MUSE SAQs & SBA Flashcards
What two blood tests can be done to help differentiate between different causes of diarrhoea?
- FBC
- Inflammatory markers (ESR & CRP)
What two stool tests can be done to help differentiate between different causes of diarrhoea?
- Faecal calprotectin
- Stool culture
What layer of the bowel wall does ulcerative colitis affect?
Mucosa
What histological features will be seen in ulcerative colitis?
- Crypt abscess
- Ulceration
- Increase in plasma cells in the lamina propria
- Continuous inflammation
What histological features will be seen in Crohn’s?
- Cobble stone appearance of mucosa
- Rose thorn ulcers
- Skip lesions
What sort of rash is associated with meningitis?
Non blanching purpura rash
What are some causes of breast lump?
- Cancer
- Abscess
- Cyst
- Hamartoma
What cancers metastasise to bone?
- Breast
- Lung
- Kidney
- Thyroid
- Prostate
What is the treatment for breast cancer?
Chemotherapy with trastuzumab
What are the histopathological findings in the brain in Parkinson’s?
- Loss of dopaminergic neurones in the substantia nigra!!
- Lewy Bodies
Name a dopamine agonist?
Cabergoline
What is the inheritance pattern for Familial Adenomatous Polyposis?
Autosomal Dominant
What is an adenocarcinoma?
A malignant tumour of glandular epithelium
What is a squamous cell carcinoma of the lung?
Cancer of the flat cells that line the airways in the lungs
Where are squamous cell lung cancers typically found?
Near a bronchus
What is the first line management for severe hyperkalaemia with ECG changes?
Calcium gluconate
What artery performs an important role in erectile function?
Internal pudendal artery
Name some pre-renal causes of AKI?
- Sepsis
- Dehydration
- Haemorrhage
Name some intra-renal causes of AKI?
- Nephrotoxins
- Parenchymal disease
Name some post-renal causes of AKI?
- Renal calculi
- Prostatic enlargement
- Tumours
What drugs are nephrotoxic?
- NSAIDs
- ACEi / ARB
- Aminoglycosides (Gentamicin)
- Some chemotherapy (Cisplatin)
What is Pelvic Inflammatory Disease?
Inflammation and infection of a woman’s reproductive organ
What are the symptoms of pelvic inflammatory disease?
- Abnormal vaginal discharge
- Pain during sex (Dyspareunia)
- Fever
- Abnormal bleeding
What two pathogens can commonly cause PID?
- Neisseria Gonorrhoeae
- Chlamydia Trachomatis
What are the risk factors for PID?
- Multiple sexual partners
- Existing STI
- Not using barrier contraception
What can help support a diagnosis of PID?
Raised inflammatory markers
What is the 1st line investigation for stroke?
CT head
What are some symptoms of Wilson’s disease?
- Fatigue
- Golden brown eye discolouration (Kayer Fleischer rings)
- Micrographia (Small handwriting)
- Tremor
What is the inheritance pattern of Huntington’s?
Autosomal dominant
What are the symptoms of Huntington’s?
- Chorea
- Depression
What are the symptoms of Huntington’s?
- Chorea
- Depression
- Stumbling and clumsiness
- Difficulty concentrating
- Mood swings / personality changes
What clinical feature would suggest a severe aortic stenosis?
A small volume and slow rising pulse
What is peripheral arterial disease?
Narrowing of the arteries supplying the limbs and periphery, reducing the blood supply to these areas
What is claudication?
Muscle pain that happens when you’re active and stops when you rest
What can peripheral arterial disease cause?
Critical ischaemia
What are the 6P’s of acute limb ischaemia?
- Pain
- Pallor
- Pulselessness
- Paraesthesia
- Perishing cold
- Paralysis
What test can be used to assess peripheral arterial disease in the leg?
Buerger’s Test
What is Buerger’s test?
- Lie on back adn raise legs to 45 degree angle for 1-2 mins - look for pallor
- Upon hanging legs over bed: Healthy - pink legs
PAD - Blue as ischaemic tissue deoxygenates the blood, then dark red
What is the 1st line treatment for peripheral arterial disease?
Reduce lifestyle factors & Exercise program
What artery can be affected in duodenal ulcers?
Gastroduodenal artery
What are some symptoms of ketoacidosis?
- Thirst
- Polyuria
- Kussmaul breathing
- Fruity smelling breath
- Headache
- Nausea & Vomiting
What is Turner syndrome?
A genetic disorder where females only have 1 normal X chromosome rather than 2
What are some symptoms of Turner’s syndrome?
- Webbed neck
- Short stature
- Ovarian insufficiency
What is Kallmann syndrome?
A genetic disorder where specific neurons that communicate with the hypothalamus are underdeveloped, leading to lack of Gonadotrophin Releasing Hormone
(Hypogonadotrophic hypogonadism characterised by late or absent puberty and anosmia)
What are some symptoms of Kallmann syndrome?
- Anosmia
- Cleft lip or palate
- Short fingers or toes, especially ring finger
What is a potential complication of carbimazole?
- Acute pancreatitis
- Agranulocytosis - Urgent FBC and aggressive treatment for infections
What is a potential complication of Lithium?
Thyroid problems
What is a seminoma?
A type of neoplasm that begins in germ cells of men, typically in the testicles or more rarely in the mediastinum
What is a germinoma?
A neoplasm of germ cells that occurs in the brain - it has an identical histology to the testicular seminoma
What can differentiate between a germinoma and a seminoma?
Germinoma may present with more hormone abnormalities
What is the correct course of action if a patient has an adverse drug reaction?
- Stop drug
- Patient informed
- Report via yellow card system
What is the appropriate therapy for reversal of patient’s warfarin?
- IV Vitamin K
- IV Prothrombin Complex Concentrate
What is the treatment for disseminated intra-vascular coagulation (DIC)?
- Cryoprecipitate (it has lots of fibrinogen)
What type of cell is implicated in myeloma?
Plasma cell
What is Immune Thrombocytopenia?
An autoimmune disorder in which the immune system inappropriately destroys platelets
What is Thrombotic Thrombocytopenia Purpura?
A blood disorder where platelets cause clots to develop in small blood vessels of the body
What are some symptoms of ITP?
- Bruising
- Petechiae
- Bleeding from nose or mouth
- Fatigue
What are some symptoms of TTP?
- Nervous system - headaches, vision change, confusion
- Skin - Brusing, bleeding, pale
- Urinary - kidney problems, haematuria
What are some symptoms of TTP?
- Nervous system - headaches, vision change, confusion
- Skin - Brusing, bleeding, pale
- Urinary - kidney problems, haematuria
What is asthma?
A chronic inflammatory condition of the airways that causes episodic exacerbations of bronchoconstriction
What is eosinophilic asthma?
A type of asthma caused by high levels of eosinophils in the lungs
What 3 conditions form the atopic triad?
- Eczema / Atopic Dermatitis
- Allergic Rhinitis
- Asthma
What should be given in an emergency asthma attack?
- O2
- Nebulised salbutamol
What is Ipatropium Bromide?
A muscarinic acetylcholine receptor antagonist that acts as a bronchodilator
What are the symptoms of bronchiectasis?
Persistent productive cough
What is COPD?
A non reversible, chronic deterioration in air flow through the lungs caused by tissue damage
What is the pathophysiology of COPD?
1.Neutrophils are activated by the inhalation of toxic particles
2. Neutrophils secrete proteases that cause tissue destruction and inflammation
What is the treatment for COPD?
- SABA (Salbutamol) or SAMA (Ipatropium Bromide)
- LABA
What is bronchiectasis?
An inflammatory lung disease that causes permanent dilation of the bronchi and bronchioles
What is the most common type of lung cancer?
Adenocarcinoma
What is the function of TLR4?
Senses LPS on the outer membrane of gram negative bacteria
What is the function of TLR5?
Senses flagellin
What is more indicative of Rheumatoid Arthritis?
- Longer morning stiffness
- Pain eases with use
- Good response to NSAIDS
- Bilateral
- Systemic symptoms
What is more indicative of osteoarthritis?
- Clicking / crunching
- Aching in evening
- Pain worsens with use
- Unilateral
What deformities can be seen in osteoarthritis?
- Degeneration of 1st metatarso-phalangeal joint
- Heberden’s and Bouchard’s node
What deformities can be seen in rheumatoid arthritis?
- Swan neck deformity
- Boutonierre deformity
- Ulnar deviation of the metacarpophalangeal joint
What does cANCA indicate?
Wegener’s Granulomatosis
What does Sjogrens cause increased risk of?
Lymphoma
What is Felty’s syndrome?
A rare autoimmune disease characterised by
1. Rheumatoid arthritis
2. Splenomegaly
3. Low neutrophil count
What is the role of a 1,3 beta-D-glucan assay?
Detect invasive fungal pathogens
1. Candida albicans
2. Pneumocystis Jirovecii
3. Aspergillus fumigatus
What is the mechanism of action of cholera?
Secretes a toxin that deregulates ion transport in epithelial cells
What antibitoics are usually given for URTIs?
Penicillin, eg. Amoxicillin
What are some conditions that are risk factors for colorectal cancer?
- Familial Adenomatous Polyposis
- Lynch Syndrome (Hereditary Non Polyposis Colorectal Cancer)
- IBD
What is Mycobacterium Tuberculosis?
An acid fast bacilli
