Part 7 Flashcards
Dopaminergic Pathways?
MiLcTINS
Nigrostriatal: extrapyramidal motor system
Tuberoinfundibular: prolactin release inhibition
Mesolimbic: rewards
What comprises the mesolimbic pathway?
Ventral Tegmental Area – Nucleus Accumbens (dopamine)
what is a signet ring cell carcinoma
highly malignant adenocarcinoma
stomach, breast, gallbladder, pancreas
Different serotypes of Chlamydia
Serovars
A-C - trachoma - blindness
D-K - genitals
L1-3 - LGV
Epidural injection affects what?
Nerve roots
refers to a solitary, abnormal belief that is neither delusional nor obsessional in nature, but which is preoccupying to the extent of dominating the sufferer’s life.
Overvalued idea
found a mass that needs to be removed during another surgery – can you proceed?
No - need consent
greatest risk factor for Schizophrenia ?
having a first degree relative
Side effects of methotrexate
fever, headache, nausea, vomiting
skin rash/sun sensitivity
Mouth ulcers, sore gums, sore throat
side effects of prednisolone
N+V, Headache, Dizziness, Weight gain Cushing's Osteoperosis Hirsutism Hypertension
genetics of MS
HLA DRB1 (1st degree relative = 15x risk)
how does optic neuritis present?
Retro orbital pain on movement of eye
progressing to rapid vision loss (days to a week)
Presentation + Degrees of uterine prolapse
Dragging, Lump, Incontinence
1st degree (cervix remains in vagina), 2nd degree (at vaginal orifice), 3rd degree (outside vagina), uterine procidentia (entirely outside vagina)
Surgery for prolapse
Sacrospinous fixation
Causes of Hypothalamic dysfunction –> low GnRH, low FSH/LH, low oestrogen/progesterone
Idiopathic Hypogonadotropic Hypogonadism (anorexia, high stress levels, chronic illness, alcohol abuse, prolonged exercise)
Kallmann’s + anosmia
Causes of pituitary dysfunction –> High GnRH, low FSH/LH, low oestrogen
Sheehan’s (post PPH)
Hyperprolactinaemia - drugs (dopamine antagonists) + micro/macro prolactinoma.
Ix = Serum prolactin, MRI, med review
Tx = dopamine agonists (cabergoline), surgery for tumour
What is a primary cause of painful periods (dysmenorhhea)? + Tx?
increased endometrial prostaglandins
Mefanamic acid
Tx for menorrhagia?
1st line = Mirena IUS
2nd line = Tranexamic acid
3rd line = IM progestogens
Histology of Vagina to cervix
Ectocervix (squamous cells)
Transition Zone
Endocervix (columnar glandular epithelium
what may present with clear, non smelling vaginal discharge?
Cervical ectropion
How do cervical smears detect cancer?
Smear cells are taken from the transition zone and cells are sent for cytology: Cytological diagnosis is based on dyskaryosis- change in appearance of cells- nuclear abnormalities, enlargement, hyperchromasia, irregular nuclear membrane
Treatments for types of CIN
CIN 1 = basal 1/3rd (biopsy in 6 months)
CIN2 or 3 = LLETZ (large loop excision of transformation zone)
Which drug can typically be used to treat painful periods?
And which drug is used for large haemorrhage or heavy periods?
Mefenamic acid for painful periods (NSAID)
Tranexamic acid for big bleeds (antifibrinolytic)
Txfor paracetamol overdose
N-acetyl cysteine
Triad of wernicke’s (thiamine deficiency)
confusion
Ataxia
Ophthalmoplegia
2 main groups of endometrial carcinoma
Endometroid - good prognosis - oestrogen driven
Serous Carcinoma - TP53 mutation, aggressive, BAD prognosis
what might present with a benign ovarian tumour, ascites and pleural effusion?
Meig’s Syndrome
