Passmed TANGS Flashcards
Name 3 features of hereditary haemochromatosis?
Inheritance ?
early symptoms include fatigue, erectile dysfunction and
arthralgia (often of the hands)
‘bronze’ skin pigmentation
diabetes mellitus
liver: stigmata of chronic liver disease, hepatomegaly, cirrhosis, hepatocellular deposition)
cardiac failure (2nd to dilated cardiomyopathy)
hypogonadism (2nd to cirrhosis and pituitary dysfunction - hypogonadotrophic hypogonadism)
AR
ACS Mx ?
Post Mx?
Morphine
Oxygen
Nitrates
Aspirin
STEMI -> PCI
ABSeeD ACEI B blocker Statin Dual antiplatelet - clopi / aspririn
Nec Fash most common cause? Microbiology will report?
Streptococcus pyogenes
- Gram-positive in chains
Staphylococcus aureus is usually found in clusters.
Foreign travel and fever alternating days?
malaria
At what point do pregnancy-induced hypertension or pre-eclampsia occur?
After 20 weeks
Mx of gonno
single dose of:
oral azithromycin and intramuscular ceftriaxone
Features of cephalohaematoma
Several hours after birth, doesn’t cross suture lines, can take months to resolve
Normal pressure hydrocephalus pres ? mx?
Urinary incontinence + gait abnormality + dementia
ventriculoperitoneal shunting
What is charcot triad ? indicitive of?
Mx?
right upper quadrant pain, fever and jaundice
Ascending cholangitis
Management
intravenous antibiotics
ERCP after 24-48hrs to remove blockage
Which lobe if seizure has movement of arms/legs
frontal
Seen on bloods of:
Hyposplenism e.g. post-splenectomy
Iron-deficiency anaemia
Myelofibrosis
Intravascular haemolysis
Megaloblastic anaemia
Hyposplenism e.g. post-splenectomy target cells Howell-Jolly bodies Pappenheimer bodies siderotic granules acanthocytes
Iron-deficiency anaemia
target cells
‘pencil’ poikilocytes
if combined with B12/folate deficiency a ‘dimorphic’ film occurs with mixed microcytic and macrocytic cells
Myelofibrosis
‘tear-drop’ poikilocytes
Intravascular haemolysis
schistocytes
Megaloblastic anaemia
hypersegmented neutrophils
Sickle cell aplastic anaemia crisis ?
Parvovirus B19
Drug for smoking cessation
Varenicline
Brown sequard
ipsilateral weakness below lesion
ipsilateral loss of proprioception and vibration sensation
contralateral loss of pain and temperature sensation
PCOS hirtuism
COCP
Spirolactone
copd cxr
hyperinflation, bullae, flat hemidiaphragm
What marker for severity of COPD
FEV1
(NOT ratio)
> 80 = mild
50-80 - mod
30-50 - severe
4 sezure lobes and features
Temporal lobe (HEAD) Hallucinations (auditory/gustatory/olfactory), Epigastric rising/Emotional, Automatisms (lip smacking/grabbing), Deja vu/Dysphasia post-ictal)
Frontal lobe (motor) Head/leg movements , posturing, post-ictal weakness
Parietal lobe (sensory) Paraesthesia
Occipital lobe (visual) Floaters/flashes
Lung Ca paraneoplastic features
Squamous - PTH = HyperCa
Small cell - ACTH / LES
3 causes of upper lobe fibrosis
SCART (upper lobe):
- Sarcoidosis
- Coal miners pneum.
- Ank spon
- Radiation
- TB
RASIO (lower lober)
- Rheumatoid
- Asbestosis
- Scleroderma
- Idiopathic Pulmonary fibrosis (most common cause overall)
- Othe
Cor pulmonale mx
loop diuretic for oedema
consider long-term oxygen therapy
Acute mesenteric ischaemia 1st Ix
serum lacate
Med to avoid in obstruction
Metoclopramide
prophylaxis of oesophageal bleeding from varicies
If bleeding?
propranolol
Terlipressin
dyspnoea, fatigue and lethargy
lemon tinge to skin?
Pernicious
Cushing’s disease - response to dexamethasone
pit adenoma - responds to high levels (secretes less)
SSLC - does not respond
2 ECG changes pericarditis
Name 3 causes
widespread ‘saddle-shaped’ ST elevation
PR depression: most specific ECG marker for pericarditis
viral infections (Coxsackie) tuberculosis uraemia (causes 'fibrinous' pericarditis) trauma post-myocardial infarction, Dressler's syndrome connective tissue disease hypothyroidism malignancy
2 features ECG hypoK
U waves small or absent T waves (occasionally inversion) prolong PR interval ST depression long QT
[U have no Pot and no T, but a long PR and a long QT]
Most common cause of pepperpot skull
primary HPT
2 features of somatosation disorder
multiple physical SYMPTOMS present for at least 2 years
patient refuses to accept reassurance or negative test results
What is conversion disorder
typically involves loss of motor or sensory function
the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)
What is dissociative disorder
dissociation is a process of ‘separating off’ certain memories from normal consciousness
in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor
What is facticious disorder
Munchausen’s syndrome
the intentional production of physical or psychological symptoms
What is malingering disorder
fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain
MgSO4 antidote
calcium gluconate
Compare Ruptured cyst and torsion Sx
- Cyst - acute onset pain, maximal at onset, may have prior hx of others
- Torsion - Gradually progressively worsening pain, associated with hx of sport
- USS - Whirlpool sign
Lynch syndrome? common ca?
HNPCC
Colo rectal cancer 30-70%
Endometrial cancer 30-70%
Gastric cancer 5-10%
