Laz Paper 2 Flashcards

1
Q

What is the difference in presentation between right and left sided colorectal cancer?

A

Right sided

  • More insideous onset
  • Anaemia symptoms
  • Abdominal pain

Left sided

  • PR bleeding
  • Change in bowel habit
  • Tenesmus
  • Earlier onset
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2
Q

What is tenesmus?

A

The feeling of incomplete defecation due to a space occupying lesion in the rectum

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3
Q

What are the most common sites of colorectal cancers?

A
  • Rectum
  • Sigmoid
    *
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4
Q

How does gastric cancer present?

A
  • Bloating
  • Premature fullness
  • Melaena
  • Dyspepsia
  • Vomiting
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5
Q

What are the investigations for colorectal cancer?

A
  • DRE
  • Serum CEA
  • Colonoscopy and biopsy
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6
Q

What does the anterior cerebral artery supply?

A

The medial aspects of the frontal and parietal lobes

  • Change in behaviour
  • Weakness leg>arm
  • Some hemisensory loss
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7
Q

What does the middle cerebral artery supply?

A

Lateral aspects of the frontal, temporal and parietal lobes

  • Weakness face>arm>leg
  • Hemisensory loss
  • Visual field defects
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8
Q

What does the posterior cerebral artery supply?

A

The occipital and temporal lobes

  • Contralateral homonymous hemianopia
  • Sensory deficit
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9
Q

What is subclavian steal syndrome?

A

A stenosis of the subclavian artery leading to reduced blood flow down the arm from the aorta, this leads to retrograde flow from the vertebral arteries when the arm is in use leading to syncope

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10
Q

What are the primary renal conditions that can lead to nephrotic syndrome?

A
  • Minimal change disease (most common cause of nephrotic syndrome in children)
  • Membranous nephropathy

SLE is a secondary cause

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11
Q

Which organism commonly causes Guillan Barre Syndrome?

A

Campylobacter jejuni

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12
Q

What is used to treat Pneumocystis Jerovecii?

A

Co-trimoxazole

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13
Q

What is the management for C.diff?

A
  • Oral vancomycin
  • Oral metronidazole
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14
Q

When would flucloxacillin be used?

A

For gram positive bacteria, commonly staph aureus

Usually used in skin conditions such as cellulitis

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15
Q

What are the side effects of opioids?

A
  • Constipation
  • Respiratory depression
  • Nausea
  • Drowsiness
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16
Q

What is podagra?

A

Inflammation of the first metatarsal joint (commonly found in gout)

17
Q

What is the most common cause of adrenal insufficiency worldwide?

A

TB

18
Q

Which investigation is gold standard for diagnosing adrenal insufficiency?

A

Short synacthen test, it should increase levels of cortisol

Adrenal insufficiency can be diagnosed if cortisol is <550nmol/L after 30 mins

19
Q

How can hyponatraemia be fatal?

A

If Na+ falls rapidly within 24-28 hours, it can lead to cerebral oedema, coning and respiratory depression

20
Q

What are the severity levels and symptoms of hyponatraemia?

A
  • 135-130
    • Usually asymptomatic
  • 130-125
    • Non-specific symptoms
    • Nausea
    • Vomiting
    • Headache
  • <120 very severe
    • Seizures
    • Hallucinations
    • Loss of consciousness
    • Memory loss
21
Q

What is the golden S sign on x-ray?

A

Right lower lobe collapse

22
Q

What is the 3, 6, 9 rule on x-ray?

A
  • Small bowel should be 3cm
  • Colon should be 6cm
  • Sigmoid colon should be 9cm
23
Q

What is the management of bowel obstruction?

A
  1. NG tube for aspirating stomach contents and IV fluids (drip and suck)
  2. Correction of the underlying cause

Surgery= exploratory laparotomy

24
Q

When would surgery be considered in bowel obstruction?

A
  • Obstruction has not resolved within 72 hours of conservative treatment
  • Patient is showing signs of peritonitis
  • Patient is showing signs of bowel ischaemia
  • Patient appears to have a strangulation hernia
25
Q

Which criteria is used for congestive heart failure?

A

Framingham criteria

26
Q

What is meralgia paraesthetica?

A

Damage to the lateral femoral nerve causing a pain and burning sensation to the lateral aspect of the thigh, commonly caused by weight gain and increasingly tight belts putting strain on the femoral nerve

27
Q

What is the management of meralgia paraesthetica?

A

Commonly weight loss as tighter belts and clothing puts strain on the femoral nerve, NSAIDs can also be used

28
Q

What is PBC associated with?

A

Autoimmune conditions

  • Rheumatoid arthritis
  • Sjorgen’s syndrome
  • Coeliac disease
  • Scleroderma
29
Q

What is the presentation of primary biliary cirrhosis?

A
  • Jaundice
  • Xanthelasma
  • Pruritis
  • Hepatomegaly (late stage)
30
Q

Which antibodies are present in PBC?

A

Anti-mitochondrial

31
Q
A