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buzzwords > Path Key Points Bank > Flashcards

Path Key Points Bank Flashcards

1
Q

BPH

A

Lower urinary tract symptoms (frequency, urgency, nocturia, terminal dribbling, poor stream)

Mx

  • alpha reductase inhibitor - finasteride
  • alpha blocker (with HTN - prazosin; without HTN - tamsulosin)
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2
Q

Grading system for RCC

A

Furhman’s system

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3
Q

Clear cell RCC

A

Most common RCC
Golden colour due to lipid collection
Clear cytoplasm arranged in nests

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4
Q

Papillary RCC

A

Friable brown tumours

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5
Q

Chromophobe RCC

A

Variable chromosomal changes

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6
Q

Prostate cancer

A

Genes associated - PTEN, AMACR, P27, E-cadherin
Associated with eating red meats
Prognosis - Gleason score

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7
Q

Varicocele

A

Non-translucent

Dull ache with venous dilation

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8
Q

Hydrocele

A

Translucent

Due to trauma or pathology

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9
Q

Zoon’s balanitis

A

Inflammation of glans –> redness –> biopsy - can be dysplastic

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10
Q

Fournier’s gangrene

A

Necrotising fasciitis of male genitalia

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11
Q

High risk HPV

A

16 & 18

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12
Q

Low risk HPV

A

6 & 11

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13
Q

Cervical intra-epithelial neoplasia (CIN)

A

Figo staging
CIN IA - invasive diagnosis only by microscopy - cone biopsy
CIN IB - visible lesion confined to microscopy - radical trachelectomy with lymphadenectomy if tumour <2cm otherwise radical hysterectomy with lymphadenectomy
CIN II - beyond uterus but not past the lower third of vagina or pelvic wall - chemoradiotherapy
CIN III - tumour extends to pelvic wall ± lower third of vagina ± hydronephrosis - chemoradiotherapy
CIN IVA - spread to bladder or rectum - chemoradiotherapy
CIN IVB - distant metastases - combination chemotherapy

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14
Q

Endometrial hyperplasia

A

PCOS, anovulation, perimenopause, granulose cell tumours, unopposed oestrogen therapy, endometrial cancer
Type 1 - K-RAS, BRAF
Type 2 - P53

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15
Q

Endometrial hyperplasia prognostic factors

A 
Figo stage
1 - uterus
2 - spread to cervix
3 - pelvic spread
4 - distant spread
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16
Q

Sex cord stromal tumours

A

Benign - fibromas, thecomas

Variable - granulosa cell tumour, sertoli-leydig cell tumours

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17
Q

Lynch syndrome (hereditary non-polyposis colorectal cancer)

A

Autosomal dominant

Colorectal and endometrial tumours

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18
Q

Krukenberg tumour

A

Ovarian metastases from stomach tumour - signet ring cells

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19
Q

Dermatomyositis

A

Tender inflamed muscles - raised CK

Gottron’s papules

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20
Q

Sarcoidosis

A

Lungs - SOB + dry cough
Skin - lupus pernio, erythema nodosum
Heart - pericarditis, HF, valvular lesions
Non-caseating granulomas, hypergammaglobulinaemia, high serum ACE, hypercalcaemia

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21
Q

What causes erythema nodosum?

A

Sarcoidosis, IBD, Behcet’s disease, streptococcus, mycobacterium tuberculosis, pregnancy, OCP

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22
Q

What causes parotid enlargement?

A

Sarcoidosis, Sjogren’s disease, mumps, alcoholism, parotid cancer

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23
Q

Large vessel vasculitis

A

Takayasu arteritis

Giant cell arteritis - >50s, jaw claudication, scalp tenderness

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24
Q

Medium vessel vasculitis

A

Polyarteritis nodosa - renal/mesenteric vessels affected, beads of vessels on angiogram
Kawasaki’s disease - children, fever, erythematous rash on palsm and soles, conjunctivitis, lymphadenopathy

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25
Q

Small vessel vasculitis

A

Eosinophilic granulomatosis with polyangitis (Churg Strauss) - atopy + eosinophilia + vasculitis
Granulomatosis with polyangitis (Wegener’s granulomatosis) - nose bleeds, crusting, sinusitis, ear/lung problems, haemat/proteinuria
Mx
- cyclophosphamide + steroids

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26
Q

Reactions to antibiotics

A 
Renal failure - gentamicin, vancomycin
Anaphylaxis - penicillin
Hepatitis - meropenem
Liver failure - fusidic acid + statin
INR raise - warfarin + ciprofloxacin/clarithromycin
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27
Q

Community acquired pneumonia

A

Streptococcus pneumoniae
Haemophilus
Moraxella

Mx - augmentin

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28
Q

Severe community acquired pneumonia

A

Legionella
Mycoplasma

Mx - clarithromycin + augmentin

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29
Q

Hospital acquired pneumonia

A

Gram -ves –> cephalosporins, ciprofloxacin, tazocin

MRSA –> vancomycin

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30
Q

Meningitis

A

Neisseria meningitidis
Streptococcus pneumoniae
Listeria - very young/old, pregnant, immunocompromised

Mx 
- dexamethasone 10 mg IV
THEN
- empirical therapy - cephalosporin
- neonates - penicillin + cephalosporin
- >60 or immunocompromised - penicillin + cephalosporin
- listeria - amoxicillin/ampicillin
- neisseria - benzylpenicillin + cephalosporin
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31
Q

Community UTI

A

Trimethoprim

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32
Q

Iatrogenic UTI

A

Cephalexin/augmentin

If infected cather - change under gentamycin cover

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33
Q

C.diff enterocolitis

A

Stop offending agent - cephalosporin

PO metronidazole –> PO vancomycin

34
Q

Pneumocystis carinii

A

HIV +ve + CD4 <200

Oral co-trimoxazole

35
Q

Gout

A

Due to drugs - thiazides, furosemide, alcohol, pyrazinamide
Mx
- acute - NSAID, steroid injection, colchicine
- 2 weeks later - allopurinol

36
Q

Hairy cell leukaemia

A

Middle aged men

Pancytopenia, splenomegaly, hepatomegaly

37
Q

Burkitt’s lymphoma

A

Due to latent EBV
Mandibular/abdominal mass
Starry sky appearance on microscopy

38
Q

Hodgkin’s lymphoma

A

Painless, asymmetrical lymphadenopathy that is painful on alcohol consumption
Reed Sternberg cells

39
Q

Mantle cell lymphoma

A

Old men

Translocation between Chr 11 and 14

40
Q

Follicular lymphoma

A

Middle aged people
Translocation between Chr 14 and 18
Painless, generalised lymphadenopathy
Centrocytes and centroblasts

41
Q

Diffuse large B cell lymphoma

A

Old people

Large lymphocytes

42
Q

SIADH

A

2 low in blood - sodium and osmolality
2 high in urine - sodium and osmolality
3 exclusions - renal/adrenal/thyroid/cardiac cause, hypovolaemia, contributing drugs

43
Q

AIHA

A

Warm - IgG mediated - lymphoproliferative disease, drugs (penicillins), autoimmune diseases (SLE)
Cold - IgM mediated - mycoplasma/EBV
DAT +ve + spherocytes

44
Q

Common variable immunodeficiency syndrome

A

Adults
MHC III mutation
Low B cells, Ig A/G/E

45
Q

Chronic granulomatous disease

A

X-linked
Chronic inflammation with non-caseating granuloma
Niotroblue tetrazolium - colourless

46
Q

Bare lymphocyte syndrome

A

Low MHC I/II

Sclerosing cholangitis + hepatomegaly + jaundice

47
Q

Selective IgA deficiency

A

Mild respiratory and gastro infections

Linked to RA and SLE

48
Q

Reticular dysgenesis

A

No granulocytes and lymphocytes

Sepss few days after birth

49
Q

Interferon gamma deficiency

A

No granulomas

Mycobacterium and salmonella infections

50
Q

Goodpasture’s disease

A

Respiratory feature - haemoptysis, dyspnoea, cough
Renal features - haematuria, AKI, nephrotic syndrome
IgG in basement membrane

51
Q

Di George syndrome

A

22q11 deletion
Cardiac abnormalities + atresia + thymic aplasia + cleft palate + hypocalcaemia
Low CD4, CD8, IgG, gA

52
Q

Rabies

A

Progressive encephalitis + hydrophobia + muscle spasm

53
Q

Q fever

A

Coxiella burnetti

Inhalation of urine/faeces of infected livestock

54
Q

Cat scratch disease

A

Bartonella species
Bites from cats
Tender and swollen lymph nodes + headache + backache

55
Q

Kala azar

A

Visceral leishmaniasis
Fever + splenomegaly
Hepatomegaly, hyperpigmentation, dry warty skin

56
Q

Cutaneous leishmaniasis

A

Itchy papule at bite site –> ulcer with raised edges

57
Q

Brucellosis

A

Brucella abortis
Unsterilised milk/cheese
Fever, muscle and joint pain, weight loss, fatigue, sacroilitis, depression
Mx - amoxicillin and doxycycline for 6 weeks

58
Q

Lyme disease

A

Borrelia burgdorferi
Local - erythema chronicum migrans (red papule/macule –> target lesion), fever, headache
Disseminated - peripheral neuropathy, erythema chronicum migrans, cranial nerve palsies, arthritis
Late - persistent arthritis, chronic encephalitis
Mx - oral doxycycline

59
Q

Sporadic CJD

A

Rapidly progressing dementia at 65, lower motor neuron signs, akinetic mutism, myoclonus, cortical blindness
LP for 14-3-3 protein
EEG - generalised triphasic sharp complexes

60
Q

Variant CJD

A

26 years
Initially psych feature –> ataxia, dementia, myoclonus
MRI - positive pulvinar sign
EEG - normal

61
Q

Sleeping sickness

A

Trypanosoma brucei
Subcutaneous chancre at bite site
Fever, weaknes, arthralgia, headache

62
Q

Chagas disease

A

Trypansoma cruzi
Red nodule at bite site
Acute - swollen eyelids, fever, diarrhoea, vomiting, lethargy
Chronic - colon/cardiac/oesophageal dilation

63
Q

Wilson’s disease

A

Cirrhosis, parkinsonism, seizures, dementia

64
Q

Pemphigoid

A

Autimmune deep bullous

Nikolsky sign -ve

65
Q

Pemphigus

A

Autoimmune bullous disease

Nikolsky sign +ve

66
Q

Psoriasis

A

Salmon-pink plaque + silver white scale on extensor surfaces

67
Q

Pityriasis rosea

A

Single scaly salmon-pink macule <5cm

Becomes a fir tree pattern after a few days

68
Q

Lichen planus

A

Pruritic, purple, polygonal, planar, papular, plaques, pearl sheen

69
Q

Acute tubular necrosis

A

Damage to tubular epithelium –> AKI

Ischaemic/toxic injury - loss of polarity, glomerular back pressure, interstitial leakage

70
Q

IgA nephropathy

A

Few days after infection

71
Q

Post-streptococcal glomerulonephritis

A

Few weeks after infection

72
Q

Osteochondroma

A

10-30 years

Bone cancer of large joints

73
Q

Osteoid osteoma

A

Dull pain
Bone cancer
X-ray - central nidus and sclerotic rim

74
Q

Endochondroma

A

10-40 years

Bone cancer of small joints

75
Q

Pyoderma gangrenosum

A

Necrotic ulcer with purple edges

Caused by UC, CD, RA, AML, CML, PRV, multiple myeloma

76
Q

Polymyositis

A

Weakness, pain and swelling of proximal muscles and facial muscles, ptosis, dysphagia

77
Q

Dermatitis herpetiformis

A

Symmetrical, itchy papulovesicular rash on extensor surfaces (elbows, buttocks)
Associated with gluten intake in Coeliac’s disease

78
Q

Dengue fever

A

Abrupt onset fever, retrobulbar pain, facial flushing

Generalised maculopapular rash

79
Q

Guttate psoriasis

A

Abrupt onset small salmon-pink lesions in young adults/children
Strep throat infection 2/3 weeks before

80
Q

Giardia

A

Bloating, flatulence
From India
Mx - Metronidazole PO 400mg tds for 5 days

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