QNA 2 Flashcards
Hypothalamo-pituitary-adrenal axis for corticosteroids
CRH -> ACTH -> cortisol
Hypothalamus hormones
GnRH
GHRH
CRH
TRH
PRH
Anterior pituitary hormones
FSH/LH
TSH
Prolactin
ACTH
GH
Posterior pituitary hormones
ADH
Oxytocin
How does adenosian crisis affect glucose levels
too little cortisol
Hypoglycaemia (insulin sensitivity)
Where to check for melanoma
Back of legs and back
Soles of hand and feet
Nailbeds
How to identify what phenotype of cancer cells
immunohystochemistry/immunocystochemistry
How does immunohistochemistry work
adding various antibodies and visualising antibody-antigen formation
Visualisation either by an enzyme like peroxidase attached to antibody changing colour of the solution or immunofluorescence where antibody tagged by fluorecine
How does immunohistochemistry work
adding various antibodies and visualising antibody-antigen formation
Visualisation either by an enzyme like peroxidase attached to antibody changing colour of the solution or immunofluorescence where antibody tagged by fluorecine
Differential for foreing traveller with lymph node in neck
Lymphoma (hodgkin vs non hodgkin)
TB
What to do if suspected TB
Put in a category 3 biohazard bag
Inform public health england
Contact tracing
Adult polycystic kidney disease genetics
Autosomal dominant
PKD1 and PKD2 mutations
APKD cyst formation pathophysiology
Tubular cells relentlessy divide, lead to formation of outpouching that slowly cuts itself off the main tubule, but keeps filling with the secretions of other tubules
Complications of APKD
Renal failure
Infection
HTN
Associated with cerebral aneurysm
How does CLO test work
Based on H pylori producing urease urea- >ammonia
Biopsy placed in urea medium
Add an indicator eg phenol red
If H pylori present, produces ammonia, increasing pH changing colour to red
Causes of PUD
H pylori
Smoking
High calcium (hyperparathyroid)
How to investigate parathyroid issues
PTH assay
Sestamibi scan (giving radionucleotide sestamibi and image with gamma camera to identify hyperfunctioning parathyroid adenoma)
Commonest histology of gallbladder carcinoma
Adenocarcinoma
Commonest cause of gallbladder cancer
Chronic inflammation from cholecystitis
Where does gallbladder cancer spread to first
Segment V of liver
Lymphatic spread to cystic and pericholedochal lymph nodes
Where does gallbladder cancer spread to first
Segment V of liver
Lymphatic spread to cystic and pericholedochal lymph nodes
Patient treated for nec fascitis. Develops bloody diarrhoea. What’s the cause
Pseudomembranous colitis
Ischaemic colitis
Infective enterocolitis
Stress ulcer
Pathophysiology of Pseudomembranes caused by c diff
Exudative fibrin deposition as bacteria secrete proteases to damage the bowel mucosa
Antibiotic treatment for abscess drainage
Recent evidence has shown that antibiotics reduce the risk of recurrence by 5% at 1 month and 8% at 3 months
Antibiotic treatment for abscess drainage
Recent evidence has shown that antibiotics reduce the risk of recurrence by 5% at 1 month and 8% at 3 months
What is sickle cell disease
Hereditary haemoglobinopathy
Mutation in B globin leading to HbS formation
Forms abnormally shaped RBC, less flexible, more likely to be broken down
Surgical complications of sickle cell
Gallstones
Autosplenectomy -> immunosuppression
AVN of bone
Most common brain tumour
High grade:
Glioblastomas
Low grade:
Meningioma
Metastatic disease
Common bacteria causing skin infection
Staph aureus
Group A strep (pyogenes)
Pheochromocytoma testing
Urine: Vanillyl mandelic acid (metabolite of catecholamines)
Plama: catecholamines and metanephrine
What malignancy occurs in immunosupressed patients
SCC, BCC
Lymphoma
Kaposi sarcoma
How do neutrophils migrate towards site of infection
Marginisation and rolling along the vessel wall
Transfer between endothelial cells
Migrate towards chemostatic stimulus
How does endometriosis migrate to colon?
3 theories
Regurgitation: retrograde flow of menstrual endometrium
Vascular/lymphatic
Metaplastic: arises directly from coelomic epithelium of pelvis
Which thyroid cancer will not show response to iodine uptake (not picked up by dionuclide scan)
Parafollicular C cells (medullary carcinoma)
Dont pick of up iodine
Which thyroid cancer will not show response to iodine uptake (not picked up by dionuclide scan)
Parafollicular C cells (medullary carcinoma)
Dont pick of up iodine
Classification of lung cancer
Small cell
Non small cell (adeno, SCC, large cell)
Which lung cancer in smoker/nonsmoker
Smoker: squamous (male)
Non smoker: adeno (female)
