PassMed Question Bank Flashcards
what can cause a rise in faecal calprotectin
- IBD
- bowel malignancy
- coeliac disease
- infectious colitis
- use of NSAIDs
what is zollinger-ellison syndrome
condition characterised by excessive levels of gastrin secondary to a gastrin-secreting tumour
- majority found in 1st part of duodenum, then pancreas
what are features of zollinger-ellison syndrome
- multiple gastroduodenal ulcers (epigastric pain)
- diarrhoea
- malabsorption
how can zollinger-ellison syndrome be diagnosed
- fasting gastrin levels
- secretin stimualtion test
what are risk factors of femoral hernias
- female gender
- pregnancy
what are the key features of inguinal hernias
- groin lump superior and medial to the pubic tubercle and disappears on pressure
- discomfort and ache, severe pain is uncommon
- strangulation is rare
what are desmoid tumours
fibrous neoplasms arising from musculoaponeurotic structures
- typically arise from myofibroblasts
- occur in 15% pt with FAP
- commonly occur in women after childbirth in the rectus abdominus muscle
- treated by radical surgical resection
- high tendency to local recurrence
describe the blood supply to the pancreas
- head: pancreaticoduodenal
- tail: branches of splenic
what is the most common causative organism of threadworms
enterobius vermicularis
what is the most common complication of ERCP
acute pancreatitis
what is Beckwith-Wiedemann syndrome
an overgrowth disorder characterised by: macrosomia, macroglossia and abdo wall defects e.g. omphalocele
- also visceromegaly, hypogylc, inc risk of childhood tumours
what is Prader-Willi syndrome
genetic disorder caused by loss of function of specific genes on Chr 15
- neonatal hypotonia
- feeding disabilities
- intellectual disability
- hyperphagia
- obesity
what are the actions of BNP
- vasodilation: decrease cardiac afterload
- diuretic & natriuretic
- suppress sympathetic tone + RAAS
what does damage to the anterior interosseous nerve cause
- pain in forearm
- loss of pincer movement as it innervates FPL & FDP
- minimal loss of sensation due to lack of cutaneous branch
what is the consequence of over corrected severe hyponatremia
osmotic demyelination syndrome
- typically presents with dysarthria, dysphagia, seizures, confusion
what is Courvoisier’s sign
a palpable gallbladder RUQ in the presence of painless jaundice is unlikely to be gallstones
- most common cancers causing this sign are cholangiocarcinoma and adenocarcinoma of the pancreatic head
what sign is indicative of carpal tunnel syndrome
positive Phalen’s test
- provoking numbness and pain in the thumb and index finger by maintaining wrist flexion for 60 s
what are the requirements for routine IV fluids
- 25-30 ml/kg/day of water
- 1mmol/kg/day of K+, Na+, Cl-
- 50-100g/day of glucose
what would bloating and abdo cramps in females > 50 raise suspicion of
ovarian cancer
- serum CA125 levels then if raised arrange an USS abdo + pelvis
what are the functions of insulin
- secreted in response to hyperglycaemia
- inhibits lipolysis
- reduces muscle protein loss
- inc cellular uptake of K+ via Na+/K+ ATPase pump)
what is a recognised feature of RCC
polycythaemia
what is a collapsing pulse typically indicative of and what type of murmur does it lead to
aortic regurgitation
- diastolic murmur in the aortic area
what are the features of Klinefelter syndrome 47, XXY
- taller than average
- lack of secondary sexual characteristics
- small, firm testes
- gynaecomastia
- poor coordination + muscle weakness
- rounded body
- microorchidism
- diagnose with karyotyping
how does Turner syndrome present 45, X0
- short stature
- widely spaced nipples
- webbed neck
- high arched palate
- phenotypically female due to absence of Y chromosome
during an oesophagectomy for carcinoma of the lower 1/3, which structure is divided to allow mobilisation of the oesophagus
azygous vein
- it arches anteriorly to insert into the SVC on the right side
what is the most common cause of hypothyroidism and what antibodies are most likely to be positive
Hashimoto’s
- anti-thyroid peroxidase antibodies present in 90% cases
what clinical features lead point to rheumatic fever and how does this infection develop
polyarthritis, chest pain (suggestive of pericarditis), raised ESR/leucocytosis
- cross reactive immune response with Strep pyogenes M protein (type II) mediated by molecular mimicry
- Aschoff bodies are granulomatous nodules found in rheumatic heart fever
how does excess alcohol lead to poyluria
ADH suppression in the posterior pituitary
what condition might parietal lobe lesions cause
astereognosis:
inability to recognise or identify objects through sense of touch
- typically arises due to damage to the somatosensory cortex
why do children with tetralogy of fallot adopt a squatting position
increases systemic vascular resistance and decreases the L-R shunt so improves cyanosis
what sign is visible on x-ray in tetralogy of fallot
boot shaped heart due to RV hypertrophy
what is a rare complication from a NOF fracture and what are its associated features
sciatic nerve lesion
- ankle and plantar reflex lost but knee jerk is intact
what is the most common cause of sepsis in neonates
group B strep
what does trisomy 21 increase the risk of and why
Alzheimer’s disease
- APP gene is located on Chr 21 and Down syndrome patients have an extra copy
- results in overproduction of amyloid-beta plaques
what type of reaction is hyperacute transplant rejection
type II hypersensitivity
what is the typical history of a patient with primary hyperaldosteronism
high BP
tired & weak
bloods show hypokalaemia
where is ischaemic colitis most likely to affect
splenic flexure - located at the borders of the territory supplied by superior and inferior mesenteric arteries
what are the clinical features of ischaemic colitis
ARRR
- abdo pain
- rectal bleeding
- raised WCC
- raised lactate
what is a risk factor of ischaemic colitis
atrial fibrillation
what would an AXR of ischaemic colitis show
thumbprinting - mucosal oedema
what areas of the brain are most affected by Wilson’s disease and what sign does this create
basal ganglia (motor control)
thalamus
midbrain
pons
- double panda sign on T2 MRI
which abx is associated with a high risk of c.diff
clindamycin
what is the gold standard for diagnosis of coeliac disease
endoscopic intestinal biopsy
what is Budd-Chiari syndrome and what triad of symptoms does it lead to
occlusion of the hepatic veins
- abdo pain, ascites, hepatomegaly
what organism is responsible for majority of duodenal ulceration cases and how can it be diagnosed
H.pylori
- serology, microbiology, histology, CLO testing
describe what kind of organism H.pylori is
gram negative, oxidase positive, catalase positive comma-shaped rod
how is TPN adminstered and what are its complications
- into a central vein as it can result in thrombophlebitis if infused peripherally
- sepsis, re-feeding syndrome and hepatic dysfunction
