Mix 1 Flashcards
Cat Scratch Disease
Organism, what does it cause
Cause: Bartonella henselae
Common cause of chronic lymphadenopathy in children/young people in UK
Cat Scratch Disease Mx
1,2,3
co-trimoxole (trimethoprim-sulfamethoxazole), ciprofloxacin, azithromycin
Ormands disease
- describe
- causes
- management
Retroperitoneal fibrosis - Anterior surface of L4-5,
AA diseases, metastatic cancer, methyldopa, beta blockers, methysergide
Mx - steroids, surgery, tamoxifen/azathioprine
Fifth disease, Erythema infectiosum, slapped cheek disease
- cause
- natural history
Human parvovirus B19
Long incubation, prodromal symptoms, symptom-free period then red cheek rash that can fade and recur
CMI
- presentation
- cause
Chronic Mesenteric Ischaemia
abdo pain + nausea, fear of eating and weight loss
Cause - atherosclerosis 95%, vasculitis, radiation damage
CAGE Questionnaire
C-ut down
A-nnoyed by questions
G-uilty about drinking
E-ye opener (morning drink)
2+ should be investigated
Steroid creams - least to most potent
Hydrocortisone 0.5-2.5%
Betamethasone valerate(betnovate)
Clobetasone butyrate(eumovate)
Fluticasone propionate(cutivate)
Clobetasol proprionate(dermovate)
Amoebiasis (Entamoeba histolytica)
- infection source
- symptoms
- risk factors
- management
Ingestion of cystic form of protazoa
Can cause fever, weight loss, abdominal pain (RUQ) liver abscess, bloody diarrhoea
Immunosuppressed, anal sex, institutionalised, migrants to UK
Mx - Metronidazole
Acne conglobata
- describe
- associated with
Unusual severe form of acne, erupting scarring lesions
Associated w Hydradenitis suppurverita and steroid use
Normal Pressure Hydrocephalus
- triad
- radiology
- management
Gait disturbance, dementia, urinary incontinence
CT - large ventricles, normal subarrachnoid space
Ventriculoperitoneal shunt may relieve it
What are milia
Tiny cream coloured sebaceous cysts on the nose/cheeks/below eyes
Port wine stain
Erythematous macular lesion present from birth, usually on face
Stork mark
- AKA
- Describe
- when does it appear
Telangiectatic naevus
multiple erythematous macular lesions - back of neck, or face
Present from birth
Anterior uveitis
- presentation
- test
- associated with
Red, painful eye
Talbots test (pain on pupil constriction)
HLA-B27 disease
Cervical ripeness assessment
Bishops score - PEDSS
P-osition
E-ffacement/length
D-ilation
S-oftness/consitency
S-tation of baby’s head
Shingles
Mx - Oral acyclovir within 72-120hr
Direct lesion contact = infectious
Rash does NOT cross the midline
Pupil dilators
Antimuscarinics -
Atropine, cyclopentolate, tropicamide
Sympathomimetics -
Phenylepherine
Primary hyperaldosteronism
- Conn’s (unilateral aldosterone producing adenoma)
- Bilateral adrenal hyperplasia or idiopathic hyperaldosteronism
Measles- features
Red maculopapular rash, classically starts behind the ears spreads to face, body
Kopliks spots - WHITE spots in buccal mucosa opposite lower molars
Prodrome including conjunctivitis, cough, coryza
Hypocalcaemia
Symtpoms and ECG
Parasthesia, cramps, spasms
Isolated prolonged QTc
Suggestive of Downs Sydrome
Thickened nuccal transleucency
Increase B-HCG
Reduced PAPP-A
Dermatomyositis
Skin rash on knuckles and cheeks/eyelides
Muscle weakness
Idiopathic, connective tissue disorder or cancer - ovarian, breast, lung,
Migraine Mx
Acute: oral triptan + NSAID(or paracetamol)
Prophylaxis: propranolol or topiramate
Gestational diabetes
5678
Fasting > 5.6
2 hour post-glucose >7.8
Desogestrel
Inhibits ovulation
Thickens cervical mucous
Panayiotopoulos syndrome
characterised by seizures, often prolonged, with predominantly autonomic symptoms such as nausea and retching.
Idiopathic childhood occipital epilepsy of gastaut
Mainly visual hallucinations
Benign Rolandic epilepsy
Partial seizures at night in childhood
Local anaesthetic toxicity
Rapid cardiopulmonary deterioration after local anaesthetic
20% lipid emulsion IV
Patent ductus arteriosus
Indomethacin or ibuprofen will close
prostaglandin will keep it patent
Bisphosphonates
In patient >75yrs
Start Alendronate + Ca2+ supplementation
Treating acute gout
NSAID or colchicine ‘cover’ should be used when starting allopurinol
Rinne test
Rinne under the pinny!
Conductive hearing loss BC > AC
Normal AC > BC
Weber test
Weber it’s R or L sensorineural hearing loss
Localises to the good ear if unilateral sensorineural hearing loss
Perthe’s disease
Avascular necrosis of the femoral epiphysis
Age 4-8 years,
5:1 boys
Perthe’s management
To keep the femoral head within the acetabulum: cast, braces
If less than 6 years: observation
Older: surgical management with moderate results
Operate on severe deformities
Methotrexate Antibiotics
Avoid trimethoprim and co-timoxazole due to the risk of bone marrow aplasia
Gestational diabetes Mx
Trial diet and exercise but most need metformin +/- short acting insulin
Alpha-1 anti-trypsin deficiency
Investigations
A1AT concentrations
spirometry: obstructive picture
Management
no smoking
supportive: bronchodilators, physiotherapy
intravenous alpha1-antitrypsin protein concentrates
surgery: lung volume reduction surgery, lung transplantation
Alpha-1 anti-trypsin deficiency genetics
Chromosome 14
PiZZ
PiSS
PiMZ
GORD in infants
Commonest cause of vomiting in infants, presents before 8 weeks
milky meal vomit, excessive crying at meal time
Mx - alginate (gaviscon) -> PPI
Labial adhesions
Oestrogen cream
Treponema pallidum
Syphilis can cause a painless ulcer (chancre) which classically resolves within six to eight weeks even without treatment.
Penile cancer
Strong association with HIV
weight loss, malaise
UC flare
Truelove and Witts severity index
May need to admit for IV corticosteroids
Heel prick test (neonatal blood spot test)
Phenylketonuria, Sickle cell disease, Cystic fibrosis and Hypothyroidism
Dermatitis herpetiformis
Itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)
IgA deposition in the dermis
Dapsone, gluten free diet
