Misc 4 Flashcards
Describe euthyroid sick syndrome
Abnormal TFTs in euthyroid pts with nonthyroidal systemic illness
What is ectopia lentis?
Lens dislocation = common in Marfans
Sudden deterioration of vision, usually following trauma
Medical management of serotonin syndrome
Cyproheptadine (5-HT2A antagonist)
What is unique to the DSM criteria for bulimia?
Loss of control when eating
Describe aortic arch dissection
Usually due to trauma
Widened mediastinum - needs CT
What is telogen effluvium?
Shedding hair loss that occurs after a stressful event (3 mths after)
What is anagen effluvium?
Diffuse hair loss from chemo
What is the cut off for portal HTN?
pressure gradient >5
What features are common in portal HTN?
Caput medusae
Hemorrhoids
Splenomegaly
Esophageal varices
What is the medical management of essential tremor?
Younger pts = propranolol
Older = primidone
Management of OCD
SSRIs or clomipramine
Describe superior mesenteric artery syndrome
Rapid weight loss + GI symptoms (epigastric pain, N/V, early satiety)
Compression of duodenum by aorta + SMA
Diagnose with CT
AXR shows gastric distention
What genetic conditions cause an increase + decrease in FSH?
Increase = Turners Decrease = Kallmans
What investigation would you do for mulerian agenesis?
MRI urography
Describe mulerian agenesis
Mayer–Rokitansky–Küster–Hauser syndrome
Absent uterus
Primary amenorrhea with normal secondary sexual characteristics eg breast tissue
46 XX
What is the triad of symptoms in Lofgrens?
Bilateral hilar lymphadenopathy
Erythema nodosum
Arthralgia
What meds are used to stimulate the heart in hypothermia?
Bretylium
What rate of warming is appropriate in hypothermia or frost bite?
> 2C an hour
What are the CXR findings in transient tachypnea of newborn?
Similar to HF but no enlarged heart
Prominent vasculature
What is pontiac fever?
Acute febrile illness caused by legionella, no resp symptoms
What is the Widal test?
Measures ab against typhoid antigens
Management of epididymitis
Ceftrixone IM + doxycycline 7 days
What is neurocardiogenic syncope?
Vasovagal + vasodepressor
Commonest form
In absence of other forms, this is the most likely
What is situational syncope?
Syncope during cough, dysphagia, constipation, micturition
What is carotid sinus hypersensitivity syncope?
Syncope while shaving, wearing tight collars or turning head to side
What is the management of central retinal artery occlusion?
Ocular massage + carbogen therapy
What is the management of diabetic eye disease?
Laser photocoagulation + ranibizumab
What is the threshold of reduced Hb required for cyanosis?
<50
When does the O2-Hb curve flatten (aka when pulse oximetry is insensitive to change)
Above 60
What is the most common cause of fetal growth restriction?
Maternal HTN
What is the most common cause of pancreatitis?
Biliary tract disease
What is the main complication post kidney transplant + what is diagnostic of this?
Viral infections = ‘buffy coat’ inclusion bodies
CMV pneumonitis
Describe S+S of TTP + management
Pentad of: Hemolytic anemia Thrombocytopenic purpura Neuro abnormalities Fever Renal disease
Managed with plasma exchange, steroids, rituximab
What is nail fold microscopy useful in assessing?
Cause of raynauds - in secondary causes, nail fold capillaries are distorted + dilated
Describe the 3 stages of eosinophilic granulomatous polyangitis
1) allergy - asthma/ allergic rhinitis - inflammation of nasal passage can lead to polyps
2) eosinophilia
3) vasculitis of small + medium vessels leading to kidney, lung, GI tract + heart damage
What are the cardinal S+S of nephritic syndrome?
Proteinuria
Haematuria
HTN
Oliguria
Describe symptoms of lateral medullary syndrome
Ipsilateral ataxia Nystagmus Dysphagia Facial numbness Cranial nerve palsy Contralateral hemisensory loss
Presentation of primary hyperaldosteronism
HTN
Hypernatraemia
Hypokalaemia
Due to increase in aldosterone leading to increased Na resorption + excretion of K = causing HTN
Signs of right sided heart failure
Raised JVP
Ankle oedema
Hepatomegaly
What info is needed to calculate modified Glasgow score for pancreatitis?
PANCREAS PaO2 <8 Age >55 Neutrophilia >15 Calcium <2 Renal function (urea >16) Enzymes LDH + AST Albumin <32 Sugar (glucose) >10
What is nicorandil an example of, what is it mainly used for and what are the key SE?
K channel activator
Good for angina
SE: headache, flushing, anal ulceration
Describe presentation of 3rd nerve palsy
Large fixed pupul
Ptosis
Inability to adduct or supraduct eye
What visual field defect is common with a pituitary lesion?
Bi temporal hemianopia due to compression of optic chiasm
What is Hoover’s sign?
Distinguishes between organic + functional cause of lower leg weakness
If the pt is making an effort, the normal limb pushes down when pt tries to lift ‘weak’ leg
What is Hoffman’s sign?
Reflex test to investigate corticospinal tract lesions
What is an anti-Jo ab indicative of?
(Dermato)myositis
