KEY Flashcards
Inheritance of haemophilia
X linked recessive
haemophilllia A
factor VIII deficiency
haemophillia B
factor IX deficiency
inheritance of cystic fibrosis
autosomal recessive
genetics of trisomy 14
errors of chromosomal separation (non disjunction)
What is meant by mosaic?
some cells contain the extra chromosome while others are normal
Downs syndrome?
trisomy 21
what is chromosome translocation?
chromosome abnormality caused by rearrangements between non homologous chromosomes
What is meant by balanced and unbalanced translocation?
an even exchange of information
uneven exchange of information resulting in extra or missing genes
Cause of downs syndrome extra 21 chromosome?
non disjunction (failure of 21st chromosome to separate in egg or sperm) or robertsonian translocation
main neurotransmitter involved in sleep?
melatonin
treatment of cervical cancer stage 2?
chemoradiation (cisplatin)
surgery
what is stage 2 cervical cancer?
cancer has spread outside the cervix
what does prothrombin time measure and when is it used?
warfarin
extrinsic pathway
I/fibrinogen, II/prothrombin, V, VII, X
what does APTT measure and when is it used?
un fractioned heparin
intrinsic pathway
I/fibrinogen, II/prothrombin, V, VIII, IX, X
formation of fibrin clot?
TF/VIIa initiates
V/Xa - prothrombin to thrombin- fibrin to fibrinogen
VIII/IXaamplified by thrombin
what are the vit k dependent clotting factors?
II(prothrombin), VII, IX, and proteins C, S
What is stage 1B ovarian Ca?
tumour limited to both ovaries
How do you treat stage 1B ovarian Ca?
salpingo oopherectomy and hysterectomy
what are the treatments for advanced ovarian Ca?
surgery and chemo
reed sternbergs cells?
hodgekins lymphoma
radial nerve damage?
humerous fracture
wrist drop
loss of sensation in back of hand except little finger and half of ring (ulnar)
median nerve damage?
injuries to forearm
loss of ability to abduct and oppose the thumb- ape hand deformity
sensory loss in thumb to half of ring finger
Axiliary nerve damage?
during shoulder dislocation
loss of sensation in badge area
philadelphia chromosome?
reciprocal translocation between chromosome 22 and 9. new material on 22 codes for a tyrosine kinase signalling protein that causes the cell to divide uncontrollably
seen in CML
syndenhams chorea?
rapid uncoordinated jerky movements primarily in hands face and feet
results from childhood infection of Group A strep resulting 6 months after
What is lie?
relationship of fetal longitudinal axis to longitudinal axis of uterus
longitudinal
transverse
oblique
What is presentation?
leading part presenting into pelvis
What is the vertex?
part of the fetal head lined by ant and post frontanelles and parietal emnences
what is the position?
position of the presenting part in relation to mother
OA, OP
what is the station?
location of presenting part in birth canal-5 to -1 above imaginary line at ischial spines 1 to 5 below
What is engagement?
when the widest leading part has passed through pelvic inlet
Parts 1, 2 and 3 of labour?
1- onset to full dilation 10cm
2- full dilation to delivery of fetus
3- delivery of placenta
Key things to look for on a partogram?
deaccelerations:
early- physiological- as contraction happens HR decreases due to squeezing of fetal head and stimulation of the parasympa
late- pathological- HR slows a few seconds after contraction may have overcompensatory increase after
beat to beat variability: > 5secs normal
moving accelerations: baby moving in womb >15 normal
normal fetal HR?
110-150
Fetal tachycardia and late deaccelerations. 6cm dilated. Management?
fetal blood sample to look for hypoxia. If hypoxic pH will be less than 7.3 which warrants a c section
6cm dilating and not progressing management?
syntocinon infusion and re-examin in 4hrs
if this fails to pregress labour C section
When is forceps delivery appropriate?
mother fully dilated and no progress even after syntocinon
gram negative
pink
woman with hyponatraemia and hyperkalaemia and skin pigmentation changes
Addisons
side effect of iron
makes stools black
ALL key features?
young
treatment of CML?
imatinib
What is adenomyosis?
endometriosis in myometrium
Thrush treatment?
FUNGUS NOT STI. WHITE ITCHY DISCHARGE. VULVOVAGINAL SWAB
topical clotrimazole
oral fluconazole
BV treatment?
BACTERIAL- GARDERELLA VAGINALIS IMBALANCE NOT STI. CLUE CELLS. FISHY WATERY DISCHARGE. VULVOVAGINAL SWAB
metronidazole
prostatitis treatment?
BACTERIAL FOLLOWING STI
ciproflaxin 28 days
trimethoprim if c.diff risk
Chlamydia treatment?
BACTERIA STI. DOES NOT GRAM STAIN. NAAT & PCR. VULVOVAGINAL SWAB.
azithromycin 1g or
doxycline 7days
Gonorrhoea treatment?
BACTERIA STI. GRAM -VE DIPLOCOCCUS. PURULENT DISCHARGE. FIRST PASS URINE NAAT & PCR.
IM ceftriaxone and oral azithromycin
Syphilis treatment?
BACTERIA STI. TREPONEMA PALLIDUM- spirochaete organism. DOES NOT GRAM STAIN. SWAB & PCR EARLY LESION. SEROLOGICAL BLOOD TESTS- disease activities and identify ABs
Long acting penicillin
Genital warts treatment?
clinical diagnosis
cryotherapy
podophyllotoxin cream
Trichomonas Vaginalis treatment?
PARASITE. GREEN DISCHARGE VULVOVAGINAL SWAB.
Metronidazole
What are the four main medicines in end of life care and what are they for?
morphine (pain/SOB)
midazolam (distress)
ledomepromazine (nausea)
buscopan (resp secretions)
right upper quadrant pain radiating to shoulder tip?
cholecysistis
investigation in elderly with anemia?
sigmoid colonscopy
endoscopy
(Checking for chronic bleeds)
CML and CLL seen in what age group classically?
Adults
how do you treat pneumocytis pneumonia?
co-trimoxazole
how do you treat TB?
RIPE
Isoniazid if latent
reduces inhibition?
levodopa
diarrhoaea and progressive ascending weakness?
guillain barre
battle sign behind ears
fracture of mastoid process of temporal bone/ middle cranial fossa
racoon/panda eyes
fracture of ant cranial fossa
high stepping gait and rombergs positive
cervical myelpathy
treatment of hypertensive crisis
phentolamine infusion
statin avoid with
grapefruit juice
metronidizole avoid with
alcohol
warfarinavoid with
cranberry
what happens with warfarin and amioderone?
amioderone potentiates effect of anticoagulant
avoid statin and
clarithromycin
clacium and thyroxine cause
decreased absorption from gut
warfarin and nsaid cause?
bleeds (not low dose aspirin)
digoxin and verapamil cause
digoxin toxicity
fluocetie and phenelzine cause?
serotonin syndrome - hyperthermia, tremor
what is priapism ass. with
sickle cell disease
gum infiltration
bilobed large mononuclear cells
AML
smudge cells, peripheral blood lymphocytes, small mature lymphocytes
CLL
VWD
prolonged bleeding and APTT
IgM paraprotein
waldenstorms macroglobulinaemia
raised esr and osteoporosis
myeloma until proven other wise
