Review posters 05/05/2016

Question 1

Marfans genetics

Answer 1

Autosomal dominant inherited disorder
Defect on the MFS1 gene for fibrillin.
Diagnosis based on family linkage and mutations found.

Question 2

Marfans appearence

Answer 2

Tall, thin (usually man) with long arms, legs and fingers.

High arched palette, retinal detachment/lens dislocation.

Question 3

Cardiac implications of Marfans

Answer 3

Often have abdominal aortic aneurysms. Lots of patients also have arrhythmias. Also mitral valve regurgitation along with mitral valve stenosis.

Question 4

Management of Marfans.

Answer 4

Beta blocker- stops further dilatation of the aorta
ACE inhibitor. In marfans TNF beta is upregulated. ACE inhibitors stop this.
Lifestyle advice- avoid prolonged strenuous exercise such as cross country running.

Question 5

Monitoring

Answer 5

Dilatation monitored until greater than 5.5cm in diameter- then it is surgically removed.

Question 6

The common cold (acute coryza)

Answer 6

Common-

Most commonly caused by rhinovirus.

Question 7

Symptoms of coryza

Answer 7

Watery nasal discharge
Or blocked nose
Sneezing
Sore throat
Tiredness
Slight fever
Malaise

Question 8

How is the common cold spread?

Answer 8

Direct contact

Question 9

Pharyngitis

Answer 9

Inflammation of the pharynx

Question 10

Symptoms of pharyngitis

Answer 10

Sore throat
Oropharynx and soft palette are redenned.
Tonsils are inflamed and swollen.

Question 11

Treatment of pharyngitis

Answer 11

Self limiting

Question 12

What most commonly causes pharyngitis?

Answer 12

Adenovirus

Question 13

Epiglottis

Answer 13

Inflammation of the epiglottis- blocks trachea

Question 14

Symptoms of epiglottitis

Answer 14

Increasing difficulty breathing- acute air flow obstruction
Hypoxia
Epiglottis is large and inflamed
Extreme illness

Question 15

What do you do with a case of epiglottitis?

Answer 15

Leave the mouth alone- no examination, no looking- any of these may make it more inflamed worsening the obstruction.
CALL AN AMBULANCE- medical emergency.

Question 16

Influenza

Answer 16

Could be influenza A or B

Question 17

Which influenza strain is responsible for possible worldwide pandemics?

Answer 17

Influenza A

Question 18

Symptoms of influenza infection

Answer 18

Fever
Shivering
Generalised aches

Followed by a severe headache, dry cough and sore throat. Possibly accompanied with diarrhoea.

Question 19

What is the incubation period for influenza?

Answer 19

1-3 days

Question 20

Sinusitis

Answer 20

Inflammation of the sinus’s

Question 21

Symptoms of sinusitis

Answer 21

Blocked nose (due to the channels from the sinuses being blocked by inflammation 
Watery discharge
Painful headache that may spread to the cheeks, eyes and forehead.

Question 22

Treatment of sinusitis

Answer 22

Usually self limiting- however may need assistance with antibiotics.

Question 23

Diptheria

Answer 23

Contagious bacterial infection.

Question 24

How is diptheria spread?

Answer 24

By direct contact, contact with an infected surroundings or touching something that the infected individual has touched.

Question 25

Symptoms of diptheria

Answer 25

Grey/black coating at the back of the mouth Fever Sore throat Breathing difficulties

Question 26

Treatment

Answer 26

Antibiotics and antitoxins.

Question 27

Rhinitis

Answer 27

Two types, seasonal or persistent (perrenial)

Question 28

Seasonal rhinitis

Answer 28

``` Hayfever- Itchy eyes Itchy soft palate Sneezing Watery nasal discharge ```

Question 29

Allergic rhinitis

Answer 29

Most commonly to dust mites that live in the house. Could also be to household pets saliva.

Question 30

Name the three types of persistent rhinitis.

Answer 30

Allergic, non-allergic eosinophilia, vasomotor rhinitis

Question 31

Non-allergic eosinophilia

Answer 31

No extrinsic cause. | eosinophillic granulocytes present in nasal discharge

Question 32

Vasomotor rhinitis

Answer 32

Occurs when come into contact with cold air, smoke etc. Due to a nervous response.

Question 33

Treatment of rhinitis

Answer 33

Antihistamines Sodium cromoglycate (anti-inflammatory) Corticosteroids Avoidance of irritant

Question 34

Laryngitis symptoms

Answer 34

Hoarse throat Barking cough Audible stridor Progressive airway obstruction

Question 35

Obstruction

Answer 35

Most likely to be in right main bronchus.

Question 36

Treatment of influenza A/B

Answer 36

Paracetamol and bed rest

Question 37

The term pneumocoinosis refers to which occupational lung disorders?

Answer 37

Coal workers lung Silicosis Beryliosis Asbestosis

Question 38

The term hypersensitivity pneumonitis encompasses which occupational lung disorders?

Answer 38

Farmers lung Bird fanciers lung Cheese workers lung

Question 39

Coal workers lung

Answer 39

Two types- simple pneumocoinosis or progressive massive fibrosis

Question 40

Simple pneumocoinosis

Answer 40

Dust particles from coal get into the lung. The more exposure to these duct particles, the more likely you are to develop pneumocoinosis.

Question 41

Catagories of simple pneumocoinosis

Answer 41

1) small round nodular opacities relatively few in number 2) Small round nodular opacities in numerous quantities however lung markings still visible 3) Small round nodular opacities numerous in quantity- lung markings not visible,

Question 42

Progressive massive fibrosis

Answer 42

Develops from simple pneumocoinosis. Round masses are developed several centimetres in diameter. Sometimes have necrotic centres

Question 43

What would a lung function test of someone with progressive massive fibrosis show?

Answer 43

Restrictive and obstructive properties.

Question 44

Symptoms of progressive massive fibrosis

Answer 44

Considerable SOB Cough Sputum may be black.

Question 45

Silicosis

Answer 45

Silica fibres inside the lung Particularly toxic to alveolar macrophages Increased risk of TB

Question 46

Signs of silicosis

Answer 46

Eggshell calcification around the hilar regions

Question 47

Asbestosis

Answer 47

Inhalation of asbestos fibres These deposit in the tissues in the lung. White blood cells then take up the particles- causing inflammation.

Question 48

Types of asbestos

Answer 48

Crysotile- white (least fibrinogenic) (90%) Croicodolite- blue (most fibrinogenic) (6%) amosite (4%)

Question 49

Relationship between asbestos and smoking

Answer 49

Synergistic

Question 50

Mesothelioma

Answer 50

Cancer of the mesothelial cells (cells of the pleura that secrete the intrapleural fluid) Related to asbestos exposure

Question 51

Symptoms of mesothelioma

Answer 51

Chest wall pain | Pleural effusion

Question 52

Byssinosis

Answer 52

Exposure to cotton wool dust | "Monday sickness"- worse when you've had a break from it and gets better throughout the week.

Question 53

Berylliosis

Answer 53

Egg shell calcification Inhalation of beryllium (copper alloy) Clinical picture similar to sarcoidosis

Question 54

Risk factors for PE

Answer 54

``` Contraceptive pill Pregnancy Obesity Trauma Malignancy Pelvic obstruction Immobility Recent surgery Thrombophilia (increased tendency of blood to clot) ```

Question 55

What is a PE

Answer 55

DVT from legs have enlodged in the pulmonary circulation- causing blockage.

Question 56

Symptoms of PE

Answer 56

``` Pleuritic chest pain Shortness of breath (acute in onset) Heamoptysis Leg pain/swelling Collapse ```

Question 57

Signs of PE

Answer 57

Hypoxia Low BP Tachycardia Cyanosed

Question 58

Investigations and their findings of PE

Answer 58

V/Q mismatch- shows where obstruction is CT pulmonary angiogram- could do the same Chest X-ray- normal D-dimers raised Leg- ultrasound may show atherosclerotic plaque

Question 59

Treatment of PE

Answer 59

Warfarin Low molecular weight heparin Aspirin/clopidogrel

Question 60

Prevention of further PE's occuring

Answer 60

Early mobilisation after operations TED compression stockings Novel anticoagulant e.g. dabigatran