MEDgems Flashcards
what is the chemotherapy option for pancreatic cancer?
folfirinox
5-FU based
what enzyme is specific to Liver?
alanine aminotransferase
hepatocyte
ALT
what enzyme is present in liver, muscle and heart cells?
aspartate aminotransferases
ast
what pattern suggests alcoholic hepatitis?
AST:ALT ration>2
just raised GGT
enzyme marker in gilberts?
UDP-glucuronyl transferase
what is the pancreatic cancer marker?
carbohydrate antigen 19-9
what is INR and what is good to measure?
so basically time it takes to clot - prothrombin time is a good measure of this and the inr is an internationalused normalised ratio of that
histochemical stain for wilsons?
rhodanine
first line management for severe haemochromatosis
therapeutic phlebotomy
how can wilson be managed?
trientine - copper chelator
iron chelator used to treat haemochromatosis?
desferrioxamine
MEN - inheritance pattern?
MEN 1 - all P’s
autosomal dominant
autosomal dominant
pituitary adenoma
parathyroid hyperplasia
pancreatic
men 2A
think all C’s
parathyroid hyperplasia
medullary thryoid carcinoma
phaeochromoctyoma
calcitonin (medullary thyroid)
calcium (parathyroid)
catecholamine (phaeo)
MEN2B
think B’s
Big marfanoid
belly problems
medullary thyroid carcinoma
phaeo
marfanoid
mucosal neuroma’s
hepatocellular carcinoma
tumour marker
alpha fetoprotein
zollinger-ellison syndrome - which neuroendocrine syndrome
gastrinoma
biliart tract markers?
Gamma glutamyltransferase
alkaline phosphatase
hepatic adenomas are associated with what common medication?
OCP
hepatic ischaemia biomarker
alanine aminotransferase
wilson’s disease serum findings
low serum copper and low serum ceruloplasmin
low ceruloplasmin implies abnormal copper handling- wilsons
palpable lymph node - left supraclavicular
troisier sign
what is metaplasia
1 cell type > another
what is dysplasia?
abnormal cells within tissue/organ
poorly controlled UC can lead to what subtype of malignancy?
adenocarcinoma
what structure represent weak point in bowel wall?
lead to formation of diverticula
taenia colia
dilated veins commonly found in oesphagus associated with portal hypertension
varices
regenerating mucosa which project into lumen of bowel
visualised in colonoscopy of pt with UC?
pseudopolyp
non-caseating granuloma seen in IBD?
Crohn’s
what does CEA stand for?
carcinoembryonic antigen
what protein in stool presence of intestinal inflammation?
calprotectin
- increased intraluminal neutrophil
- sign of IBD
honeycomb lung?
SOB,dry cough
interstitial lung disease
oat shaped cells on biopsy - what cancer?
small cell lung cancer
in UK most common lung cancer?
adenocarcinoma
positive signet ring sign - HRCT
bronchial wall thickening
bronchiectasis
what enzyme released by neutrophils causes development of emphysema in lungs?
what inhibits this?
neutrophil elastase
alpha 1 antitrypsin
what makes up COPD?
chronic bronchitis
emphysema
restrictive picture on spirometry?
reduced FEV1
reduced FVC
normal FEV1/FVC ratio
tram track opacities on xray
CF - colonised with pseudomonas aeruginosa
bronchiectasis
ix of pulmonary fibrosis?
lung function test
spirometry - restrictive pattern
CXR - normal
high resolution lung CT
> honeycombing and ground glass opacities
lambert-eaton myasthenic syndrome is associated with?
SCLC
what does SCLC produce that causes the paraneoplastic Cushing syndrome?
ACTH
most common cancer men
prostate
lung
bowel
most common cancer women
breast
lung
bowel
uterus
post infection nephritis?
post streptococcal glomerulonephritis
prostate cancer scoring system
gleason
what intracerebral tumour is MEN type 1 associated with?
pituitary adenoma
types of testicular tumours?
seminoma (most common)
teratoma (LDh.bhcg, afp)
yolk sac tumour
what is a common symptom of multiple sclerosis
that affects the eye ?
how to best investigate this?
MRI brain and optic nerves
to investigate optic neuritis
alport is inherited how?
x linked
affects kidneys and ears
more common in men
nephritis
deafness
eye disorder
new st elevation
normal troponin?
myocardial infarction as troponin takes time to be diagnostic - 4 hours minimum
what is the treatment for metastatic high grade prostate cancer?
mets probably to bone, bladder
gleason score >8
docetaxel based chemo
anti-androgen therapy BICALUMATAMIDE
lucid interval followed by LOC suggests what on the background of TBI?
extradural haemorrhage
suspected renal cancer
‘ neoplastic cells with transparent cytoplasm. Cell arranged in nest’s with intervening blood vessels’
clear cell cancer
suspected renal cancer
‘ neoplastic cells with transparent cytoplasm. sheet of large cells with distinct cell borders seen’
chromophobe
Clinical Assessment and Imaging are two parts of the “Triple Assessment” for suspected breast malignancy.
What is the final component of Triple Assessment?
histology
first line chemo drug for prostate cancer?
docetaxel
Extradural haemorrhage - damage to which vessel?
middle meningeal artery
fasting blood glucose values above whatis diagnostic of diabetes?
7
_____ are typically soft, systolic murmurs heard best at the left lower sternal edge.
Flow murmurs
hyperdynamic cicrulations ; pregnancy, anaemia, severe blood loss
waxy casts in urine- associated with?
ckd
> breakdown of kidney tissue; indicates severe damage
what organism is commonly associated with HUS?
escherichia coli
surgical option for prostate cancer?
radical prostatectomy
Kimmelstiel Wilson nodules found in a renal biopsy are associated with
Diabetes
Thickened glomerular basement membrane, scarring, and antibody complex and complement deposits.
nephrotic syndrome subtype?
focal segmental glomerulosclerosis
Persistent ST elevation post myocardial infarction- no chest pain?
ventricular aneurysm
> ventricular free wall rupture and eath
cardiac MRI/echo
recent history of a sore throat, a non-blanching rash over his legs, and presents with nephritic syndrome and cola coloured urine
IgA nephropathy
v1 and V2 show which aspect of the heart?
anteroseptal
