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PACES revision > General questions- causes > Flashcards

General questions- causes Flashcards

1
Q

Respiratory causes of clubbing?

A
  • IPF
  • Bronchiectasis
  • Bronchial carcinoma
  • Mesothelioma
  • Empyema
  • CF
  • Asbestosis
  • Lung abcess
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2
Q

Causes of clubbing and crackles?

A
  • IPF
  • Bronchogenic carcinoma
  • Asbestosis
  • Bronchiectasis
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3
Q

Causes of bronchiectasis

A 
Congenital:
- Cystic fibrosis
- Young’s syndrome
- Kartagener’s syndrome
- Sequestered bronchopulmonary segments
Infection:
- TB
- Measles
- Varicella
- Pertussis
- Obstruction
- Foreign body
- Bronchogenic carcinoma
Immunodeficiency
- Congenital: - Hypogammaglobulinaemia
- Acquired: HIV
Aspiration
Traction
- IPF
- COPD
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4
Q

Causes of upper lobe fibrosis

A
  • Ankylosing spondylitis
  • Allergic bronchopulmonary aspergillosis
  • Hypersensitivity pneumonitis
  • Coal workers pneumoconiosis
  • sarcoidosis
  • TB
  • Histiocytosis X
  • Histoplasmosis
  • Radiation
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5
Q

Causes of lower zone fibrosis

A
  • Asbestosis
  • Drugs: bleomycin, Busulphan, Cyclophosphamide, Methotrexate, Amiodarone, Nitrofurantoin, Sulphasalazine, Gold
  • IPF
  • Connective tissue disease- scleroderma, PM, DM, Sjorgrens, SLE, MCTD
  • RA
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6
Q

Causes of transudative pleural effusions

A
  • CCF
  • Chronic liver disease
  • Chronic renal failure
  • Hypoalbumianemia- malnutrition, sepsis
  • Hypothyroidism
  • Meigs syndrome
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7
Q

Causes of exudative pleural effusions

A
  • Malignancy
  • Pneumonia
  • COnnective tissue disease
  • Infarction/ PE
  • TB
  • sarcoidosis
  • Drugs: quinidine, procainamide, hydralazine, Bromocriptine, Methotrexate, Methylsergide, nitrofuratoin
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8
Q

Differential diagnosis of dullness at lung bases

A
  • pleural thickening
  • consolidation
  • collapse
  • fibrosis
  • raised hemidiaphragm
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9
Q

Causes of SVCO

A
  • Bronchogenic carcinoma- SCLC
  • Lymphoma
  • Thrombosis
  • Thymoma
  • Teratoma
  • Aortic aneurysm
  • Post radiation fibrosis
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10
Q

Indications for lobectomy/pneumonectomy

A
  • cancer
  • emphysema
  • bronchiectasis
  • cystic fibrosis
  • IPF
  • TB
  • Aspergillosis
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11
Q

Causes of cor pulmonale

A
  • IPF
  • COPD
  • OSA
  • Kyphoscoliosis
  • neuromuscular weakness
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12
Q

Causes of pulmonary hypertension

A

WHO classification

  1. Primary arterial htn- idiopathic pul.htn, familial pul.htn, disease related to collagen vascular disease, HIV and drugs
  2. Pulmonary venous hypertension: LVF/CCF
  3. Chronic hypoxia: COPD, IPF, OSA, Kyphoscoliosis
  4. Thrombotic/embolic disease: PE, sickle cell
  5. Miscellaneous: sarcoidosis, Langerhans cell histiocytosis
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13
Q

Causes of clubbing

A 
Abdominal:
-IBD
- Cirrhosis
- Coeliac disease
Respiratory:
- Bronchiectasis
- Cancer
- IPF
- Abscess
- Asbestosis
- Cystic fibrosis
- Empyema
Cardiac:
- Congenital cyanotic heart disease
- Atrial myxoma
- SBE
Miscellaneous:
- Hyperthyroidism
- Fistulae
- Infected grafts
- Familial
- Idiopathic
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14
Q

Causes of leuchonychia

A
  • Hypoalbuminaemia- malnutrition, malabsorption, protein losing enteropathy, nephrotic syndrome
  • Cirrhosis
  • Idiopathic
  • Familial
  • Arsenic poisoning
  • Heavy metal poisoning
  • chemotherapy
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15
Q

Causes of Koilonychia

A
  • Idiopathic
  • Familial
  • Chronic iron def anaemia
  • Nail-patella syndrome
  • Exposure to solvents
  • Peripheral vascular disease
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16
Q

Causes of spider naevi

A
  • Childhood
  • pregnancy
  • OCP
  • cirrhosis
  • thyrotoxicosis
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17
Q

Causes of acanthosis nigricans

A
  • obesity
  • T2DM
  • PCOS
  • hypothyroidism
  • GI malignancy
  • Acromegaly
  • Cushings syndrome
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18
Q

causes of gynaecomastic

A
  • physiological
  • hypogonadism
  • cirrhosis
  • Drugs: spironolactone, digoxin, cimetidine, oestrogens
  • Thyrotoxicosis
  • Klienfelters syndrome
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19
Q

Causes of chronic liver disease

A
  • Alcohol
  • Viral hepatitis
  • NAFLD
  • Drug induced liver injury
  • autoimmune hepatitis/PBC
  • Haemochromatosis
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20
Q

Causes of jaundice

A

Pre-hepatic:

  • Congenital haemolysis: Heridary spherocytosis/HE, sickle cell, G6DP
  • Acquired haemolysis: AIHA, malaria

Hepatic:

  • Hepatitis- alcohol, viruses, DILI, ischaemia, AIH
  • Rotor/Dubin-Johnson
  • Gilberts/ Crigler-Najar

Post hepatic:
- Obstruction- stones, tumour, PSC, LNs, Strictures

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21
Q

causes of ascites

A
  • cirrhosis
  • CCF
  • chronic kidney disease- nephrotic
  • Portal vein thrombosis/Budd chiari
  • Mesothelioma/peritoneal mets
  • TB
  • constrictive pericarditis
  • Malabsorption syndromes
  • Ovarian cancer/fibroma
  • Myxoedema
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22
Q

Causes of isolated splenomegaly

A

Massive:

  • CML
  • Myelofibrosis
  • Kala-azar
  • malaria

Moderate:

  • CLL
  • portal hypertension

Mild:

  • SBE, CMV, EBV
  • Schistosomiasis
  • Feltys
  • AIHA
  • Lymphoid malignancy
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23
Q

Causes of hepatosplenomegaly

A
  • Cirrhosis with portal hypertension
  • Lymphoproliferative disease- CLL
  • Myeloproliferative disease- CML
  • infection
  • amyloidosis
  • Glycogen storage disease
  • Lysosomal storage disease- Gauchers, Neimann Pick
  • Haemochromatosis
  • Wilsons disease
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24
Q

Causes of epigastric mass

A
  • carcinoma- stomach, pancreas, colon
  • Lymphoma
  • AAA
  • caudate lobe of liver
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25
Q

Causes of right iliac fossa mass

A
  • renal transplant
  • caecal cancer
  • appendix mass
  • Crohns inflammatory mass
  • faeces
  • ovarian tumour
26
Q

Causes of left iliac fossa mass

A
  • colon cancer
  • renal transplant
  • ovarian tumour
  • faeces
  • diverticular mass/abcess
27
Q

causes of unilateral renal enlargement

A
  • hydronephrosis
  • renal carcinoma
  • renal cyst
  • congenital abnormality- horseshoe kidney
  • unilaterally palpable bilateral pathology
28
Q

Causes of bilateral renal enlargement

A
  • ADPKD
  • Tuberous sclerosis
  • Von Hippel Lindau
  • Bilateral hydronephrosis
  • Amyloidosis
  • congential abnormalities
29
Q

Causes of aortic stenosis

A
  • calcific
  • bicuspid
  • rheumatic
30
Q

Indications for aortic valve replacement in aortic stenosis

A

Symptomatic- syncope, angina, dyspnoea

Asymptomatic, mean gradient >40mmHg and:

  • LVEF <45%
  • Reduction in BP with exercise
  • VT
  • Valve area <0.6cm
  • LVH >15mm

TAVR/TAVI if meet criteria but mod-high surgical risk

31
Q

Causes of aortic regurgitation

A

Acute:

  • Aortic dissection
  • Infective endocarditis
  • Rheumatic heart disease
  • Prosthetic valve failure

Chronic:

  • HTN
  • Bicuspid aortic valve
  • Ankylosing spondylitis
  • Marfans syndrome
  • Rheumatic heart disease
  • Endocarditis
  • Syphilis
  • Osteogenesis imperfecta
32
Q

Indications for aortic valve replacement in aortic regurgitation

A

Acute AR- severity anything more than mild

Chronic- if symptomatic
Asymptomatic + any of:
- Dilated LV
- EF <50%
- Regurgitant fraction >50%
-
33
Q

Causes of mitral stenosis

A
  • Rheumatic heart disease
  • Degenerative – severe calcification
  • Non-valvular: LA thrombus, atrial myxoma, endocarditis vegetations
  • Congenital:
    Cor triatriatum
    Shone’s syndrome
    Mucopolysaccharidoses
    Bronchial carcinoid
  • Drugs: methylsergide, cabergoline
34
Q

Indications for percutaneous mitral balloon valvulopasty in mitral stenosis

A

Symptomatic- NYHA II+ & moderate/sever MS

Asymptomatic with
- moderate (MVA 1-1.5cm2 or mean gradient 5-10mmHg)
- severe (MVA <1cm2, mean gradient >10mmHg)
- PASP 50mmHg at rest, rises to >60mmHg on exercise
- new AF
PAWP >25mmHg

NYHA III-IV should have surgery ideally

35
Q

Causes of mitral regurgitation

A 
Myxomatous degeneration
Functional secondary to LV dilatation
Ischaemic
Rheumatic
Mitral valve prolapse
- Idiopathic
- Hereditary
-Connective tissue disease
36
Q

Indications for mitral valve repair in MR

A
  • EF 30-60% + LV end systolic >40mm

- severe MR and new AF or PASP >50mmHg

37
Q

Causes of tricuspid regurgitation

A
  • pul.htn
  • Endocarditis
  • Ebsteins anormaly
  • Carcinoid syndrome
  • Rheumatic fever
38
Q

Causes of pul. stenosis

A
  • Congenital- maternal rubella, tetralogy of fallot, foetal alcohol syndrome
  • Occasionally rheumatic fever
39
Q

Causes of left sided heart failure

A
  • HTN
  • IHD
  • valve disease
  • cardiomyopathy- DCM, restrictive, hypertrophic
  • myocarditis
40
Q

Causes of right sided heart failure

A
  • Cor pulmonale
  • Left sided heart failure
  • RV cardiomyopathy
  • pulmonary and tricuspid valve problems
41
Q

Causes of constrictive pericarditis

A
  • idiopathic
  • radiotherapy
  • uraemia
  • TB
  • Malignancy
  • Autoimmune
  • Post-traumatic
42
Q

Causes of PDA

A
  • idiopathic
  • congenital rubella
  • high altitude
  • prostaglandins
  • prematurity
43
Q

Associations with coarctation

A 
Bicuspid aortic valve
VSD
Mitral valve prolapse
PDA
Turner’s syndrome
Marfan’s syndrome
Berry aneurysms
NF1
44
Q

Causes of spastic gait

A 
Demyelination
Cerebral palsy
Transverse myelitis
MND
Spinal cord compression
Syringomyelia
Anterior spinal artery infarction
Hereditary spastic paraparesis
Tropical spastic paraparesis
Parasagittal meningioma
Fredreich’s ataxia
B1 deficiency
B12 deficiency
45
Q

Causes of parkinsonism

A 
Parkinson’s disease
Parkinson’s plus syndrome
Vascular parkinsonism
MPTP, manganese
Neuroleptics, antiemetics
Huntington’s disease
Wilson’s disease
Dementia pugilistica
NPH
46
Q

Causes of hemiparesis

A 
Infarction/haemorrhage
Space occupying lesion
Demyelination
Trauma
AVM
47
Q

Causes of proximal weakness

A 
Hypothyroidism
Cushing’s
Inflammatory myopathies: PM, DM
Toxins: alcohol, statins
Muscular dystrophies
Metabolic myopathies: McArdle’s
Myasthenia/LEMS
GBS/CIDP
Cord lesion
48
Q

Causes of pseudobulbar palsy

A 
Infarction/haemorrhage
Demyelination
MND
Tumours
Traumatic brain injury
Neurodegenerative disorders
Neurosyphilis
49
Q

Causes of bulbar palsy

A 
Infarction/haemorrhage
Tumour
Demyelination
Myasthenia
MND
Polio
Syringobulbia
50
Q

Causes of chorea

A 
Sydenham’s chorea
Drug-induced: OCP, anti-convulsants
Pregnancy
PRV
Infarction
Wilson’s disease
Huntington’s disease
Spinocerebellar ataxias
Ataxia telangiectasia
Prion disease
51
Q

Causes of cerebellar syndrome

A 
Infection/haemorrhage
Demyelination
Tumour
Alcohol, carbamazepine, phenytoin
Vitamin B12, copper, vitamin E deficiency
Hypothyroidism
Spinocerebellar ataxias
Ataxia telangiectasia
Fredreich’s ataxia
Multiple systems atrophy
Paraneoplastic syndrome
52
Q

Causes of Ptosis

A 
CN III palsy
Horner’s syndrome
Myasthenia gravis
Myotonic dystrophy
Oculopharyngeal muscular dystrophy
Chronic progressive external ophthalmoplegia
53
Q

Causes of Ophthalmoplegia

A 
Thyroid eye disease
Myasthenia gravis
Chronic progressive external ophthalmoplegia
Kearns-Sayre
Miller-Fisher syndrome
Cranial nerve palsies
Brainstem lesion
54
Q

causes of downbeat nystagmus

A

Arnold-Chiari malformation
Syringobulbia
Demyelination
Drug toxicity – Phenytoin

55
Q

Causes of upbeat nystagmus

A

Demyelination
Stroke
Wernickes encephalopathy

56
Q

Causes of absent ankle jerks and extensor plantars

A

Implies mixed upper and lower MN:

  • Mixed pathology- PN and cervical myelopathy
  • MND
  • Fredrichs ataxia
  • B12 def
  • Syringomyelia
  • neurosyphilis
  • tumours of cauda or conus
57
Q

Causes of radiculopathy

A 
Disc herniation
Cervical and lumbar spondylosis
Spinal stenosis
Compression: Tumours, abscess, metastasis
GBS
Infection: CMV, Borrelia, Zoster
58
Q

Causes of sensorimotor neuropathy

A

Diabetes
B12/Folate
Alcohol
Drugs: Metronidazole, nitrofurantoin, cisplatin, vincristine, amiodarone, isoniazid
Hypothyroidism
Renal failure
Liver failure
Infections – VZV, HIV, leprosy, syphillis
Vasculitis – SLE, Sarcoidosis, RA, Cyroglobulinaemia

59
Q

Causes of motor neuropathy

A 
Diabetes (Amyotrophy)
Porphyria
Heavy metal toxicity – Lead
GBS/CIDP
Myeloma/MGUS
Multifocal motor neuropathy with conduction block
60
Q

Causes of motor neuropathy

A 
Diabetes (Amyotrophy)
Porphyria
Heavy metal toxicity – Lead
GBS/CIDP
Myeloma/MGUS
Multifocal motor neuropathy with conduction block
61
Q

Causes of sensory neuropathy

A

Paraneoplastic
Sjogren’s syndrome
Drugs
Fredreich’s ataxia

62
Q

Causes of mononeuritis multiplex

A 
Diabetes mellitus
Alcohol
Primary vasculitis: PAN, Churg-Strauss
Secondary vasculitis: RA, SLE, cryoglobulinaemia, sarcoid
Infection – HIV
Paraneoplastic

PACES revision (12 decks)

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