HIGH YIELD CRAM Flashcards
Which 2 types of renal stones are radio-lucent
Urate and xathine
Cysteine are semi-opaque
Calcium and phosphate are radio-opaque
5 inducers of the P450 system
SCARS
Smoking
Chronic Alcohol
Anti-epileptics but not valproate (carbemazepine, phenytoin)
Rifampicin
St John’s Wart
Also barbiturates
9 inhibitors of the P450 system
SSRIs
Omeprazole
Valproate
Acute Achilles
Antibiotics e.g. ciproflox, eryth
Amiodarone
Allopurinol
Isoniazid
Zoles e.g. ketoconazole
How do the 3 main types of brain bleed present on CT and which vessels
Extradural haemorrhage= biconvex (lemon) that doesn’t cross the suture lines= arterial injury
Subdural haemorrhage= crescent-shaped that can cross suture lines = bridging veins
Subarachnoid haemorrhage= hemorrhage in the CSF where the CofW is located
I think these will all be hyperdense (blood, IV contrast)- gets less light as time goes on
Air, fat and ischaemia are all hypodense
Hyperdense= lighter
How does the presentation of extradural and subdural haemorrhage differ from each other
Extradural haemorrhage= biconvex (lemon) that doesn’t cross the suture lines= arterial injury
Subdural haemorrhage= crescent-shaped that can cross suture lines = bridging veins
Subarachnoid haemorrhage= hemorrhage in the CSF where the CofW is located
I think these will all be hyperdense (blood, IV contrast)- gets less light as time goes on
Air, fat and ischaemia are all hypodense
Hyperdense= lighter
Management of extradural vs subdural haemorrhage
Extradural = expedient evacuation via craniotomy
Subdural = depends on size and location but often conservative or drain with burr holes
Difference between Weber’s syndrome and lateral medullary syndrome
Weber’s= contralateral WEAKNESS of upper and lower extremity + ipsilateral CN III palsy (down and out). Caused by branches of the posterior cerebral artery that supply the midbrain
Lateral medullary syndrome= PICA infarction. Ipsilateral facial pain and temp loss and contralateral pain and temperature loss- also nystagmus and ataxia (cerebellar signs)
Which region of stroke causes aphasia
Middle cerebral side on their dominant hemisphere which is pretty much always the LEFT side
So aphasia probably put LMCA
How does aortic stenosis present
Ejection systolic
Radiates to carotids
Slow rising pulse
Heaving apex beat
(Caused by calcification, bicuspid aortic valve, rheumatic HD)
How does aortic regurg present
Early diastolic
Loudest at left sternal edge
Collapsing pulse
(Caused by bicuspid aortic valve, congenital defects, infective EC, dissection, Marfans)
How does pulmonary stenosis present
Ejection systolic
Loudest at pulmonary area, radiates to left shoulder
Prominent “A waves” in JVP
Caused by congenital syndromes, RF, carcinoid
How does pulmonary regurgitation pressent
Early diastolic murmur
Loudest at left sternal edge
Loudest on inspiration
Caused by pulmonary hypertension, IEC, congenital HD
How does mitral stenosis present
Mid-diastolic murmur
Loudest at apex
Low-volume pulse, malar flush
Caused by rheumatic fever, congenital, myxoma, connective tissue disorders
How does mitral regurg present
Pansystolic murmur
Loudest at mitral area
Radiates to axilla
Displaced, hyper dynamic apex beat
Caused by infective endocarditis, MI, rheumatic fever, congenital, cardiomyopathy
How does tricuspid stenosis present
Mid diastolic murmur
Loudest at left sternal edge
Loudest on inspiration
Raised JVP, peripheral oedema, ascites
Caused by rheumatic fever, congenital disease, IEC,
How does tricuspid regurgitation pressent
Pan-systolic murmur
Loudest at tricuspid area
Loudest on inspiration
Large “V-waves” in JVP, hepatic pulsations, signs of RHF
How does duct Ectasia differ on mammogram to cancer
Microcalcifications in duct ectasia
How to distinguish between Wegener’s, Churg-Strauss and Goodpastures disease
Wegeners= GpA= cANCA, renal+URT+LRT symptoms
Churg-Strauss= eGpA= pANCA, URT+asthma symptoms
Goodpastures= anti-GBM= haemoptysis, rapid nephritis
