Laz Paper 9 Flashcards
What is the most common causative organism of post-infective glomerulonephritis?
Streptococcus pyogenes
What does post-infectious glomerulonephritis lead to?
Post-infectious glomerulonephritis leads to nephritic syndrome
Why are NSAIDs contraindicated in heart failure?
NSAIDs are contraindicated in heart failure as they can lead to increased Na+ and H2O absorption, therefore increasing blood pressure
They’re also nephrotoxic and therefore can further damage an already poorly perfused kidney
What is the management of heart failure?
Management of heart failure:
- ACE inhibitor
- Beta blocker (used with caution)
- Digoxin
- Diuretics
- Spironolactone (K+ sparing diuretic)
What is the function of alpha 1 antitrypsin?
Alpha 1 antitrypsin inhibits neutrophil produced elastase
How does alpha 1 antitrypsin deficiency present?
It presents as emphysema and cirrhosis in a young person due to elastase damage to the lungs and liver
What is prosopagnosia?
Prosopagnosia is the inability to recognise faces?
What is Paget’s disease of the breast?
Paget’s disease of the breast is eczema overlying the areolar area commonly associated with underlying breast malignancy
How does an intraductal papilloma present?
Intraductal papilloma presents as a firm lump near to the nipple with bloody discharge
What is a paradoxical embolism?
A paradoxical embolism is an embolus that traverses an atrial septal defect
What is saponification?
Saponification is the process by which acute pancreatitis can lead to hypocalcaemia as the calcium is bound to lipids
Which drugs can lead to acute pancreatitis?
Azathioprine and sodium valproate
Why is adenosine contraindicated in asthmatics?
Because it can lead to bronchospasm
What is primary amenorrhoea?
Primary amenorrhoea is never having menstruated
What is the moa of Bendroflumethiazide?
Bendroflumethiazide is a thiazide diuretic meaning it inhibits on the Na+/Cl- channels on the distal convoluted tubule, reducing water reabsorption
What is the moa of loop diuretics?
Loop diuretics act on the ascending limb of the loop of henle and inhibit the Na+/K+/Cl- triple transporter and therefore reduce water reabsorption
What is the moa of potassium sparing diuretics?
K+ sparing diuretics like spironolactone, inhibit the action of aldosterone in the collecting duct by reducing its Na+ reabsorption capabilities and therefore increase H2O excretion
What is the moa of osmotic diuretics?
Osmotic diuretics are freely filtered into the tubules and are not reabsorbed therefore increasing osmotic pressure on the tubule liquid
How would a recurrent laryngeal nerve injury present?
Dysphonia and a bovine cough
Which types of tumours can compress the recurrent laryngeal nerve?
Apical lung tumours, more commonly on the left side
What are the main investigation findings for MS?
CSF would show oligoclonal banding, MRI would show scleral plaques
What are Bence Jones proteins?
Bence Jones proteins are light chain-Ig complexes found in the urine due to multiple myeloma
Which conditions are high CSF proteins characteristic of?
High CSF proteins will be present in Guillan-Barre syndrome (autoimmune) and bacterial and fungal meningitis
What is xanthochromia?
Xanthochromia are the breakdown products of red blood cells, commonly found in the CSF 12 hours after a subarachnoid haemorrhage
What are the main acquired causes of long QT syndrome?
Hypokalaemia, hypomagnesium
What are the main inherited causes of long QT syndrome?
Romano-Ward syndrome, Jervill and Lang-Neilson syndrome
How does multiple myelosis lead to renal failure?
Multiple myelosis leads to the collection of Ig complexes which act as a precursor for amyloid fibril formation, which can deposit on the glomerulus leading to renal failure
Which organism is the most common cause of UTI?
E.coli
What are the appropriate investigations for pneumonia?
Sputum culture, chest x-ray, bronchioalveolar lavage and culture and biopsy
What are the atypical pneumonias treated with?
Atypical pneumonias are treated with clarythromicin or co-trimoxazole
How does use of antibiotics lead to C.diff infection?
Antibiotics destroy competing cut bacteria
What is the management of C.diff?
Oral vancomycin or oral metronidazole
What would be seen on C.diff colonoscopy?
Pseudomembranous colitis
What is the transmission mechanism of C.diff?
Faeco-oral
What is a codocyte?
A codocyte is another word for a target cell
Which layer is torn in an aortic dissection?
The tunica intima
How do ruptured AAAs present?
Ruptured AAAs present as acute abdominal pain with circulatory collapse
What is the ABCD2 score?
A score to assess the risk of stroke in patients with a TIA
What is the GRACE score?
A score to triage patients who have unstable angina or NSTEMI
What is the Ranson score?
Ranson score is used to assess acute pancreatitis (although the Glasgow score is now more widely used)
What is the Waterlow score?
Waterlow score is used to assess risk of pressure sores
What is the Rockall score?
Rockall score is used to assess risk of re-bleed following upper GI bleed
Why can Conn’s syndrome present with polydipsia?
Conn’s syndrome is hyperaldosteronism and can lead to hypertension and hypokalaemia.
Hypokalaemia can lead to nephrogenic diabetes insipidus
What are the ECG changes in hyperkalaemia?
- Tented T waves
- Broad QRS complexes
- Reduced P waves
What are the ECG changes in hypokalaemia?
- U waves
- ST depression
- Flattened T waves
- Prolonged PR interval
What are the secondary causes of hypertension in a young person?
- Conn’s
- Renal artery stenosis
- Co-arctation of the aorta
What is the triad for Wernicke’s encephalopathy?
- Confusion
- Ataxia
- Opthalmoplegia
What is the progression of untreated Wernicke’s encephalopathy?
Korsakoff’s psychosis (irreversible)
What are the reversible causes of cardiac arrest?
Hypovolaemia
Hypothermia
Hypoxia
Hypokalaemia/ hyperkalaemia
Toxic
Thromboembolic
Tension pneumothorax
Tamponade
How can hypothyroidism lead to hyperprolactinaemia?
Hypothyroidism increases TRH levels, which stimulates prolactin release
What does hyperprolactinaemia inhibit?
Hyperprolactinaemia inhibits GnRH release leading to hypogonadism
What is used instead of adenosine in asthmatic patients with narrow complex SVT?
Verapamil
