Miscellaneous Flashcards

Question

How can you prevent breast cancer?

Answer 1

Promote awareness | Screening - 2 view mammography every 3 years for women aged 47-73 years

Answer 2

Group of disorders of protein metabolism where there is extracellular deposition of insoluble fibrillar protein called amyloid which is resistant to degradation Localised amyloidosis deposition occurs in brain of patients with Alzheimer's Local amyloid deposition also feature of T2DM and long-term haemodialysis

Answer 3

Rare disease Systemic amyloidosis is fatal and responsible for 1 in 1500 deaths per year in UK Can be acquired or inherited May be localised or systemic

Answer 4

By nature of precursor plasma proteins that form the fibrillar deposits AL amyloid - primary AA amylodosis - secondary ATTR familial

Answer 5

AL amyloidosis Abnormal plasma cells in bone marrow produce light chain amyloid protein Light chains normally part of healthy immunoglobulins and thus proteins referred to as amyloidogenic monoclonal immunoglobulin fibrillar light chain proteins Protein get deposited and result in organ failure and death Associated with myeloma and non-Hodgkin's lymphoma

Answer 6

Affects normal structures and function of affected tissue Kidneys - glomerular lesions resulting in proteinuria and nephrotic syndrome Heart - restrictive cardiomyopathy, arrhythmias and angina Nerves - peripheral and autonomic nephropathy and carpal tunnel syndrome GI - macroglossia, malabsorption, weight loss, perforation, haemorrhage, obstruction, hepatomegaly Vascular - purpura especially periorbital Treatment - optimise nutrition, alkylating agent and corticosteroid eg oral melphalan and prednisolone

Answer 7

AA amyloidosis Derived from serum amyloid A, an acute phase protein, related to chronic inflammatory disorders and chronic infection - RA, UC/Crohn's, familial Mediterranean fever, chronic infections eg TB, bronchiectasis, osteomyelitis

Answer 8

Affects kidneys, liver and spleen Proteinuria, nephrotic syndrome, hepatosplenomegaly, macroglossia NOT SEEN, cardiac involvement rare Treat underlying cause

Answer 9

Autosomal dominant condition | Usually caused by mutations in transthyretin where mutant protein forms amyloid fibils

Answer 10

Sensory and autonomic neuropathy Cardiomyopathy Renal involvement Treatment - liver transplant can cure

Answer 11

Biopsy of affected tissue - Rectum or subcutaneous fat relatively non-invasive sites for biopsy and positive 80% - Biopsy positive if there is congo red staining with red-green birefringence under polarised light microscopy

Answer 12

Median survival 1-2 years | Patients with myeloma and amyloidosis have shorter survival then those with myeloma alone

Answer 13

Chronic, non-pitting oedema caused by lymphatic insufficiency ie failure of lymphatic drainage Most commonly affects legs and tends to progress with age Legs can become enormous and prevent normal shoes being worn Chronic disease may cause secondary cobblestone thickening of skin

Answer 14

Primary lymphoedema - Presents in early life - Due to inherited deficiency of lymphatic vessels Severe lymphoedema - Due to obstruction of lymphatic vessels - filiarial infection, malignant disease, trauma, radiotherapy, surgery

Answer 15

Compression stockings Physical massage For filariasis infection give oral diethylcarbamazine - Kills worms and microfilaeiae - Serious allergic responses may occur as parasites are killed - S/E facial swelling, headaches, lethargy If recurrent cellulitis, long-term antibiotics advisable as each episode of cellulitis will further damage lymph vessels eg prophylaxis low-dose antibiotics twice daily Surgery should be avoided

Answer 16

Group of rare solid tumours of connective tissues - more than 50 different histological subtypes known Cancers develop in muscle, bone, nerves, cartilage, tendons, blood vessels and fatty and fibrous tissues Mesodernal origin tumours

Answer 17

1% of all adult tumours | Soft tissue sarcoma more common than bone sarcoma (80%)

Answer 18

Can affect any body part More common in middle aged and elderly Eg leiomyosarcoma STS red flag - lump that is big/getting bigger, deep in body tissues, painful and occurs when older

Answer 19

Lump that is painless at first Pain and soreness as lump grows and presses against nerves and muscles Leiomyosarcoma in womb may cause bleeding other than when patient having period/menopause Most metastasis to lung initially

Answer 20

MRI and core needle biopsy | CT thorax for lung metastases

Answer 21

Surgical resection and chemotherapy +/- radiotherapy | Chemotherapy +/- radiotherapy is unresectable

Answer 22

Only affect less than 500 people in UK per year More common under 20 Osteosarcoma Red flags - non-mechanical bone pain, night pain, palpable bony mass, average duration of symptoms 3m, bone destruction, new bone formation, periosteal swelling, soft tissue swelling suggests new tumour

Answer 23

``` Non-mechanical bone pain still present when lying still Swelling Feeling tired Pyrexia Weight loss ```

Answer 24

X-ray CT/MRI Bone scans and biopsy

Answer 25

Wide surgical resection and reconstruction | Chemotherapy +/- radiotherapy

Answer 26

Epirubicin + CMF (cyclophosphamide, methotrexate, fluorouracil)

Answer 27

``` Hot flushes Weight gain Mood changes Vaginal discharge Thromboembolism ```

Answer 28

Anatrozole

Answer 29

Target peripheral oestrogen synthesis

Answer 30

``` Hot flushes Vaginal dryness Arthralgia Skin rash Osteoporosis ```

Miscellaneous Flashcards

(55 cards)