Laz Paper 4 Flashcards
What is myaesthenia gravis?
An autoimmune condition characterised by anti-ach receptor antibodies, leading to increased weakness with muscle use but preserved reflexes
What are some of the early signs of myaesthenia gravis?
The most common early signs are ptosis and fatigue of the face/ neck muscles
What are the two types of bladder cancer?
- Transitional cell carcinoma
- Squamous cell carcinoma
- Schistosomiasis
What’s the gold standard investigation for bladder cancer?
Cystoscopy and biopsy
Does glomerulonephritis cause haematuria?
It causes microscopic haematuria
Which drugs can lead to GORD?
Mucosal damage
- Steroids
- NSAIDs
- Bisphosphonates
- Aspirin
Drugs that reduce motility
- Nitrates
- TCAs
- Anti-cholinergics
What is the management of GORD?
Medical
- PPI once daily
- PPI twice daily (if not responding)
Conservative
- Smaller meals
- Stop smoking
- Weight loss
- Not eating before bed
Which organism is seborrhaic eczema thought to be associated with?
Pityrosporum yeast
What is the atopic triad?
- Asthma
- Hay fever
- Eczema
Which COPD patients should long term O2 therapy be started in?
- O2 <7.3kPa on maximum treatment
- O2 7.3-8 kPa with pulmonary hypertension, polycythaemia, nocturnal hypoxia, peripheral oedema
- Terminally ill patients
What is the triad of acute mesenteric ischaemia?
Patients are classically female
- Severe abdominal pain
- Normal abdominal examination
- Shock
What is mesenteric ischaemia?
Occlusion of the superior mesenteric artery leading to ischaemia
What is the traid of chronic mesenteric ischaemia?
- Gut claudication
- PR bleeding
- Weight loss
What would abdominal x-ray of chronic mesenteric ischaemia show?
- Gasless abdomen
- Pneumatosis
- Thickening of the bowel wall
What are the most common causes of viral meningitis?
- Coxsackie A
- Herpes viruses
- HSV
- EBV
- VSV
What is not a feature of goodpasture’s syndrome?
Nasal bleeding
Which antibodies are present in auto-immune hepatitis?
Type 1
- Anti-smooth muscle
- ANA
Type 2
- Anti-LKM1
Why is lactate measured in sepsis?
Because increased lactate levels indicate increased end organ failure due to lack of perfusion
What is arthritis mutilans?
Pencilling of the joints in psoriatic arthritis
How long are patients unconscious in an epileptic seizure?
Minutes
What is overflow diarrhoea?
Faecal impaction/ blockage leads to constipation which leads to build up of faecal matter behind the blockage. Eventually diarrhoea seeps through
What is a rectocele?
A herniation of the rectum into the vaginal canal due to loss of integrity of the rectovaginal septum
What is the presentation of rectocele?
- Tenesmus
- Dysparunia
- Constipation
- Faecal incontinence
What is the inheritance pattern of PCOS?
Autosomal dominant with variable expressivity
What are the features of Turner’s syndrome?
Females only inheriting one X chromosome
- Short stature
- Primary amenorrhea
- Low set posterior hairline
- Webbed neck
What is a hypopyon?
Yellow exudate seen on the anterior chamber of the eye associated with corneal ulcers
What is a hyphema?
Blood seen in the anterior chamber of the eye associated with ocular trauma
What is the inheritance pattern of HOCM?
Autosomal dominant
What are the examination findings of HOCM?
- Ejection systolic murmur
- Double apex beat
- Jerky carotid pulse
Which medication is used to reduce the symptoms of alcohol withdrawal?
IV chlordiazepoxide
What is the function of loperamide?
Low level opioid used as an anti-diarrhoeal agent
What is the function of risperidone?
Anti-psychotic used in schizophrenia and bipolar disorder
Which stain is used for AML?
Sudan black stain
What are the two features of CLL?
- Smear cells on blood film
- Warm agglutinins
What is the presentation of Hodgekin’s lymphoma?
- Lymphadenopathy painful after alcohol
- Reed-Sternberg cells
What is the presentation of non-hodgekin’s lymphoma?
Painless cervical lymphadenopathy (enlarging)
What are the haematological features of myelodysplasia?
- Granulocytes without granules
- Hyposegmented leukocytes
- Ringed sideroblasts
What are the defining features of myelofibrosis?
- Dacrocytes
- Dry tap on biopsy/ aspiration
- Exposure to radiation
- Massive splenomegaly
What is Steven Johnson Syndrome?
A really really bad case of erythema multiforme
What is Stevens-Johnson syndrome most commonly associated with?
Anti-epileptic drugs eg. lamotrigine
What should be given alongside RIPE TB treatment?
Pyridoxine which is a vitamin B6 replacement as Isoniazid decreases B6 levels, which can lead to peripheral neuropathy
What is the normal pressure hydrocephalus triad?
- Dementia/ confusion
- Urinary incontinence
- Gait ataxia
Wacky, wet, wobbly
