Random Facts

Question 0

Definition of ARDS

Answer 0

Acute lung injury, caused directly by lung damage or secondary to another cause.
Results in increased capillary permeability which causes pulmonary oedema, often accompanied by MOF.

Respiratory failure which is not responding to high oxygen therapy.

Question 1

Causes of ARDS

Answer 1

BEAT ARDS:
Burns
Emboli, Eclampsia
Aspiration (ie. pneumonia)
Trauma, 
Acute pancreatitis
Radiation
Drugs, DIC
Sepsis

Others:
Hypovolaemia, near drowning, massive transfusion, head injuries and raised ICP

Question 2

Management of ARDS

Answer 2

ITU for supportive therapy
Treat any underlying causes

CPAP & high flow oxygen
Invasive haemodynamic monitor and inotrope
Enteral nutrition

50-75% mortality

Question 3

Main sources of bone mets

Answer 3

Breast
Bronchial
Kidney (lytic)
Prostate (sclerotic)
Thyroid

Question 4

Haemophilus Ducreyi

1. Symptoms
2. Diagnosis/microbio
3. Treatment

Answer 4

1. Painful CHANCRE (chancroid) with purulent base. Can destroy tissue, form inguinal abscesses and chronic suppurative sinuses.
2. Short and fat G-ve, in (school of fish) arrangement when swabbed from the chancre.
3. AZITHROMYCIN, (erythromycin, ciprofloxacin)

Question 5

LFT interpretations, especially ALT:

> 1000iu/l causes
500iu/l causes

Answer 5

ALT > 1000:
- acute viral hepatitis
- drug reaction
- ischaemic hepatitis
ALT >500:
- alcoholic hepatitis (usually ~200)

NASH: usually mildly elevated LFTs

Question 6

Pseudoxanthoma elasticum (pathophys.)

1. Skin signs
2. Ocular signs
3. Cardiovascular features

Answer 6

Genetic defect in ABCC6 gene on chromosome 16

1. Reduced elastin. Flexural distribution of loose skin, “cobblestone appearance”. Some papules inside skin give appearance of “xanthoma” and yellow tinge.
2. Angioid streaks (grey-red streaks radiating from optic disc). Represent fissures in disruptions of Bruch’s membrane.
3. HTN, Peripheral vascular disease, cardiac disease. Due to calcified elastic media.

Question 7

Drug causes of Erythroderma

Answer 7

Antiepileptic drugs: carbamazepine, phenytoin
Sulphonamides
Diltiazem
Cimetidine

Question 8

Things that flare up Psoriasis

Answer 8

Beta blockers 
Antimalarials
Steroids
Interferons
Lithium 

“BASIL”

Question 9

Stuff to look for under Woods lamp (and what it is)

Answer 9

Woods lamp = UV radiation, and stuff lights up.

1. Fungal infections
2. Depigmentation areas (VITILIGO)
3. Hypopigmentation regions in TUBEROUS SCLEROSIS

Question 10

Caloric reflex

Answer 10

“COWS”

Cold opposite
Warm same

(Direction of fast beat of the nystagmus)

Coldness reduces vestibular nerve firing, simulates head turning opposite. Eyes look ipsilaterally with fast beat of nystagmus AWAY.