Revision Y2 Flashcards by Miranda King

Cellulitis

= bacteral infection of the dermis that is not associated with necrosis

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Malignant melanoma

Melanocytes in the basal layer of the epidermis

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Seborrheic keratoses

Can see keratin pearls under the dermascope

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Management of candidiasis

1st topical imidazole cream

2nd oral fluconazole

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Calcipotriol

Vitamin D analogue

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Erythema multiforme

Target lesions with erythema

Triggers: HSV, mycoplasma pneumoniae

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Nikolskys sign

The top layer of the skin slip away from the lower layers when slightly rubbed
-> shows plane of cleavage in the epidermis

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Splenunculus

Small nodules of spleen that are detached fro the main body of the spleen

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White areas at autopsy found in the abdomen

Saponification

= classic feature of acute pancreatitis

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Bilateral pleural effusions and heavy lungs at autopsy

Acute pancreatitis

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ARDS pathological features

Hyaline membrane formation

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Osteoclast

Bone destroyer

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Bone found at the epiphysis

Trabecular

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Outer shell/shaft of long bone

Cortical

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Lines around the osteon

Cement lines

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ECM

75% water, 25% organic material

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Lucent, painless lesion on x-ray

Simple bone cyst

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Tumour often occurring around the knee and distal radius with a soap bubble appearance

Giant cell tumour

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A single lucent lesion, often an incidental finding, found most commonly within metaphyseal regions

Simple bone cyst

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A tumour extensively involving the proximal femur with cortical thinning and a Sheperd’s crook deformity

Fibrous dysplasia

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Osteochondroma

Produces a cony outgrowth in the external surface with a cartilaginous cap

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Malignant tumour of unknown histogenesis characterised by the t(11;22) translocation

Ewings Sarcoma

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Most common form of primary bone tumour, producing abnormal bone
Most cases seen in younger age groups and 60% involving bones around the knee

Osteosarcoma

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A malignant tumour that only rarely occurs in bone and only if the bone is abnormal

Fibrosarcoma

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Where are chondrocytes found

Lacuna

Spine affected in RA

C1 and C2

Raynaud's phenomenon

Over constriction/spasm of the vessels: so white in the cold weather, when they become warm > vessels become red and painful

Test used to diagnose Sjogrens syndrome

Schirmer

Diffuse systemic sclerosis

``` Pulmonary fibrosis Raynauds Dry eyes Facial telangiectasia Puffy hands ```

Patellar dislocation

Patella 'always' dislocates laterally

Ankylosing spondylitis

Lower back pain, radiating to the buttocks, no precipitant, family history

Extracapsular hip fractures

Limb shortening and external rotation

Positive Thomas Test

Loss of hip extension (early arthritis of the hip)

Flexor digitorum superfacialis

Median Nerve

Flexor digitorum profundus

Median 1/2 | Ulnar 1/2

Radial nerve palsy

Wrist drop | = fracture of the humerus

T-score

- 1 and -2.5 = osteopenia | - 2.5 and lower = osteoporosis

Induction of remission - vasculitis

Cyclophosphamide | IV steroids

Maintenance of remission - | vasculitis

Methotrexate | Azathioprine

Transient synovitis

Reluctant to weight bear, range of movement restricted, recent infection

Hypo in the night

Can have morning headache

Long term diabetics risk

Autonomic neuropathy | Symptoms of a hypo which are autonomic disappear

Hydroxycholoroquine

Can cause sudden onset vision loss

Sulfasalazine

Can cause yellow discolouration of body fluids e.g. tears

Starting insulin calculation of dose

1 unit of insulin/kg

1:2 insulin sensitivity

1 unit of insulin lowers the blood glucose by 2 mmol

Absorption of iron

Duodenum

Multi-nodular goitre

Supressed TSH | Normalish levels of T3 and T4

Cortisol action on bone

Increases osteoclastic activity

Saline supression test

Administration of saline should cause the levels of aldosterone to decrease, failure to decrease by 50% = primary hyperaldosteronism

Drugs used in Cushings

Metyrapone | Ketoconazole

Hypothyroidism signs

Chvotsek sign | Trosseaus sign

Insulin receptor

Tyrosine kinase receptor

Growth Hormone receptor

Cytokine receptor

Calcium

G protein coupled receptor

Action of insulin

Increases hepatic glycogen synthesis

Right Cavernous sinus | NERVES

CN III, IV, V1, V2, VI

Dapagliflosin

SGLT2 inhibitor | also promotes diuresis

SGLT2 channel location

Kidney

SGLT1 channel location

Gut

A 70-year old patient with T2DM presents complaining of fever, sweats and nausea. Examination of foot reveals and ulcer on his left big toe

Management = IV antibiotics immediately

Glomerulosclerosis

Hardening of the glomerulus

Prolactinoma prolactin levels

40,000 average, can be up to 300,000

Toxic multinodular goitre uptake scan

See patches of increased uptake

Graves uptake scan

Whole thyroid would light up

Agranulocytosis

Complication of carbimazole (or PTU), stop taking carbimazole and request urgent FBC

Cabergoline

Dopamine receptor agonist | - used to treat macroprolactinoma

Pegvisomont

Growth hormone receptor antagonist

Phaechromocytoma treatment

Alpha blockers THEN Beta blockers

Initial investigation for Conn's

Paired renin and aldosterone measurement

Uptake scan in carcinoma of the parathyroid

Usually have several hot spots

MEN 1

Prolactinomas Hyperparathyroidism Pituitary tumours

1st test for Cushings

Low dose dexamethasone supression test

Test used in acromegaly

Oral glucose tolerance test (look at growth hormone response)

Management of newly diagnosed Type 2 diabetes WITH OSMOTIC SYMPTOMS

Diet Lifestyle Glicazide

Subclinical Hypothyroidism

When the T4 is still within normal ranges