Misc Diseases Flashcards
What is the epidemiology of sarcoma?
- 1% of all adult tumours
- Soft tissue sarcoma is more common than bone sarcoma (80% are soft tissue)
What are the two types of sarcoma?
Soft tissue sarcoma or bone sarcoma
What are the clinical features of soft tissue sarcoma?
- Lump that is painless at first
- Pain as lump grows and presses against nerves and muscles
- A leiomyosarcoma in the womb may cause bleeding outside period
- Most sarcoma metastasis to lung initially
How is soft tissue sarcoma diagnosed?
- MRI and core needle biopsy
- CT thorax for lung metastasis
How is soft tissue sarcoma treated?
- Surgical resection (if possible) + chemotherapy
+/- radiotherapy
How is bone sarcoma diagnosed?
- X ray, CT or MRI
- Bone scans and biopsy
How is bone sarcoma treated?
- Wide surgical resection/ reconstruction
- Chemotherapy +/- radiotherapy
What are the clinical features of bone sarcoma?
- Non mechanical bone pain that is still present when still
- Swelling
- Feeling tired
- Pyrexia
- Weight loss
What is lymphoedema?
- Chronic non-pitting oedema causing by lymphatic insufficiency
- Most commonly affects the legs and tends to progress with age
How is lymphoedema treated?
- Compression stockings
- Physical massage
- For filariasis infection, give oral diethylcarbamazine
- If recurrent cellulitis, long term cellulitis
What are the causes of primary lymphoedema?
- Inherited deficiency of lymphatic vessels
What are the causes of secondary lymphoedema?
- Obstruction of lymphatic vessels e.g. filarial infection (parasitic worms)
- Malignant disease
- Trauma
- Radiotherapy
- Surgery
Briefly explain the pathophysiology of paracetamol poisoning
Paracetamol is predominantly metabolised via a phase II reaction and conjugated with glucuronic acid and sulphate. If glucuronic acid and sulphate stores are low, paracetamol will undergo a phase I metabolism via oxidation to produce a toxic compound NAPQI that is immediately conjugated. An excess of paracetamol leads to a toxic build up of NAPQI.
How is paracetamol overdose treated?
- Gastric decontamination= activated charcoal
- Give IV Acetycysteine
Give 3 types of amyloidosis
- AL amyloid (primary)
- AA amyloid (Secondary)
- ATTR familial amyloidosis