brain cells due to osmotic gradient
Start of what drug can sometimes cause SIADH
SSRI prescription
What mode of inheritance is familial hyper cholesterol anemia
Autosomal dominant
How to assess endogenous insulin production
C-peptide
(Secreted in proportion to insulin and is a marker of endogenous insulin production)
What would histology show for IgA nephropathy
Mesangial hypercellularity with positive immunofluorescence for IgA and C 3
What would show on histology for post-strep glomerulonephritis
Endothelial proliferation with neutrophils with ‘starry sky’ appearance on immunofluorescence
Minimal change histology
Fusion of podocytes and effacement of foot processes
Histology of anti-GBM
Linear IgG deposits along basement membrane
Histology for acute interstitial nephritis
Marked interstitial oedema and interstitial infiltrate in the connective tissue between renal tubules
Management of IgA nephropathy if there is isolated haematuria , no or minimal proteinuria (less than 500-1000) and a normal eGFR
No treatment needed - just follow up renal functions
Management of IgA nephropathy with persistent proteinuria (above 500-1000d) with slightly reduced eGFR
ACEi
Management of IgA nephropathy with active disease (falling eGFR) or failure to respond to ACEi
Immunosuppression with corticosteroids
Best long term management for osteoarthritis
Regular low impact aerobic exercises and muscles strengthening
*old man with bone pain and isolated raised ALP
Paget’s disease of bone
*commonest cause of lateral knee pain in keen runners
Iliotibial band syndrome
Should synovial fluid sampling be taken before or after starting antibiotics for someone with suspected septic arthritis
NICE suggest sampling before giving antibiotics
*twisting sports injury followed by delayed onset of knee swelling and locking
Meniscus tear
What is the treatment for a torn meniscus
Arthroscopic menisectomy
*tibia lying back on femur injury
PCL rupture
Can be drawn forward during a paradoxical drawer test
What is the classification system for tibial plateau fractures
Schatzker classification
Why wouldn’t doctors use colchicine in a gout flare up
Diarrhoea
Mutation in what protein is responsible for Marfans
Fibrillin
What would blood tests show for someone with osteoporosis
Normal ALP
Normal calcium
Normal phosphate
Normal PTH
What would blood tests show for osteomalacia
Raised ALP
Raised PTH
Decreased calcium and phosphate
Why is PTH raised in osteomalacia
In an attempt to raise calcium stores for bone mineralisation
Osteomalacia is characterised by impaired mineralisation of bone due to vit D deficiency / liver disease
X-ray findings of AS
Subchondral erosions
Sclerosis
Squaring of lumbar vertebrae
What is the main neurovascular structure that is compromised in a scaphoid fracture
Dorsal carpal arch of the radial artery
What is the best investigation to confirm AS
Pelvic x-ray
(More so than HLAB27 etc)
Common complication of someone with RA
IHD
Which nerve is commonly injured in a posterior hip dislocation
Sciatic nerve
*ped planus, pectus excavatum
Marfans
*fever / back pain with pain on extension of hip
Iliopsoas abscess
