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Incorrect qs Flashcards

1
Q

causes of hypothyroidism

A

HASHIMOTO’S THYROIDITIS
atrophic hypothyroidism
post-partum thyroiditis
iatrogenic- thyroidectomy, radioactive iodine tx
drug-induced
iodine deficiency

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2
Q

difference between Hashimoto’s thyroiditis and atrophic hypothyroidism

A

goitre or thyroid peroxidase antibodies (TPO-Ab) in Hashimoto’s

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3
Q

difference between UMN lesion and extrapyramidal lesion in Parkinsons

A

UMN: rigidity in limb mvt where resistance falls as mvt continues (clasp knife reflex)
Parkinsons: rigidity and resistance remains the same throughout the mvt

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4
Q

why is a decarboxylase inhibitor given with levodopa to treat Parkinson’s?

A

decarboxylase inhibitor prevents levodopa being converted to dopamine so there’s fewer peripheral side effects of levodopa AND/OR maximises the dose that crosses the bbb

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5
Q

what is seen on an AF ECG

A

no P wave
irregular + rapid QRS

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6
Q

acute AF management

A

cardioversion by DC shock w LMWH or IV amiodarone (anti-arrhythmic)
OR
ventricular rate control w either CCB, BB, digoxin or amiodarone

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7
Q

how does the body develop autoantibodies in SLE?

A

Reduced clearance by phagocytes of nuclear antigens following apoptosis so they’re transferred to lymphoid tissue where self-antigens are developed. The complexes deposit in tissue, activating complement causing inflammation and damage.

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8
Q

method of SLE dx

A

ESR raised but CRP normal
ANA +ve
MRI and CT for lesions on the brain
histological deposition of IgG and complement

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9
Q

mild SLE tx

A

prednisolone + hydroxychloroquine + NSAIDs

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10
Q

moderate + severe SLE tx

A

prednisolone + hydroxychloroquine + immunosuppressant

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11
Q

what happens in asbestosis?

A

interstitial lung disease where there’s fibrosis of the lungs from asbestos dust

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12
Q

what can develop from asbestosis and define this

A

mesothelioma- tumor of the mesothelial cells of the pleura
bronchial adenocarcinoma- tumour of the mucous-secreting glandular cells

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13
Q

asbestosis tx

A

corticosteroids

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14
Q

DIC pathophysiology

A

pro-coagulants eg cytokines/ tissue factor activate the coagulation cascade, forming blood clots which use up platelets and coagulation factors leading to microvascular thrombosis and organ failure or bleeding

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15
Q

DIC ix + dx

A

severe thrombocytopenia
hx of sepsis, trauma, malignancy
decreased fibrinogen
elevated PTT

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16
Q

conditions causing profuse bleeding

A

congenital thrombocytopenia
infiltration of bone marrow
low B12/ folate
liver disease
hypersplenism

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17
Q

UTI-causing microorganisms

A

KEEPS

Klebsiella pneumoniae
Enterococcus faecalis/ enterobacter cloacae
E coli
Pseudomonas aeruginosa/ proteus mirabilis
Staphylococcus saprophyticus/ serratia marcescens

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18
Q

pyelonephritis differentials

A

diverticulitis, aaa, kidney stones, cystitis, prostatitis

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19
Q

Define T1 + 2 DM

A

T1: insulin deficiency from autoimmune destruction of beta-cells in the pancreas (islets of Langerhans)

T2: combination of insulin resistance and deficiency

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20
Q

describe DKA

A

uncontrolled catabolism from insulin deficiency
causes peripheral lipolysis
so more free fatty acids broken down to acetyl coA in the liver
this is converted to ketones in the mitochondria
accumulation of ketones causes metabolic acidosis

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21
Q

diabetes dx from random plasma glucose and fasting plasma glucose

A

random: 11.1mmol/L
fasting: 7mmol/L

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22
Q

Age range offered mammogram and how often

A

50-69 every 3 years

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23
Q

type and species of organism that causes malaria

A

protozoa
plasmodium falciparum, p ovale, p vivax, p malariae

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24
Q

type of mosquito that carries plasmodium protozoa to humans

A

female anopheles mosquito

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25
areas of the body malaria-causing protozoa inhabit
liver RBCs gut
26
complications of malaria
fever, haemolysis, myalgia, nausea/ vomiting, anaemia, jaundice, hepatosplenomegaly, coma, ARDS, hypoglycaemia, renal failure, hypovolaemia, shock, pulmonary oedema, DIC
27
malaria tx
quinine, doxycycline, chloroquine
28
malaria differential in children
meningitis
29
adrenal hyperplasia pharmacological tx
aldosterone agonists: spironolactone, amiloride
30
hyperaldosteronism sx
HTN, weakness, cramps, polyuria, polydipsia
31
Why do 95% of abdominal aneurysms occur below the renal arteries but above the aortic bifurcation?
naturally less elastin in the arterial walls
32
What area of Virchow’s triangle does an abdominal aortic aneurysm affect?
stasis, abnormal blood flow
33
size of aneurysm to be operable
>5.5cm2
34
State Laplace’s Law
R = 1/r4
35
Describe the lifecycle of a malarial plasmodium within the human body, naming each stage of plasmodium development
Sporozoites in mosquito saliva -> goes into blood, mature into hypnozoite in liver, released as schizont into blood stream, schizont explodes releasing merezoites, which enter RBCs and become trophozoites, eventually become gametocytes, taken up by mosquito.
36
malaria gold standard ix
thick and think blood smears stained w Giemsa stain
37
target bp for DM pt
>130/80
38
complications of htn
retinopathy, heart failure, IHD, renal failure, headache, nausea
39
how to test for organ damage from htn
echo for left ventricular hypertrophy or past MI urine analysis for proteinuria from renal damage
40
signs of anaphylaxis
low bp, dyspnoea from bronchoconstriction, rash, swelling, vomiting
41
mechanism of re-exposure in anaphylaxis
allergen binds to IgE receptor cross linking causes a cascade mast cell degranulation of histamine
42
pathophysiology of BPH
benign nodular or diffuse proliferation of musculofibrous and glandular layers of prostate inner/ transitional zone enlarges
43
meningitis triad presentation
neck stiffness fever headache
44
bacterial causes of meningitis in children
streptococcus pneumoniae neisseria meningitidis haemophilus influenzae
45
meningitis CSF sample
cloudy colour neutrophils high protein low glucose
46
how to differentiate meningitis and SAH
SAH headache is sudden onset and more severe
47
meningococcal septicaemia management
IV cefotaxime no lumbar puncture due to risk of coning cerebellar tonsils/ raised intracranial pressure confirm dx w blood culture
48
DEXA results
>-1.0 normal -1.0 to -2.5 osteopenia <-2.5 osteoporosis <-2.5 plus fracture severe osteoporosis
49
what does DEXA stand for
dual energy x-ray absorptiometry
50
example of bisphosphonates
oral alendronate/ oral risedronate
51
UC histology
increased plasma cells in lamina propria crypt distortion/ branching/ abscess ulceration
52
appearance of meningococcal bacteria on microscopic examination
gram negative diplococci
53
who should be notified and when following meningitis dx
PHE immediately
54
damage to which nerve causes foot drop
common peroneal nerve
55
"owl eyes" on histology is indicative of what
cytomegalovirus
56
Wernicke's encephalopathy triad of sx
ataxia, confusion, ophthalmoplegia
57
how does menopause cause osteoporosis?
post-menopause there's lower oestrogen levels so increased number of osteoclasts and premature arrest of osteoblastic synthetic activity so high bone turnover
58
tests and results to differentiate osteoporosis and osteomalacia
bloods: Ca/ phosphate/ alkaline phosphatase is normal in osteoporosis low Ca/ low phosphate/ high alkaline phosphatase in osteomalacia
59
triad of ketoacidosis
hyperglycaemia, ketonaemia, acidaemia
60
bloods to diagnose ketoacidosis
pH <7.3 bicarbonate <15mmol/L glucose >11mmol/L ketones >3mmol/L
61
how does ketoacidosis occur?
in absence of insulin unrestrained increase in hepatic gluconeogenesis/ peripheral uptake by tissues is reduced ketones produced as bodies require glucose in cells
62
HbA1c for suspected diabetes
>48mmol/mol 6.5%
63
complicated malaria organism
plasmodium falciparum
64
complicated malaria sx
shock cerebral malaria renal failure ARDS
65
3 stages of malaria infection
exoerythrocytic stage endoerythrocytic stage hypnozoite stage/ dormant
66
uncomplicated malaria tx
quinine and doxycycline
67
Wernicke's encephalopathy triad
confusion ataxia ophthalmoplegia
68
how does COPD lead to peripheral oedema?
hypoxic kidney not perfused no excreted sodium and water
69
side effects of insulin therapy
hypoglycaemia, weight gain, hypokalaemia
70
angina gold ix
CT angiography
71
Hodgkin's RFs
HIV EBV SLE FHx
72
most common subtype of Hodgkin's
Nodular sclerosing
73
Hodgkin's subtype w worst prognosis
Lymphocyte depleted
74
which drugs are in ABVD chemo?
doxorubicin bleomycin vinblastine dacarbazine
75
4 types of seronegative spondyloarthropathies
ankylosing spondylitis psoriatic arthritis enteropathic arthritis reactive arthritis
76
what are vertebral syndesmophytes?
bony proliferations due to enthesitis between ligaments and vertebrae
77
indications of worse prognosis in ank spond
ESR >30 onset <16yrs early hip involvement poor response to NSAIDs
78
ank spond tx
NSAIDs steroids anti-TNFs
79
most common cause of an AKI
sepsis
80
hyperkalaemia first line tx 2 drugs
insulin dextrose
81
most common type of MND
amyotrophic lateral sclerosis
82
which sub-types of MND affect which type of MN
amyotrophic lateral sclerosis: UMN + LMN progressive bulbar palsy: UMN + LMN primary lateral sclerosis: UMN progressive muscular atrophy: LMN
83
how can MND be distinguished from MS and polyneuropathies?
no sensory loss or sphincter disturbance in MND
84
how can MND be distinguished from Myasthenia Gravis?
MND never affects eye movements
85
MND tx + mechanism
riluzole inhibitor of glutamate release and NMDA receptor antagonist
86
HIV tx
2 NRTI + NNRTI nucleoside reverse transcriptase inhibitor: abacavir zidovudine non-nucleoside reverse transcriptase inhibitor: nevirapine
87
define carcinoma
malignant tumour of epithelial cells
88
most common type of carcinoma in CRC
adenocarcinoma
89
bowel cancer screening programme
faecal occult blood test in men + women age 60-69
90
2 methods to stage CRC
91
aortic stenosis murmur
ejection systolic at the 2nd intercostal space, right sternal border, radiates to carotid arteries
92
mitral stenosis murmur
loud first heart sound early diastolic opening snap low-pitched decrescendo-crescendo rumbling diastolic murmur louder after Valsalva manoeuvre + exercise
93
mitral regurgitation murmur
pansystolic murmur heard best at the apex
94
aortic regurgitation murmur
blowing, high-pitched, diastolic, decrescendo begins soon after aortic component of S2 (A2) loudest at 3rd or 4th left parasternal intercostal space
95
tricuspid regurgitation
pansystolic heard best at left middle or lower sternal border

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