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Year 4 Final > Long Term Conditions > Flashcards

Long Term Conditions Flashcards

1
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Contact dermatitis

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2
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Alopecia Arata

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3
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Nail trauma

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4
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Lichen planus

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5
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Acitinic keratosis

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6
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Necrobiosis lipoidica

Yellow bits are lipids

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7
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Basal cell cancer

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8
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Impetiginous eczema

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9
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Bullous pemphigoid

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10
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Acne

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11
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Erythematous ecoriations- Treat with emolients

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12
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Vitilligo

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13
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Onocholysis

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14
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Red man syndrome

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15
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Scabies

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16
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Guttate psoriasis

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17
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Acne

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18
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Dermatomyositis

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19
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Urticaria

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20
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Erythema multiforme

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21
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Vasculitis

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22
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Eczema herpeticum

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23
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Tinea captis

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24
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TEN

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25
Signs and symptoms of hyperprolactinaemia
Galactorrhoea Irregular periods Painful periods Reduced libido Infertility Impotence
26
What are the indications for treatment of hyperprolactinaemia?
Desire for fertility Symptoms – oligomenorrhoea, amenorrhoea, galactorrhoea, loss of libido Bone density maintenance Existing or impending neurological symptoms/signs eg visual field loss, cranial nerve palsies
27
What is a short synacthen test?
The short Synacthen test is a test of adrenal insufficiency which can be used as a screening procedure in the non-critically ill patient. The test is based on the measurement of serum cortisol before and after an injection of synthetic ACTH
28
How will you investigate your suspicion of acromegaly?
IGF-1
29
Which of the following would be most effective at suppressing adrenal androgen production in classical CAH?
Hydrocortisone
30
What happens in a saline suppression test?
Give 2 L of saline over 4 hours. Normally think saline will suppress aldosterone
31
What does MEN1 involve
Hyperparathyroidism (90%) Pancreatic neuroendocrine tumours (30-70%) Pituitary adenomas (30-40%)
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What does MEN2 involve?
Medullary Thyroid Carcinoma (90-100%) Phaeochromocytoma (40-50%) Hyperparathyroidism (20-30% of MEN2A)
33
What is medullary thyroid cancer?
Neuroendocrine tumour of C cells. Produce calcitonin
34
What is the presentation of phaeochromocytoma?
Palpitations Pain Perspiration
35
Clinical features of hypocalcaemia?
Neuromuscular excitability Paraesthesia Muscle twitching Trousseau’s sign Chovstek sign Seizure Laryngospasm Bronchospasm Cardiac Prolonged QT Arrhythmia Hypotension Neuropsychiatric symptoms “brain fog”
36
Autoimmune Polyglandular Syndrome Type 2 features
Addison’s disease Autoimmune thyroid disease Type 1 diabetes
37
Investigations for hyperthyrodism?
Free T4 TSH Thyroid Antibodies Thyroid peroxidase Ab TSH Receptor Ab
38
Treatment options in hyperthyrodism
Anti-thyroid drugs Radioactive iodine Surgery
39
Differentials for midline neck lump?
Thyroglossal cyst Thyroid lump Dermoid cyst
40
Classification of thyroid FNAs
THY 1: Non-diagnostic THY 2: Benign THY 3a: Neoplasm possible atypical features but not enough to place into any other categories THY 3f: Neoplasm possible- follicular neoplasm is suspected THY 4: Suspicious of malignancy but definite diagnosis of maliganancy is not possible THY 5: Diagnostic of malignancy
41
Treatment of papillary thyroid cancer?
Total thyroidectomy Radioiodine ablation TSH suppression
42
What is adrenal vein sampling?
Simultaneous sampling from L and R adrenal veins and femoral vein
43
What are examples of mineralocorticoid receptor blocking drugs?
Sprinolactone Epleronone
44
Clinical features of Addison's
Malaise, fatigue, weakness Nausea, vomiting Abdominal pain Postural hypotension Myalgia, arthralgia Confusion, depression Electrolyte disturbances
45
What is MEN?
Tumour involving two or more endocrine glands
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What is MEN1?
Hyperparathyrodisim Pancreatic neuroendocrine tumours Pituirary adenomas
47
What is MEN2A?
Medullary thyroid carcinoma Phaeochromocytoma Hyperparathyroidism
48
Treatment of MEN 2A
Alpha blockade- Phenoxybenzamine
49
What is medullary thyroid cancer?
Neuroendocrine tumour of c cells
50
What does medullary thyroid cancer produce?
Calcitonin
51
Causes of hypocalcaemia?
Hypoparathyroidism Vitamin D deficiency Drugs Renal failure Osteoblastic bone mets Hungry bone syndrome Pancreatitis
52
What is the treatment of parathyroidism?
Recombinant PTH can be given as S/C injections
53
Features of APS-2
Addison's disease Autoimmune thyroid disease Type 1 diabetes
54
Classical feautres of APS1
Chronic mucocutaneous candidaiasis Hypoparathryodiism Adrenal insufficiecny
55
Autonomic symptoms of hypoglucameia?
Palpitations Anxiety Tremor Hunger Sweating
56
Neuroglucopaneia symptoms of hypoglycaemia?
Confusion Seizures Speech difficulty Incoordination Atypical behaviour Diplopia Coma
57
What is whipples triad?
Symptoms of hypoglycaemia Resolution with CHO Lab glucose less than 2.2 mmol/l
58
What other substance is “released” from beta cells with endogenous insulin?
C peptide
59
Pathogenesis of DKA
60
Management of DKA
61
What are the different durations of insulin
Prandial is short Basal is long Mixed has a long and short acting component
62
What are the prandial types of insulin?
Rapid acting analogue- Humalog, novarapid and apidra Short acting- Humulin S, Actrapid, insuman rapid
63
What are examples of basal insulin?
Intermediate acting Long acting analogue
64
What are examples of mixed insulin?
Rapid acting analogue intermediate mixuture Short acting intermediate mixture
65
Diagnosing Diabetes criteria
66
HbA1c levels and what it says about diabetes diagnosis
67
Pathophysiology of HHS
68
Management of HHS
69
Stages of diabetic retinopathy
Background Pre-proliferative Proliferative Maculopathy
70
What is the DIGAMI protocol?
For the management of patients admitted with acute MI who are either type 1, type 2 or are not known to have diabetes but present with a venous blood glucose of >11mmol/L
71
Principles of the DIGAMI protocol
Stop oral hypoglycaemics during acute episode Give IV dextrose to provide the myocardium with extra substrate Control blood glucose with IV insulin (sliding scale) for at least 24 hours Tight glycaemic control during and after acute MI
72
How does lipohypertrophy cause hypoglycaemia
Less insulin absorbed so insulin dose initally increased Difficulty to control blood glucose levels
73
What are the complications of HNF1A (MODY 3)
Sensitivity to sulfonylureas, prone to complications, glycosuria
74
What are the complications of PDX1/IPF1 (MODY 4)
Pancreatic agenesis
75
What are the complications of HNF1beta (MODY 5)
Variable pancreatic hypoplasia, urogenital probs, renal cysts, hyperuricaemia
76
What are the complications of NEUROD1 (MODY6)
Neurological abnormalities
77
What is the inheritance pattern of GCK MODY?
Autosomal dominant
78
Implications of GCK-MODY in pregnancy if mother GCK positive and fetus GCK positive?
Similar glucose sensing Low risk of macrosomia without treatment Risk of intrauterine growth retardiation if maternal hypergluycaemia overtreated
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Implications of GCK-MODY in pregnancy if mother GCK positive and fetus GCK negative?
Discordant glucose sensing Macrosomia risk multipled by 6 without treatment Mean birthweight increased by 700g
80
Implications of GCK-MODY in pregnancy if mother GCK negative and fetus GCK positive?
Discordant glucose sensing Mean birthweight decreased by 500g
81
Abnormal OGTT is defined by
A fasting glucose of more than 5.1 A two hour glucose of more than 8.5
82
What is carphology?
Aimlessly picking at clothes or bedding
83
What are the types of delerium?
Hyperactive delerium Hypoactive delerium Mixed delerium
84
Where can the lesion be in a neurology exam?
Brain Brainstem Cord Root Plexus Peripheral nerves NMJ Muscles
85
What are the different lesion types in neurological exam?
Vascular Inflammatory Neoplastic Toxic/metabolic/nutritional Infective Congenital/inherited Traumatic Degenerative Iatrogenic
86
What do antiplatelets do?
Inhibit platelet aggregation
87
What does aspirin do?
Inhibits cycloxygenase and thromboxane A2
88
What does clopidogrel do?
Blocks ADP receptors
89
Side effects of clopidogrel
Abdominal pain Diarrhoea Increased bleeding
90
What do statins do?
Inhibit HMG-CoA reductase a liver enzyme that synthesises cholestrol Reduces triglycerides, total nd LDL cholestrol and increasing HDL cholestrol
91
Why should statins be taken with the evening meal or before going to bed?
Because cholstrol is mostly produced at night
92
What does warfarin do?
Inhibits hepatic vitamin K dependent synthesis of clotting factors II, VII, IX and X
93
What is the target INR range?
2-3 Target 2.5
94
What are examples of novel oral direct factor Xa inhibitors?
Apixaban Betrixaban Endoxaban Rivoroxaban
95
What is an example of a novel oral direct thrombin (IIa) inhibitors
Dabigatran etexilate
96
What is the first line choice for AF?
Edoxaban
97
What are the blackout types?
Metabolic Brain Circulation Mind- FND
98
How can lewy body dementia be differentiated from Parkinson's?
time of onset of the dementia compared to the motor symptoms. So like in parkinson motor systems have been going on for at least a year, less than a year is lewy body dementia
99
What kind of dementia should you think if a stepwise progression of symptoms?
Vascular dementia
100
What is memantine?
NMDA receptor antagonist
101
First line for alzhiemers?
Acetylcholinestrase inhibitors donepezil, galantamine and rivastigmine

Year 4 Final (39 decks)

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