Misc 3 Flashcards
1
Q
What antibodies is myasthenia gravis associated with?
A
ACh receptor Ab
2
Q
What is the most common symptom of myasthenia gravis?
A
Ocular = ptosis
3
Q
What antibodies are associated with dermatomyositis?
A
Anti-Mi-2
4
Q
What antibodies are associated with Lambert Eaton myasthenic syndrome?
A
Voltage gated calcium channel ab
5
Q
What is Whipple’s disease?
A
Bacterial infection caused by tropheryma whipplei
Causes malabsorption
Weight loss, abdo pain, diarrhea, arthritis
Common in farmers
6
Q
Describe hereditary spherocytosis
A
Genetic condition causing sphere shaped RBCs
Causes hemolytic anemia
S+S: anemia, jaundice, splenomegaly, fatigue
Can cause pigmented gallstones
Howell Jolly bodies on blood smear
7
Q
Describe acromegaly
A
Excess growth hormone - usually due to pituitary adenoma
Large hands + feet, forehead + jaw
Joint pain, thick skin, headaches, visual problems
8
Q
What is the most common pathogen in cat bites?
A
Pasteurella multocida
9
Q
What abx should be given post animal bite?
A
Co-amox or doxycycline + metronidazole
10
Q
Describe DiGeorge syndrome
A
CATCH 22 Congenital heart abnormalities Abnormal facies Thymic aplasia cleft palate Hypocalcaemia + hypoparathyroidism
Ch22 deletion
Caused by dysmorphogenesis of 3rd + 4th pharyngeal pouches
11
Q
RF for osteosarcoma
A
African 5-20 y/o (growing) or >65 (Paget's disease) Li-Fraumeni Males Metaphysis region stress
12
Q
X ray findings for osteosarcoma
A
Moth eaten appearance
New bone formation = Codman’s triangle
Sunburst appearance
13
Q
What does an onion skin, and soap bubble, appearance on x ray suggest?
A
Onion skin = Ewings sarcoma
Soap bubble = giant cell tumor (osteoclastoma)
14
Q
What are the endocrine effects of a pituitary tumor?
A
Infertility Amenorrhea Galactorrhea Decreased libido Cushings disease Acromegly Hyperpigmentation Hypothyroidism Hypoadrenalism Hypogonadism Diabetes insipidus
15
Q
What hormones are made in the pituitary?
A
GH LH FSH TSH ACTH Prolactin
16
Q
What cranial nerves are affected by pituitary tumors?
A
3, 4, 5
17
Q
Management of FB in eye
A
Topical abx
Topical cycloplegic for pain + photophobia
Eye shield
18
Q
Describe Sheehans syndrome
A
Anterior hypopituitarism
Failure to lactate, amenorrhea, breast atrophy, hypothyroidism, adrenal cortical insufficiency
19
Q
What surgeries can be performed to help in cerebral palsy?
A
Selective dorsal rhizotomy (cutting 1a sensory fibres)
Intrathecal baclofen pump insertion
20
Q
What is an endocardial cushion defect?
A
congenital heart defect common in Downs
21
Q
What is the leading cause of death in patients with multiple myeloma?
A
Bacterial infection (with encapsulated organisms eg strep pneumonia + Hib)
22
Q
Describe haemachromatosis
A
Skin hyperpigmentation Polyuria, polydipsia Hepatomegaly Fatigue Impotence Athralgia Cardiomyopathy
Autosomal recessive disease causing accumulation of iron in organs
23
Q
Describe primary biliary cholangitis (what is it, diagnostic test, LFT results, treatment, best prognostic indicator)
A
Inflammatory disease leading to fibrous obliteration of bile ducts
Diagnosed with AMA test
High ALP + GGT
Ursodiol is used to treat
Serum bilirubin is best prognostic factor
24
Q
Describe DiGeorge syndrome
A
Failure of thymus, parathyroid + other facial structures to form properly
Reduced T cells + reduced immunity (poor thymus)
Primary hypoparathyroidism
25
What is autonomic hyperreflexia?
Sudden onset headache + HTN in pt with lesion above T6 level
Bradycardia, sweating, dilated pupils, blurred vision, flushing
Occurs months after injury
Due to bowel or bladder distension
26
What can be used to reverse steatohepatitis in obese kids?
Vitamin E
27
What is the female athlete triad?
Disordered eating
Amenorrhea
Osteoporosis
28
When do you see a pale optic disc + boxcar segmentation of vessels in the eye?
central retinal artery occlusion
29
What do you see Hollenhorst plaques?
Cholesterol bodies on fundoscopy
| Associated with TIA or amaurosis fugax
30
What is amaurosis fugax?
Painless temporary vision loss due to loss of blood supply
31
What is a corkscrew sign?
Lumen-obliterating, non-peristaltic contractions in oesophagus
32
What is the stack of coins sign?
Indicates presence of small bowel haematoma
Seen on AXR
Seen frequently in people on anti-coagulants
33
What is a bull's eye lesion on AXR?
Seen in gastric mets from melanoma or lymphoma, Kaposi's sarcoma or carcinoid tumors
34
What is a whirlpool sign?
Midgut volvulus - represents superior mesenteric artery wrapping around gut + vein
35
What is the management of ASCUS?
HPV negative = routine screening in 3 years
| Positive = colposcopy
36
What is octreotide used for in scleroderma?
Improves intestinal dysmotility
37
What is the management of Reye's syndrome?
Dextrose, Vit K, Mannitol
38
Describe petrous apicitis
Triad of retro-orbital pain, lacteral rectus palsy (CN6), otorrhea
Manifestation of Gradenigo syndrome
39
What is a likely liver infection in an hispanic individual?
Entamoaba histolytica
40
When is adenosine contraindicated in SVT + what would be used instead?
CI in asthma
| Cardiovert or CCB
41
How long do you wait while a pt is in asystole after giving adenosine before commencing CPR?
20 seconds (half life of 15 seconds)
42
Describe a craniopharyngoma
Benign tumour arising from Rathke's pouch
| Can cause diabetes insipidus
43
Describe diabetes insipidus
Low ADH
Increased serum Na
Normal extracellular fluid
Decreased arginine vasopressin
44
What is Freidrich's ataxia (genetics, symptoms, treatment)
```
Most common autosomal recessive ataxia
Onset during puberty
Progressive ataxia with loss of deep tendon reflexes
Presence of Babinski's sign
Fam hx
```
treat with 5-hydroxytryptophan
45
Describe periodic paralysis
Multiple types, most common is hypokalaemia
Weakness of hips + shoulders in young people
Diagnosed with long exercise EMG
46
What is the management of Tourette's?
clonidine or AP ie pimozide
47
What is the organism responsible for B12 deficiency causing megaloblastic anemia, and what is its management?
Fish tapeworm = diphyllobothrium
| Treat with praziquantel
48
What symptoms does a clonorchis sinensis infection produce?
obstruction of biliary tract
49
Describe an infection with echinococcus granulosus
Produce unilocular cysts on liver
| Prevalent in areas with dogs raising livestock
50
Describe an infection with taenia saginata
Beef tapeworm - diarrhea
51
Describe an infection with taenia solium
Pork tapeworm - causes cysticercosis
52
Describe Bruton agammaglobulinemia
Immunodeficiency disease
Suspected when male infant becomes unwell with repeated URTIs
Absence of plasma cells
Small tonsils
53
Describe Wiskott-Aldrich syndrome
X linked recessive disease
Eczema, thrombocytopenia, immune deficiency + bloody diarrhea
Presents with bleeding
54
Describe Chediak-Higashi syndrome
```
Recessive immunodeficiency
Decreased phagocytosis
Hypopigmentation of skin, eyes + hair
Prolonged bleeding times
Recurrent infection
Peripheral neuropathy
```
55
Describe chronic granulomatous disease
X linked condition
Deficiency of NADPH oxidase
Pneumonia, infectious dermatitis, subcutaneous abscess formation
High prevalence of colitis, enteritis + gastric outlet obstruction
56
What is Whipple's triad?
Symptoms known to be caused by hypoglycaemia
Low plasma glucose
Relief of symptoms when blood glucose is raised
57
What is Cushings triad?
Bradycardia, bradynpnea, HTN
| Associated with head injuries
58
What is Samter's triad?
Seen in aspirin induced asthma
| Aspirin sensitivity, nasal polyps, asthma
59
What is Beck's triad?
Muffled heart sounds, distended neck veins + hypotension
| Diagnostic of cardiac tamponade
60
What is the management of recurrent kidney stones?
Thiazide diuretic + potassium to counter-act the hypokalaemia caused by thiazides
Fluids + potassium to alkalinise the urine
61
What is Job's syndrome?
Hyperimmunoglobulin E syndrome
| recurrent staph infections, eczema rashes + severe lung infections
62
What is the grooved pegboard test?
Test of frontal lobe deficits, evaluates manipulative dexterity
63
What is the stroop test?
Used to measure person's attention capacity + processing speed
Name colour of word - not what the word says
64
What is the digit span test?
Repeating a phone number - used for working memory
65
What is the Rey auditory verbal learning test?
Evaluates verbal memory
| Reads list of 15 words, pt has to repeat back words that they remember
66
How does renal artery supply affect HTN?
Decreased renal artery blood supply = stimulates RAT system
| Causes vasoconstriction + increased sodium retention = HTN
67
What is Zenker's diverticulum?
High pressure in lower part of pharynx causing outpouch
| Causes dysphagia, lump in neck, halitosis
68
What part of the brain is associated with gender dysphoria?
Pre-optic hypothalamic nucleus
69
What testicular tumor has the worst prognosis?
Choriocarcinoma
70
What is isolation as a defence mechanism?
Characteristic of OCD
| Remembering fine detail but without expressing affect
71
What is undoing as a defence mechanism?
Dealing with emotional conflict with words/ behaviours designed to negate unacceptable thoughts
i.e. being told bad news + going home to organise the kitchen cupboards
72
What is displacement as a defence mechanism?
Redirecting emotions towards another object/ person
| i.e. being told bad news + taking it out on the cat
73
What is intellectualisation as a defence mechanism?
Dealing with emotional stress by excessive use of abstract thinking to control disturbing feelings
i.e. being given a a diagnosis and researching it for hours
74
Describe the blood markers for hepatitis infection (HBsAg, Anti-HBs, HBeAg, Anti-HBe, Anti-HBc)
```
HBsAg = person is infectious (acute or chronic infection)
Anti-HBs = immunity through infection or vaccine
HBeAg = indicated viral replication - acute + chronic
Anti-HBe = produced in recovery
Anti-HBc = core ab, appears at onset of infection + persists for life
IgM = recent infection
IgG = long standing infection or recovery
```
75
Management of fistulizing Crohns
Anti TNF (infliximab) 1st line - check for PPD first due to risk of reactivation of TB
Azathioprine 2nd line
Surgery if unresponsive to meds
76
Common complications of intubation in epiglottitis
Segmental atelectasis
| Pneumonia is 2nd most common complication
77
What is the recommended ART for HIV?
2 NRTIs + 1 INSTI/PI (boosted with ritonavir or cobicistat)
78
What are the NRTIs in ART?
Nuceloside reverse transcriptase inhibitors - incorporated into DNA viral chain to terminate growth
-VUDINE
79
What are the INSTIs in ART?
Integrase strand transfer inhibitors - inhibits integration of HIV DNA into human genome
-GRAVIR
80
What are the classic RF for acute glaucoma?
Asian/ first nation
Peripheral anterior synechia
Hyperopia
81
Presentation of acute glaucoma
Severe periorbital pain, ipsilateral headache, blurred vision, haloes, profuse tearing
82
Management of acute angle glaucoma
Latanoprost, bethamethasone, pilocarpine
| Definitive: laser peripheral iridotomy
83
Describe magnesium toxicity
Due to Mg administration in eclampsia
Feel warm, flushing, vomiting, muscle weakness, respiratory depression, PPH
Stop infusion + treat with calcium gluconate
84
Describe an aspergilloma infection
Caused by fungus, usually involving upper lobes of lungs
| Asymptomatic with tumor like opacity on CXR
85
Describe infection with mycoplasma pneumoniae
Erythema multiforme, low Hb + agglutination of peripheral blood smear
86
What is the most common cause of painless blood in stools in toddlers?
Meckel's diverticulum + polyps
87
How to work out odds ratio?
Odds of exposure given disease = number cases exposed/ number not exposed (for case + control)
Then divide case odds by control odds
88
Describe noonan syndrome
Similar to Turners
Short height, congenital heart disease (pulmonary valve stenosis), bleeding problems, webbed neck
Can cause leukaemia
89
Describe Reye's syndrome
Encephalopathy with hepatic fatty infiltration
Follows giving aspirin in a viral syndrome
Causes hypoglycaemia + altered mental state, vomiting + abdo pain + distention
90
What ABPI indicates PVD?
>20 mmHg decrease in systolic blood pressure
91
Management of trigeminal neuralgia
Carbamazepine or phenytoin
| Surgery
92
Describe Zollinger Ellison syndrome
Associated with MEN 1
Gastrin secreting tumor of pancreas
Causes ulcers + dyspepsia
93
Management of cerebral palsy
Botox - reduces spasticity
94
Gives examples of type 1 hypersensitivity reactions
Allergic rhinitis
95
Gives examples of type 2 hypersensitivity reactions
Myasthenia gravis
| Goodpasture's
96
Gives examples of type 3 hypersensitivity reactions
Arthus reaction
97
Gives examples of type 4 hypersensitivity reactions
Contact dermatitis
MS
Crohns
Transplant rejection
98
Diagnostic test for acute angle glaucoma
Goldmann applanation tonometry - IOP >21
| 2nd line is ultrasound biomicroscopy
99
What marker is used to test for neural tube defects in the mother + what are the results?
Elevated AFP Ach-ase activity
100
What ECG changes are seen with VSD?
High pulmonary blood flow = left atrial hypertrophy = broad bifid P waves
101
Difference between murmur in aortic stenosis vs sclerosis
Sclerosis does not radiate to clavicles/ carotid
