General medicine key points PART 2 Flashcards
CCK does what
- inhibits H+ secretion from parietal cells
- gallbladder contraction
- relaxation of sphincter of Oddi
which is the only antibody that can transfer across the placenta?
IgG
Rhomberg’s test
- patient, eyes closed hands out stretched
- positive if patient becomes unsteady
immunoglobulin associated with atopy
IgE
A newborn male born at term is noted to become quickly cyanotic when feeding and crying. Feeding of the infant is further complicated by the presence of a cleft palate. On visual inspection, the boy appears to have a small head, a smooth philtrum, and epicanthic folds.
What syndrome?
DiGeorge syndrome
C - cardiac anomalies (ToF)
A - Abnormalities of face
T - thymus hypoplasia thus recurrent infections
C - cleft palate
H - hypoparathyroidism thus hypocalcaemia
22 - location of deletion
what is the main culprit causing lower respiratory tract infections in patients with cystic fibrosis?
pseudomonas aeruginosa
An 2-year-old male is referred to the clinician due to repeated seizures. He is noted to have had repeated infections. Examination of the chest reveals a heart murmur on the left sternal edge and he has abnormal facies. Blood tests reveal hypocalcaemia, hyperphosphataemia and low parathyroid hormone levels. He is diagnosed with the congenital condition known as ……
DiGeorge syndrome
The inflammatory reaction to the Mantoux test is an example of a delayed hypersensitivity reaction. Which immune mediator is this type of reaction usually associated with?
T cells.
A 58-year-old male presents to the GP with a gradual onset of diarrhoea and memory loss. On examination, he was found to have a dermatitis rash around his neck. A diagnosis of pellagra is made. Which vitamin deficiency is the cause of this condition?
B3 deficiency typically results in
the three D’s
- dementia
- dermatitis
- diarrhoea
A 25-year-old woman is brought into the emergency department. She presents with a painful stiff neck, photophobia, and an evolving non-blanching rash. On examination, she is found to be tachycardic and pyrexial. She is provisionally diagnosed with meningitis pending further investigations. What is the most likely causative organism?
Neisseria Meningitidis
6 years - 60 years age group are at risk from meninigitis caused by Neisseria meningitidis
0-3months: group B streptococcus in neonates
achrondroplasia key facts
- growth disorder causing dwarfism
- autosomal dominant
- homozygous achondroplasia usually fatal in utero
- caused by mutation in fibroblast growth factor (FGF) receptor
- thus unlikely to respond to growth hormone
the Mantoux test is an example of what type of hypersensitivity reaction
type 4 hypersensitivity
- tuberculin skin reaction
first sign of osteoarthritis
reduction of internal rotation of hip
Robertsonian translocation
- is a form of chromosomal rearrangement
- chromosomes break at their centromeres
- long arms fuse to form a single, large chromosome with a single centromere.
Penetrance
- proportion of individuals who carry disease causing allele
- who express the related disease phenotype
Which of the following best characterizes this patient’s condition?
A 31-year-old woman presents to her family physician complaining of pain in her wrist and fingers. She has been having the pain for the past month. The pain has failed to resolve with paracetamol. The woman also complains that she has noticed a reddening of the skin of her cheeks and feels warm as if she is having a fever. She feels that going in the sun makes the rash worse and has recently been applying sunscreen to see if that helps. The woman works as a teacher, does not have any significant past medical history and there is no family history of musculoskeletal problems. On examination the find that the lady has a heart rate of 81 beats per minute, respiratory rate of 13 breaths per minute and blood pressure of 143/88 mmHg. The doctor also notices that the facial rash is butterfly-shaped.
Type 3 hypersensitivity reaction.
- classic presentation of SLE
3 y/o male, always hungry, always craving food, significant weight gain, poor muscle tone and undeveloped genitals.
signs and symptoms are consistent with what diagnosis?
Prader-Willi syndrome
e.g. genetic imprinting
A 17-year-old lady with long standing anorexia nervosa is due to undergo excision of a lipoma. Which one of the following nutritional deficiencies is most likely to be implicated in poor collagen formation as the wound heals?
vitamin c needed for cross linkage of collagen and impaired wound healing.
thus deficiency of ascorbic acid.
A known alcohol dependent man presents to the emergency department with ophthalmoplegia, ataxia and confusion. He is given IV pabrinex to correct the likely vitamin deficiency which is causing his symptoms.
Wernicke’s korscoffs encephalopathy associated with…
- thiamine deficiency
- common cause is alcoholism
- acute neurological condition characterised by:
- ——> 1. nystagmus
- ——> 2. ataxia
- ——> 3. confusion
thiamine is important for ….
catabolism of sugars and amino acids
what cells are a sign of chronic inflammation and produce histamine
basophils
which cells are responsible for inducing apoptosis?
cytotoxic T cells
acute epiglottitis 3d’s symptoms
- dysphagia
- drooling
- distress
Charcot’s triad
- fever
- right upper quadrant pain
- jaundice
