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Pathology > miscellaneous > Flashcards

miscellaneous Flashcards

1
Q

what will stimulation of baroreceptors lead to?

A

increased sympathetic stimulation>vasodilation

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2
Q

define ischaemia

A

reversible damage to tissues due to impaired perfusion which deprives tissues of nutrients and oxygen

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3
Q

what is in an atheroma?

A 
fibrous cap
lipid core
smooth muscle cells
macrophages
lymphocytes
calcium
cholesterol crystals
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4
Q

features of a malignant neoplasm

A 
rapid growth
high mitotic rate
necrosis
invasion
poor resemblance to normal tissues
irregular border
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5
Q

which lymph nodes does oesophageal carcinoma spread to?

A

para-oesophageal

supraclavicular

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6
Q

what is achalasia

A

failure of smooth muscle cells to relax, leads to birds beak on CXR if in the oesophagus

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7
Q

what does inability to swallow solids and liquids at the same time suggest?

A

not malignant, it’s something like tightening of gastrooesophageal junction

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8
Q

what is suggested by villous atrophy?

A

coealiac

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9
Q

what 3 things must a patient have to be diagnosed with coeliac disease

A

crypt hyperplasia
villous atrophy
raised intraepithelial lymphocytes

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10
Q

why does oedema occur

A

raised systemic venous pressure

fluid retention

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11
Q

why does orthopnoea occur?

A

pulmonary oedema

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12
Q

features of iron deficiency anaemia

A

microcytic
hypochromic
pencil cells
target cells

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13
Q

what will produce pale stools and dark urine

A

hepatic and post hepatic causes of jaundice

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14
Q

features of enlarged spleen on palpiatation

A

left upper quadrant

can’t feel upper border

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15
Q

colorectal cancer predispostions

A

HNPCC
APC
adenoma
positive FHx

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16
Q

define median survival

A

the time at which 50% of index cases are still alive

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17
Q

bowel cancer symptoms

A 
rectal bleeding
fatigue
abdominal pain
tenesmus
altered bowel habit
constipation
diarrhoea
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18
Q

define 5 year survival

A

the proportion of patents still living five years after diagnosis

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19
Q

what are the 2 types of stress

A

distress and eutstress

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20
Q

functions of cell membrane

A

separating intracellular contents from the extracellular environment
regulating access to the cell
semi-permeable membrane
regulating molecular transport into and out of cell
intracellular signalling
maintain cell shape

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21
Q

surface markings of oblique fissure

A

T2
mid-axillary line-4th rib
mid clavicular-end of 6th rib

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22
Q

what would cause dilated veins in arms and legs but not raised JVP?

A

raised carbon dioxide partial pressure, systemic vasodilation so JVP will be low. It is with heart failure that there would be both, raised pressure throughout systemic veins.

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23
Q

why does a small change in diameter result in a large change of blood pressure?

A

Pouseille’s law

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24
Q

where are aortic aneurysms likely to be

A

above the line that joins iliac crests

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25
Q

abdominal pain in patient with AAA?

A

aortic aneurysm dissection

mesenteric artery occlusion from local atherosclerosis

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26
Q

what are the two stages of fat digestion

A

emulsification

triglyceride hydrolysis

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27
Q

what does bile do for fat absorption

A

lipid transport system

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28
Q

where does wheeze come from

A

expiration from bronchioles

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29
Q

signs of anaphylaxis

A

swollen tongue, lips, eyes
laryngeal oedema
swollen epiglottis
hypotension

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30
Q

give the 5 responses to stress

A

behavioural-more alcohol, abenteeism, poor sleep
cognitive-impaired concentration, negative thoughts
biochemical-endorphin levels altered
emotional-tearful, mood swings, irritable
physiological-increased BP and headaches

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31
Q

define carcinoma

A

malignant neoplasm of EPITHELIUM

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32
Q

what is renal cell carcinoma associated with?

A

obesity

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33
Q

what kind of drug is morphine?

A

receptor agonist

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34
Q

what test is used for allergy?

A

serum tryptase-mast cells

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35
Q

sterile areas

A

CSF
pleural cavity
ureters

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36
Q

what is ringworm?

A

fungal infection

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37
Q

what is used to treat MRSA

A

vancomycin

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38
Q

symptoms of mononucleosis (EBV)

A 
myalgia
sore throat
tiredness
fever
splenomegaly
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39
Q

define transfer factor

A

the ability to pull oxygen out of the air, not reduced in COPD but is in EAA, pulmonary fibrosis

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40
Q

in which pulmonary disease is there endothelial destruction?

A

COPD

in asthma there is endothelial thickening

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41
Q

consequences of sarcoidosis

A

glaucoma
heart block
lymphadenopathy
skin nodules

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42
Q

location of CFTR gene?

A

ch7

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43
Q

how much fluid is in the pleural space?

A

15ml

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44
Q

which transporter do diuretics affect?

A

Na/K/2Cl

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45
Q

why are beta blockers used in heart failure?

A

block reflex sympathetic responses which stress the heart

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46
Q

what cardiac drug is likely to be causing postural hypotension?

A

calcium channel blockers

nifedipine, amplodipine

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47
Q

give an example of a selective beta blocker

A

bisoprolol

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48
Q

which drugs are negative chonotropes and inotropes?

A

calcium channel blockers and beta blockers

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49
Q

how do nitrates work?

A

vasodilation so reduce preload and after load

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50
Q

what anaemia does sickle cell disease lead to?

A

chronic haemolytic, may have normal Hb from XS reticulocytes

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51
Q

what does the coffee bean sign indicate

A

sigmoid volvulus

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52
Q

what will proximal colorectal cancer present with

A

anaemia rather than faecal blood or

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53
Q

features of paracetamol OD

A

metabolic acidosis
raised prothrombin-INR
hypoglycaemia
high alanine aminotransferase

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54
Q

high alanine aminotransferase

A

paracetamol OD
viral hepatitis
liver ischaemia

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55
Q

features of delirium tremens

A

hyperadrenergic
disorientation
hallucination
impaired consciousness

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56
Q

what joints are typical of RA?

A

MCPs PIPs

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57
Q

extra articular manifestations of RA?

A

subcutaneous nodules
scleritis
peripheral sensory neuropathy
pericardial effusion

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58
Q

high ESR

low CRP

A

SLE

systemic lupus erythematosus

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59
Q

ANCA -ve, affects over 60s

A

giant cell arteritis

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60
Q

juvenile idiopathic arthritis features

A 
thrombocytosis
daily fever
evanescent rash
splenomegaly
hyperferritinaemia
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61
Q

two types of pain

A

neuropathic

nociceptive

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62
Q

what kind of aphasia is expressive?

A

non fluent because Wernicke’s is still working so they find meaningful words but say them slowly

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63
Q

causes of hypercalcaemia

A 
hypercalcaemia of malignancy
multiple myeloma
hyperparathyroidism
sarcoidosis
vitamin D intoxication
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64
Q

what does calcitonin do?

A

decreases calcium concentration by inhibiting osteoclast activity and stopping reuptake, produced in thyroid hormone

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65
Q

causes of metabolic acidosis

A 
uraemia
diabetic ketoacidosis
salycilate overdose (aspirin)
severe sepsis
alcohol intoxication
renal tubular acidosis
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66
Q

what does immune thrombocytopenic purpura suggest?

A

AIDS

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67
Q

what are second line to beta blockers and calcium channel blockers in a patient with angina?

A

nicorandil
ivabradine
ranolazine

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68
Q

what can be seen in the cytoplasm of those with alcoholic hepatitis?

A

mallory bodies

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69
Q

diagnosis for coeliac disease?

A

DUODENAL biopsy showing villous atrophy and crypt hyperplasia

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70
Q

complications of diverticulitis

A

peritonitis (it’s not spontaneous!)
haemorrhage
abscess
fistulae

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71
Q

what neurotransmitter controls the hyperplasia of the prostate

A

ACh, so use anti cholinergic drugs

72
Q

BPH drugs

A

anti-cholinergics
5-alpha reductase inhibitors
alpha adrenergic antagonists

73
Q

what parasite can cause bladder cancer?

A

schistosomes

74
Q

nephritic syndrome causes

A

post streptococcal glomerulonephritis
rapidly progressive glomerulonephritis (SLE/Goodpasture’s)
IgA nephropathy
Thin glomerular basement membrane disease
Mesangiocapillary glomerulonephritis

75
Q

what kidney disease are berry aneurysms and subarachnoid haemorrhage associated with?

A

autosomal dominant polycystic kidney disease

76
Q

AKI causes

A

glomerlonephritis, drugs, hypertension, pre-eclampsia, acute tubulointerstitial necrosis, pyelonephritis, cholesterol emboli, haemolytic uraemia syndrome

77
Q

Bouchard’s or Boutonniere in RA?

A

Boutonniere in autoimmune, think button hole and lock and key Ig

78
Q

joint never affected by rheumatoid arthritis?

A

distal interphalangeal joint

79
Q

antibody specific for SLE?

A

double stranded DNA antibody

80
Q

extra-articular RA manifestations?

A

rheumatoid nodules, lymphadenopathy, vasculitis, fibrosing alveolitis, pleural effusion, pericardial effusion, Raynaud’s, CTS, peripheral neuropathy, splenomegaly, scleritis, sicca syndrome

81
Q

features of ank spond on XR

A

sacroiliitis
syndesmophyes (bamboo spine)
calcification

82
Q

Sx of osteomalacia

A

bone pain
fractures-femoral neck
waddling gait

83
Q

bacteria of acne?

A

Propionibacterium acnes

84
Q

what is blocked in acne?

A

pilosebaceous duct

85
Q

what is rosacea

A

inflammation on face, no commodes-treat with immunuosuppresion

86
Q

where does squamous cell carcinoma arise from?

A

keratinocytes

87
Q

for which skin lesions would you refer with a two week wait

A

squamous cell

malignant melanoma

88
Q

benign skin lesions?

A

basal cell papilloma
dermatofibroma
sebaceous cyst

89
Q

where do most skin cancers arise from?

A

epidermis-basal cell

90
Q

on which receptors do you want beta blockers to have an effect

A

beta-1 adrenoreceptors to stop them increasing heart rate and contraction

91
Q

on which receptors do does tamulosin work?

A

alpha adrenoreceptor 1 antagonist-stops smooth muscle contraction

92
Q

on which receptors do you want formaterol to work?

A

beta 2 adrenoreceptors because there are to main classes SABA and LABA, they increase bronchodilation

93
Q

what is metformin?

A

a biguanide

94
Q

give an example of a sulphonylurea

A

glicalzide

95
Q

what should methotrexate not be given with?

A

trimethoprim

96
Q

how is paracetamol OD treated

A

iv n-acetylcysteine

97
Q

when is onycholysis seen?

A

psoriasis

98
Q

when is leuconychia seen?

A

CKD

99
Q

functions of the kidneys

A 
A WET BED
Acid/base balance
Water balance
Electrolyte balance
Toxin excretion
Blood pressure
Erythropoietin
vit D activation
100
Q

statin examples

A

simvastatin

lovastatin

101
Q

what must HAART comprise of?

A

2 non nucleoside reverse transcriptase inhibitors and one nucleoside reverse transcriptase inhibitor/protease inhibitor

102
Q

2NNRTIs

A

neirapine

efavirenz

103
Q

NRTI

A

didanosine

104
Q

PIs for HIV

A

saquinavir

105
Q

an example of HAART regimen

A

NED
neirapine
efavirenz
didanosine

106
Q

to which lymph nodes is breast cancer likely to spread to?

A

axillary
para sternal
posterior intercostal

107
Q

blood and nerve supply of breast

A

internal thoracic

anterior and lateral branches of 4-6 intercostal nerves

108
Q

most common cause of bloody nipple discharge?

A

intraductal papilloma

109
Q

what are the HIV tests?

A

ELISA and Western blot-enzyme linked immunosorbent assay

nucleic acid testing

110
Q

treatment for falciparum vivax malaria?

A

oral chloroquinine

111
Q

treatment for falciparum

A

oral artesunate

112
Q

severe malaria

A

IV ARTESUNATE

113
Q

define amyloidosis

A

extracellular sometimes with intracellular deposition of insoluble abnormal amyloid fibrils which can alter the normal function of tissues-produced in bone marrow

114
Q

what might amyloidosis be secondary to?

A

multiple myeloma, chronic infectious disease (IBD, RA)

dialysis related

115
Q

causes of pre renal AKI

A

skin, liver, heart failure

116
Q

facial sign of amyloidosis

A

spontaneous periorbital purpura

117
Q

what will the blood film from a patient with amyloidosis show?

A

howell-jolly bodies

congo red when stained

118
Q

how is lymphedema reduced in breast cancer surgery?

A

sentinel node biopsy

119
Q

how is carbon monoxide poisoning treated?

A

mannitol and hyperbaric oxygen

120
Q

how is paracetamol OD treated

A

IV N-acetylcysteine

121
Q

opioid OD treatement?

A

naloxone

122
Q

most common worm in the UK

A

threadworm-nematode

123
Q

side effects of tamOxifen

A

Oestrogen inhibition so menopausal flushing, mood change, weight gain, osteoporosis

124
Q

2 features of sarcomas

A

always mesenchymal and always malignant

125
Q

side effects of chemotherapy

A 
nausea and vomiting
fatigue
peripheral neuropathy
rash
fatigue
anaphylaxis
126
Q

what are mammograms supposed to detect?

A

non-invasive ductal carcinoma in situ

127
Q

causes of breast lump other than breast cancer?

A

fibroadenoma
fibrocystic disease
abscess

128
Q

screening programme for breast cancer

A

47-73 every 3 years

129
Q

cervical cancer screening

A

25-49 every 3 years

130
Q

what is seroconversion

A 
the early symptomatic phase of HIV
temperature
night sweats
weight loss
diarrhoea
131
Q

stages of HIV change in cels

A 
fusion
entry
uncoating
reverse transcriptase
integrin
transcription
assembly
budding
132
Q

primary cause of lymphadenopathy

A

AD Milroy’s

133
Q

what causes black water?

A

plasmodium falciparum malaria infection

134
Q

blood films used for malaria?

A

thick and thin Giemsa

135
Q

side effects of HAART

A

impaired memory
decreased bone density
diarrhoea
CVD risk

136
Q

ethical grid

A

Seed house’s made up of medical indications, patient preferences, quality of life, contextual features

137
Q

what might osteosarcoma follow?

A

Paget’s disease or irridation to bone

138
Q

bowel cancer screening

A

faecal occult blood

60-74 every two years

139
Q

what effect will administering adrenaline have

A

vasoconstriction-alpha1
tachycardia and positive inotrope-beta 1
bronchodilation-beta 2

140
Q

how do you see if an allergic reaction has occurred?

A

measure TRYPTASE

141
Q

define half life

A

time taken for serum concentration of a drug to reach 50%

142
Q

hyperthyroid treatment

A

carbimazole if it doesn’t work-have to put a ‘ole in your thyroid

143
Q

antiepileptic drug

A

carbimazipine epileptic pine trees

144
Q

cabergoline is used for?

A

dopamine analogues so prolactinomas

145
Q

acromegaly treatment

A

somatostatin analogues-ocreotide

146
Q

blocks effects of opioids

A

naloxone BLOCKs

naproxene pro….inflammtory? its anti inflammatory

147
Q

complications of type 2 diabetes

A 
diabetic retinopathy
diabetic nephropathy-nephrotic syndrome
diabetic neuropathy
CVS risk
recurrent infection and sclerosis of infection sites
slow wound healing
angina
cataracts
148
Q

how do you protect the kidneys from diabetic neuropathy?

A

sartan

149
Q

associated with temporal artery biopsy

A

polymyalgia rheumatica

150
Q

miscarriages associated with SLE

A

antiphospholipid syndrome

151
Q

in what condition should a CT be done before lumbar puncture

A

meningitis

152
Q

neisseria meningitis treatment

A

cefotaxime

153
Q

treatment for Guillian Barre

A

Ig

plasmapheresis

154
Q

MS modifying drugs

A

aletuzumab

dimethyl fumarate

155
Q

list the stages of wound healing

A

vascular response, inflammatory response, proliferation, maturation

156
Q

describe the inflammatory response in wound healing

A

plts trapped in fibrin mesh (from vascular response), they release inflammatory mediators>vasodilation>exudate of WBCs

157
Q

what mediates the proliferative stage?

A

fibroblasts-secrete collagen and glycosaminoglycans

158
Q

what is granulation?

A

angiogenesis

159
Q

what is a keloid scar?

A

collagen overgrows borders of injury, unlike a hypertrophic scar

160
Q

what is healing by secondary intention

A

edges are not apposed

161
Q

what is healing by tertiary intention

A

wound is purposefully left open then cleaned then surgically closed

162
Q

list some barriers to healing

A

elderly, diabetes, malnutrition, malignancy, renal failure, hepatic failure, immunosuppression, vitamin deficiencies, prev radiotherapy, infection, oedema, vascular insufficiency

163
Q

what is the screening programme for breast cancer?

A

every 3 years for women 47-53

164
Q

what are aromatase inhibitors

A

prevent peripheral oestrogen production, post menopausal woman-letrozole

165
Q

why aren’t aromatase inhibitors given in pre menopausal women

A

the decrease in oestrogen>hypothalamic stimulation>overall increase in oestrogen prodcution

166
Q

what is the most sensitive test for DCIS?

A

mammogram (it is more common in older woman so this fits as to why m for older women)

167
Q

which breast cancer is USS most sensitive for?

A

invasive disease

168
Q

for which women would you use MRI for to look for breast cancer

A

high risk woman with multifocal disease or with implants

169
Q

SEs of breast radiotherapy?

A

pneumonitis
pericarditis
rib fractures

170
Q

what is Paget’s disease of breast?

A

scaly carcinoma near nipple that looks like eczema

171
Q

where does lymph of the breast drain to?

A

axillary
parasternal
posterior intercostal

172
Q

how is puberty staged?

A

Tanner’s 5 stages

173
Q

what is mammary dysplasia

A

benign changes in breast tissue

174
Q

describe DCIS?

A

non invasive

in lining of breast duct

175
Q

what is the most common form of breast cancer?

A

invasive/ductal

176
Q

breast cancer risk factors

A 
family history
age
uninterrupted oestrogen exposure (nulliparity, 1st preg<30,HRT)
obesity
BRCA
not breastfeeding
previous breast cancer

Pathology (21 decks)

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