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4th Year > General revision > Flashcards

General revision Flashcards

1
Q

Stages of fracture repair?

A

Haematoma
- Cytokine and growth factor release

Inflammation
- Macrophage mediated phagocytosis of debris

Granulation tissue
- Collagen and neovascularisation

Soft callus

  • in order to form cartilage in endochondral bone growth
  • mesenchymal stem cells differentiate and produce fibrous cartilage

Hard callus
- cartilage into bone through chondrocyte apoptosis and osteoclast differentiation

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2
Q

Therapies for fracture repair?

A

PTH

Anti-sclerosin

BMP
- increases strength and stiffness

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3
Q

Where are trabecular and cortical bone?

A

Trabecular inside, cortical outside

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4
Q

What type of bone do you lose in osteoporosis?

A

Trabecular

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5
Q

How do bisphosphonates work?

A

Inhibit osteoclasts

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6
Q

What’s a bone lining cell?

A

Stops osteoclasts getting to bone

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7
Q

Osteopenia and osteoporosis T score?

A
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8
Q

Who should have a DEXA scan?

A

FH

Low BMI/hypogonadism/early menopause

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9
Q

Osteoporosis Tx?

A

Lifestyle

Bisphosphonates

Raloxifen

Strontium ranelate

Teriparatide - PTH, expensive

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10
Q

Typical areas of osteoporotic fractures?

A

Vertebral

Wrist

NOF

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11
Q

Big 5 underlying problems?

A

Infections

Inflammation

Malignancy

Blood flow interruption

Trauma

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12
Q

In what two broad situations is the ALP high?

A

In childhood and in liver dysfunction (and bone)

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13
Q

What conditions cause the ALP to be high pathologically?

A

Liver disease

Bone

Trauma

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14
Q

What conditions cause the ALT to be high pathologically?

A

Liver disease

Muscle disease

Drugs

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15
Q

Commonest cause of high calcium?

A

Primary hyperparathyroidism (parathyroid producing too much PTH)

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16
Q

Is rheumatoid factor good? whats better?

A

Not very specific or sensitive really, can just be raised in inflammation.

Anti-CCP is better

17
Q

HLA B27 positive in 95% of people with what?

A

Ankylosing spondylitis - although also positive in 7% of population so not very specific

18
Q

Rise in conjugated or unconjugated bilirubin indicative of biliary dysfunction?

A

Conjugated

19
Q

Rise in conjugated bilirubin Ddx?

A

Liver disease or biliary obstruction.

20
Q

Obstructive/cholestatic picture in LFTs?

A

ALP (and GGT) > ALT

21
Q

Spirometry reading that define COPD?

A

FEV1/FVC less than 70% then COPD

22
Q

Improvement of what percent in the FEV1 following bronchodilator indicates asthma?

A

15%

23
Q

Normal treatment for TB?

A

Isoniazid and rifambucin (6 months)

Pyrazinamide and ethambutol (2 months)

If possibly meningeal then give steroids too

24
Q

Four main groups of bacteria?

A

Gram positive

Gram negative

Anaerobes

Atypicals
- can’r gram stain or grow

25
Q

Common examples of gram positive organisms?

A

Staph and strep

26
Q

Common examples of gram negative organisms?

A

E coli

Klebsiella

pseudomonas

Haemophilis influenzae

27
Q

Common examples of atypical bacteria?

A

Legionella

Chlamydia

Mycoplasma

28
Q

What is the key structural difference between Gram-positive bacteria and Gram-negative bacteria?

A

Gram-negative bacteria have a double membrane

29
Q

What drugs need therapeutic monitoring of levels?

A 
Cyclosporin
Valproate
Carbamazepine
Phenytoin
Digoxin 
Lithium
Clozapine
Gentamycin 
Vancomycin
30
Q

Stages of wound healing?

A

Haemostasis
- Clotting

Inflammation
- Neutrophils then macrophage, chemotaxis and pro inflammatory mediators

Proliferation

  • Granulation tissue
  • Fibroblasts produce collagen
  • Neovascularisation
  • epithelium forms over

Maturation or remodelling

  • Stronger collagen
  • scar tissue formed
31
Q

Steps in bone healing?

A

Haematoma

Soft callous
- Mesh from granulation tissue

Bony callous

Bone remodelling

  • Strong compact bone
  • Osteoblasts
32
Q

Type of pathogen in osteomyelitis, what type of bones?

A

Osteomyelitis - bone infection

Long bones

Staphylococcus aureus (gram +ve)

4th Year (15 decks)

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