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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
Mechanism of refeeding syndrome
Hypophasphataemia | Phosphate directly linked to calcium levels
26
What is carvallo's sign?
Murmur louder on inspiration = mitral or tricuspid regurg
27
When do you hear a mid systolic click?
mitral valve prolapse
28
What murmur do you hear with HOCM?
Crescendo decrescendo systolic murmur | Squatting = less intense, valsalva = more intense
29
What murmur do you hear with VSD?
Holosystolic murmur at left sternal border
30
What is Brugada syndrome?
Auto dominant Faulty sodium ion channel Causes ST elevation, RBBB, re-entrant loops + VT/VF
31
Mechanism of kallman syndrome
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
Mechanism of androgen insensitivity syndrome
XY doesn't respond to androgens so looks female X linked inheritance Undescended testes but female characteristics
33
Mechanism of 5a reductase deficiency
Autosomal recessive, only XY Internally male but externally female or male At puberty, increase in testosterone causes penile enlargement
34
Dx of 5a reductase deficiency
Karyotype, normal testosterone, low dihydrotestosterone
35
Tx of 5a reductase deficiency
Sex hormones
36
Mechanism of SIADH
Increased ADH leads to increased water retention, diluting sodium This reduces aldosterone which further reduces sodium Increases urine osmolarity + decreased serum sodium
37
S+S of SIADH
Muscle cramps + tremor Headaches Nausea Confusion + mood swings
38
Causes of SIADH
CNS = stroke, bleeds, trauma Meds = lithium, anti-epileptics Tumours - SCC, lung Pneumonia
39
Tx of SIADH
Fluid restrict, high salt, protein, NaCl
40
Mechanism of diabetes insipidus
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
Dx of diabetes insipidus
``` Increased serum osmolality Water deprivation test - urine osmolarity stays reducde Give desmopressin If urine osmolarity rises = CENTRAL DI If not, NEPHRO ```
42
Tx of diabetes insipidus
Desmopressin for central | Thiazide diuretics for nephrogenic
43
Hormones produced in anterior pituitary
``` GH ACTH Prolactin TSH LH FSH ```
44
Describe prolactinoma
Most common adenoma Causes amenorrhea + galactorrhea Low libido + gynaecomastia
45
Describe an adenoma of somatotropes
Produces GH Causes gigantism in kids + acromegaly in adults Can lead to heart failure
46
Describe ACTH secreting tumor
Increased ACTH so increased cortisol | Causes cushings disease - moon face, buffalo hump + truncal obesity
47
Tx of pituitary adenoma
Transphenoidal surgical resection
48
Dx of pituitary adenoma
Hormone levels + MRI
49
Hormones produced by posterior pituitary
ADH, oxytocin
50
Causes of hypopituitarism
Compression by adenoma or craniopharyngoma Apoplexy (bleeding or infarction) - due to adenoma or Sheehans Radiation or surgery
51
Dx of hypopituitarism
Baseline hormones in AM ACTH + GH through the day Stimulation with insulin
52
Causes of hyperparathyroidism
Primary = pituitary adenoma Secondary due to kidney damage Tertiary due to chronic secondary
53
Describe levels of Ca, PO4 + Vit D in primary, secondary + tertiary hypercalcaemia
``` 1 = high Ca, high PO4 2 = low Ca, high PO4, low Vit D 3 = high Ca + CKD ```
54
Causes of hypoparathyroidism
Damage during surgery MEN 1 Di George syndrome
55
S+S of hypocalcaemia/ hyperphosphatemia
``` 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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