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MSRA > Immunology & Metabolic > Flashcards

Immunology & Metabolic Flashcards

1
Q

Allergy tests: uses
- skin prick (1)
- radioallergosorbent test (RAST)
- skin patch (1)
- when to use RAST over the others? (1)

A
  • food allergies, pollen
  • determines IgE that reads, useful for foods, inhales allergens (e.g. Pollen), wasp/bee
  • contact dermatitis
  • RAST can be used in anaphylaxis/ extensive eczema/ patient taking antihistamines
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2
Q

Anaphylaxis:
- initial management? (dose+time) (3)
- management of refractory? (1)

A
  • IM adrenaline every 5 mins
  • 500 micrograms
  • IV adrenaline infusion AFTER 2 doses of IM
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3
Q

Adrenaline doses
- <6 months
- 6m - 6years
-6-12years
- >12 years

A
  • 100-150 micrograms
  • 150 micrograms
  • 300 micrograms
  • 500 micrograms (0.5 ml of 1 in 1,000)
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4
Q

Allergy tests:
- skin prick test control? (1)
- skin prick when to read? (1)
- skin patch when to read? (1)
- RAST how does it work? (1)

A
  • histamine
  • after 15-20 mins
  • 48 hr
  • IgE
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5
Q

Most useful test to determine anaphylaxis

A

serum tryptase

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6
Q

Hyponatraemia:
- causes of pseudohyponatraemia? (2)
- if urinary sodium >20? if hypovolaemic (3) and euvolaemic (2)
- if sodium <20?

A
  • hyperlipidaemia
  • taking blood from drip arm

Sodium >20
HYPOVOLAEMIC
- diuretics, Addisons, diuretic stage of renal failure
EUVOLAEMIC
- SIADH, hypothyroid

Sodium <20
- diarrhoea, vomiting, sweating
burns, adenoma of rectum
water excess, psychogenic polydipsia

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7
Q

SIADH and cancer - what type of lung? (1)
others? (2)

A

small cell lung cancer
(also pancreas and prostate)

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8
Q

SIADH causes:
- cancer (1)
- neurological (4)
- infectious (2)
- drugs (5)
- other (2)

A

CANCER:
- SCLC

HEAD:
- stroke
- SAD
- sub dural
- meningitis/ encephalitis/ abscess

INFECTION:
- TB
- pneumonia

DRUGS:
- sulfonylureas
- SSRIs, tricyclics
- carbamazepine
- vincristine
- cylophosphamide

OTHER:
- positive end-expiratory pressure
- prophyrias

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9
Q

SIADH
- investigations (2)
- management (4)

A

INVESTIGATIONS:
- urine osmolality
- urine sodium concentration

MANAGEMENT:
- slow correction (pontine myelinolysis)
- fluid restrict
- demeclocycline
- ADH vasopressin receptor antagonist

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10
Q

raised ALP and normal LFTs?
- raised calcium (2)
- low calcium (2)

A
  • bone cancer/ mets
    or hyperparathyroidism
  • osteomalacia or renal failures
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11
Q

statins and pregnancy

A

discontinue for 3 months before conception and during pregnancy

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12
Q

what 3 CVD conditions do you get high statin therapy (80mg) (3)

A

IHD, stroke, PVD

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13
Q

Hypocalaemia
- features? (4)
- Trousseau/ Chvosteks (2)

A
  • tetany: muscle twitching, cramping and spasm
  • perioral paraesthesia
  • if chronic: depression, cataracts
  • ECG: prolonged QT interval
  • carpal spasm + wrist flexion
  • tapping over parotid causes pain
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14
Q

ECG hyperkalaemia

A

tall-tented T waves, small P waves, widened QRS leading to a sinusoidal pattern and asystole

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15
Q

Hyperkalaemia:
- causes? (7)
- what type of acid/alkali disorder (1)

A

acute kidney injury
drugs*: potassium sparing diuretics, ACE inhibitors, angiotensin 2 receptor blockers, spironolactone, ciclosporin, heparin**
metabolic acidosis
Addison’s disease
rhabdomyolysis
massive blood transfusion

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16
Q

Management hyperkalaemia:
- initial? (1)
- delayed effect (2-3 days)? (1)
- other (2)

A
  • IVF
  • bisphosphonates
  • calcitonin
  • steroids for sarcoidosis
17
Q

Familial hyperlipidaemia:
- diagnosis? (2)

A
  • a total cholesterol level greater than 7.5 mmol/l

AND/ OR

  • a personal or family history of premature coronary heart disease (an event before 60 years in an index individual or first-degree relative)
18
Q

Deficiencies:
- B1 (2)
- B3 (niacin) (3)

A

THIAMINE (B1):
- polyneuropathy
- Wernicke-Korsakoff syndrome
- heart failure

NIACIN (B3): AKA pellegra
- dementia
- dairrhoea
- dermatitis

19
Q

isolated high uric acid with no Sx of gout: how to treat? (1)

A

No treatment needed (don’t treat asymptomatic hyperuricaemia)

20
Q

Parathyroid and ALP: how are the two related?

A

HYPERparathyoridism –> high ALP

Alkaline phosphatase (ALP) is an enzyme that is present in many tissues throughout the body, but primarily in the liver, bile ducts and bone. A rise in ALP levels can be caused by conditions that produce injury or inflammation to these tissues. Hypoparathyroidism, which involves decreased function of the parathyroid glands leading to low levels of parathyroid hormone (PTH), does not typically cause a rise in ALP. Instead, it leads to hypocalcaemia and hyperphosphatemia due to reduced bone turnover and renal phosphate excretion.

21
Q

what happens to albumin in infection

A

can decrease

22
Q

Familial hypercholesterolaemia inheritance pattern? (1)

A

autosomal dominant

23
Q

Familial hypercholesterolaemia features (3)

A
  • elevated LDL cholesterol (>5 mmol/L)
  • tendon xanthomata (pathognomonic for FH)
  • strong family history of premature cardiovascular disease (father’s MI at age 45)

(for mixed hyperlipidaemia: The presence of tendon xanthomata and the strong family history are not typical features of mixed hyperlipidaemia)

24
Q

what vitamin deficiency causes Diarrhoea, confusion and eczematous skin

A

niacin

25
Q

what vitamin def causes bleeding gums

A

Vit C

26
Q

chronic kidney disease leading to secondary hyperparathyroidism
Important for me blood s

A

Low serum calcium, raised serum phosphate, raised ALP and raised PTH -

27
Q

helps to distinguish pseudogout from gout

A

Chondrocalcinosis

( a painful type of arthritis that causes calcium pyrophosphate crystal deposits in the joint tissues)

28
Q

osteoporosis bloods

A

all normal

MSRA (22 decks)

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