Pas test general question review Flashcards
What is the Halo sign
Ground glass opacities surrounding a mass or alveolar nodule - indicative of aspergillosis
What is the signet ring sign?
Enlarged bronchus compared to the pulmonary arteries - occurs in Bronchiectasis, normal people have similar sized PA and Bronchus
What is the atoll sign?
Not to be confused with the halo sign, it is in effect the reverse halo sign whereby ground glass opacities are surrounded by denser tissue - usually a sign of Pulmonary Zygomycosis (PZ) - worse than aspergillosis and important to note as it effects the treatment
What is the tree in bud sign?
Found in endobronchial TB or other endobronchial pathologies such as CF and viral pneumonia
Core features of ADHD
- easily distracted
- Hyperactive
- Disrupts classmates
Syndromes and their associated heart defect
- Turner and coarctation
- Kartagener and dextrose
- Marfanoid and aortic root dilation
- Congenital rubella syndrome and PDA, PS and ASD
- Downs and ASD/VSD
Coarctation of the aorta key facts
- if severe causes heart failure and metabolic acidosis
- PGE1 can be used to keep aorta open allowing left to right shunting while awaiting surgery
- 4th and 6th arches issue
- can present with AS/ bicuspid valve
- MRI defitinitive investigation
Mitral stenosis is heard as a
Mid diastolic murmur (opening snap)
Pulmonary stenosis is heard as
Loud P2 - ejection systolic murmur
MVP is heardas
- mid systolic click followed by a late systolic murmur
VSD is heard as
Pan-systolic murmur
RBBB is heard as
Wide splitting of the second heart sound
Malarie de roger
Haemdynamically insignificant VSD
WPW syndrome
- delta wave in V1
- SVT
- congenital accessory conduction pathway
- type A - positive R wave in V1
- type B - negative R wave in V1
- RF ablation is definitive treatment
What is the deficiency in TTP
ADAMTs13
Sheehan syndrome
- hypopituitarism following childbirth
- will cause reduced prolactin, cortisol and the rest but will not effect aldosterone
Blood supply of the left atrium
Circumflex
SA nodal artery supplies…
SA node and arises from teh RCA in 60% of people and in 40% is supplied by the lCx
Posterior interventricular branch supplies and comes from
The two ventricles and interventricular septum and derives from the RCA
Management of reifenstein (partial androgen insensitivity syndrome) syndrome
Non-pharmacological: explain condition, genetic counselling, psychological support
Pharmacological: TRT
Surgical: removal of testes post puberty when feminisation is complete, this reduced testicular cancer risk
What is PIS/ reifenstein syndrome?
- PAIS - is an x linked disorder where’re the growing reproductive organs and genitals are affected
- occurs in men 46 XY
- very rare
What can be graded using the LOs Angeles classification ?
- Oesophagitis
- grades are as follows:
A- one or more muscular breaks less than or equal to 5mm
B - musical breaks greater than 5mm but with no conituity across mucosal folds
C- breaks span across two mucosal folds, but less than 75% of oesophageal circumference
D- mucosal breaks with over 75% of oesophagus circumference
Sentinel pile
External lump/skin rage found on the anus which is associated with chronic anal fissures
Myomalacia cordis
- 3-14 days post MI where there is softening of the dead muscles leafing to rupture and death
Drugs that worsen heart failure
- NSAIDS
- Central CCBS
Chemo
Pathognomonic:
- vasculopath
- procedure 2-3 days ago
- acute renal failure
- potentially mottled lower limbs
Diagnosis?
Cholesterol embolism
Pneumothorax management: primary (no underlying lung disease)
- no clinical distress and less than 2cm: no therapy is needed, give supplementary o2, with a follow up car
- breathless or large >2cm: o2, percutaneous need aspiration, insert IV cannula into pleural space, if that fails then insert chest tube or a small bore cat here
Secondary pneumothorax management or pt above the age of 50
- small (less than 1cm) and no breathlessness: O2 and obs in hospital
- moderate: 1-2 and no breathless: O2, obs, percutaneous needle aspiration, chest tube, suction
Large >2cm or breathless: pleurodesis, obs, O2, chest tube and suction
Borders of the inguinal canal
- floor - inguinal ligament (lacunar medially)
- ceiling - (lateral to medial) transverse abdominis, internal oblique, conjoint tendon
- anterior wall - mostly external oblique
- posterior wall - transversalis fascia
- medial opening - superficial inguinal ring
- lateral opening - deep inguinal ring
