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Family Medicine > Misc 3 > Flashcards

Misc 3 Flashcards

1
Q

What antibodies is myasthenia gravis associated with?

A

ACh receptor Ab

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2
Q

What is the most common symptom of myasthenia gravis?

A

Ocular = ptosis

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3
Q

What antibodies are associated with dermatomyositis?

A

Anti-Mi-2

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4
Q

What antibodies are associated with Lambert Eaton myasthenic syndrome?

A

Voltage gated calcium channel ab

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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

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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

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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

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8
Q

What is the most common pathogen in cat bites?

A

Pasteurella multocida

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9
Q

What abx should be given post animal bite?

A

Co-amox or doxycycline + metronidazole

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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

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11
Q

RF for osteosarcoma

A 
African
5-20 y/o (growing) or >65 (Paget's disease) 
Li-Fraumeni 
Males
Metaphysis region stress
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12
Q

X ray findings for osteosarcoma

A

Moth eaten appearance
New bone formation = Codman’s triangle
Sunburst appearance

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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)

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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
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15
Q

What hormones are made in the pituitary?

A 
GH 
LH
FSH
TSH
ACTH
Prolactin
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16
Q

What cranial nerves are affected by pituitary tumors?

A

3, 4, 5

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17
Q

Management of FB in eye

A

Topical abx
Topical cycloplegic for pain + photophobia
Eye shield

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18
Q

Describe Sheehans syndrome

A

Anterior hypopituitarism

Failure to lactate, amenorrhea, breast atrophy, hypothyroidism, adrenal cortical insufficiency

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19
Q

What surgeries can be performed to help in cerebral palsy?

A

Selective dorsal rhizotomy (cutting 1a sensory fibres)

Intrathecal baclofen pump insertion

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20
Q

What is an endocardial cushion defect?

A

congenital heart defect common in Downs

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21
Q

What is the leading cause of death in patients with multiple myeloma?

A

Bacterial infection (with encapsulated organisms eg strep pneumonia + Hib)

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22
Q

Describe haemachromatosis

A 
Skin hyperpigmentation 
Polyuria, polydipsia
Hepatomegaly 
Fatigue 
Impotence 
Athralgia 
Cardiomyopathy

Autosomal recessive disease causing accumulation of iron in organs

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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

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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

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25
Q

What is autonomic hyperreflexia?

A

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

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26
Q

What can be used to reverse steatohepatitis in obese kids?

A

Vitamin E

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27
Q

What is the female athlete triad?

A

Disordered eating
Amenorrhea
Osteoporosis

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28
Q

When do you see a pale optic disc + boxcar segmentation of vessels in the eye?

A

central retinal artery occlusion

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29
Q

What do you see Hollenhorst plaques?

A

Cholesterol bodies on fundoscopy

Associated with TIA or amaurosis fugax

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30
Q

What is amaurosis fugax?

A

Painless temporary vision loss due to loss of blood supply

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31
Q

What is a corkscrew sign?

A

Lumen-obliterating, non-peristaltic contractions in oesophagus

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32
Q

What is the stack of coins sign?

A

Indicates presence of small bowel haematoma
Seen on AXR
Seen frequently in people on anti-coagulants

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33
Q

What is a bull’s eye lesion on AXR?

A

Seen in gastric mets from melanoma or lymphoma, Kaposi’s sarcoma or carcinoid tumors

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34
Q

What is a whirlpool sign?

A

Midgut volvulus - represents superior mesenteric artery wrapping around gut + vein

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35
Q

What is the management of ASCUS?

A

HPV negative = routine screening in 3 years

Positive = colposcopy

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36
Q

What is octreotide used for in scleroderma?

A

Improves intestinal dysmotility

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37
Q

What is the management of Reye’s syndrome?

A

Dextrose, Vit K, Mannitol

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38
Q

Describe petrous apicitis

A

Triad of retro-orbital pain, lacteral rectus palsy (CN6), otorrhea
Manifestation of Gradenigo syndrome

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39
Q

What is a likely liver infection in an hispanic individual?

A

Entamoaba histolytica

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40
Q

When is adenosine contraindicated in SVT + what would be used instead?

A

CI in asthma

Cardiovert or CCB

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41
Q

How long do you wait while a pt is in asystole after giving adenosine before commencing CPR?

A

20 seconds (half life of 15 seconds)

42
Q

Describe a craniopharyngoma

A

Benign tumour arising from Rathke’s pouch

Can cause diabetes insipidus

43
Q

Describe diabetes insipidus

A

Low ADH
Increased serum Na
Normal extracellular fluid
Decreased arginine vasopressin

44
Q

What is Freidrich’s ataxia (genetics, symptoms, treatment)

A 
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
Q

Describe periodic paralysis

A

Multiple types, most common is hypokalaemia
Weakness of hips + shoulders in young people
Diagnosed with long exercise EMG

46
Q

What is the management of Tourette’s?

A

clonidine or AP ie pimozide

47
Q

What is the organism responsible for B12 deficiency causing megaloblastic anemia, and what is its management?

A

Fish tapeworm = diphyllobothrium

Treat with praziquantel

48
Q

What symptoms does a clonorchis sinensis infection produce?

A

obstruction of biliary tract

49
Q

Describe an infection with echinococcus granulosus

A

Produce unilocular cysts on liver

Prevalent in areas with dogs raising livestock

50
Q

Describe an infection with taenia saginata

A

Beef tapeworm - diarrhea

51
Q

Describe an infection with taenia solium

A

Pork tapeworm - causes cysticercosis

52
Q

Describe Bruton agammaglobulinemia

A

Immunodeficiency disease
Suspected when male infant becomes unwell with repeated URTIs
Absence of plasma cells
Small tonsils

53
Q

Describe Wiskott-Aldrich syndrome

A

X linked recessive disease
Eczema, thrombocytopenia, immune deficiency + bloody diarrhea
Presents with bleeding

54
Q

Describe Chediak-Higashi syndrome

A 
Recessive immunodeficiency
Decreased phagocytosis 
Hypopigmentation of skin, eyes + hair 
Prolonged bleeding times
Recurrent infection 
Peripheral neuropathy
55
Q

Describe chronic granulomatous disease

A

X linked condition
Deficiency of NADPH oxidase
Pneumonia, infectious dermatitis, subcutaneous abscess formation
High prevalence of colitis, enteritis + gastric outlet obstruction

56
Q

What is Whipple’s triad?

A

Symptoms known to be caused by hypoglycaemia
Low plasma glucose
Relief of symptoms when blood glucose is raised

57
Q

What is Cushings triad?

A

Bradycardia, bradynpnea, HTN

Associated with head injuries

58
Q

What is Samter’s triad?

A

Seen in aspirin induced asthma

Aspirin sensitivity, nasal polyps, asthma

59
Q

What is Beck’s triad?

A

Muffled heart sounds, distended neck veins + hypotension

Diagnostic of cardiac tamponade

60
Q

What is the management of recurrent kidney stones?

A

Thiazide diuretic + potassium to counter-act the hypokalaemia caused by thiazides
Fluids + potassium to alkalinise the urine

61
Q

What is Job’s syndrome?

A

Hyperimmunoglobulin E syndrome

recurrent staph infections, eczema rashes + severe lung infections

62
Q

What is the grooved pegboard test?

A

Test of frontal lobe deficits, evaluates manipulative dexterity

63
Q

What is the stroop test?

A

Used to measure person’s attention capacity + processing speed
Name colour of word - not what the word says

64
Q

What is the digit span test?

A

Repeating a phone number - used for working memory

65
Q

What is the Rey auditory verbal learning test?

A

Evaluates verbal memory

Reads list of 15 words, pt has to repeat back words that they remember

66
Q

How does renal artery supply affect HTN?

A

Decreased renal artery blood supply = stimulates RAT system

Causes vasoconstriction + increased sodium retention = HTN

67
Q

What is Zenker’s diverticulum?

A

High pressure in lower part of pharynx causing outpouch

Causes dysphagia, lump in neck, halitosis

68
Q

What part of the brain is associated with gender dysphoria?

A

Pre-optic hypothalamic nucleus

69
Q

What testicular tumor has the worst prognosis?

A

Choriocarcinoma

70
Q

What is isolation as a defence mechanism?

A

Characteristic of OCD

Remembering fine detail but without expressing affect

71
Q

What is undoing as a defence mechanism?

A

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
Q

What is displacement as a defence mechanism?

A

Redirecting emotions towards another object/ person

i.e. being told bad news + taking it out on the cat

73
Q

What is intellectualisation as a defence mechanism?

A

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
Q

Describe the blood markers for hepatitis infection (HBsAg, Anti-HBs, HBeAg, Anti-HBe, Anti-HBc)

A 
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
Q

Management of fistulizing Crohns

A

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
Q

Common complications of intubation in epiglottitis

A

Segmental atelectasis

Pneumonia is 2nd most common complication

77
Q

What is the recommended ART for HIV?

A

2 NRTIs + 1 INSTI/PI (boosted with ritonavir or cobicistat)

78
Q

What are the NRTIs in ART?

A

Nuceloside reverse transcriptase inhibitors - incorporated into DNA viral chain to terminate growth

-VUDINE

79
Q

What are the INSTIs in ART?

A

Integrase strand transfer inhibitors - inhibits integration of HIV DNA into human genome

-GRAVIR

80
Q

What are the classic RF for acute glaucoma?

A

Asian/ first nation
Peripheral anterior synechia
Hyperopia

81
Q

Presentation of acute glaucoma

A

Severe periorbital pain, ipsilateral headache, blurred vision, haloes, profuse tearing

82
Q

Management of acute angle glaucoma

A

Latanoprost, bethamethasone, pilocarpine

Definitive: laser peripheral iridotomy

83
Q

Describe magnesium toxicity

A

Due to Mg administration in eclampsia
Feel warm, flushing, vomiting, muscle weakness, respiratory depression, PPH
Stop infusion + treat with calcium gluconate

84
Q

Describe an aspergilloma infection

A

Caused by fungus, usually involving upper lobes of lungs

Asymptomatic with tumor like opacity on CXR

85
Q

Describe infection with mycoplasma pneumoniae

A

Erythema multiforme, low Hb + agglutination of peripheral blood smear

86
Q

What is the most common cause of painless blood in stools in toddlers?

A

Meckel’s diverticulum + polyps

87
Q

How to work out odds ratio?

A

Odds of exposure given disease = number cases exposed/ number not exposed (for case + control)
Then divide case odds by control odds

88
Q

Describe noonan syndrome

A

Similar to Turners
Short height, congenital heart disease (pulmonary valve stenosis), bleeding problems, webbed neck
Can cause leukaemia

89
Q

Describe Reye’s syndrome

A

Encephalopathy with hepatic fatty infiltration
Follows giving aspirin in a viral syndrome
Causes hypoglycaemia + altered mental state, vomiting + abdo pain + distention

90
Q

What ABPI indicates PVD?

A

> 20 mmHg decrease in systolic blood pressure

91
Q

Management of trigeminal neuralgia

A

Carbamazepine or phenytoin

Surgery

92
Q

Describe Zollinger Ellison syndrome

A

Associated with MEN 1
Gastrin secreting tumor of pancreas
Causes ulcers + dyspepsia

93
Q

Management of cerebral palsy

A

Botox - reduces spasticity

94
Q

Gives examples of type 1 hypersensitivity reactions

A

Allergic rhinitis

95
Q

Gives examples of type 2 hypersensitivity reactions

A

Myasthenia gravis

Goodpasture’s

96
Q

Gives examples of type 3 hypersensitivity reactions

A

Arthus reaction

97
Q

Gives examples of type 4 hypersensitivity reactions

A

Contact dermatitis
MS
Crohns
Transplant rejection

98
Q

Diagnostic test for acute angle glaucoma

A

Goldmann applanation tonometry - IOP >21

2nd line is ultrasound biomicroscopy

99
Q

What marker is used to test for neural tube defects in the mother + what are the results?

A

Elevated AFP Ach-ase activity

100
Q

What ECG changes are seen with VSD?

A

High pulmonary blood flow = left atrial hypertrophy = broad bifid P waves

101
Q

Difference between murmur in aortic stenosis vs sclerosis

A

Sclerosis does not radiate to clavicles/ carotid

Family Medicine (10 decks)

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