First thousand - useful info Flashcards

Question

Reversible cerebrovascular vasoconstriction syndrome

Answer 1

Thunder clap headaches s associated with hypertension and seizures and diagnosed by arterial beeding on angiography.

Answer 2

Thunder clap headaches associated with hypertension and specific changes on MRI brain secondary to vasogenic brain oedema.

Answer 3

thunderclap headache commonly following minor trauma Horner's syndrome, tinnitus or tongue palsy. CT brain and lumbar puncture are usually normal

Answer 4

ST elevation in the apical leads (V5, V6). coronary angio - normal apical ballooning - echo take it easy no - treatment

Answer 5

T wave inversion in the anteroseptal leads. (V1-v3)

Answer 6

ST elevation and T wave inversion in V1-V2. Rbbb

Answer 7

in alcoholic Biphasic T-waves/ deeply inverted t waves in v2-v3

Answer 8

paroxysmal hemicrania is characterised by recurrent attacks lasting 2-30 minutes, occurring more than five times a day for more than half of the time. hemicrania continua is a continuous unilateral headache that persists for more than 3 months, punctuated with exacerbations of severe pain as seen in this patient. temporal pattern  both conditions are responsive to indomethacin

Answer 9

Methylphenidate, dextroamphetamine, and, lamotrigine

Answer 10

barbiturates, sulfonamides, chloroquin, griseofulvin, diphenyl hydantoin

Answer 11

Hypercalcaemia (6%) may also occur. This is partly due to a reduction in calcium removal by the kidney and an increase in mobilization of calcium from bone stores. Thyroid stimulating hormone (TSH) can be elevated in primary hypoadrenalism due to a loss of feedback on the pituitary gland.

Answer 12

VVI pacemaker fatigue, dizziness and hypotension.

Answer 13

systemic hypertension and inducing tachycardia. It can aggravate a fragile myocardium into acute failure and is hence not recommended by NICE in patients with ACS or severe heart failure

Answer 14

hsv In adults with HSV encephalitis the CSF opening pressure is typically moderately elevated; there is a moderate CSF pleocytosis (tens to hundreds of cells × 106/L), a mildly elevated CSF protein, and normal CSF:plasma glucose ratio'

Answer 15

- unable to recognise him - not orientated to time or place - extremely irritable - extremely tearful Diagnostic criteria for encephalitis are as follows: * Alteration in consciousness, cognition, personality or behaviour >24hrs

Answer 16

posterior fossa - get MRI previous neurosurgery or head trauma can similarly result in siderosis. There is no current treatment for superficial siderosis

Answer 17

cluster headaches males below the age of 40 typically onset at night, last from 15 minutes to 3 hour rarely more than 3 times per day triggered by alcohol SUNCT is more common in older patients above the age of 40. occur at any time of day and typically lasts for seconds to minutes 75 times per day

Answer 18

Drugs that inhibit xanthine oxidase e.g. allopurinol Drugs that can also cause myelosuppression e.g.sulphonamides, trimethoprim Reduced activity of TPMT

Answer 19

Thalassaemias, lead/arsenic poisoning, sideroblastic anaemia and megaloblastic anaemias (such as B12 deficiency)

Answer 20

vit b12 deficiency

Answer 21

also deactivates protein C and protein S, two endogenous anticoagulants. Since protein C has a short half-life (8 hours) and warfarin initially decreases protein C levels faster than the coagulation factors, it can paradoxically increase the coagulation tendency when treatment is first begun, leading to massive thrombosis with skin necrosis

Answer 22

MRI whole-spine should be performed within 7 days

Answer 23

Nodule <5mm, or clear benign features, or unsuitable for treatment: can be discharged Nodule 5-7mm, and low-risk*: then CT surveillance CT surveillance: if 5-6mm then at 1 year, =>6 then in three months Nodule =>8mm and high risk*: then CT-PET, and if CT-PET shows high uptake then biopsy

Answer 24

5 year follow up Extensive colitis with no active endoscopic/histological inflammation OR left sided colitis OR Crohn's colitis of <50% colon 3 year colonoscopy Extensive colitis with mild active endoscopy/histological inflammation OR post-inflammatory polyps OR family history of colorectal cancer in a first degree relative aged 50 or over 1 year follow up colonoscopy Extensive colitis with moderate/severe active endoscopic/histological inflammation OR stricture in past 5 years OR dysplasia in past 5 years declining surgery OR primary sclerosing cholangitis / transplant for primary sclerosing cholangitis OR family history of colorectal cancer in first degree relatives aged <50 years

Answer 25

Contraindications to percutaneous liver biopsy deranged clotting (e.g. INR > 1.4) low platelets (e.g. < 60 * 109/l) anaemia extrahepatic biliary obstruction hydatid cyst haemoangioma uncooperative patient ascites

Answer 26

chronic mucocutaneous candidiasis (typically first feature as young child) Addison's disease primary hypoparathyroidism

Answer 27

Patients have Addison's disease plus either: type 1 diabetes mellitus autoimmune thyroid disease

Answer 28

oral iron should be offered for patients who are not on ESAs or haemodialysis. If target Hb levels are not reached within 3 months then patients should be switched to IV iron patients on ESAs or haemodialysis generally require IV iron

Answer 29

mantle cell lymphoma CD4, CD19, CD20 , BCL1 trans location (11-14) , high grade, Ki-67 high follicular cell lymphoma CD19, CD20 , BCL2 trans location (14-18), low grade , Ki-67 low

Answer 30

Low risk: one or two adenomas smaller than 10 mm. Intermediate risk: three or four adenomas smaller than 10 mm or one or two adenomas if one is 10 mm or larger. High risk: five or more adenomas smaller than 10 mm or three or more adenomas if one is 10 mm or larger.