questions Flashcards
what is pagets disease of the bone
chronic condition involving cellular remodeling and deformity of one or more bones
effects: long bones, pelvic, lumbar spine and skull
presents with pain, enlargement of bone, increased metabolism
investigations for pagets disease of the bone
Xray- lytic phase, or sclerotic phase
isotope bone scan
biochem: increased ALP
treatment of pagets disease of the bone
analgesics then bisphosphonates
SLE presentation
fever, fatigue, weight loss
joint pain
malar rash
photosensitivity rash
oral/nasal ulceration
raynauds
management of SLE
For skin disease and arthralgia:
- Hydroxychloroquine
- Topical steroids
- NSAIDs
Inflammatory arthritis or evidence of organ involvement:
- Immunosuppression: azathioprine
Severe organ disease:
IV steroids and cyclophosphamide
neurotransmitter involved with sleep
GABA
(maybe also serotonin)
key event of the coagulation cascade
production of protease (factor IIa) that cleaves fibrinogen to fibrin (forming a solid clot)
mechanism of action of warfarin
inhibit vit K
factors II (prothrombin), VII, IX, and X (+protein C and S) require vit K
mechanism of action of aspirin
inhibits cyclo-oxygenase which is necessary to produce thromboxane A2
management of benign ovarian tumours
Lactate dehydrogenase, AFP and hCG should be measured in all women <40 years to rule
out germ cell tumours
* Usually excised if >5cm or it is persistent
* Often can’t distinguish between benign or malignant tumours and diagnosis occurs after
surgery has been performed
how does cervical cancer spread
direct invasion inro surrounding structures and by lymphatic spread
management of stage 1 cervical cancer
Stage 1a
- preservation of fertility is required: Local excision with cone biopsy and close follow up
OR: Radical trachelectomy (excision of cervix and upper vagina)
- Hysterectomy with lymphadenectomy – if nodes are positive, radiotherapy would
also be offered
Stage 1a2-1b2
- Radical hysterectomy (Wertheim’s) and pelvic lymphadenopathy. Oophorectomy
can be performed if required, although cervical cancer rarely spreads to the ovaries.
- Radical radiotherapy is an alternative to surgery (Side effects of radiotherapy include: diarrhoea, vaginal stenosis, cystitis and
sexual dysfunction. )
management of cervical cancer > stage 1
Stage 2a-IV
o Treatment recommendation in cases where cancer extends past the cervix is chemoradiotherapy over surgery. Cisplatin is usually the chemo of choice
o Consider palliative therapy in more advanced disease/individual basis
extrapyramidal side effects of typical antipsychotics
Parkinsonism
acute dystonia- sustained muscle contraction (e.g. torticollis, oculogyric crisis)
- may be managed with procyclidine
akathisia (severe restlessness)
tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)
