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Family Medicine > Extras > Flashcards

Extras Flashcards

1
Q

What are auer rods associated with?

A

AML

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2
Q

What is the philadelphia chromosome associated with?

A

CML

9:22

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3
Q

What are smudge cells associated with?

A

CLL

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4
Q

Describe primary + secondary causes of hyperaldosteronism

A 
Primary = idiopathic, Conn's (adenoma), familial 
Secondary = chronic low BP (due to HF or cirrhosis)
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5
Q

Describe mechanism of hyperaldosteronism

A

Increased RAS system
Hypokalaemia (constipation)
Hypernatraemia
High BP (flushing, headaches)

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6
Q

Describe the causes of hypoaldosteronism

A

Addisons, congenital adrenal hyperplasia, pituitary disease

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7
Q

Describe mechanism of hypoaldosteronism

A

Hyperkalaemia
Hyponatraemia (salt cravings, N/V, dizziness)
Causes a metabolic acidosis type 4

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8
Q

Describe mechanism of Addisons

A

Reduced aldosterone, cortisol + androgens

Low cortisol causes fatigue + hyperpigmentation

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9
Q

S+S of Addisons

A

Hyperpigmented skin
Back/ leg/ abdo pain
N/V/D
Low BP

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10
Q

Dx for Addisons

A

ACTH stimulation test (short synacthen test)

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11
Q

Causes of Addisons

A

Autoimmune, mets, TB

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12
Q

What is Waterhouse Friderichsen syndrome?

A

Sudden increase in BP causes adrenal vessels to rupture

leads to tissue ischaemia and adrenal gland failure

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13
Q

Describe mechanism of congenital adrenal hyperplasia

A

Autosomal recessive
Low cortisol so increased ACTH
Due to deficiency in 21-hydroxylase
Causes low steroids + high androgens

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14
Q

S+S of congenital adrenal hyperplasia

A

Females = enlarged clit
Males (classic) = no signs at birth, presents at 2-4 y/o
Males (salt losing) = vomiting + weight loss at 7-14 days due to deficiency in aldosterone

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15
Q

Dx for congenital adrenal hyperplasia

A

increased 17-hydroxyprogesterone

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16
Q

Tx of congenital adrenal hyperplasia

A

Steroids

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17
Q

Mechanism of acromegaly

A

Excess GH

Usually due to pituitary adenoma, pancreatic cancer or lung cancer (cancers that release GHRH or GH)

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18
Q

S+S of acromegaly

A 
SOL = headache 
Pituitary adenoma causing bitemporal hemianopia 
Frontal bossing 
Macroglossia 
Large hands + feet 
HTN 
T2DM
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19
Q

Tx of acromegaly

A

Surgery
Pigvisomant
Orcgotide
Bromocriptine

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20
Q

Mechanism of phaechromocytoma

A

catecholamine (adrenaline) producing tumor of adrenal medulla

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21
Q

What conditions are associated with phaechromocytoma?

A

NF, von-Hippel Lindau, MEN 2a + 2b

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22
Q

S+S of phaechromocytoma

A

Headache, flushing, palpitations, HTN, panic

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23
Q

Dx of phaechromocytoma

A

Increased serum/ urine metanephrines

24
Q

Tx of phaechromocytoma

A 
Alpha blockers (phenoxybenzamine) then BB 
Surgery
25
Q

Mechanism of refeeding syndrome

A

Hypophasphataemia

Phosphate directly linked to calcium levels

26
Q

What is carvallo’s sign?

A

Murmur louder on inspiration = mitral or tricuspid regurg

27
Q

When do you hear a mid systolic click?

A

mitral valve prolapse

28
Q

What murmur do you hear with HOCM?

A

Crescendo decrescendo systolic murmur

Squatting = less intense, valsalva = more intense

29
Q

What murmur do you hear with VSD?

A

Holosystolic murmur at left sternal border

30
Q

What is Brugada syndrome?

A

Auto dominant
Faulty sodium ion channel
Causes ST elevation, RBBB, re-entrant loops + VT/VF

31
Q

Mechanism of kallman syndrome

A

Decrease in sex hormones causing failure to start puberty
Defect in neurons from olfactory placode = loss of sense of smell, low GNRH so low LH + FSH, low testosterone, progesterone + estrogen

32
Q

Mechanism of androgen insensitivity syndrome

A

XY doesn’t respond to androgens so looks female
X linked inheritance
Undescended testes but female characteristics

33
Q

Mechanism of 5a reductase deficiency

A

Autosomal recessive, only XY
Internally male but externally female or male
At puberty, increase in testosterone causes penile enlargement

34
Q

Dx of 5a reductase deficiency

A

Karyotype, normal testosterone, low dihydrotestosterone

35
Q

Tx of 5a reductase deficiency

A

Sex hormones

36
Q

Mechanism of SIADH

A

Increased ADH leads to increased water retention, diluting sodium
This reduces aldosterone which further reduces sodium
Increases urine osmolarity + decreased serum sodium

37
Q

S+S of SIADH

A

Muscle cramps + tremor
Headaches
Nausea
Confusion + mood swings

38
Q

Causes of SIADH

A

CNS = stroke, bleeds, trauma
Meds = lithium, anti-epileptics
Tumours - SCC, lung
Pneumonia

39
Q

Tx of SIADH

A

Fluid restrict, high salt, protein, NaCl

40
Q

Mechanism of diabetes insipidus

A

Kidneys absorb too little water, producing too much urine
Central DI = reduced ADH from hypothalamus/ pituitary
Nephrogenic DI = kidneys unresponsive to ADH (due to lithium, PKD)

41
Q

Dx of diabetes insipidus

A 
Increased serum osmolality 
Water deprivation test - urine osmolarity stays reducde 
Give desmopressin 
If urine osmolarity rises = CENTRAL DI 
If not, NEPHRO
42
Q

Tx of diabetes insipidus

A

Desmopressin for central

Thiazide diuretics for nephrogenic

43
Q

Hormones produced in anterior pituitary

A 
GH
ACTH 
Prolactin 
TSH
LH 
FSH
44
Q

Describe prolactinoma

A

Most common adenoma
Causes amenorrhea + galactorrhea
Low libido + gynaecomastia

45
Q

Describe an adenoma of somatotropes

A

Produces GH
Causes gigantism in kids + acromegaly in adults
Can lead to heart failure

46
Q

Describe ACTH secreting tumor

A

Increased ACTH so increased cortisol

Causes cushings disease - moon face, buffalo hump + truncal obesity

47
Q

Tx of pituitary adenoma

A

Transphenoidal surgical resection

48
Q

Dx of pituitary adenoma

A

Hormone levels + MRI

49
Q

Hormones produced by posterior pituitary

A

ADH, oxytocin

50
Q

Causes of hypopituitarism

A

Compression by adenoma or craniopharyngoma
Apoplexy (bleeding or infarction) - due to adenoma or Sheehans
Radiation or surgery

51
Q

Dx of hypopituitarism

A

Baseline hormones in AM
ACTH + GH through the day
Stimulation with insulin

52
Q

Causes of hyperparathyroidism

A

Primary = pituitary adenoma
Secondary due to kidney damage
Tertiary due to chronic secondary

53
Q

Describe levels of Ca, PO4 + Vit D in primary, secondary + tertiary hypercalcaemia

A 
1 = high Ca, high PO4 
2 = low Ca, high PO4, low Vit D 
3 = high Ca + CKD
54
Q

Causes of hypoparathyroidism

A

Damage during surgery
MEN 1
Di George syndrome

55
Q

S+S of hypocalcaemia/ hyperphosphatemia

A 
Tetany
Paraesthesia 
Calcification of basal ganglia or eyes 
Changes in cardiac output 
Chvostek's sign = tapping facial nerve 
Trousseua's sign = BP cuff causes carpopedal spasm

Family Medicine (10 decks)

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