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my flow > Fawzia > Flashcards

Fawzia Flashcards

1
Q

Origin of iliopsoas?

A

T12-L5

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2
Q

Aldosterone effect is by?

A

Na-K ATPhase in COLLECTING DUCTS

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3
Q

Lung ventilation effect on the heart?

A

Decreased preload and afterload

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4
Q

Gallstones causes?

A

Cholesterol - most common - YELLOW LARGE SINGLE

Unconjugated bilirubin - DARK SMALL (hemolysis, sickle cell)

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5
Q

Polycythemia as a paraneoplastic syndrome?

A

RCC

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6
Q

Rare complication of ulcerative colitis?

A

Plyarteriitis

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7
Q

Post splenectomy changes?

A

Platelets RISE!!!! -> weeks -> Howell Jolly bodies -> target cells and Pappenheimer bodies
Risk of sepsis!

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8
Q

Inferior border of quadrangular triangle?

A

Teres MAJOR!!!!

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9
Q

Osteomyelitis in sickle cell?

A

SALMONELLA (S - S)

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10
Q

Cause of discitis?

A

Staph aureus

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11
Q

Cause of discitis?

A

Staph aureus

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12
Q

Nerve involved in smiling?

A

Marginal mandibular

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13
Q

Nerve responsable for hyperacusis?

A

FACIAL!

NOT TRIGEMINAL! Chorda tympani, membrane etc

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14
Q

Bladder embryologic origin?

A

Urogenital sinus

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15
Q

Course or right renal artery?

A

Posterior to IVC, posterior to right renal vein

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15
Q

Course or right renal artery?

A

Posterior to IVC, posterior to right renal vein

16
Q

You review a 42-year-old woman 8 months following a renal transplant for focal segmental glomerulosclerosis. She is on a combination of tacrolimus, mycophenolate, and prednisolone. She has now presented with a five day history of feeling generally unwell with jaundice, fatigue and arthralgia. On examination she has jaundice, widespread lymphadenopathy and hepatomegaly. What is the most likely diagnosis?

Hepatitis C
Epstein-Barr virus
HIV
Hepatitis B
Cytomegalovirus
A

Post transplant complications

CMV: 4 weeks to 6 months post transplant
EBV: post transplant lymphoproliferative disease. > 6 months post transplant
Post transplant lymphoproliferative disorder is most commonly associated with Epstein-Barr virus. It typically occurs 6 months post transplant and is associated with high dose immunosupressant therapy. Remember cytomegalovirus presents within the first 4 weeks to 6 months post transplant.

17
Q

Which of the following transplants is most susceptible to donor- recipient HLA mismatches?

Autologous skin graft
Renal allograft
Liver allograft
Corneal allograft
Cardiac valve allograft
A

KIDNEY!!! VERY DEMANDING FOR HLA MATCHING
Autologous transplant- same individual (genetically identical)
Allograft - Genetically different
The kidney is highly susceptible to HLA mismatches and hyperacute rejection may occur in patients with IgG anti HLA Class I antibodies. The liver is at far lower risk of rejection of this nature. Although the heart is sensitive to HLA mismatches this is less than the kidney. Cardiac valves and the cornea incite little immunological response.

18
Q

A 48 year old lady with end stage renal failure receives a cadaveric renal transplant. The organ is ABO group matched only. On completion of the vascular anastomoses the surgeons remove the clamps. Over the course of the next twelve minutes the donated kidney becomes dusky and swollen and appears non viable. Which of the following is the most likely process that has caused this event?

IgG anti HLA Class I antibodies in the recipient
IgM anti HLA Class I antibodies in the recipient
IgG anti HLA Class I antibodies from the donor
IgM anti HLA Class I antibodies from the donor
IgM anti HLA Class II antibodies from the recipient

A

HYPERCAUTE - IGG HLA CLASS I IN RECEPIENT
Episodes of hyperacute rejection are typically due to preformed antibodies. ABO mismatch is the best example. However, IgG anti HLA Class I antibodies are another potential cause. These events are now seen less commonly because the cross matching process generally takes this possibility into account.

19
Q

A 68 year old farmer presents with a skin lesion on his forehead. It has been present for the past 6 months and has grown slightly in size during that time. On examination, he has an ulcerated lesion with pearly white raised edges that measures 2cm in diameter. What is the most likely diagnosis?

Keratoacanthoma
Squamous cell carcinoma
Pyogenic granuloma
Basal cell carcinoma
Bowens disease
A

RAISED PEARLY EDGES - BCC! SUN - BCC

The raised pearly edges in an ulcerated lesion at a sun exposed site makes BCC most likely.

20
Q

A 34 year old gardener presents with a lesion affecting the dorsum of his right hand. It has been present for the past 10 days and occurred after he had been pruning rose bushes. On examination, he has a raised ulcerated lesion which bleeds easily on contact. What is the diagnosis?

Keratoacanthoma
Pyogenic granuloma
Basal cell carcinoma
Squamous cell carcinoma
Amelanotic melanoma
A

YOUNG + TRAUMA + BLEEDING ULCER = PYOGENIC GRANULOMA

Trauma is a common precipitant of pyogenic granuloma and contact bleeding and ulceration are common.

21
Q

A 25 year old man is diagnosed as having an undisplaced fracture of the proximal pole of the scaphoid. What is the best course of action?

Immobilisation in future splint for 5 weeks
Arrange an MRI scan
Immobilisation in plaster cast for 4 weeks
Surgical fixation
Initial immbolisation in plaster cast for 2 weeks with check radiographs at that stage

A

PROXIMAL SCAPHOID - SURGERY
It is generally accepted that proximal pole fractures of the scaphoid should be surgically fixed as non union rates of up to 34% can be seen when cast immobilization alone is attempted.

22
Q

In matching donated kidneys to the most appropriate recipient, apart from ABO matching, which of the following is most important?

HLA DR
Rhesus
HLA A
HLA B
Duffy antigen

The rhesus group is not important in matching donor and recipient kidneys.

A

When HLA matching for a renal transplant the relative importance of the HLA antigens are as follows DR > B > A

23
Q

A 21 year old lady presents with a nodule on the posterior aspect of her right calf. It has been present at the site for the past 6 months and occurred at the site of a previous insect bite. Although the nodule appears small, on palpation it appears to be nearly twice the size it appears on examination. The overlying skin is faintly pigmented. What is the most likely cause?

Pilar cyst
Dermatofibroma
Spitz naevus
Seborrhoeic wart
Basal cell carcinoma
A

Dermatofibromas may be pigmented and are often larger than they appear. They frequently occur at sites of previous trauma.

24
Q

A 72 year old man presents with a large nodule on his face. It is friable. There is no regional lymphadenopathy. He is lost to follow up and re-attends several months later. On this occasion the lesion has been noted to resolve with scarring. What is the most likely lesion?

Pyogenic granuloma
Keratoacanthoma
Melanoma
Basal cell carcinoma
Dermatitis artifacta
A

Keratoacanthomas may reach a considerable size prior to sloughing off and scarring.

25
Q

A 72 year old man presents with a large nodule on his face. It is friable. There is no regional lymphadenopathy. He is lost to follow up and re-attends several months later. On this occasion the lesion has been noted to resolve with scarring. What is the most likely lesion?

Pyogenic granuloma
Keratoacanthoma
Melanoma
Basal cell carcinoma
Dermatitis artifacta
A

Keratoacanthomas may reach a considerable size prior to sloughing off and scarring.

26
Q

Common peroneal nerve roots?

A

L4, L5, S1, S2

27
Q

Low TSH + Low T4?

A

Secondary hypothyroidism

28
Q

Parotid tumour with rapid growth, invasion?

A

Adenoid cystic carcinoma

29
Q

Erythema connected with ulcerative colitis?

A

Erythema nodosum

30
Q

Which nerve is responsible for looking downwards and inwards?

A

Trochlear

31
Q

Duke’s C?

A

my flow (24 decks)

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