Miscellaneous Flashcards
Images + tables from all specialities (84 cards)
1
Q
fill in the table
A
2
Q
fill in the table provided with cause of peripheral neuropathy
A
3
Q
How would you manage a pneumothorax?
A
4
Q
fill in table with causes of hyponatraemia with assocaited fluid status
A
5
Q
What acute events might a patient with sickle cell anaemia present with?
A
- acute painful crisis
- stroke
- sequestration crises where RBC pool in the lungs of the spleen
- lungs -> SOB, cough, fever
- spleen -> exacerbated anaemia
- gallstones, chronic cholecystitis
6
Q
differentials for amenorrhoea
A
- Pregnancy
- Hypothalamus
- Pituitary
- Thyroid disorder (hypo or hyper)
- PCOS
- Ovarian failure
7
Q
Fill in the table with the appropriate management for each sickle cell disease crisis
A
8
Q
What visual field deficit would lesions in the corresponding areas cause?
A
9
Q
fill in the table
A
10
Q
fill in the table
A
11
Q
Fill in the table with the conditions associated with these signs
A
12
Q
Fill in the table with the conditions associated with these signs
A
13
Q
Fill in the table with the conditions associated with these signs
A
14
Q
What does this investigation show?
what is the sign called?
what kind of investigation is this?
A
Barium follow through
apple core lesion
colon adenocarcinoma (apple core suggests malignancy of the bowel)
15
Q
What is this sign and what is the pathology?
A
foetus sign
caecal volvulus
16
Q
what is this?
A
Large bowel obstruction
line across bowel are the haustra
17
Q
what does this AXR show?
A
small bowel obstruction
the lines across the bowel are valvulae conniventes
18
Q
What is this sign and what is the pathology?
A
coffee bean sign
sigmoid volvulus
19
Q
What is the abnormality?
A
staghorn calculus
20
Q
What is the sign? what pathologies might cause this sign?
A
thumbprinting
seen in colitis and mesenteric ischaemic due to mucosal thickening
21
Q
what does this AXR show?
A
toxic mega colon
22
Q
what are the clinical features of meniere’s disease?
A
recurrent episodes of tinnitus, paroxysmal vertigo and unilateral fluctuating hearing loss
23
Q
what is the diagnostic test for BPPV?
A
Hallpikes test
24
Q
what conditions are associated with PCOS?
A
obesity
dyslipidaemia
insulin resistance
type 2 diabetes
25
what is the presentation of renal cell carcinoma?
haematuria + flank pain + abdominal mass
+ FLAWS symptoms
26
how do you investigate renal artery stenosis
bloods: U&Es, aldosterone:renin ratio (\>20)
duplex USS -\> blood flow
renal USS to look at kidneys
gold standard = digital subtraction angiography
27
what is the presentation of a hydrocele?
painless scrotal swellling
fluid filled lump which may feel cystic, fluctuant, seperate from testes and can palpate above
transilluminates
28
what is the presentation of bladder cancer?
painless haematuria + FLAWs
29
what are the main causes of AKI?
acute tubular necrosis
sepsis (causes hypotension and therefore ischaemia)
30
what are the risk factors for bladder cancer?
smoking, aromatic amines, dye stuff, chrnoic cystitis, pelvic irritation, schistosomiasis
31
what stain on a kidney biopsy confirms amyloidosis?
positive congo red stain
32
what is the treatment of epididymitis and orchitis?
rest, analgesia, scrotal support, abstain from sex
if STD -\> test partner
NSAIDs and empirical tx -\> doxycycline for chlamydia, ceftraxiaxone for gonorrhoea
if severe admit the patient for IV therapy
33
what is the presentation of epididymitis/orchitis?
unilateral scrotal swelling with pain
_+_ dysuria
_+_ pain on walking
_+_ fevers
34
what organisms are commonly implicated in epididymitis/orchitis?
\< 35 years -\> STD chlamydia or gonorrhoea
\> 35 years -\> gram -ve such as e.coli or pseudomonas
most common viral is mumps
35
what are the clinical features and signs of PCOS?
* mestrual irregularities (oligomenorrhoea or amenorrhoea)
* dysfunctional uterine bleeding
* infertility
* hirsutism
* male-pattern hair loss
* acne
36
what is benign paroxysmal positional vertigo and what are the signs?
vertigo lasting for a seconds-minutes in response to changing head position.
dizziness, vertigo, loss of balance, nausea/vomiting
37
what are cataracts?
opacification of lens of the eye
38
what is the presentation of cataracts?
gradual-onset painless loss of vision, glare when looking at bright light
vision may worsen in light
some may no longer need their reading glassess
1. loss of red reflex
2. hazy lens appearance
3. reduced visual acuity
39
what is glaucoma?
it is an optic neuropathy with a dield deficit which is usually associated with ocular hypertension (\>21 mmHg)
40
what are signs of glaucoma?
redness of eye + dilated pupil + cloudy cornea
41
what are the features of acute closed angle glaucoma?
red eye
hazy cornea
loss of red reflex
fixed and dilated pupil
eye is tender and hard on palpation
cupped optic disc
visual field deficit
moderate raised intra ocular pressure
42
How does primary open angle glaucoma present?
slow progressive loss of peripheral fields.
few signs. the optic disc may be cupped on fundoscopy
43
What are the characteristics of alcohol dependence?
_3 or more of:_
* withdrawal when they stop drinking
* tolerance
* compulsion to drink, difficulty controlling termination or levels of use
* persistant desire to cut down or control use
* time spent obtaining, using or recovering from alcohol
* negect of other interests
* continued use despite physical and psychological problems
44
What is the maximum recommended alcohol intake?
in units
14 units a week
45
What is the pathophysiology of alcohol withdrawal?
alcohol enhances inhibitory GABA and inhibits exictatoy glutamate neurotransmission
the body adapts by: reducing GABA receptors and upregulating glutamate receptors
stop drinking = overactivation of excitatory receptors
46
What questions might you ask to initially screen for alcohol dependence?
CAGE questions
* have you felt like you should **c**ut down on drinking?
* have you felt **a**nnoyed by people telling you to stop drinking:
* have you ever felt **g**uilty about how much you drink?
* do you feel like you need a drink to way you up in the morning? (**e**ye opener)
47
What are the features of alcohol withdrawal?
nausea, sweating, tremor, restlessness, agitation, visual hallucinations, confusion, seizures
48
What is the diagnostic criteria for anxiety?
* excessive anxiety + worry occuring more days than not for at least 6 months
* difficult to control worry
* associated with:
* restlessness
* easily fatigued
* difficulty concentrating
* irritability
* muscle tension
* sleep disturbance
49
What is the diagnostic criteria for depression?
at least 1 of the following:
1. persistent sadness or low mood nearly every day
2. loss of interests or pleasure in most activities
plus some of the following:
* fatigue or loss of energy
* worthlessness, excessive/inappropriate guilt
* suicidal thoughts
* diminished ability to think or concentrate
* psychomotor agitation or retardation
* insomnia
* changes in appetite and/or weight loss
symptoms must have persisted for at least 2 weeks
50
What assessment tools can be used to assess depression?
patient health questionnaire (PHQ-9)
hospital anxiety and depression scale (HAD)
Beck's depression inventory
51
What is pseudohyponatraemia?
a mildly low sodium due to hyperlipidaemia or hyperproteinaemia
52
What is necrobiosis lipoidica?
shiny yellow skin patches usually over shins
DM complication
53
What are the stages of HTN retinopathy?
stage I = **silver wiring**
stage II = silver wiring + **arteriovenous nipping**
stage III = silver wiring + arteriovenous nipping + **flame haemorrhages + cotton wool exudates**
stage IV = silver wiring + AV nipping + flame haemorrhages + cotton wool exudates + **PAPILLOEDEMA**
54
what is stage I of HTN retinopathy?
silver wiring
55
what is stage II of HTN retinopathy?
silver wiring + AV nipping
56
what is stage III of HTN retinopathy?
silver wiring + AV nipping + flame haemorrhages + cotton wool exudates
57
what is stage IV of HTN retinopathy?
silver wiring + AV nipping + flame haemorrhages + cotton wool exudates + papilloedema
58
what are the stages of diabetic retinopathy?
1. **background** = hard exudates + blot haemorrhages
2. **pre-proliferative** = cotton wool spots, pre-retinal haemorrhages
3. **proliferative** = new vessels forming
4. **maculopathy** = any of the above occuring closer or on the macular threatening sight
higher risk for glaucoma, cataracts and transient visual loss
59
What are causes of haemolytic anaemia?
60
what are the causes of a true polycythaemia?
61
What are the benign breast conditions?
* fibroadenomas
* fibrocystic changes
* breast cyst
* sclerosing adnosis
* intraductal papilloma
* duct ectasia
* fat necrosis
* periductal mastitis
62
What are the features of duct ectasia?
yellow/green discharge
occurs due to central ducts become dilated with ductal secretions due to lactiferous duct blockage
63
describe the triple assessment at the breast clinic
1. examination
2. imaging (\< 35 USS, \>35 mammogram 2 views
3. cytology/histology of lump - FNA or excision biopsy
64
what is the common causative organism of breast abscesses?
staphylococcus aureus
65
what kind of breast abscesses tend to recur?
non-lactational
66
what is the treatment for the 2 types of breast abscess?
lactational abcess = flucloxacillin
non-lactational abcess = flucloxacillin + metronidazole
* only fluclox for lactation as mainly s. aureus
* non-lactitional tx needs to cover s.aureus and anaerobes
67
what are the direct consequences of HIV on the following organ systems ?
68
what is the management of VZV infection?
69
what is the test for BPPV?
hallpike manouevre
70
71
which row shows results indicative of primary, secondary or tertiary hyperparathyroidism?
72
describe the motor component of the GCS score.
73
gram stain of streptococcus pneumoniae
gram +ve cocci chains
74
gram stain of S. aureus
gram +ve cocci clusters
75
gram stain of N. meningitides
gram -ve cocci
76
life threatening differentials of syncope
* PE
* Ectopic pregnancy
* AAA
* Aortic dissection
* MI
* SAH
* Aortic stenosis
* Arrhythmias - SVT/VF/VT or bradycardia or heart-block
77
differentials for purpuric rash
* infection - meningococcal septicaemia
* IgA vasculitis (HSP)
* small vessel vasculitis
* lower platelet - ITP, etc
78
what are the retroperitoneal organs?
SAD PUCKER
**S**uprarenal (adrenal) gland
**A**orta/IVC
**D**uodenum (2nd and 3rd part)
**P**ancreas (except the tail)
**U**reters
**C**olon (ascending and descending)
**K**idneys
**O**esophagus
**R**ectum
79
what are the features of excess acetylcholine?
e.g. organophosphate poisoning
SLUD
* salivation
* lacrimation
* urinary
* defecation/diarrhoea
* CVD - hypotension, bradycardia
* small pupils
* muscle fasciculation
management with atropine
80
describe the cervical screening
* every 3 years from 25-49
* every 5 years from 50-64
81
describe the breast screening program
* invited from 50 - 70
* every 3 years
82
describe the bowel cancer screening program
* home test screening kit every 2 years from 60-74
* faecal immunochemistry test
83
describe the AAA screening
1 off USS to men \> 65
can refer women \> 70 with RF (COPD, cerebrovascular/coronary/peripheral arterial disease, FHx, hyperlipidaemia, HTN, current or ex-smoker)
84
causes of normal anion gap or hyperchloraemic metabolic acidosis
* GI bicarb loss - diarrhoea, fistula
* renal tubular acidosis
* drugs - acetazolamide
* ammonium chloride injection
* addison's disease
