NEED TO KNOW Flashcards
Autoimmune hepatitis type 1
Anti-actin
Anti-SLA/LP
ANA
SMA
Autoimmune hepatitis type 2
Anti-LKM1
Anti-LC1
PSC
p-ANCA
PBC
AMA
Wilson’s disease
Caeruloplasmin
Hereditary haemochromatosis
Raised ferritin
Raised transferrin saturation
Low TIBC
**Raised transferrin saturation is >55% in men and >50% in women,
Active Hep B infection
HBsAg
Current or previous Hep B infection
HBcAb
IgM = current IgG = previous
Core Hep B antigen
HBcAg
Active replication of Hep B infection
HBeAg
Antibody showing that Hep B has stopped replicating
HBeAb
Vaccination against Hep B
HBsAb
Direct count of Hep B viral load
HBV DNA
Screening tests for Hep B
HBcAb + HBsAg
Tests done if Hep B screening is positive
HBeAg + HBV DNA
Coeliac disease
anti-TTG/ anti-EMA
**MUST check IgA first.
Myasthenia gravis
Anti-ACh
Anti-MUSK
Anti-LPR4
Churg-Strauss syndrome
Eosinophilic granulomatosis with polyangiitis
pANCA
Eosinophils >10%
(+ asthma + paranasal sinusitis + pulmonary infiltrates)
Lambert-Eaton myasthenia syndrome
Antibodies to voltage gated calcium channels
Membranous glomerulonephritis
Anti-phospholipase A2 receptor antibodies
Post-streptococcal glomerulonephritis
Anti-streptolysin O titres
Anti-DNAase B
Decreased serum C3
SLE
Sensitive? ANA.
Specific? anti-dsDNA/ anti-smith
Others: low C3 and C4
Granulomatosis with polyangiitis
cANCA
Microscopic polyangiitis
pANCA
Goodpastures disease.
Anti-GBM antibodies.
Grave’s disease.
Anti-TPO antibodies
TSH receptor antibodies
Hashimoto’s thyroiditis
Anti-TPO antibodies
Anti-thyroglobulin antibodies
Rheumatoid arthritis
RF
Anti-CCP
Multiple sclerosis
Oligoclonal bands in CSF
Coagulation results in haemophilia?
APTT prolonged.
PT, prothrombin time + bleeding time all normal.
Coagulation results in von willebrand disease?
APTT prolonged
Bleeding time prolonged
PT normal
IDA
Low serum iron
Low ferritin
High transferrin
High TIBC
Anaemic of chronic disease
Low/ normal serum iron
Low/ normal ferritin
Low transferrin
Low TIBC
Sideroblastic anaemia
Ringed sideroblasts (iron engorged peri-nuclear mitochondria in developing RBCs)
Pernicious anaemia
Increased IgA antibodies against intrinsic factor/ parietal cells.
Hereditary spherocytosis
Circular cells
Low Hb
Raised reticulocytes
G6PD deficiency
Heinz bodies
Warm AIHA
IgG
Cold AIHA
IgM
AML/ acute pro-myelocytic anaemia
Auer rods
AML blood film
Auer rods
Blast cells
CML
Leukoerythroblasts
Myelofibrosis
Tear drop poikilocytosis
CLL
Smear/ smudge cells
Myeloma
Rouleaux formation
BJPs.
Hodgkin’s lymphoma
Reed-Sternberg cells
Burkitt’s lymphoma
Starry-sky appearance on blood film.
Polycythaemia vera
Isolated rise in RBC count.
Von Willebrand’s disease clotting profile.
Prolonged APTT
Prolonged bleeding time
Normal PT
Von Willebrand’s disease.
Reduced VIII and reduced VWF.
Haemophilia clotting profile.
Prolonged APTT
Normal PT
Relationship between all spondyloarthropathies?
HLAB27
Gout joint aspiration findings?
Negatively birefringent, needle shaped, monosodium urate crystals.
Pseudogout joint asporation findings?
Positively birefringent, rhomboid shaped, calcium pyrophosphate crystals.
Pseudogout pathognomonic XR finding?
Chondrocalcinosis
SLE
Sensitive? ANA.
Specific? anti-dsDNA/ anti-smith
Others: low C3 and C4
Anti-phospholipid syndrome
Anticardiolipin antibodies
Anti-beta-2 glycoprotein I antibodies.
Limited cutaneous systemic sclerosis (CREST syndrome).
Anti-centromere antibodies
Diffuse cutaneous systemic sclerosis.
Anti-Scl-70 antibodies.
Sjogren’s syndrome
Anti-Ro + Anti-La antibodies.
Dermatomyositis.
Anti-Mi-2 antibodies
ANA
Sometimes Anti-Jo-1 antibodies.
Polymyositis.
Anti-Jo-1 antibodies.
MEN type 1 gene.
MEN 1 gene.
Most common presentation of MEN 1?
Hypercalcaemia.
MEN type 2 gene.
RET oncogene.
Most common thyroid cancer.
Papillary.
Thyroid cancer associated with Hashimoto’s thyroiditis?
Lymphoma.
Blood clotting results in vitamin K deficiency?
APTT increased.
PT increased.
Bleeding time increased.
Primary + Tertiary hyperparathyroidism?
High PTH.
High calcium.
Secondary hyperparathyroidism?
High PTH.
Low calcium.
Drug-induced lupus.
Anti-histone antibodies.
HbA1c target for T2DM on lifestyle management?
<48
HbA1c target for T2DM on lifestyle + metformin management?
<48
HbA1c target for T2DM on any management more than lifestyle + metformin?
<53
HbA1c target for T1DM?
<48
How often for diabetic eye screening?
2 yearly if low risk, annually for everyone else.
How often for diabetic foot screening?
Annually.
How often for diabetic kidney disease screening?
Annually.
How often for CVD risk factor assessment in those with diabetes?
Annually.
Water deprivation tests results for cranial diabetes insipidus?
Urine osmolality low after water deprivation.
Urine osmolality high after ADH.
Water deprivation tests results for nephrogenic diabetes insipidus?
Urine osmolality low after water deprivation.
Urine osmolality low after ADH.
Water deprivation tests results for primary polydipsia?
Urine osmolality high after deprivation.
Urine osmolality high after ADH.
**No need to give ADH if initial water deprivation step high as this can only be primary polydipsia.
Gold standard investigation for diabetes insipidus?
Water deprivation test.
Primary hypothyroidism TFTS?
high TSH
low T3 + T4
Secondary hypothyroidism TFTs?
low/ normal TSH
low/ normal T3 + T4
Hyperthyroidism TFTs?
low TSH
high T3 + T4
Most common thyroid cancer?
Papillary.
Thyroid cancer associated with Hashimoto’s thyroiditis?
Lymphoma.
Hypoparathyroidism blood results?
low PTH
low calcium
high phosphate
ECG findings in hypoparathyroidism?
prolonged QT interval
Primary hyperparathyroidism blood results?
high PTH
high calcium
Secondary hyperparathyroidism blood results?
high PTH
low/ normal calcium
Tertiary hyperparathyroidism blood results?
high PTH
high calcium
Gold standard investigation for Cushing’s syndrome?
Dexamethasone suppression test.
Dexamethasone suppression test results in pituitary adenoma (Cushing’s disease)?
Cortisol suppressed.
ACTH suppressed.
Dexamethasone suppression test results in adrenal adenoma?
Cortisol not suppressed.
ACTH suppressed.
Dexamethasone suppression test results in ectopic ACTH production?
Cortisol not suppressed.
ACTH not suppressed.
What is present if cortisol level is not suppressed in the low dose dexamethasone suppression test?
Cushing’s syndrome.
Gold standard investigation for adrenal insufficiency?
Short synacthen test.
Short synacthen test results in primary adrenal insufficiency?
Cortisol does not rise.
Short synacthen test results in secondary adrenal insufficiency?
Cortisol level doubles.
1st line investigation for acromegaly?
Serum IGF-1 levels
**Raised in acromegaly.
2nd line investigation for acromegaly to confirm diagnosis if IGF-1 levels are raised?
OGTT
**no suppression of GH with hyperglycaemia in those with acromegaly.
1st line investigation for hyperaldosteronism?
Renin:aldosterone ratio
Renin:aldosterone ratio results for primary hyperaldosteronism?
High aldosterone
Low renin
Renin:aldosterone ratio for secondary hyperaldosteronism?
High aldosterone
High renin
What might U&Es show in hyperaldosteronism?
Hypokalaemia.
Most common cause of nephrotic syndrome in children?
Minimal change disease.
Antibody found in membranous glomerulonephritis?
Anti-phospholipase A2 antibodies.
**Also IgG and C3 deposits in GBM.
Most common cause of nephrotic syndrome in adults?
Focal segmental glomerulosclerosis.
Most common type of glomerulonephritis in adults?
IgA nephropathy
Kidney disease developing 24-48 hours after an URTI.
IgA nephropathy.
Kidney disease developing >/= 2 weeks after an infection?
Post-streptococcal glomerulonephritis.
Post-streptococcal glomerulonephritis findings?
Anti-streptolysin O titres
Increased anti-DNAase B
Decreased serum C3
Goodpasture’s disease.
Anti-GBM antibodies.
Kidney disease + eye disease + sensorineural hearing loss?
Alport syndrome.