passmed !!!!!!! Flashcards
pale retina
central retinal artery occlusion
causes of papilloedema
- space-occupying lesion: neoplastic, vascular
- malignant hypertension
- idiopathic intracranial hypertension
- hydrocephalus
- hypercapnia
how do beta blockers work in glaucoma
decrease production of aqueous fluid
complication of mydriatic drops
acute angle closure glaucoma
management for someone with an organic foreign body in their eye
refer to opthalmology that day
how does latanoprost work in glaucoma
-increasing uveoscleral outflow
prostaglandin analogue
what organism for contact lens keratitis
psuedomonas
treatment for patients with temporal arteritis and vision loss
IV methylprednisolone
what are stag horn calculi composed of
struvite
isolated raise in ALP
PAGETS
what does renal cell carcinoma look like on CT scan
mass with contain solid and liquid components
which thyroid cancer has family inheritance
medullary
which GN can be caused by HIV
FSGS
first line management of osteomalacia
vitamin D supplements
most common std organism for septic arthritis
gonorrhea
hyponatraemia after removal of a ureteric stone
salt-losing nephropathy
what nerve is most likely to be injured in a mid humeral shaft fracture
radial nerve
treatment if someone has undescended testes at the age of 30
remove it
is acromegaly associated with diabetes
yes
which ventricular hypertrophy is acromegaly associated with
left ventricular hypertrophy
management for paraphimosis
soak the foreskin and then put it back manually
tender pea-sized nodule in the upper pole of testes
torsion of testicular appendage
commonest cause of addisons in the UK
autoimmune
what do medullary thyroid cancers secrete
calcitonin (amyloid)
what type of cells are found in medullary thyroid cancer
polygonal cells
which chromosome has the defect in medullary thyroid cancer
chromosome 10
complication of pagets
malignancy
which drugs can worsen psoriasis
bisoprolol
causes of pyoderma gangrenosum
- UC/crohns
- rheumatoid arthritis/SLE
- lymphoma
- GPA
- primary biliary cirrhosis
what hypersensitivity for contact/allergic dermatitis
type 4
what nerve fibres are responsible for pupillary constriction
parasympathetic
what is the pathophysiology behind dupuytren’s contracture
- excessive myofibroblast proliferation
- altered collagen matrix composition
- this leads to thickened fascia
- then fixed flexion deformity
what area of the eye has the highest concentration of cones
fovea
what affect does increasing the venomotor tone have on the heart
increases venous return to the heart
what nerve crosses the posterior triangle of the neck
accessory nerve
what is the best genetic test for chromosomal imbalance in a 4 year old with learning difficulties
array comparative genomic hybridisation
how long is the PR interval in an ECG
- 12-0.2
- represents AV nodal delya
what is the p wave caused by
atrial depolarisation
how long is the QRS complex
<0.12 seconds
what drug could precipitate and acute attack of gout and why
allopurinol
-causes rapid lowering of serum uric acid which can (rarely) precipitate an acute attack
what test should be done before performing a lumbar puncture
clotting screen
what is hallux rigidus
a form of osteoarthritis which occurs when the cartilage within the joint wears out
-usually in the big toe
projectile vomiting in child
pyloric stenosis
bile coloured vomit
volvulus
eye manifestation of rheumatoid arthritis
scleritis
most common cause of reduced CD4 count
HIV
what is cataract surgery called
phacoemulsification
what type of keratitis for swimming pool with contact lenses on
bacterial
whereabouts in the eye is the blind spot
optic disc
facial palsy + swelling at angle of the jaw
parotid gland adenocarcinoma
which chromosome for ADPKD
16
what is distal hypoperfusion ischaemic syndrome
complication of an AV fistula
- shunting of the blood flow through the fistula and distal ischaemia
- results in ulcers and necrosis on the hands
initial investigation in a man with fertility problems
semen analysis
do melanomas bleed
yes they can
-very concerning factor
management of erythrodermic psoriasis
urgent hospital admission
treatment of advanced prostate cancer
- GnRH agonists (goserelin)
- anti-androgens (apalutamide)
what is epidermolysis bullosa
breakdown of anchoring between dermis and epidermis
what is epidermolysis bullosa
breakdown of anchoring between dermis and epidermis
which insulin do you give once a day
bolus
example of a soluble insulin
actrapid
give an example of an insulin analogue
NovoRapid
example of a long acting insulin
lantus
complications of pagets
- deafness
- cardiac failure
- fractures
- skull thickening
what DMARD causes interstitial pneumonitis
methotrexate
what rheumatoid drugs are nephrotoxic
- gold
- penicillamine
at what age can a child build a tower of 3 bricks and enjoy picture books
18 months
what type of blood does the placental artery carry
deoxygenated
what type of blood does the placental vein carry
oxygenated
where is the virus reactivated in ramsay hunt syndrome
the geniculate ganglion of CN 7
causes of central scotoma
dry ARMD
optic neurits
first line investigation for hydrocele
doppler USS with colour
what GFR for stage 3 CKD
30-60
what trimester does gestational diabetes usually occur in
third
what drug can cause hypothyroidism
amiodarone
what is pseudohypoparathyroidism
failure of cells to respond to PTH
signs of pseudohypoparathyroidism
- short fingers
- round face
- short stature
- calcified basal ganglia
what is pseudo-pseudohypoparathyroidism
same as pseudohypoparathyroidism but normal biochemistry
what medication is given pre-op for a laparoscopic adrenalectomy in conn’s
spironolactone
treatment for bilateral adrenal hyperplasia
spironolactone or eplerenone
cause of secondary hyperaldosteronism
- reduced renal blood flow leads to excess renin
- and then excess angiotensin II
- so then loads of aldosterone
what drug for hirtuism
metformin
genotype for kleinfelter’s
47XXY
symptoms: infertile, small firm testes
what are the three histological types of pituitary tumour
- chromophobe (most common)
- acidophil (secrete GH and PRL)
- basophil (secrete ACTH)
where do craniopharyngiomas originate from?
Rathke’s pouch
what type of deficiency causes congenital adrenal hyperplasia
21 alpha hydroxylase
what is sheehan syndrome
a condition that affects women who lose a life-threatening amount of blood or have severe or low blood pressure during or after childbirth
- causes damage to the pituitary stalk
- symptoms of hypopituitarism
what drugs for hyperthyroidism in pregnancy
- prophylthiouracil in first trimester
- carbimazole 2nd/3rd trimester
but try and avoid both and just control with beta blockers
what drug class is phenoxybenzamine
alpha blocker
what drugs do you give before phaechromocytoma surgery
beta blockers and alpha blockers
what drug class is spironolactone
aldosterone antagonist
what drug for ascites
aldosterone antagonist (spironolactone)
mechanism of action of orlistat
pancreatic lipase inhibitor
what is the first indicator of diabetic nephropathy
microalbuminuria
screening for diabetic nephropathy
ACR ratio
features seen in grave’s and not other thyroid problems
eye signs (30% of patients)
- exophthalmos
- ophthalmoplegia
pretibial myxoedema
thyroid acropachy, a triad of:
- digital clubbing
- soft tissue swelling of the hands and feet
- periosteal new bone formation
