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Year 3 Medicine > Laz Paper 10 > Flashcards

Laz Paper 10 Flashcards

1
Q

What is the initial management in the GP of someone presenting with meningitis?

A

IV or IM benzylpenicillin

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2
Q

What is Kernig’s sign?

A

Kernig’s sign is lying the patient supine with flexed hip and knee and passively extending the knee elicits pain

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3
Q

What is Brudzinski’s sign?

A

Patient is lying supine and neck is flexed causing patient to flex hips and knees

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4
Q

When would dexamethasone be used in meningitis?

A

Dexamethasone would be used to reduce cerebral oedema in meningitis

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5
Q

Which crystals are associated with gout?

A

Monosodium urate rod shaped negatively birefringent crystals are associated with gout

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6
Q

What are the manifestations of gout?

A
  • Swelling of the first metatarsal joint
  • Tophi in the tendons
  • Tophi in the pinna
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7
Q

What is primary ciliary dyskinesia?

A

Disorder of the cilia which leads to ciliary paresis of the respiratory tract meaning patients may develop recurrent chest infections

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8
Q

What is the presentation of primary ciliary dyskinesia?

A
  • Recurrent chest infections (occasionally leading to bronchiectasis)
  • Situs inversus (cilia guide placement of organs, in 50% of cases organs will be on the wrong side)
  • Recurrent otitis media
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9
Q

What is Kartagener’s syndrome?

A
  • Primary ciliary dyskinesia

- Situs inversus

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10
Q

What is Caplan’s syndrome?

A
  • Rheumatoid arthritis

- Pneumoconiosis

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11
Q

What is Young’s syndrome?

A
  • Sinusitis
  • Infertility
  • Bronchiectasis
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12
Q

What is situs inversus?

A

When the organ systems develop on the wrong side of the body

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13
Q

What is the Ann Arbor scale used to stage?

A

Hodgekins and non-hodgekins lymphoma

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14
Q

What is the Gleason score used for?

A

To stage prostate cancer

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15
Q

What is the Dukes’ score used for?

A
  • Staging of colorectal cancer

- Diagnosing infective endocarditis

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16
Q

What is the Rai and Binet score used for?

A

Staging of chronic lymphocytic leukaemia

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17
Q

What is the Breslow score used for?

A

Staging of melanoma

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18
Q

Where are venous ulcers most commonly found?

A

Superior/ lateral to the medial malleolus

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19
Q

What are the common associated features with venous ulcers?

A
  • Stasis eczema
  • Lipodermatosclerosis
  • Haemosiderin deposition
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20
Q

What are simple partial seizures?

A

Simple = patient does not lose consciousness or have impaired memory

Partial = the seizure is localised to one area of the cerebrum

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21
Q

What is a Jacksonian March?

A

Jacksonian march is where the seizure starts by affecting one muscle group and spreads to other adjacent muscle groups

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22
Q

What are automatisms?

A

Automatisms are involuntary muscle movements

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23
Q

What are the scores for pressure ulcers?

A
  • Waterlow

- EPUAP (european pressure ulcer advisory panel)

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24
Q

What is the EPUAP for pressure ulcers?

A
  • Grade 1: intact skin with non-blanching erythema, may be painful or itchy
  • Grade 2: partial thickness loss of dermis, may be a blister or shallow open wound
  • Grade 3: full thickness loss of dermis, subcutaneous tissue visible, slough (tissue necrosis) may be present
  • Grade 4: full thickness loss of tissue with bone, tendon and muscle exposed, slough may be present
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25
Q

What is the most common cause of encephalitis?

A

HSV

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26
Q

What is extrinsic allergic alveolitis?

A

A hypersensitivity reaction to inhaled dust/ pollution that leads to interstitial lung disease

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27
Q

What is the difference between extrinsic allergic alveolitis and pneumoconiosis?

A

Both lead to interstitial lung disease, but pneumoconiosis is not a result of hypersensitivity reactions

28
Q

What is the moa of tamsulosin?

A

Alpha blocker

29
Q

What is the moa of finasteride?

A

5-alpha-reductase inhibitor

30
Q

What are two examples of anti-cholingergics used to treat urinary incontinence?

A

Oxybutynin and solifenacin

31
Q

Why does it take several years to develop vitamin B12 deficiency?

A

Because there are large stores in the liver

32
Q

What are the features of anti-phospholipid syndrome?

A
  • Miscarriage (recurrent)
  • Livedo reticularis
  • Thrombophilia
  • Thrombocytopaenia
33
Q

Which antibodies are associated with rheumatoid arthritis?

A

Anti-CCP

34
Q

What are anti-Jo-1 antibodies associated with?

A

Polymyositis

35
Q

What are anti-centromere antibodies associated with?

A

Limited cutaneous systemic sclerosis

36
Q

What are rose spots?

A

Red spots on the trunk due to typhoid fever

37
Q

What are roth spots?

A

Spots seen on fundoscopy due to infective endocarditis

38
Q

What is stress incontinence?

A

Increased intra-abdominal pressure causes incontinence eg. sneezing, straining etc

39
Q

What is urge incontinence?

A

The feeling of needing to urinate followed by an uncontrollable urination

40
Q

What is overflow incontience?

A

Involuntary release of urine from an already full bladder it occurs in patients with outflow obstruction or an underactive detrusor muscle

41
Q

What is double incontinence?

A

Urine and faecal incontinence

42
Q

How can Acromegaly lead to carpel tunner syndrome?

A

It causes soft tissue swelling of the wrist

43
Q

What is the Alvarado score used for?

A

Appendicitis diagnosis

44
Q

What is the modified Glasgow score?

A

A score used to triage the severity of acute pancreatits

P--> PaO2 <7.9mmol/L
A--> Age >55
N--> Neutrophils > 15x10^9/L
C--> Calcium <2 mmol/L
R--> Renal function (urea >16mmol/L)
E--> Enzymes (LDH >600, ALT >200)
A--> Albumin <32 g/L
S--> Sugar >10 mmol

A score of >3 indicates severe acute pancreatitis

45
Q

What are Lisch nodules?

A

Yellow spots on the iris that indicate neurofibromatosis type 1

46
Q

Why do patients with COPD have a bounding pulse?

A

Due to CO2 retention

47
Q

What is paraphimosis?

A

Paraphimosis is when a tight foreskin is retracted over the glans and can’t be replaced

48
Q

What is balanitis?

A

Inflammation of the foreskin and glans

49
Q

What is phimosis?

A

A tight foreskin obstructing the meatus

50
Q

What is Quincke’s sign?

A

Pulsation of the nail beds in aortic regurgitation

51
Q

What is De Musset’s sign?

A

Nodding of the head in time with the pulse in aortic regurgitation

52
Q

What is Traube’s sign?

A

‘Pistol-shot’ like systolic and diastolic pulse in the femoral artery

53
Q

What is Corrigan’s sign?

A

Pulsation of the neck in aortic regurgitation

54
Q

What is Becker’s sign?

A

Pulsation of the pupils and retinal arteries in aortic regurgitation

55
Q

What is the management of H.pylori?

A

Omeprazole (or other PPI), amoxicillin and clarithyromycin x2 per day

56
Q

What is the mechanism of neural tube defects?

A

Inability of the neural tube to close during gestation leading to anencephaly (affecting the brain) or spina bifida (affecting the spine)

57
Q

What is the sepsis 6 protocol?

A

Give 3, take 3

  • Give IV fluids
  • Give broad spectrum antibiotics
  • Give high flow O2
  • Take blood cultures
  • Take serum lactate and Hb
  • Take urine output
58
Q

What are the parameters that define sepsis?

A
  • Temperature >38, <36
  • Heart rate <90 bpm
  • Resp rate >20
  • Cell count >12,000/mm3, <4,000/mm3
  • CO2 <4.3kPa
59
Q

What is the inheritance pattern of Wilson’s disease?

A

Autosomal recessive

60
Q

How does Wilson’s present?

A

Deposits in the basal ganglia:

  • Parkinsonian symptoms
  • Changes in behaviour
  • Seizures

Deposits in the eyes:

  • Kaiser-Fleischer rings

Deposits in the liver:

  • Jaundice
  • Easy bruising
  • Variceal bleeding
61
Q

What would blood results of Wilson’s show?

A
  • Low caeruloplasmin

- Low copper

62
Q

What is the mechanism of CF?

A

Reduced functioning of the CFTR chloride ion channel leading to abnormally thick mucosal secretions

63
Q

What is the diagnostic test for CF?

A

The sweat test, >60 mmol/L of Cl- in the sweat makes CF likely

64
Q

What is Virchow’s triad?

A
  • Stasis
  • Epithelial cell damage
  • Hypercoagulability
65
Q

What will an x-ray of mesothelioma show?

A

Lung tumour proximal to the pleura (peripheral)

Year 3 Medicine (22 decks)

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