Passmed Flashcards
Association of AS and gastrointestinal bleeding
heyde’s syndrome - angiodysplasia of the stomach - ? related to lysis of VWF from stenosed valve
Hallmarks of homocysteinurea
deficieny of cystathionine beta synthase similar to marfans fine fair hair downward dislocation of the lens VTE risk livedo reticularis malar flush
DOES NOT CAUSE RENAL STONES
associations of primary sclerosing cholangitis
UC
chrons less so
HIV
presents with jaundice and pruritis
RUQ pain
fatigue
investigate with ERCP or MRCP
positive ANCA ?
may progreess to cholangiocarcinoma and associated with increased colorectal cancer risk
Secondary causes of osteoporosis
premature menopause steroids testosterone deficieny in yonger men vitamin d deficieny/ calcium def thyroid disorders myeloma or malignancy
What classes as stage 2 hypertension
150/95 - treat.
signs of quinine overdose
visual disturbances, tinnitus flushing
hypoglycaemia and metabolic acidosis
can get flash pulmonary odema
MArkers of poor prognosis in IgA nephropathy
hypertension proteinuria male gender smoker (frank blood is a good prognostic)
differnce between an IgA nephropathy and a post streptoccal glomerulonephritis
IGA frank blood and more often men, comes on after 1-2 day sof URTI
PSG - comes on afetr 2 weeks and just protein
friendrichs ataxia
cerebellar ataxia and signs - often presents in young
die from HOCM
often get diabetes and high arched palate
optic atrophy
digeorge identifiers
CATCH 22 - t cell deficiency cardiac abnormalities abnormal facies thymic aplasia cleft palate hyocalcaemia/hypoparathyroidism chromosome 22 deltion
MEN1
PPP
parathyroid - hyper para
pituitary
pancreas - inulinoma or gastrinoma
collagen 1 problems
osteogenesis imperfecta
collagen 3 and 5 problems
ehlers danlos - vascular variant
collagen 4 problems
goodpastures - autoanibody
alports syndrome
sensitivity
im really sensitive i feel everything - chance that you pick up positives.
calculated as tested positives as a percentage of total positives i.e includes fase negatives
chromosome for APKD
type 1 - chromosome 16
type 2 - chromosome 4
indications for bipap
copd with respiratory acidosis
type 2 resp failure secondary to OSA/chest wall deformity/neuromuscular disease
withdrawal of intubation
cardiogenic pulmonary odea - non responsive to cpap
recomended inspiratory and end pressurees in copd - bipap
4-5cm EPAP
10-15cm IPAP
back up rate - 15 / min
inspiration:expiration 1:3
risk factors for contrast induced nephroathy
age >70 known renal impairment/diabetes dehydration cardiac failure nephrotoxics
give fluids for 12 hours before and after 1ml/kg/hr
Hypersensitivity types: gell and coombes
type 1 - anapjylactic (IgE mediated)
type 2 - cell bound - binds to antigen on cell surace
type 3 - imune complex - free antigen antibody e.g SLE/ post strep glom
type 4 - t cell meicated - eg TB, GVHD, scabies, MS, GBS
thickening of the bone
pagets - increase in osteoclast and osteoblast
osteopetrosis - thick but brittle bone - osteoclastic failure to resorp
hallmark of sarcoid
non caseating granulomas
high ACE
african american females
birbeck granules
tennis racket shaped lesions of langerhans cell histiocytosis
hallmarks of sarcoid - presentation
fevers, erythema nodosum, arthralgia, bilateral hilar lymphadenopathy, cough, malaise, weight loss.
others:hypercalcaemia, parotitis
diagnosis of polyarteritis nodosa
biopsy of nodules - necrotising arteritis
, MRI angiogram showing medium vessel aneurysm
livedo reticularis
think PAN - along with fevers, arthralgia, weight loss. HTN, testicuar pain, renal failure hep b in 30%
most common type of renal stone
calcium oxalate
increased likelihood if you have hypercalkciurea
reversal agent for beta blckers
IV glucagon
hypokalaemia and hypertension
hyperaldosteronism
hyonatraemia and hypotension
adrenal insufficiency - addisons
young female, hypertension, assymetrical kidneys
fibromuscular dysplasia (often found with renal artery stenosis after ACEi initiation and drop in renal function)
ecg changes of a TCA overdose
sinus tachy, broad QRS, long QT
whats the problem in acromegaly
too much growth hormone - treat ment with surgical removal, and somatostatin analogues - octreotide
then use GH recepter antagonists - pegvisomant - reduced IGF1 levels to norm
homogentisic acid dioxygenase deficiency
alkaptonuria
mobitz 1 vs 2
mobits 1keback
2 - pauses
type of kidney disease closest to that of post streptococcal glomerulonephritis
diffuse proliferative GN
Vitamin associated with poor wound healing
vit c
CEA marker
colrectal
causes of a raised anion gap acidosis
high cpncentration of inorganic acids which mean 15 or over difference. Lactic acidosis methanol ethylene glycol urate - renal tings ketoacids in diabetes paracetamol
causes of a normal anion gap acidosis
loss of bicarb or hyperchloraemic(due to retention to compensate) - 14 or less
renal tubular acidosis
carbonic anhydrase inhibitors
diarrhoea
Causes of pyoderma gangrenosum
idiopathic UC chrons SLE RA Myeloproliferative myeloma monoclonal gommopathy
Purple painful pretibial pathergy progressive
what is fanconi syndrome
abnormality with dysnuctional PCT - results in RTA t2, loss of electrolytes, hypovolaemia, loss of glucose, polyuria
sjogrens, nephrotic syndrome, wilsons and myeloma.
causes of left bundle branch blcok
aortic stenosis
IHD
cardiomyopathy hypertension
Causes of heinz bodies.
G6PD or alpha thalaseemia
NOT howel jolly bodies
causes of howel jolly bodies
hyposplenism
target cells
sickle cell
IDA
hyposplenism
liver disease
Massive splenomegaly
visceral leishmaniasis
CML / myelofibrosis
malaria
gauchers
non massive splenomegaly
infection - edocarditis, hepatitis, galndular fever
malignancy - lymphoproliferative disorder
portal hypertenison - chirrosis
c-anca
PR3 - wegeners
p anca
churg strauss - MPO - cresenteric immune glomerulonephritis
philadelphia chromasome
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