Last week panic Flashcards
What eye change is seen in Gardner syndrome?
Congenital hypertrophy of retinal pigment
What is Borchardt’s triad?
Epigastric pain
Retching without vomiting
Inability to pass NG
Indicates gastric volvulus
What local anaesthetic causes chocolate coloured blood?
Prilocaine
Due to methaemaglobin
What is leriche syndrome?
Triad of atherosclerotic occlusive disease involving the abdominal aorta and/or both of the iliac arteries.
Claudication in buttocks and thighs
Atrophy of musculature in legs
Impotence due to paralysis of L1
What is colle’s fascia?
A continuation of scarper’s fascia and a membranous layer of the superficial fascia of the perineum
What are the following, continuations of
- Dartos muscle + Colle’s fascia
- External spermatic fascia
- Cremasteric muscle
- Internal spermatic fascia
- Tunica vaginalis
- Scarpa’s fascia
- External oblique aponeurosis
- Internal oblique
- Transversalis fascia
- Peritoneum
What test is used to assess compression of upper airway?
flow volume loop
Anaemia and low reticulocyte count in sickle cell disease means what?
Parvovirus
What is the fluid regime for electrical burns?
4ml/kg/TBSA to achieve urine ouput of 100ml/hr
What is the antidote for methaemoglobinaemia? And what caused it?
Caused by prilocaine and antidote is methylene blue.
What is the effect of cholecystokinin on gastric emptying?
Decreases gastric emptying
What type of cancer is associated with wood work?
Ethmoid sinus cancer
What is the treatment of pseudomyxoma peritoneii?
peritonectomy (Sugarbaker procedure) and heated intra peritoneal chemotherapy
Which cells produce tumour necrosis factor?
Macrophages
Which disorder causes discrepancy in leg length?
Neurofibromatosis Type 1
It is called plexiform neurofibroma, which is a sheet of neurofibromatosis tissue which encases major nerves. In children this attracts extra blood circulation, which can accelerate growth of the affected limb.
saphena varix features
Fat people
Varicose veins present
Absent on lying down, present on standing up
More of a swelling than a mass
What is the management for proximal oesophageal SCC?
Radical chemoradiotherapy
Where do oesphageal varices drain?
Azygous/hemiazygous vein
What drugs reduce secretion of renin?
NSAIDs
Beta blockers
What is a merkel cell tumour?
Type of skin cancer
Consist of sheets and nodules of hyperchromatic epithelial cells, with high rates of mitosis and apoptosis.
The periorbital area is the commonest site.
Lymphovascular invasion is commonly seen.
What type of incision is made for an open appendicectomy in children?
Lanz
What is the blood supply to the prostate?
Inferior vesicle artery
Where does the middle rectal artery branch from?
Internal iliac artery
What is the management of malignant hyperthermia?
Dantrolene
Which muscle relaxant may produce histamine release?
Atracurium
Due to ester hydrolysis
What is the blood supply to the lacrimal apparatus?
What is the nerve supply?
Ophthalmic artery
Ophthalmic nerve (V1) - via pterygopalatine
ganglion
Causes of normal anion gap acidosis
H - hyperventilation
A - acetazolamide
R - renal tubular acidosis
D - Diarrhoea
U - Ureteral diversion
P - Pancreatic fistula
What is intravesical BCG used for?
TCC of bladder
Where does middle thyroid vein drain?
Internal jugular vein
What is the first line investigation for a 65 year old with iron deficiency anaemia?
Colonoscopy
What percentage of patients are hypertensive in phaeocromocytomas?
90%
Where are musculi pectinati found?
Right atrium
What hormone causes release of prolactin from the pituitary?
Thyrotropin releasing hormone
Does atrophic gastritis increase or decrease risk of gastric ca?
Increase
What type of necrosis is seen in malignant hypertension?
Fibrinoid necrosis
What statistical test is done for a small sample size?
Fisher’s
What is a systolic murmur and rib notching indicative of?
Coarctation of the aorta
Drugs likely to cause SIADH?
A - Analgesia (opioids, NSAIDs, amitriptyline)
B - Barbituates
C - Carbamazepine, cyclophosphamide, chlorpromazine
D - Diuretics
+ Haloperidol
What nerve provides sensory innervation to the skin overlying the lateral aspect of the nose?
Anterior ethmoidal
(branch of nasociliary, which is a branch of the ophthlamic nerve CN V1)
What condition are retinal and cerebellar haemorrhages associated with?
Von Hippel-Lindau syndrome
What vessels lie posterior to ascending colon?
Gonadal vessels
Do beta blockers increase or decrease release of insulin?
Decrease
Dobutamine binds to what receptors?
B1
What is the lymphatic drainage of the ear?
Lateral upper half - parotid
Medial upper half - mastoid and deep cervical
Lower half and lobule - superficial cervical
What renal tumours are associated with tuberous sclerosis?
Angiomyolipoma
Which type of breast cancer associated with lymphocytic infiltrate?
Medullary breast cancer
What do the spinothalamic tracts do?
Sensory - pain and temperature
What sympathetic ganglion should be divided to treat hyperhydrosis?
T2 and T3
Which nerve is responsible for the corneal reflex?
Afferent - Ophthalmic V1
Efferent - Facial
Causes of increased ion acidosis
M - methanol
U - ureaemia
D - DKA
P -Paraldehyde
I - Iron
L - Lactic acidosis
E - ethanol
S - Salicylates
What is the normal anion gap?
8-14
What antibody is associated with primary biliary cholangitis?
Anti-mitochondiral antibodies
What is meralgia paresthetica?
Meralgia paresthetica is a disorder characterized by tingling, numbness, and burning pain in the outer side of the thigh. The disorder occurs when the lateral femoral cutaneous nerve is compressed or squeezed as it exits the pelvis.
What is the embryology of the bladder?
Primitive urogenital sinus
What does c diff look like on histology?
Gram positive anaerobic rods
What does ventricular septal defect develop from?
What about atrioventricular septal defect?
bulbus cordis
Endocardial cushion
Features of central cord syndrome
Occurs due to hyperextension in elderly patient
Combination of sensory and motor symptoms
Which antibiotic can cause peripheral neuropathy?
Metronidazole
What does heart dominance mean?
Refers to which coronary artery gives off posterior descending artery
What is gold therapy used for?
Rheumatoid arthritis
Which nerve is at risk of damage during posteromedial approach of baker cyst excision?
Saphenous
Where is osteosarcoma going to metastasize first?
Lung
What bacteria causes haemolytic uraemic syndrome?
E.coli
What is the active form of vitamin D
1-25 dihydroxy cholecalciferol
Calcitriol
What is seen on histology for hashimotos thyroiditis?
intense lymphocytic infiltrate with acinar destruction and fibrosis.
How much fluid do you give as a bolus in children?
10ml/kg over 10 mins
Type of anaemia with atrophic gastritis
marcrocytic
Why might a patient by hypocalcaemic after transfusion?
Citrate toxicity
Which rotator cuff muscle is responsible for internal rotation?
Subscapularis
Mechanism of action of dobutamine
Increases contractility of heart - B1 receptors
Reduces BP - B2
Common cause of ear infection in children
moraxella cateralis
Painful neck swelling and siderophages
Thyroid cyst
What causes hyperfibrinolysis in DIC/trauma
tissue plasminogen (activator)
Nerve injured in supracondylar fractures
Anterior interosseus (median)
What is the mechanism of action of naloxone?
Competitive antagonist
Amyloid composition in:
- renal
- multiple myeloma
- heart
- AA
- AL
- Attr
Bifurcation of carotids?
C4
Histological finding in rheumatoid arthritis?
Necrobiotic granuloma
Antibiotic for bacteroides?
Metronidazole
Which muscle causes abduction and adduction of vocal cords?
Abduction - Posterior cricoarytenoid
Adduction - Lateral cricoarytenoid
What is the q sofa score?
screening for sepsis
Altered mental state
Systolic BP<100
RR>22
What type of antibiotic is vancomycin?
glycopeptide
What drains into the superior meatus
posterior ethmoid
sphenoid
Klumke’s presentation
Claw hand
Supinated
Loss of sensation in C8-T1 dermatomes
Horner’s syndrome
monitor for recurrence in medullary cancer if calcitonin isnt available
CEA
stellate ganglion lcoation
C7-T1
Which part of kidney produces EPO
Interstitial fibroblasts
