Questions to review Flashcards
What is the most useful test to confirm rheumatoid arthritis
Anti -CCP antibodies
More useful than RF
What would you expect to see on analysis of synovial fluid on joint aspiration for gout
urate needle shaped crystals
RA or OA?
Joint space narrowing
Subchondral sclerosis
Osteophytes
Osteopenia
Bony erosions
Joint space narrowing - both
Subchondral sclerosis - OA
Osteophytes - OA
Osteopenia - RA
Bony erosions - RA
Features of NSTEMI
Plaque rupture which does NOT fully occlude blood vessel but narrows so you get pain at rest, ST depression on ECG, and increased troponin (due to death of myocytes and apoptosis)
Features of unstable angina
Chest pain due to ischaemia to heart muscle. Occurs during exercise but resolves with rest.
Features of STEMI
Complete occlusion of blood flow which can cause myocardial ischaemia and apoptosis. ST elevation.
What is Hydroxocobalamin used to treat
vitamin B12 deficiency including pernicious anemia
What is Adcal D3 for
osteoporosis
What is atorvastatin for
high cholesterol
What is bisoprolol for
hypertension
What is a free fluid diet
you can take any item that is a smooth liquid, with no lumps or pieces, or anything that quickly melts in the mouth into liquid form
What is a clear liquid diet
limits you to options such as water, broth and plain gelatin. These are easy to digest, and they don’t leave food bits in your digestive tract.Nothing thick.
Pancreatitis nutritional support
Early enteral nutrition. Gastric and jejunal feeding are equally effective.
Parenteral nutrition should be considered in patients who cannot tolerate enteral nutrition.
Where is GALT located
Mucosa, submucosa and lamina propria of the small intestine (Peyer’s patches)
Ischaemic colitis vs acute mesenteric ischaemia
Ischaemic colitis - bloody diarrhoea and LLQ pain.
Acute mesenteric ischaemia - widespread pain, examination may be normal
Rule of 1s for adrenal gland
If enzyme starts with 1 (eg 11 or 17 hydroxylase) it causes hypertension due to increased DOC which acts like aldosterone
If enzyme ends with 1 (eg 11 or 21 hydroxylase) it causes virilisation in females and precocious puberty in males
Mechanism by which high prolactin causes secondary hypogonadism
Prolactin binds to prolactin receptors on hypothalamic kisspeptin neurons to inhibit
kisspeptin release, this results in a reduction in gonadotrophin releasing hormone pulsatility which reduces FSH and LH secretion from the anterior pituitary.
What should you think of if you see low serum sodium and high serum potassium
Addison’s disease
Which white matter tract connects the two hemispheres
Callosal fibres connect hemispheres. The major tract connecting the left and
right hemispheres is the corpus callosum.
Treatment of prolactinoma
dopamine agonist cabergoline
Binds to D2 receptors on prolactinoma to reduce prolactin and shrink tumour.
What type of hormone is growth hormone
Polypeptide / protein hormone (hence can’t be given orally)
What type of hormone has a long duration of action
steroid hormones NOT peptides
What do peptides act on
membrane bound receptors and have a second messenger
acromegaly vs gigantism
Gigantism occurs when growth hormone hypersecretion occurs before the fusion of the long bone epiphysis and is characterized by tall stature. Acromegaly occurs when GH hypersecretion occurs after the fusion of the epiphysis leading to large extremities, prognathism, macroglossia.
