Brainscape's Knowledge GenomeTM

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


See full index

finals > finals neuro/rheum > Flashcards

finals neuro/rheum Flashcards

1
Q

how to manage hypogycaemia?

A

mild hypo (patient conscious)
- A-E
-consume fast acting carbs (e.g. glucose tablet, a small can of coke, sweets or fruit juice0
-consume some slow-acting carbs after (e.g. toast)
- AVOID CHOCOLATE

severe hypo (e.g. seizures/ patines unconscious)
- A-E
- Administer 200ml of 10% dextrose IV
- IF no IV access administer 1mg/kg of glucagon IM (wont work if hypo is caused by alcohol because of drug mechanism)

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

what is the first line treatment for Alzheimer’s disease?

A

Donepezil

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

how does chronic mesenteric ischaemia present?

A

Diffuse, colicky abdominal pain, which worsens after eating
Significant weight loss, as patients avoid eating due to the pain

Gastrointestinal bleeding, presenting as melaena or haematochezia (secondary to mucosal sloughing)

An epigastric bruit may be present, indicative of turbulent flow in the narrowed vessels.

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

what are some examples of aura with migraines and what is it?

A

Aura can affect vision, sensation or language. Visual symptoms are the most common. These may be:

Sparks in the vision
Blurred vision
Lines across the vision
Loss of visual fields (e.g., scotoma)

Sensation changes may include tingling or numbness. Language symptoms include dysphasia (difficulty speaking).

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

what does a hemiplegic migraine mimic that is it important to rule out?

A

stroke

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

what 3 drugs can be given for migraine prophylaxis and when shouldn’t they be given?

A

-Propranolol (a non-selective beta blocker)
-Amitriptyline (a tricyclic antidepressant)
-Topiramate (teratogenic and very effective contraception is needed)

propanalol- asthma
topiramate- caution in women of childbearing age

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

when should triptans be taken and can you take another if it doesn’t work?

A

Triptans (e.g., sumatriptan) are taken as soon as a migraine headache starts. They should halt the attack. If the attack resolves and then reoccurs, another dose can be taken. If it does not work the first time, another second dose should not be taken for the same attack.

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

what pain relief shouldnt be taken for migraines and can actually make them worse?

A

opiods

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

what is the management for tension headaces?

A

Reassurance
Simple analgesia (e.g., ibuprofen or paracetamol)

Amitriptyline is generally first-line for chronic or frequent tension headaches.

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

how do cluster headaches present?

A

Cluster headaches are severe and unbearable unilateral headaches, usually centred around the eye.

Cluster headaches cause severe pain. They are sometimes called “suicide headaches” due to their severity.

Associated symptoms are typically unilateral:

Red, swollen and watering eye
Pupil constriction (miosis)
Eyelid drooping (ptosis)
Nasal discharge
Facial sweating

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

how to manage a cluster headache? acute and phrophylaxis

A

Treatment options during acute attacks are:

  • Triptans (e.g., subcutaneous or intranasal sumatriptan)
  • High-flow 100% oxygen (may be kept at home)

Verapamil is the first line for prophylaxis (to prevent attacks).

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

where do cluster headaches get their name from?

A

They are called cluster headaches as they come in clusters of attacks and then disappear for extended periods. For example, a patient may suffer 3-4 episodes a day for weeks or months, followed by a pain-free period lasting several years. Attacks last between 15 minutes and 3 hours.

A typical patient is a 30-50 year old male smoker. They may have triggers, such as alcohol, strong smells or exercise.

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

what is the first line treatment for trigeminal neuralgia?

A

Carbamazepine

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

what condition is trigeminal neuralgia commonly associated with?

A

multiple sclerosis

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

how does trigeminal neuralgia present?

A

intense facial pain in the distribution of the trigeminal nerve, which has three branches

90% of cases unilateral

pain comes on suddenly and can last seconds to hours. It may be described as an electricity-like, shooting, stabbing or burning pain. It may be triggered by touch, taking, eating, shaving or cold.

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

what are the three brancehs of the trigeminal nerve

A

v1- opthalmic
v2- maxillary
v3- mandibular

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

difference between orbital and pre orbital cellulitis. How to distinguish between them?

A

pre orbital -
an eyelid and skin infection in front of the orbital septum (in front of the eye). It presents with swollen, red, hot skin around the eyelid and eye.

orbital cellulitihs an eyelid and skin infection in front of the orbital septum (in front of the eye). It presents with swollen, red, hot skin around the eyelid and eye. infection of the actual eye

A CT scan can help distinguish them. aslo orbital has painful eye movements/ reduced eye movement and visual changes whereas pre orbital is just the swelling of eyelid

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

symptoms and treatment of preoribtal cellulits?

A

swollen, red, hot skin around the eyelid and eye.

Treatment is with systemic antibiotics (oral or IV). Preorbital cellulitis can develop into orbital cellulitis, so vulnerable patients (e.g., children) or severe cases may require admission for monitoring.

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

symptoms and treatment of oribtal cellulits?

A

Orbital cellulitis is an infection around the eyeball involving the tissues behind the orbital septum. Symptoms include pain with eye movement, reduced eye movements, vision changes, abnormal pupil reactions, and proptosis (bulging forward of the eyeball).

Orbital cellulitis requires emergency admission under ophthalmology and intravenous antibiotics. Surgical drainage may be needed if an abscess forms.

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

different between complex and simple febrile convulsion?

A

Febrile convulsions can be described as complex when they consist of partial or focal seizures, last more than 15 minutes or occur multiple times during the same febrile illness.

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

Does having febrile seizures increase the risk of having epilepsy in the future?

A

Children who have had a febrile seizure have a slightly increased chance of having epilepsy later in life, but this is rare.
2-5%

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

what can Alpha-1 Antitrypsin Deficiency lead to?

A

lung and liver problems

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

MAINTENANCE FLUID REQUIREMENTS IN CHILDREN

A

1st 10kg of bodyweight at 100ml/kg/day
2nd 10kg of bodyweight at 50ml/kg/day
Remaining bodyweight at 20ml/kg/day
The fluid type routinely used is 0.9% sodium chloride + 5% dextrose. Potassim is added as required depending on their U&Es.

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

What does LOSS stand for oseoarthiritis?

A

L – Loss of joint space

O – Osteophytes (little bits of exta bone growing)

S – Subarticular sclerosis (increased density of the bone along the joint line)

S – Subchondral cysts (fluid-filled holes in the bone)

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

what are the hand signs seen in osteoarthritis?

A

-Heberden’s nodes (in the DIP joints)
-Bouchard’s nodes (in the PIP joints)
-Squaring at the base of the thumb (CMC joint)
-Weak grip
-Reduced range of motion

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

Investigations for asthma?

A

The NICE guidelines (2020) recommend initial investigations in patients with suspected asthma:

Fractional exhaled nitric oxide (FeNO)
Spirometry with bronchodilator reversibility

Where there is diagnostic uncertainty after initial investigations, the next step is testing the peak flow variability.

Where there is still uncertainty, the next step is a direct bronchial challenge test with histamine or methacholine.

spirometry- should show obstructive picture

reversibility testing- giving a bronchodilator (e.g., salbutamol) before repeating the spirometry. Greater than 12% increase in FEV1 on reversibility testing supports a diagnosis of asthma.

Fractional exhaled nitric oxide (FeNO) measures the concentration of nitric oxide exhaled by the patient. Nitric oxide is a marker of airway inflammation.

Peak flow diary

Direct bronchial challenge testing is the opposite of reversibility testing. Inhaled histamine or methacholine is used to stimulate bronchoconstriction, reducing the FEV1 in patients with asthma. NICE say a PC20 (provocation concentration of methacholine causing a 20% reduction in FEV1) of 8 mg/ml or less is a positive test result.

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

why cant someone go home after they are stable from anaphylaxis?

A

All children should have a period of assessment and observation after an anaphylactic reaction, as biphasic reactions can occur, meaning they can have a second anaphylactic reaction after successful treatment of the first.

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

Once a diagnosis of anaphylaxis is established, there are three medications given to treat the reaction. What are they?

A

Intramuscular adrenalin, repeated after 5 minutes if required
Antihistamines, such as oral chlorphenamine or cetirizine
Steroids, usually intravenous hydrocortisone

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

what must you do in the after management of anaphylaxis.

A

keep in for observation in case of a biphasic reaction.

Anaphylaxis can be confirmed by measuring the serum mast cell tryptase within 6 hours of the event. Tryptase is released during mast cell degranulation and stays in the blood for 6 hours before gradually disappearing.

Remember to measure mast cell tryptase within 6 hours of an anaphylactic reaction. This is a common exam question and also something that will impress senior colleagues if it is part of your management plan when managing children with anaphylaxis.

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

How to use an epi pen?

A

Prepare the device by removing the safety cap on the non-needle end. (it wont work unless you remove the cap, this is how you activate it)

Grip the device in a fist with the needle end pointing downwards. Do not put your thumb over the end, because if the device is upside down you will inject your thumb with adrenalin and could risk losing it.

Administer the injection by firmly jabbing the device into the outer portion of the mid thigh until the device clicks. This can be done through clothing. EpiPen advise holding it in place for 3 seconds and Jext advise 10 seconds before removing the device.

Remove the device and gently massage the area for 10 seconds.

Phone an emergency ambulance. A second dose may be given (with a new pen) after 5 minutes if required.

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

what are the guidelines for taking GTN and when to call an ambulance?

A

Take the GTN when the symptoms start
Take a second dose after 5 minutes if the symptoms remain
Take a third dose after a further 5 minutes if the symptoms remain
Call an ambulance after a further 5 minutes if the symptoms remain

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

what is the management of angina (broken down into 3)

A

-Immediate symptomatic relief during episodes of angina
-Long-term symptomatic relief
-Secondary prevention of cardiovascular disease

Immediate- GTN (headaches and dizziness due to vasodiation)

Longterm- For long-term symptomatic relief, first-line is with either, or a combination, of:

Beta blocker (e.g., bisoprolol)
Calcium-channel blocker (e.g., diltiazem or verapamil – both avoided in heart failure with reduced ejection fraction)

secondary prevention-
Medications for secondary prevention can be remembered with the “four As” mnemonic:

A – Aspirin 75mg once daily
A – Atorvastatin 80mg once daily
A – ACE inhibitor (if diabetes, hypertension, CKD or heart failure are also present)
A – Already on a beta blocker for symptomatic relief

+ surgical interventions in severe disease where medical treatment is not controlling symptoms.

Percutaneous coronary intervention (PCI)- scars around the brachial and femoral arteries (previous PCI) and along the inner calves (saphenous vein harvesting scar)

Coronary artery bypass graft (CABG) - midline sternotomy scar

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

what does a cardiac stress test involve and what is it testing for?

A

nvolves assessing the patient’s heart function during exertion.
This can involve having the patient exercise or giving medication (e.g., dobutamine) to stress the heart.

The options for assessing cardiac function during stress testing are an ECG, echocardiogram, MRI or a myocardial perfusion scan (nuclear medicine scan).

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

what is an ectopic and how is it treated

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

mobitz type 1 vs mobitz type 2 in 2nd degree heart block

A

type 1- p wave gradually gets larger then drops off

type 2- P waves randomly dropped. There is usually a set ratio of P waves to QRS complexes, for example, three P waves for each QRS complex (3:1 block). The PR interval remains normal.

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

Which heart blocks do you treat and why. Also how do u treat them

A

motbitz type 2 and complete because they both have a risk of asystole.

refer to cardiology for pacemaker.

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

cardiac output=

A

Stroke volume x heart rate

36
Q

what is a common Iatrogenic cause of acute HF/LVF?

A

aggressive IV fluids in a frail elderly patient with impaired left ventricular function

37
Q

treatment of of acute HF/LVF?

A

S – Sit up
O – Oxygen
D – Diuretics
I – Intravenous fluids should be stopped
U – Underlying causes need to be identified and treated (e.g., myocardial infarction)
M – Monitor fluid balance

38
Q

inotropes vs vasopressors

A

Inotropes are medications that alter the contractility of the heart. Positive inotropes act to increase the contractility of the heart. This increases cardiac output (CO) and mean arterial pressure (MAP). They are used in patients with a low cardiac output, for example, due to acute heart failure, recent myocardial infarction or following heart surgery.

Vasopressors are medications that cause vasoconstriction (narrowing of blood vessels). This increases the systemic vascular resistance and, consequently, mean arterial pressure (MAP). Vasopressors are commonly used by anaesthetists as a bolus dose or in ICU as an infusion to improve patient’s blood pressure and, therefore, tissue perfusion.

39
Q

right sided HF symptoms vs left sided HF symptoms

A

right:
Raised JVP
Odema
ascites
englarged liver and spleen

Left:
Paroxsymal dyspnea
pulmonary congestion: wheezze, crackles cough

40
Q

hf with preserved EF vs HF with reduced ejection fraction difference

A

preserved: clinical features of HF but EF of over 50%

Reduced: EF less than 50%

41
Q

what is the medical treatment of chronic heart faliure?

A

A – ACE inhibitor (e.g., ramipril) titrated as high as tolerated
B – Beta blocker (e.g., bisoprolol) titrated as high as tolerated
A – Aldosterone antagonist when symptoms are not controlled with A and B (e.g., spironolactone or eplerenone)
L – Loop diuretics (e.g., furosemide or bumetanide)

42
Q

what are some causes of chronic heart failure?

A

Ischaemic heart disease
Valvular heart disease (commonly aortic stenosis)
Hypertension
Arrhythmias (commonly atrial fibrillation)
Cardiomyopathy

43
Q

essential vs secondary hypertension? and the most common cause of secondary hypertension?

A

Essential hypertension accounts for 90% of hypertension. This is also known as primary hypertension. It means a high blood pressure has developed on its own and does not have a secondary cause.

Secondary causes of hypertension can be remembered with the “ROPED” mnemonic:

R – Renal disease
O – Obesity
P – Pregnancy-induced hypertension or pre-eclampsia
E – Endocrine
D – Drugs (e.g., alcohol, steroids, NSAIDs, oestrogen and liquorice)

Renal disease is the most common cause of secondary hypertension. When the blood pressure is very high or does not respond to treatment, consider renal artery stenosis. Renal artery stenosis can be diagnosed with duplex ultrasound or an MR or CT angiogram.

44
Q

lifestyle advice for hypertension?

A

healthy diet
stopping smoking
reducing alcohol
caffeine and salt intake taking regular exercise

45
Q

what is the step ladder treatment for hypertension? for step 4 how do you pick between two options

A

Step 1: Aged under 55 or type 2 diabetic of any age or family origin, use A. Aged over 55 or Black African use C.
Step 2: A + C. Alternatively, A + D or C + D.
Step 3: A + C + D
Step 4: A + C + D + fourth agent (see below)

step 4 depends on serum potassium.
if 4.5 or less- spironolactone
of more than 4.5 then alpha or beta blocker

46
Q

what is malignant/accelerated hypertension?

A

Accelerated hypertension, also called malignant hypertension, refers to extremely high blood pressure, above 180/120, with retinal haemorrhages or papilloedema.

emergency-go hospital

47
Q

causes of primary vs seconary hyperaldosteronism

A

Primary hyperaldosteronism is when the adrenal glands are directly responsible for producing too much aldosterone. Serum renin will be low as the high blood pressure suppresses it.

The adrenals may produce too much aldosterone for several possible reasons:

Bilateral adrenal hyperplasia (most common)
An adrenal adenoma secreting aldosterone (known as Conn’s syndrome)
Familial hyperaldosteronism (rare)

Secondary hyperaldosteronism is caused by excessive renin stimulating the release of excessive aldosterone.

Excessive renin is released due to disproportionately lower blood pressure in the kidneys, usually due to:

Renal artery stenosis
Heart failure
Liver cirrhosis and ascites

48
Q

how do you screen for the difference between primary and secondary hyperaldosteronism?

A

The aldosterone-to-renin ratio (ARR) is used as a screening test:

High aldosterone and low renin indicate primary hyperaldosteronism
(adrenals producing high amounts of aldosterone so renin low as trying to suppress this)

High aldosterone and high renin indicate secondary hyperaldosteronism (bp in kidneys is percieved to be low so high amounts of renin produced to try bump bp but actuallly bp is high its just in the kidneys its low due to renal artery stenosis for example).

49
Q

symptoms of hyperaldosteronism?

A

low sodium (not always)
high BP
alkalosis on blood gas

Hyperaldosteronism is worth remembering as the most common cause of secondary hypertension. Consider testing for hyperaldosteronism in patients with hypertension, who are younger, fail to respond to treatment or have a low potassium. Be aware that potassium levels may be normal in hyperaldosteronism.

50
Q

treatment of hyperaldosteronism?

A

Medical management is with aldosterone antagonists:

Spironolactone
Eplerenone

Treating the underlying cause involves:

-Surgical removal of the adrenal adenoma
-Percutaneous renal artery angioplasty via the femoral artery to treat renal artery stenosis

investigations for route cause: CT or MRI to look for an adrenal tumour or adrenal hyperplasia
Renal artery imaging for renal artery stenosis (Doppler, CT angiogram or MR angiography)
Adrenal vein sampling of blood from both adrenal veins to locate which gland is producing more aldosterone

51
Q

most commonly affected part of the bowel for diverticular disease?

A

sigmoid common

52
Q

risk factors for diverticulosis

A

age
low fibre diet
obesity
NSAID use

53
Q

which type of laxatives should be avoided in diverticulitis and why?

A

stimulant laxatives e.g. senna as they irritate the gut

54
Q

investigation for diverticulits

A

-CRP and ESR – usually raised
-Ultrasound / CT – can show wall thickening, diverticulae, and also abscess or perforation

Sigmoidoscopy – if other investigations have been inconclusive

55
Q

management of diverticulitis

A

-Antibiotics (usually metronidazole)
-Fluids
-Analgesia – but be careful! You don’t want to give a constipating analgesic
avoid NSAIDS (remember risk factor fir diverticulitis) and svoid Opiods

long term
-weight loss
-high fibre, laxatives if necessary but avoid stimulants.
Surgery – to resect the sigmoid colon – in severe cases

56
Q

What is a key red flag symptom for an urgent 2ww referral for endoscopy?

A

Remember dysphagia as a critical red flag. Any patient presenting with the feeling that food is getting stuck on the way down needs an urgent two week wait referral for an endoscopy.

57
Q

what marker would be abnormal in paget’s disease?

A

paget’s disease presents with normal electrolytes but markedly raised ALP.

58
Q

what is the most common ecg change in a pe

A

Sinus tachycardia with right ventricular strain

This is the most likely ECG pattern seen in pulmonary embolism. Sinus tachycardia is related to increased sympathetic outflow to maintain cardiac output, while the right ventricular strain is related to high pulmonary artery pressures.

59
Q

what is a key complication in the treatment of DKA that can cause a drop in GCS, new onset headache and bradycardia?

A

cerebral oedema

Cerebral oedema is a severe complication of diabetic ketoacidosis that more frequently occurs in children and presents with new-onset headache, changes to GCS, and bradycardia. It is due to rapid correction of hyperglycaemia, which causes a shift of water out of the brain cells. It is managed by senior clinicians due to its high mortality. Slowing IV fluids would be the first step in the management of this patient, as well as alerting seniors as soon as this has been done.

60
Q

Is neuro imaging for brain bleeds CT done with contrast on non-contrast?

A

non-contrast

61
Q

When should a lumbar puncture for a suspected SAH be done?

A

12 hours after onset of smyptoms

if ct is done within 6 hours and nothing comes up think about different differentials but don’t completely exclude SAH

62
Q

what will a lumbar puncture done 12hours after a SAH show?

A

xanthochromia

63
Q

what disease does the ziehl-neelsen stain test for

A

tuberculosis

64
Q

what are symptoms of hypercalcaemia?

A

stone, bones, groans and moans

-Kidney stones
-Painful bones
-Abdominal groans (constipation, nausea and vomiting) Remember any GI symptoms
-Psychiatric moans (fatigue, depression and psychosis) Remember can just be fatigue

65
Q

what are symptoms of hypocalcemia

A

-muscles twitching, spasms and cramps (tetany)
-parasthesia particulary
numbness or tingling in feet and hands.
numbness or tingling around the mouth.

66
Q

what are the causes and what will the PTH and calcium level be in primary, secondary and teritiary hyperparathyroidsm?

A

Primary:
tumour, PTH- high C-high

Secondary
low vit D or CKD, PTH-high C- low or normal

Tertiary
prolonged low vit pleading to hyperplasia on PT glands, PTH- high C-high

67
Q

What is the role of the parathyroid glands

A

calcium regulation

68
Q

what is the relationship between calcium and phosphate levels?

A

Within the body calcium and phosphate are inversely related: as blood calcium levels rise, phosphate levels fall. and vice versa.

69
Q

what are chvostek’s sign and trousseau’s sign?

A

The Chvostek sign is a clinical finding associated with hypocalcemia, or low levels of calcium in the blood. This clinical sign refers to a twitch of the facial muscles that occurs when gently tapping an individual’s cheek, in front of the ear.

The Trousseau sign of latent tetany is one of the clinical signs associated with hypocalcemia, or low calcium levels in the blood. activate blood pressure cuff about 20 over systolic pressure for 2-3 minutes this occludes brachial artery and positive sign the wrist will flex up

70
Q

what are the 4 features of myeloma?

A

C – Calcium (elevated)
R – Renal failure
A – Anaemia (most common feature)
B – Bone lesions and bone pain

71
Q

what causes anaemia in myeloma?

A

he cancerous plasma cells invade the bone marrow (bone marrow infiltration), resulting in suppression of the other blood cell lines, leading to anaemia (low haemoglobin), leukopenia (low white blood cells) and thrombocytopenia (low platelets). Anaemia in myeloma is normocytic (normal size) and normochromic (normal colour).

72
Q

lethargic, weight loss, painful round shin lesions, swelling in ankles- diagnosis and investigations?

A

sarcoidosis

I - Raised calcium and ACE
ACE usually used as screening test/

73
Q

treatment for sarcoidosis

A

conservative in mild symptoms
if treated steroids for 6 months -2 years (bisphosphonates to protect from osteoporosis)

74
Q

Symptoms of sarcoidosis (Inflammatory disease)

A

can affect any organ but lungs most commonly affected

Lungs:
Mediastinal lymphadenopathy
Pulmonary fibrosis
Pulmonary nodules

Systemic Symptoms:
Fever
Fatigue
Weight loss

Liver:
Liver nodules
Cirrhosis
Cholestasis

Eyes:
Uveitis
Conjunctivitis
Optic neuritis

Heart:
Bundle branch block
Heart block
Myocardial muscle involvement

Kidneys:
Kidney stones (due to hypercalcaemia)
Nephrocalcinosis
Interstitial nephritis

Central nervous system:
Nodules
Pituitary involvement (diabetes insipidus)
Encephalopathy

Peripheral Nervous System:
Facial nerve palsy
Mononeuritis multiplex

Bones:
Arthralgia
Arthritis
Myopathy

75
Q

What are two main causes of erthyema nodusm? raised red tender painful lesions on the shins

A

IBD and sarcoidosis

76
Q

Lofgren’s syndrome refers to a specific presentation of sarcoidosis with a classic triad of symptoms which are :

A

Erythema nodosum
Bilateral hilar lymphadenopathy
Polyarthralgia (joint pain in multiple joints)

77
Q

what muscle group is affected in a positive trandelenburg test?

A

gluteal/abductors

78
Q

what histological finding would you find in lung cancer causing cushings syndrome?

A

small cell lung cancer

79
Q

what histological finding would you find in lung cancer SIADH presenting as hyponatremia?

A

small cell lung cancer

80
Q

what histological finding would you find in lung cancer causing hypercalcemia?

A

squamous cell carinoma

81
Q

Superior vena cava obstruction is a complication of lung cancer. It is caused by direct tumour compression on the superior vena cava. how does it present?

A

facial swelling, difficulty breathing, and distended neck and upper chest veins. Pemberton’s sign is where raising the hands over the head causes facial congestion and cyanosis. SVC obstruction is a medical emergency.

82
Q

what is the first line investigation for suspected lung cancer and what would it show?

A

chest x ray

Hilar enlargement
Peripheral opacity (a visible lesion in the lung field)
Pleural effusion (usually unilateral in cancer)
Collapse

83
Q

what is the most common type of cancers for non-smokers?

A

adenocarinoma

84
Q

allmost all of this type of lung cancer is caused by smoking?

A

small cell lung cancer

85
Q

how does Recurrent laryngeal nerve palsy present and what is it caused by?

A

horse voice

a tumour pressing on or affecting the recurrent laryngeal nerve as it passes through the mediastinum.

86
Q

lung cancer can cause a phrenic nerve palsy, how does this present?

A

due to nerve compression, causes diaphragm weakness and presents with shortness of breath.

87
Q

Limbic encephalitis is a paraneoplastic syndrome where the immune system makes antibodies to tissues in the brain, specifically the limbic system, causing inflammation in these areas. This causes symptoms such as hallucinations, confusion and seizures. short-term memory impairment- this is caused by which type of lung cancer

A

small cell lung cancer

all of the paraneoplastic syndrome are caused by small cell lung cancer apart from hypercalcemia which is caused by scc

88
Q
A

finals (6 decks)

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