Random Qs Flashcards
What is the eponymous triad for insulinoma
<3mmol/L
sympotamtic + symptoms relieved by glucose
What are the cells seen in hyposplenism
Blood film in hyposplenism:
Howell-Jolly bodies
Pappenheimer bodies
Poikilocytes (Target cells)
Erythrocyte containing siderotic granules
Heinz bodies
What are the sequlae of acute inflammation
Resolution
Typically occurs with minimal initial injury
Stimulus removed and normal tissue architecture results
Organisation
Delayed removal of exudate
Tissues undergo organisation and usually fibrosis
Suppuration
Typically formation of an abscess or an empyema
Sequestration of large quantities of dead neutrophils
Progression to chronic inflammation
Coupled inflammatory and reparative activities
Usually occurs when initial infection or suppuration has been inadequately managed
Describe the diaphragmatic hiatuses
T8 - central tendon - IVC + right phrenic (left phrenic pierces alone)
T10 - right crUS - oesophagUS - vagUS
T12 - Aorta (behind median arcuate ligaement)
Staph infections
Osteomyelitis
Surgical site infection
Toxic shock syndrome
Food poisoning
Felon
Discitiis
Mycotic aneurysm
What are the contents of the deltopectoral groove
Cephalic vein
Thoracoacromial artery
Lateral pectoral nerve
What is the pathway of CSF
Lateral ventricles
Third via interventricular foramen of munro
Fourth via duct of sylvius
Atachenoid by foramen of magendie and luschka
Sites of ureteric constriction
Pelvoureteric junction
Pelvic inlet
Meatus
Describe the boundaries and contents of the quadrangular space and triangular space
- What are the boundaries of triagnular space** Upper:Roof - teres minorBelow - teres majorLaterally - long head of triceps*** Lower:Roof - teres majorLaterally - shaft of humerusMedially - long head of triceps
- What are the contents of the triangular spaceupper: circmflex scapular arterylower: radial nerve, profunda brachii artery
- What are the boundaries of the quadrangular spaceroof: teres minorfloor - teres majorlaterally - surgical neck of humerusmedially - long head of triceps
- What are the contents of quandrangular spaceaxillary nerveposterior circumflex humeral artery
What nerves come off the superior trunk
n to subclavisu
suprascapular
What nerves come off the posterior cord
Upper suprascapular
THoracodorsal
Lower suprascapular
What comes off the medial cord
median pectoral
median cutaneous n of arm
median cutaneous n of forearm
what comes off the lateral cord
lateral pectoral
What are conditions causing normal anion gap
Diarrhoea
Pancreatic fistula
Renal tubular acidosis
Drugs: Acetazolamide
Addisions
Metabolic acidosis with raised AG
Primary problem is raised acid production
High lactate
High ketone
Renal failure
Acid poisoning
What is a normla CVP
2-12
What is a normal urine specific gracity
50-1200
What is a normal urinary sodium
40-220
side effects of propofol
Anti-emetic
Moderate myocardial depression
Sodium thiopentone
Extremely rapid onset of action making it the agent of choice for rapid sequence of induction
Marked myocardial depression may occur
Metabolites build up quickly
Ketamine
Has moderate to strong analgesic properties
Produces little myocardial depression making it a suitable agent for anaesthesia in those who are haemodynamically unstable
May induce state of dissociative anaesthesia resulting in nightmares
Etomidate
favorable cardiac safety profile with very little haemodynamic instability
no analgesic
Unsuitable for maintaining sedation as prolonged (and even brief) use may result in adrenal suppression
Post operative vomiting is common
Suxamethonium
Depolarising neuromuscular blocker
Inhibits action of acetylcholine at the neuromuscular junction
Produces generalised muscular contraction prior to paralysis
Adverse effects include hyperkalaemia, malignant hyperthermia, delayed recovery
Atracurium
Generalised histamine release on administration may produce facial flushing, tachycardia and hypotension
Not excreted by liver or kidney, broken down in tissues by hydrolysis
Reversed by neostigmine
Vecuronium
Degraded by liver and kidney and effects prolonged in organ dysfunction
Effects may be reversed by neostigmine
Pancuronium
Onset of action approximately 2-3 minutes
Duration of action up to 2 hours
Effects may be partially reversed with drugs such as neostigmine
What are the relations of the left adrenal gland
Crus of the diaphragm-Postero- medially, Pancreas and splenic vessels-Inferiorly, Lesser sac and stomach-Anteriorly
What are the relations of the right adrenal gland
Diaphragm-Posteriorly, Kidney-Inferiorly, Vena Cava-Medially, Hepato-renal pouch and bare area of the liver-Anteriorly
What controls voluntary micturition
External urethral sphincter
Pudendal nerve
What is the blood supply to the heart
SA node
- 60% RCA
- 40% LCA
AV node
- 80% RCA
- 10% LCA
RA most of RV and part of LV
- RCA
Septum
- posterior third septum - RCA
LCA
- LA
- Most of LV
- Part of RV
- Anterior two thirds
Paeds resus fluids
10-20mls/kg
What does the IMV drain into
IMV –> Splenic vein –> portal vein
Posterior relation of pancreatic body
Left crus of diaphragm
Drainage of fluid intraperitoneal
Erect - Pouch of douglas (female) - Vesicorectal/uterine
Supine - Hepatorenal
What is the rule of thumb for diarrhoea and treatment due to parasites
Bloody stool x low income country - entamoeba histolytica - metronidazole
Anal pruritus and eggs seen in tap - enterobius vermicularis - mebendazole
Foul smelling idarrhoea, often after swimming in river - giardia - metro
Immunocompromised - cryptosporidum - nitaazoxanide
Rule of thumb - ova and cyst - metro
cysts only - mebendazole
What are the tumour markers for germ cell tumours
Seminoma - beta hcg
chroriocarcinoma - beta hcg
yolk sac - AFP
teratoma - ni
What vit def causes pellagra
B3 (niacin)
What vit def causes beri beri
B1 (thiamine)
What vit def causes ecchymosis
vit k
Most common brain tumour in children? Most common malignant tumour
Astrocystoma
Medulloblastoma
What vit def causes dry skin/night blindness
vit A
What is the range for glucose intolerance in fasting
5.6 - 7
> 7 normal
What is the range for glucose intolerance post prandial
7.8-11 - glucose intolerance
> 11 diabetes
What anaesthetic agents can cause liver damage
Halothane
Lymph drainage of gastric fundus
Coeliac
Innervation of erection and ejaculation
erection - pelvic splanchnic
ejaculation - hypogastric splanchnic
Lymphatic drainage of mid oesophagus
Hilar/mediastinal
Heparin action
Enhances anti-thrombin 3
What causes glossitis
B2 - Riboflavin
What causes fertility disorders
vit E
