Intensive Revision Period Flashcards
What does the DEXA score relate to?
Compares the bone density compared to that of a healthy young adult
Key differences between psoriatic and rheumatoid arthritis
Psoriatic arthritis = results in DIP swelling, dactylitis
Both have a pattern of inflammatory arthritis
What is Scheurmann’s Disease?
Usually seen in pubertal females
See abnormal ossification of the thoracic vertebrae
Sudeck’s Atrophy =
= complex regional pain syndrome
Sulphasalazine can result in… (males)
= oligospermia
If on long term steroids need…
Need bisphosphonates e.g. alendronic acid
Make sure that they are not calcium or vitamin D deficient
What does the Weber classification relate to?
Used to assess ankle fractures
Relates to the syndesmosis (made of anterior and posterior inferior tibiofibular ligament)
Sunburst appearance =
= osteosarcoma
Blood test changes associated with Lupus (4)
Flare VS Infection
Haemolytic anaemia Leucopaenia Lymphopaenia Thrombocytopaenia ESR = raised in a flare CRP = raised in an infection
Difference in blood tests:
Primary vs Secondary Hyperparathryoidism
= calcium
Will be high in primary, low in secondary (appropriate response to hypocalcaemia)
Difference in blood tests:
Osteomalacia VS Paget’s
= calcium
Both will have high ALP and may present with pain
Calcium will be normal in osteomalacia and raised in Paget’s disease
Epidural abscess VS discitis
Discitis pain will be a prominent feature
In an abscess there may not be focal pain
Behcet’s Disease =
= a vasculitis, classically see oral and genital ulcers and uveitis
May also see a polyarteritis, arterial thrombosis or DVT
PCI - deciding on anti-platelets
= dual antiplatelets e.g. aspirin + another agent
Aspirin + Prasugrel/Ticagrelor = if not on anti-coagulants
Aspirin + Clopidogrel = on anti-coagulants
What is osteochondritis dissecans?
= loss of blood supply to part of bone, part of bone breaks off and causes pain and locking symptoms
How long are people with shingles infectious for?
Until the vesicles have crusted
What formulation is the chicken pox vaccine in?
2 doses
What is the pathophysiology of seborrhoeic dermatitis?
It is a reaction to malassezia (type of fungus)
Features of hereditary haemorrhagic telangiectasia (4)
Epistaxis
Telangiectases
Visceral lesions
Family history
Investigation of suspected contact dermatitis
Patch testing
PUVA
- Uses
- Risk
Used in management of psoriasis
Associated with SSC
Prescribing courses of topical steroids in psoriasis
Need to have a gap of 4 weeks between courses
Dot haemorrhages diagnostic of
Diabetic retinopathy
Which cells in the body rely on glycolysis?
Erythrocytes
They don’t have any mitochondria
What causes erysipelas?
Strep pyogenes
Association of thrombophelbitis migrans
What is it?
Pancreatic cancer
= Trosseau syndrome: phelbitis with a thrombus
Unusual presentation of hyperglycaemic hyperosmolar state
Focal neurology
Lateral medullary vs Weber’s Syndrome
Lateral medullary = sensory
Contralateral sensory loss body
Ipsilateral sensory loss face
Weber’s = motor
Contralateral hemiplegia
Ipsilateral CN III palsy
CMV eye disease in HIV
Use ganciclovir
Wait to start HAART until they have recovered - may cause a deterioration
Lichen planus VS sclerosus
Planus = purple Sclerosus = white, itchy, vulva
Definition of orthostatic hypotension
Drop of 20 SBP after three minutes of standing
Fluconazole and warfarin
= p450 inhibitor
Greater availability of warfarin, INR increases
Previous fracture + discharging sinus
Consider osteomyelitis
1y hyperaldosteronism VS renal cell tumour
1y = high aldosterone and low renin RCC = high aldosterone and high renin
ECG signs in digoxin toxicity (3)
T wave inversion
ST depression
Short QT
Widespread T wave inversion on ECG…
Think non-cardiac cause e.g. head injury
Indication for stopping a statin
Liver enzymes 3x the upper limit of normal
Below that, keep them on the statin and monitor
Add in management for hypertension but potassium is high
Avoid spirinolactone
Use alpha or beta blocker instead
What is cortical blindess?
= blindness without an ophthalmological cause
e.g. occipital lesion
What is reverse cholesterol transport?
Transport of cholesterol from peripheral tissues to the liver
Done by HDL - need HDL to process cholesterol
Ascending cholangitis VS acute cholecystitis
Cholecystitis = normal bilirubin Cholangitis = abnormal bilirubin, may be jaundiced
Management of acute sinusitis
Pain management
Symptoms for 2 weeks = intranasal steroid
Symptoms for 4 weeks or severe = phenoxymethylpenicillin