Prep 2 Flashcards

1
Q

What are the most common autoantibodies found in lupus?

A
anti nuclear antibodies
anti ds DNA
anti smith
anti ro
anti jo
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2
Q

How do symptoms arise in lupus?

A

Antinuclear antibody-antigen complex deposit in different tissues around the body (common in kidneys, skin, joints, and heart) triggering local inflammation and complement activation (type 3 hypersensitivity)

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3
Q

What are the common triggers for lupus (cause the initial cell damage that exposes nuclear components for ANAs to bind to)

A
Sunlight
infections
smoking
medications
oestrogen (more common in women)
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4
Q

Why can SLE give false positive for syphilis?

A

sub type of antiphospholipid antibody (anticardiolipin is found in syphilis)

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5
Q

Dactylitis

A

inflammation of digit

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6
Q

what investigation in a male with sternal pain and multiple lytic bone lesions?

A
urine electrophoresis (look for bence jones proteins/M spike)
multiple myeloma
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7
Q

What is multiple myeloma?

A

clonal proliferation of plasma cells (all secrete the same ABs most commonly IgG type)

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8
Q

What is MGUS?

A

monoclonal gammopathy of undetermined significance
<10% plasma cells on bone marrow biopsy
M spike present (monoclonal ABs)
patient is asymptomatic

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9
Q

Symptoms of multiple myeloma?

A
CRAB
hyperCalcaemia
Renal failure
Anaemia
Bone pain (fractures, neuropathy - weakness of bone due to bone marrow proliferation and plasma cells secrete osteoclast activating factor)
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10
Q

What age group is multiple myeloma common in?

A

70s

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11
Q

What is amyloidosis

A
Misfolded proteins (amyloids) build up and excreted out of cell forming clumps that deposit throughout the body can be localised or systemic
about 30 different types due to different proteins
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12
Q

What is AL amyloidosis and when is it commonly seen?

A

Plasma cells produce abnormal light chains (component of AB). Light chains accumulate and clump
seen in multiple myeloma

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13
Q

What are bence jones proteins

A

abnormal light chains in the urine

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14
Q

What is a roleaux formation?

A

RBCs attached in chains (attached by the light chains secreted by plasma cells in multiple myeloma)

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15
Q

soap bubble appearance on bone xray

A

multiple myeloma (lytic lesions)

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16
Q

What does bone marrow biopsy in multiple myeloma show?

A

> 10% plasma cells

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17
Q

Management of MGUS?

A

watch and wait

risk of multiple myeloma

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18
Q

What is smoldering myeloma?

A

M spike and >10% plasma cells but assymtpomatic (watch and wait as increased risk of multiple myeloma)

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19
Q

Management of myeloma?

A

chemotherapy

marrow transplant

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20
Q

What type of therapy is beck’s triad?

A

CBT

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21
Q

What food interacts with warfarin?

A

green veg (high in vit K)

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22
Q

What is freudian theory?

A

psychoanalytical theory (personality develops in stages characterised by internal conflicts

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23
Q

What food interferes with statins?

A

grapefruit

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24
Q

Common side effect of amoxicillin

A

n&v

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25
Q

Surfer with gradual unilateral hearing loss

A

exostosis (surfer’s ear)
prolonged and repeated exposure to cold water cause the bone surrounding ear canal to develop spurs that constrict the ear canal (one side often worse as one striking the wave or wind)

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26
Q

Woman with permanent complete unilateral hearing loss in pregnancy

A

otosclerosis (pregnancy accelerates it)

abnormal growth of bones in inner ear, stapes thickens and becomes fixed at oval window

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27
Q

otitis media effusion

A

glue ear (non infective) usually due to eustachian tube defect

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28
Q

Hearing loss after getting off a plane

A

tympanic perforation

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29
Q

Bird beak appearance barium swallow

A

achalasia

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30
Q

Female with dysphagia and anaemia

A

Patterson kelly brown syndrome (iron deficiency anaemia, atrophic glossitis, oesophageal webs)

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31
Q

Management of mild dyskarosis on smear?

A

repeat test in 6 months

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32
Q

Management of severe dyskarosis on smear?

A

colposcopy

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33
Q

Pulseless VT

A

amioderone 300mg

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34
Q

epiglottitis management

A

IV ceftriaxone

35
Q

Croup management

A

emergency: oxygen and nebulised adrenaline

non emergency dexamethasone

36
Q

HSV encepalopathy management

A

aciclovir IV

37
Q

meningitis management in kids

A

<3months cefotaxime + amoxicillin

>3months ceftriaxone

38
Q

build 3 blocks and enjoy picture books

A

18 months

39
Q

Child with abdo and joint pain and then has purpuric rash down buttocks to thighs feeling slightly unwell:

A

HSP

40
Q

Child at 2 weeks old very unwell, resp distress, temperature

A

bronchiolitits (RSV)

41
Q

born and then 20 mins later short of breath and needing oxygen fast resp rate

A

TTN

42
Q

Child who was feeding well until changed from milk to solid foods

A

coeliac

43
Q

Croup

A

parainfluenza virus

44
Q

Sand paper rash

A

scarlet fever

45
Q

mild systemic upset, oral ulcers, vesicles on palms and soles of feet

A

hand foot & mouth

coxsackie

46
Q

Single palmar crease

A

downs syndrome

47
Q

simple instructions

A

2 years

48
Q

“sicky baby” with intractable crying and chronic hiccups

A

gord

49
Q

walking up and down stairs alternating feet

A

3 years

50
Q

drawing triangle

A

5 years

51
Q

Child at party, has eaten peanut, cyanosed, SOB etc, trachea deviated to one side

A

foreign body

52
Q

Stridor, better with crying 9-month-old

A

laryngomalacia

53
Q

Stridor, drooling and unwell

A

epiglottis

call 999

54
Q

stridor generally unwell

A

croup

oral dexamethasone

55
Q

CF inheritance

A

AR mutation in CFTR gene

56
Q

Baby born at 25 weeks most likely respiratory distress

A

RDS

57
Q

Baby was born by C-section most likely respiratory distress

A

TTN

58
Q

Child has had a cold for a few days before waking up in middle of night struggling for breath

A

croup

59
Q

CN6 palsy

A

inability to abduct the eye (lateral rectus)

60
Q

CN3 palsy

A
down and out with ptosis
oculomotor supplies (SR, IN, MR, IO, levator palpabrae)
61
Q

contraception in breast cancer

A

IUD

62
Q

facial nerve passes through which foramen

A

internal aucoustic meatus

63
Q

trochlear passes through which foramen

A

SOF

64
Q

Facial canal

A

internal acoustic meatus to stylomastoid foramen

65
Q

IVDU new born child

A

Hep B vaccine

66
Q

Double bubble appearance

A

duodenal atresia

67
Q

erythemia infectiosum

A

slapped cheek syndrome

68
Q

baby finds it difficult to breathe especially when feeding

A

choanal atresia

69
Q

precociuous puberty

A

<8 in girls

<9 in boys

70
Q

laissez faire

A

anything goes

71
Q

diagnostic test in toddlers in hypovolaemic shock and non-blanching rash

A

meningococcal PCR

72
Q

ABGs in a foetus

A

fetal scalp monitoring

73
Q

splitting of the second heart sound

A

atrial septal defect

74
Q

What do all babies in scotland get tested for 5 days after birth

A

PKU

75
Q

age to start solid food

A

4-6 months

76
Q

A 14 month old baby presents with loose stools containing foods stuffs such as peas and beans, all else is normal

A

toddlers diarrhoea

77
Q

What proportion of the UK population grows below the third centile?

A

3%

78
Q

Nutritional deficiency in a maize based diet?

A

kwashiorkor syndrome (protein deficiency)

79
Q

The limit for an acceptable low birth weight in the UK?

A

2500g

80
Q

foetal head in relation to its limb and trunk

A

attitude (foetal body parts to one another)

81
Q

fracture in a child, blue sclera

A

osteogonesis imperfecta

82
Q

<1yr old unwell with mild fever, cough, reduced oral intake, noisy breathing, resp distress, good air entry but high pitched rhonchi and fine crepitations on auscultation

A

bronchiolitis RSV

admit and supportive therapy

83
Q

why should tetracycline be avoided in under 12 years

A

permanent tooth discolouration