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Year 4 Final > Long Term Conditions > Flashcards

Long Term Conditions Flashcards

1
Q
A

Contact dermatitis

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2
Q
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Alopecia Arata

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3
Q
A

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
Q
A

Necrobiosis lipoidica

Yellow bits are lipids

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7
Q
A

Basal cell cancer

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8
Q
A

Impetiginous eczema

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9
Q
A

Bullous pemphigoid

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10
Q
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Acne

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11
Q
A

Erythematous ecoriations- Treat with emolients

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12
Q
A

Vitilligo

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13
Q
A

Onocholysis

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14
Q
A

Red man syndrome

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15
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A

Scabies

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16
Q
A

Guttate psoriasis

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17
Q
A

Acne

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18
Q
A

Dermatomyositis

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19
Q
A

Urticaria

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20
Q
A

Erythema multiforme

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21
Q
A

Vasculitis

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22
Q
A

Eczema herpeticum

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23
Q
A

Tinea captis

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24
Q
A

TEN

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25
Q

Signs and symptoms of hyperprolactinaemia

A

Galactorrhoea
Irregular periods
Painful periods
Reduced libido
Infertility
Impotence

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26
Q

What are the indications for treatment of hyperprolactinaemia?

A

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

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27
Q

What is a short synacthen test?

A

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

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28
Q

How will you investigate your suspicion of acromegaly?

A

IGF-1

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29
Q

Which of the following would be most effective at suppressing adrenal androgen production in classical CAH?

A

Hydrocortisone

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30
Q

What happens in a saline suppression test?

A

Give 2 L of saline over 4 hours. Normally think saline will suppress aldosterone

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31
Q

What does MEN1 involve

A

Hyperparathyroidism (90%)
Pancreatic neuroendocrine tumours (30-70%)
Pituitary adenomas (30-40%)

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32
Q

What does MEN2 involve?

A

Medullary Thyroid Carcinoma (90-100%)
Phaeochromocytoma (40-50%)
Hyperparathyroidism (20-30% of MEN2A)

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33
Q

What is medullary thyroid cancer?

A

Neuroendocrine tumour of C cells. Produce calcitonin

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34
Q

What is the presentation of phaeochromocytoma?

A

Palpitations
Pain
Perspiration

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35
Q

Clinical features of hypocalcaemia?

A

Neuromuscular excitability
Paraesthesia
Muscle twitching
Trousseau’s sign
Chovstek sign
Seizure
Laryngospasm
Bronchospasm

Cardiac
Prolonged QT
Arrhythmia
Hypotension

Neuropsychiatric symptoms
“brain fog”

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36
Q

Autoimmune Polyglandular Syndrome Type 2 features

A

Addison’s disease
Autoimmune thyroid disease
Type 1 diabetes

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37
Q

Investigations for hyperthyrodism?

A

Free T4
TSH
Thyroid Antibodies
Thyroid peroxidase Ab
TSH Receptor Ab

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38
Q

Treatment options in hyperthyrodism

A

Anti-thyroid drugs
Radioactive iodine
Surgery

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39
Q

Differentials for midline neck lump?

A

Thyroglossal cyst
Thyroid lump
Dermoid cyst

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40
Q

Classification of thyroid FNAs

A

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

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41
Q

Treatment of papillary thyroid cancer?

A

Total thyroidectomy
Radioiodine ablation
TSH suppression

42
Q

What is adrenal vein sampling?

A

Simultaneous sampling from L and R adrenal veins and femoral vein

43
Q

What are examples of mineralocorticoid receptor blocking drugs?

A

Sprinolactone
Epleronone

44
Q

Clinical features of Addison’s

A

Malaise, fatigue, weakness
Nausea, vomiting
Abdominal pain
Postural hypotension
Myalgia, arthralgia
Confusion, depression
Electrolyte disturbances

45
Q

What is MEN?

A

Tumour involving two or more endocrine glands

46
Q

What is MEN1?

A

Hyperparathyrodisim
Pancreatic neuroendocrine tumours
Pituirary adenomas

47
Q

What is MEN2A?

A

Medullary thyroid carcinoma
Phaeochromocytoma
Hyperparathyroidism

48
Q

Treatment of MEN 2A

A

Alpha blockade- Phenoxybenzamine

49
Q

What is medullary thyroid cancer?

A

Neuroendocrine tumour of c cells

50
Q

What does medullary thyroid cancer produce?

A

Calcitonin

51
Q

Causes of hypocalcaemia?

A

Hypoparathyroidism
Vitamin D deficiency
Drugs
Renal failure
Osteoblastic bone mets
Hungry bone syndrome
Pancreatitis

52
Q

What is the treatment of parathyroidism?

A

Recombinant PTH can be given as S/C injections

53
Q

Features of APS-2

A

Addison’s disease
Autoimmune thyroid disease
Type 1 diabetes

54
Q

Classical feautres of APS1

A

Chronic mucocutaneous candidaiasis
Hypoparathryodiism
Adrenal insufficiecny

55
Q

Autonomic symptoms of hypoglucameia?

A

Palpitations
Anxiety
Tremor
Hunger
Sweating

56
Q

Neuroglucopaneia symptoms of hypoglycaemia?

A

Confusion
Seizures
Speech difficulty
Incoordination
Atypical behaviour
Diplopia
Coma

57
Q

What is whipples triad?

A

Symptoms of hypoglycaemia
Resolution with CHO
Lab glucose less than 2.2 mmol/l

58
Q

What other substance is “released” from beta cells with endogenous insulin?

A

C peptide

59
Q

Pathogenesis of DKA

A
60
Q

Management of DKA

A
61
Q

What are the different durations of insulin

A

Prandial is short
Basal is long
Mixed has a long and short acting component

62
Q

What are the prandial types of insulin?

A

Rapid acting analogue- Humalog, novarapid and apidra
Short acting- Humulin S, Actrapid, insuman rapid

63
Q

What are examples of basal insulin?

A

Intermediate acting
Long acting analogue

64
Q

What are examples of mixed insulin?

A

Rapid acting analogue intermediate mixuture
Short acting intermediate mixture

65
Q

Diagnosing Diabetes criteria

A
66
Q

HbA1c levels and what it says about diabetes diagnosis

A
67
Q

Pathophysiology of HHS

A
68
Q

Management of HHS

A
69
Q

Stages of diabetic retinopathy

A

Background
Pre-proliferative
Proliferative
Maculopathy

70
Q

What is the DIGAMI protocol?

A

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
Q

Principles of the DIGAMI protocol

A

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
Q

How does lipohypertrophy cause hypoglycaemia

A

Less insulin absorbed so insulin dose initally increased
Difficulty to control blood glucose levels

73
Q

What are the complications of HNF1A (MODY 3)

A

Sensitivity to sulfonylureas, prone to complications, glycosuria

74
Q

What are the complications of PDX1/IPF1 (MODY 4)

A

Pancreatic agenesis

75
Q

What are the complications of HNF1beta (MODY 5)

A

Variable pancreatic hypoplasia, urogenital probs, renal cysts, hyperuricaemia

76
Q

What are the complications of NEUROD1 (MODY6)

A

Neurological abnormalities

77
Q

What is the inheritance pattern of GCK MODY?

A

Autosomal dominant

78
Q

Implications of GCK-MODY in pregnancy if mother GCK positive and fetus GCK positive?

A

Similar glucose sensing
Low risk of macrosomia without treatment
Risk of intrauterine growth retardiation if maternal hypergluycaemia overtreated

79
Q

Implications of GCK-MODY in pregnancy if mother GCK positive and fetus GCK negative?

A

Discordant glucose sensing
Macrosomia risk multipled by 6 without treatment
Mean birthweight increased by 700g

80
Q

Implications of GCK-MODY in pregnancy if mother GCK negative and fetus GCK positive?

A

Discordant glucose sensing
Mean birthweight decreased by 500g

81
Q

Abnormal OGTT is defined by

A

A fasting glucose of more than 5.1
A two hour glucose of more than 8.5

82
Q

What is carphology?

A

Aimlessly picking at clothes or bedding

83
Q

What are the types of delerium?

A

Hyperactive delerium
Hypoactive delerium
Mixed delerium

84
Q

Where can the lesion be in a neurology exam?

A

Brain
Brainstem
Cord
Root
Plexus
Peripheral nerves
NMJ
Muscles

85
Q

What are the different lesion types in neurological exam?

A

Vascular
Inflammatory
Neoplastic
Toxic/metabolic/nutritional
Infective
Congenital/inherited
Traumatic
Degenerative
Iatrogenic

86
Q

What do antiplatelets do?

A

Inhibit platelet aggregation

87
Q

What does aspirin do?

A

Inhibits cycloxygenase and thromboxane A2

88
Q

What does clopidogrel do?

A

Blocks ADP receptors

89
Q

Side effects of clopidogrel

A

Abdominal pain
Diarrhoea
Increased bleeding

90
Q

What do statins do?

A

Inhibit HMG-CoA reductase a liver enzyme that synthesises cholestrol
Reduces triglycerides, total nd LDL cholestrol and increasing HDL cholestrol

91
Q

Why should statins be taken with the evening meal or before going to bed?

A

Because cholstrol is mostly produced at night

92
Q

What does warfarin do?

A

Inhibits hepatic vitamin K dependent synthesis of clotting factors II, VII, IX and X

93
Q

What is the target INR range?

A

2-3
Target 2.5

94
Q

What are examples of novel oral direct factor Xa inhibitors?

A

Apixaban
Betrixaban
Endoxaban
Rivoroxaban

95
Q

What is an example of a novel oral direct thrombin (IIa) inhibitors

A

Dabigatran etexilate

96
Q

What is the first line choice for AF?

A

Edoxaban

97
Q

What are the blackout types?

A

Metabolic
Brain
Circulation
Mind- FND

98
Q

How can lewy body dementia be differentiated from Parkinson’s?

A

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
Q

What kind of dementia should you think if a stepwise progression of symptoms?

A

Vascular dementia

100
Q

What is memantine?

A

NMDA receptor antagonist

101
Q

First line for alzhiemers?

A

Acetylcholinestrase inhibitors
donepezil, galantamine and rivastigmine

Year 4 Final (39 decks)

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