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PassMed Revision > Mon 26th > Flashcards

Mon 26th Flashcards

1
Q

Vertigo

A

false sensation that the body or environment is moving

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2
Q

Viral labyrinthitis

A

Recent viral infection
Sudden onset
Nausea and vomiting
Hearing may be affected

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3
Q

Malaria

A 
fever 
hepatosplenomegaly
diarrhoea
jaundice 
anaemia
thrombocytopaenia 
rosetting of red blood cells
auto-agglutination of RBCs

Severe signs: acidosis, parasitaemia >2%, hypoglycaemia

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4
Q

Propionibacterium acne

A

causes acne vulgaris, the skin condition

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5
Q

Bartonella quintana

A

trench fever

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6
Q

Malaria complications

A
  • cerebral malaria: seizures, coma
  • acute renal failure: blackwater fever, secondary to intravascular haemolysis, mechanism unknown
  • acute respiratory distress syndrome (ARDS)
  • hypoglycaemia
  • disseminated intravascular coagulation (DIC)
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7
Q

Pregnancy: DVT/PE

A

treat: sub-cutaneous low molecular weight heparin

- warfarin counter-indicated due to teratogenic effects

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8
Q

Primary herpes simplex virus infection

A

gingivostomatitis treat with oral aciclovir, chlorhexidine mouthwash

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9
Q

Wernicke’s encephalopathy

A
  • neuropsychiatric disorder caused by thiamine deficiency which is most commonly seen in alcoholics
  • nystagmus (the most common ocular sign)
  • ophthalmoplegia
  • ataxia
  • confusion, altered GCS
  • peripheral sensory neuropathy
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10
Q

Wernicke-Korsakoff syndrome

A

If Wernicke’s encephalopathy not treated then Korsakoff’s syndrome may develop as well

  • addition of antero- and retrograde amnesia and confabulation
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11
Q

Methotrexate = folate antagonist that inhibits dihydrofolate reductase - essential for the synthesis of purines and pyrimidines

A

**avoid prescribing trimethoprim or co-trimoxazole concurrently - increases risk of marrow aplasia&raquo_space; myelosuppression and even pancytopenia

**high-dose aspirin increases the risk of methotrexate toxicity secondary to reduced excretion

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12
Q

Methotrexate toxicity

A

treatment of choice is folinic acid

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13
Q

Co-trimoxazole contains trimethoprim

A

folate antagonist

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14
Q

Takayasu’s arteritis

A
  • Large vessel granulomatous vasculitis
  • Results in intimal narrowing
  • Most commonly affects young asian females
  • Patients present with features of mild systemic illness, followed by pulseless phase with symptoms of vascular insufficiency
  • Treatment is with systemic steroids
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15
Q

Aortic dissection

A
  • Chest pain (anterior chest pain- ascending aorta, back pain - descending aorta)
  • Widening of aorta on chest x-ray
  • Diagnosis made by CT scanning
  • Treatment is either medical (Type B disease) or surgical (Type A disease)
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16
Q

Cervical rib

A
  • Supernumery fibrous band arising from seventh cervical vertebra
  • Incidence of 1 in 500
  • May cause thoracic outlet syndrome
  • Treatment involves surgical division of rib
17
Q

Subclavian steal syndrome

A
  • Due to proximal stenotic lesion of the subclavian artery
  • Results in retrograte flow through vertebral or internal thoracic arteries
  • The result is that decrease in cerebral blood flow may occur and produce syncopal symptoms
  • Increased metabolic needs of the arm then cause retrograde flow and symptoms of CNS vascular insufficiency
  • A duplex scan and/ or angiogram will delineate the lesion and allow treatment to be planned
18
Q

Patent ductus arteriosus

A
  • Ductus arteriosus is a normal foetal vessel that closes spontaneously after birth
  • Results in high pressure, oxygenated blood entering the pulmonary circuit
  • Untreated patients develop symptoms of congestive cardiac failure
19
Q

Coarctation of the aorta

A
  • Aortic stenosis at the site of the ductus arteriosus insertion
  • Most common in boys and girls with Turners syndrome
  • Patients may present with symptoms of arterial insufficiency, such as syncope and claudication
  • Blood pressure mismatch may be seen, as may mismatch of pulse pressure in the upper and lower limbs
  • Treatment is either with angioplasty or surgical resection (the former is the most common)
  • Weak arm pulses may be seen
  • Radiofemoral delay is the classical physical finding
  • Collateral flow through the intercostal vessels may produce notching of the ribs, if the disease is long standing
20
Q

Digoxin

A
  • increases the force of cardiac muscle contraction due to inhibition of the Na+/K+ ATPase pump. Also stimulates vagus nerve
  • decreases conduction through the AV node which slows the ventricular rate in atrial fibrillation and flutter
  • narrow therapeutic index
21
Q

Digoxin toxicity

A
  • generally unwell, lethargy, nausea & vomiting, anorexia, confusion, yellow-green vision
  • arrhythmias (e.g. AV block, bradycardia)
  • gynaecomastia

Precipitated by:

  • digoxin normally binds to the ATPase pump on the same site as potassium. Hypokalaemia → digoxin more easily bind to the ATPase pump → increased inhibitory effects
  • drugs: amiodarone, quinidine, verapamil, diltiazem, spironolactone (competes for secretion in DCT therefore reduce excretion), ciclosporin. Also drugs which cause hypokalaemia e.g. thiazides and loop diuretics

Management:

  • Digibind
  • correct arrhythmias
  • monitor potassium
22
Q

Statins + erythromycin/clarithromycin

A
  • myalgia
    +++ creatine kinase
  • statin-induced myopathy secondary to clarithromycin
23
Q

Statins

A

inhibit the action of HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis

Adverse effects:

  • myopathy: includes myalgia, myositis, rhabdomyolysis and asymptomatic raised creatine kinase
  • Liver impairment
  • may increase the risk of intracerebral haemorrhage in patients who’ve previously had a stroke

Contra-indications:

  • macrolides
  • pregnancy
24
Q

HSV-1

A

Sunlight is a common trigger for cold sores

25
Q

Medullary thyroid cancer

A

only thyroid cancer that will cause a rise in calcitonin, as it originates from the parafollicular cells, which produce calcitonin

26
Q

mAb: CA 125

A

Ovarian cancer

27
Q

mAb: CA 19-9

A

Pancreatic cancer

28
Q

mAb: CA 15-3

A

Breast cancer

29
Q

Prostate specific antigen (PSA)

A

Prostatic carcinoma

30
Q

Alpha-feto protein (AFP)

A

Hepatocellular carcinoma

Teratoma

31
Q

Carcinoembryonic antigen (CEA)

A

Colorectal cancer

32
Q

S-100

A

Melanoma

schwannomas

33
Q

Bombesin

A

Small cell lung carcinoma
gastric cancer
neuroblastoma

34
Q

Carotid endarterectomy

A

TIA with carotid artery stenosis exceeding 70%

PassMed Revision (13 decks)

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