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Misc. Notes Year 2 > Rhodia > Flashcards

Rhodia Flashcards

1
Q

Which muscle flexes the interphalangeal joint of the thumb

A

Flexor Pollicus Longus

Longus flexes the joint a LONG distance away from palm

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2
Q

Which muscle flexes the metacarpophalangeal joint of the thumb

A

Flexor Pollicus Brevis

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3
Q

Is apoptosis of osteoblasts a feature of Avascular Necrosis

A

No, because apoptosis is a physiological process, Avascular Necrosis is pathological

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4
Q

Which nerve passes through both the greater and lesser sciatic foramen

A

Pudendal nerve

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5
Q

Which foramen does the obturator nerve pass through

A

Only the lesser sciatic foramen

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6
Q

Which nerve supplies the deltoid

A

Axillary nerve

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7
Q

Which nerve supplies the teres minor

A

Axillary nerve

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8
Q

Which nerve supplies the Supraspinatus

A

Suprascapular nerve

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9
Q

Which nerve supplies the Infraspinatus

A

Suprascapular nerve

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10
Q

Which nerve supplies the Subscapularis

A

Superior and Inferior subscapular nerves

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11
Q

What is indicated for an intracapsular displaced femoral fracture

A

Hemiarthroplasty

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12
Q

What is the nerve supply of the rectus abdomini

A

T7-12

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13
Q

Which nerve roots are involved in the biceps jerk reflex

A

C5-C6

Musculocutaneous nerve

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14
Q

Which nerve roots are involved in the triceps jerk reflex

A

C7-8

Radial nerve

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15
Q

Which nerve is at risk due to a shoulder dislocation/fracture

A

Axillary nerve

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16
Q

What is a telltale sign of axillary nerve palsy

A

numb badge patch region

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17
Q

Name 2 diseases which are type V hypersensitivities

A

Grave’s Diseases

Myasthenia Gravis

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18
Q

What is the Koebner phenomenon

A

Lesions at the sight of injury

Seen in psoriasis

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19
Q

What is Auspitz sign

A

The appearance of small bleeding points after successive layers of scale has been removed from the surface of psoriatic papules

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20
Q

What are the compartments of the thigh

A

Anterior
Medial
Posterior

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21
Q

What is the nerve supply to the anterior compartment of the thigh

A

Femoral nerve

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22
Q

What is the nerve supply to the medial compartment of the thigh

A

Obturator nerve

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23
Q

What is the nerve supply to the posterior compartment of the thigh

A

Sciatic nerve

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24
Q

What is the arterial supply to the anterior compartment of the thigh

A

Femoral artery

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25
Q

What is the arterial supply to the medial compartment of the thigh

A

Profunda femoris artery

Obturator artery

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26
Q

What is the arterial supply to the posterior compartment of the thigh

A

Profunda femoris artery

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27
Q

What are the compartments of the lower leg

A

Anterior
Lateral
Posterior

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28
Q

What is the nerve supply to the anterior compartment of the lower leg

A

Deep fibular (peroneal) nerve

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29
Q

What is the nerve supply to the lateral compartment of the lower leg

A

Superficial fibular (peroneal) nerve

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30
Q

What is the nerve supply to the posterior compartment of the lower leg

A

Tibial nerve

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31
Q

What is the arterial supply to the anterior compartment of the lower leg

A

Anterior tibial artery

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32
Q

What is the arterial supply to the lateral compartment of the lower leg

A

Fibular (peroneal) artery

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33
Q

What is the arterial supply to the posterior compartment of the lower leg

A

Posterior tibial artery

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34
Q

What is the insertion of the biceps brachii

A

Radial tuberosity

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35
Q

What is the origin of the long head of the biceps brachii

A

Supraglenoid tubercle

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36
Q

What is the origin of the short head of the biceps brachii

A

Coracoid process of scapula

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37
Q

What kind of hypersensitivity is Scabies

A

Type 4

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38
Q

Which of the carpal bone is a sesamoid bone

A

Pisiform

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39
Q

Which tendon does the Pisiform bone sit within

A

Tendon of Flexor Carpi Ulnaris

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40
Q

What is the innervation of the Trapezius

A

Spinal accessory

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41
Q

What major neck muscle does the spinal accessory nerve innervate

A

Sternocleidomastoid

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42
Q

Is pruritis a feature of Acne Rosacea

A

Not commonly no

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43
Q

What type of hypersensitivity is Rheumatoid Arthritis

A

Type 3

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44
Q

How many structures are in the carpal tunnel

A

10

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45
Q

How many tendons are in the carpal tunnel

A

9

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46
Q

Which nerve is in the carpal tunnel

A

Median Nerve

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47
Q

Name the tendons in the carpal tunnel

A

Flexor Digitorum Profundus x4
Flexor Digitorum Superficialis x4
Flexor Pollicus Longus

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48
Q

Which gene is defective in Marfan’s Syndrome

A

Fibrillin Gene

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49
Q

What is a cardiac pathology associated with Marfan’s Syndrome

A

Aortic Dissection

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50
Q

Which ligament connects the radial head to the radial notch of the ulna

A

Annular Ligament

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51
Q

Which of the muscle types has nuclei located peripherally

A

Skeletal

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52
Q

What is the insertion of the pectoralis major

A

Lateral lip of the bicipital groove of the humerus

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53
Q

What is the mechanism of action of Azathioprine

A

Purine synthesis inhibition

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54
Q

Which arm muscle does not insert into the radius (and where does it insert)

A

Brachialis

Coronoid process of ulna

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55
Q

Which nerve can be injured in small saphenous vein surgery

A

Sural nerve

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56
Q

Where does the psoas major insert

A

The lesser trochanter of the femur

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57
Q

What is the floor of the anatomical snuffbox

A

Scaphoid bone

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58
Q

Which nerve lies medially on the thyroid gland and in the groove between the oesophagus and trachea

A

Recurrent Laryngeal Nerve

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59
Q

Where does the scaphoid derive the majority of its blood supply

A

Distal end

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60
Q

Does alcohol inhibit glycogenolysis or gluconeogenesis

A

Alcohol inhibits glycogenolysis

Hence the hypoglycaemia in the morning

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61
Q

What are the two incretins

A

GLP-1

GIP

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62
Q

Where is GLP-1 secreted from

A

Ileum

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63
Q

Where is GIP secreted from

A

Duodenum

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64
Q

What are the tests for Acromegaly

A

IGF-1 blood test

Oral Glucose tolerance test

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65
Q

How does Acromegaly increase risk of Type 2 Diabetes Mellitus

A

GH excess

GH mobilises glucose from fat stores

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66
Q

Which layer of the adrenal cortex is Cortisol released from

A

Zona Fasiculata

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67
Q

What are the 3 layers of the adrenal cortex, from superficial to deep

A

Zona Glomelurosa
Zona Fasiculata
Zona Reticularis

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68
Q

What is released by the zona glomerulosa

A

Mineralocorticoids e.g Aldosterone

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69
Q

What is released by the zona fasiculata

A

Glucocorticoids e.g Cortisol

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70
Q

What is released by the zona reticularis

A

Androgens e.g Testosterone

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71
Q

What does PTH do to serum calcium levels

A

Increase

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72
Q

How does PTH increase serum calcium

A

Via Vitamin D to increase reabsorption of calcium in distal convoluted tubule of kidneys

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73
Q

Which cells release somatostatin

A

Delta cells

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74
Q

Which 3 things does somatostatin decrease

A

Insulin
GH
Pancreatic exocrine secretions

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75
Q

What are 4 features of Men 2b

A

Medullary thyroid carcinoma
Phaeochromocytoma
Mucosal Neuroma
Marfanoid features

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76
Q

What are the levels of PTH, Calcium & Phosphate in primary hyperparathyroidism

A

Elevated PTH
Elevated Calcium
Decreased Phosphate

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77
Q

What are the levels of PTH, Calcium & Phosphate in secondary hyperparathyroidism

A

Elevated PTH
Decreased Calcium
Increased Phosphate

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78
Q

What are the levels of PTH, Calcium & Phosphate in tertiary hyperparathyroidism

A

Grossly Elevated PTH
Elevated Calcium
Decreased Phosphate

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79
Q

What is the Pes Anserius

A

The conjoined tendons of the Sartorius, Gracialis and Semitendinous muscles

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80
Q

Which hormones are increased in the stress response

A 
GH
Cortisol
Glucagon 
Prolactin 
ADH 
ACTH
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81
Q

Which hormones are decreased in the stress response

A

Insulin
Testosterone
Estrogen

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82
Q

Where does the superior thyroid vein drain

A

Into the Internal Jugular Vein

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83
Q

Where does the middle thyroid vein drain

A

Into the Internal Jugular Vein

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84
Q

Where does the inferior thyroid vein drain

A

Into the Brachiocephalic Vein

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85
Q

What is the pneumonic for the lateral rotators of the hip

A 
P-GO-Q 
Piriformis 
Gemilus (superior & inferior) 
Obturator (internus & externus) 
Quadratus femoris
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86
Q

Which two thumb muscles does De Quiverains tenosynovitis affect

A

Extensor Pollicus Brevis

Abductor Pollicus Longus

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87
Q

Treatment for Intertrochanteric fracture of femur

A

Dynamic Hip Screw

Or IM nail

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88
Q

Treatment for sub-capital femoral neck fracture

A

Total Hip Replacement

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89
Q

What happens to Anti-dsDNA levels when SLE is more active

A

They rise

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90
Q

What type of systemic sclerosis is pulmonary fibrosis more common in

A

Diffuse systemic sclerosis

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91
Q

What antibody is associated with diffuse systemic sclerosis

A

Anti-Scl70

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92
Q

What antibody is associated with limited systemic sclerosis

A

Anti-Centromere

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93
Q

Which autoimmune disease puts you at higher risk of lymphoma

A

Sjogren’s Syndrome

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94
Q

Is thrombocytosis a feature of Anti-Phospholipid syndrome

A

Not commonly no

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95
Q

What autoimmune condition is a butterfly rash associated with

A

SLE

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96
Q

What autoimmune condition is a Pneumothorax associated with

A

Marfan’s

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97
Q

What is symmetrical small joint swelling suggestive of

A

Rheumatoid Arthritis

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98
Q

What is one way to treat Enteropathic Arthritis apart from methotrexate

A

Treat the underlying IBD

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99
Q

What is a crystal arthropathy associated with erosive joint changes

A

Gout

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100
Q

What is the new name for Churg Strauss syndrome

A

Eosinophilic Granulomatosis with Polyangiitis

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101
Q

What is the triad associated with Churg Strauss syndrome

A

Asthma, Rhinitis, Eosinophilia

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102
Q

Which autoimmune disease which has cutaneous changes is associated with an increased chance of malignancy

A

Dermatomyositis

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103
Q

What are the possible starting doses of prednisolone for Polymyalgia Rheumatica

A

15mg

40mg if also Giant Cell Arteritis

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104
Q

What is the commonest benign bone tumour

A

Osteochondroma

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105
Q

What tumour is a bony spur growing away from the metaphysis of long bones

A

Osteochondroma

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106
Q

Is an osteochondroma completely benign

A

No

Has a 1% chance of malignancy

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107
Q

What are two names for the kind of bone found at the epiphysis of long bones

A

Trabecular

Cancellous

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108
Q

What is Osgood-Schlatter’s disease

A

Traction osteochondritis at the tibial tubercle

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109
Q

What is Sever’s disease

A

Traction osteochondritis at calcaneus

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110
Q

What is described as a single lucent lesion in metaphyseal regions of bones

A

Simple Bone Cyst

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111
Q

What is a buzzword for the appearance of a Giant Cell tumour

A

Soap bubble around knee usually

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112
Q

What pathology can be described as Sheperd’s crook deformity

A

Fibrous Dysplasia

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113
Q

Where is fibrous dysplasia normally seen

A

Proximal femur

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114
Q

What tumour is described as a mostly lucent lesion with patchy sclerosis

A

Enchondroma

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115
Q

What pathology is described as a lucent multi-loculated cyst and where is it usually found

A

Aneurysmal bone cyst

usually in the medulla of bones

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116
Q

What is the name given to the space which chondrocytes occupy

A

Lacuna

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117
Q

Which cancer arises as a result of an (11;22) translocation & how common is it

A

Ewing’s Sarcoma

Rare

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118
Q

Which bone tumour only arises in abnormal bone

A

Fibrosarcoma

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119
Q

Give an example of a disease where abnormal bone is present and could thus result in a fibrosarcoma forming

A

Paget’s disease

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120
Q

What is the most common primary bone tumour

A

Osteosarcoma

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121
Q

What are osteoprogenitor cells

A

A reserve pool of osteoblasts

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122
Q

What are osteoblasts

A

Bone forming cells

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123
Q

Where are osteoblasts found

A

On the surface of developing bone

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124
Q

Which two antibodies are associated with Rheumatoid Arthritis

A

Anti-CCP

Rheumatoid Factor

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125
Q

What is the treatment pathway for Rheumatoid Arthritis

A

Methotrexate

Biologics

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126
Q

What is the timeframe within which Methotrexate should be started after a diagnosis of Rheumatoid Arthritis

A

3 Months

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127
Q

What is the name of the severity scale for monitoring Rheumatoid Arthritis

A

DAS-28

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128
Q

Which antibodies are associated with Sjogren’s Syndrome

A

Anti-Ro

Anti-La

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129
Q

What are two treatment options for Sjogren’s Syndrome

A

Eyedrops

Pilocarpine

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130
Q

What is the test used to diagnose Sjogren’s called and how is it performed

A

Schirmer’s test

paper strips inserted into the eye for several minutes to measure the production of tears

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131
Q

What is the pathology of Systemic Sclerosis

A

Excess collagen deposition

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132
Q

What is limited Systemic Sclerosis also sometimes called

A 
Calcinosis 
Raynaud's 
Esophagal dysmotility
Sclerodactyly 
Telangiectasia
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133
Q

What antibody is associated with MCTD (mixed connective tissue disease)

A

Anti-RNP

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134
Q

Which antibodies are associated with Anti-Phospholipid Syndrome

A

Lupus-Anticoagulant
Anti-cardiolipin
Anti-beta2 Glycoprotein

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135
Q

What is a cutaneous manifestation of Anti-Phospholipid Syndrome

A

Livedo Reticularis

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136
Q

What is the diagnostic procedure for Giant Cell Arteritis

A

Temporal Artery Biopsy

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137
Q

Which antibodies are associated with Polymyositis

A

Anti-Jo1 mainly

but also Anti-RNP

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138
Q

What three investigations can be done for suspected Polymyositis

A

Serum CK
EMG (Electromyograph|)
Muscle biopsy

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139
Q

What are the 3 changes seen in Dermatomyositis but not in Polymyositis

A

Gottron’s papules
V-shaped Rash over chest
Heliotrope rash

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140
Q

What nail changed are seen in Dermatomyositis

A

Nail fold infarcts

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141
Q

Which antibodies are associated with SLE

A

Anti-dsDNA

Anti-sm

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142
Q

Which drug is always given in SLE for symptomatic relief regardless of severity

A

Hydroxychloroquine (anti-malarial)

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143
Q

What is the pathology in Osteogenesis Imperfecta

A

Defect in type 1 collagen

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144
Q

What is a special procedure which can be done for treatment for Osteogenesis Imperfecta

A

Sofield procedure

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145
Q

Which gene is abnormal in Marfan’s Syndrome

A

Fibrillin gene

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146
Q

What cardiac pathology is associated with Marfan’s Syndrome

A

Aortic Dissection

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147
Q

What is the pathology of Ehler-Danlos syndrome

A

Abnormal collagen and elastin formation

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148
Q

Which disease can cause blue sclera

A

Osteogenesis Imperfecta

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149
Q

Which two conditions are associated with atlantoaxial instability

A

Down’s Syndrome

Rheumatoid Arthritis

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150
Q

Which gene is abnormal in Duchenne Muscular Dystrophy and what is it normally involved in

A

Dystrophin gene

Calcium transport

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151
Q

What is the difference between Duchenne Muscular Dystrophy and Becker’s Muscular Dystrophy

A

Becker’s is milder - leads to death in 30’s-40’s rather than 20’s

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152
Q

What are the two severities of spina bifida called and which one is more severe

A

Spina bifida Occulta

Spina bifida Cystica - more severe

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153
Q

What are the two types of Spina Bifida Cystica and what is the difference

A

Meningocele - herniation of only meninges

Myelomeningocele - herniation of meninges + spinal cord

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154
Q

What is a possible treatment for Poliomyelitis

A

Arthrodesis

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155
Q

Which spinal roots are affected in Erb’s Palsy

A

C5+C6

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156
Q

Which muscles lose function in Erb’s palsy

A 
Biceps 
Brachialis
Deltoid 
Supraspinatus 
Infraspinatus
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157
Q

What happens to the humerus with Erb’s Palsy

A

Internal rotation

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158
Q

What posture is associated with Erb’s Palsy

A

Waiter’s tip

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159
Q

Which spinal roots are affected in Klumpke’s Palsy

A

C8 + T1

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160
Q

Which muscles lose function in Klumpke’s Palsy

A

Intrinsic hand muscles

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161
Q

Which syndrome can Klumpke’s Palsy sometimes cause

A

Horner’s

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162
Q

Which action can bring about Klumpke’s Palsy

A

Forceful adduction of arm

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163
Q

What does Froment’s Test test for

A

Ulnar Nerve Palsy

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164
Q

The action of which muscle is tested in Froment’s test

A

Adductor Pollicus

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165
Q

Which type of collagen is produced in Dupuytren’s Contracture

A

Type 3

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166
Q

What is the pathology in Dupuytren’s Contracture

A

Nodular Hypertrophy of palmar fascia

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167
Q

Is periosteum thicker in children’s bones or adult’s bones

A

Children’s

Reason for greenstick fractures

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168
Q

What is a nightstick fracture

A

Isolated fracture of the ulna

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169
Q

What is Wolff’s Law

A

Bone is laid down in areas of stress

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170
Q

What may be considered instead of a total joint replacement in a young patient with knee arthritis

A

Tibial Osteotomy

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171
Q

Which wrist movement is required to acquire full grip strength

A

10 degrees of wrist extension

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172
Q

Which fracture can result in loss of wrist extension and thus a loss in grip strength

A

Distal Radial Fracture

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173
Q

What is a Monteggia fracture

A

Fracture of the proximal third of the ulna with dislocation of the proximal head of the radius

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174
Q

What is a Galeazzi fracture

A

Fracture of the distal third of the radius with dislocation of the distal radioulnar joint

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175
Q

How is a Nightstick fracture treated

A

Conservatively

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176
Q

How is a Monteggia fracture treated

A

ORIF of the ulna after reduction of radial head

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177
Q

How is a Galeazzi fracture treated

A

ORIF of the radius after reduction of ulna

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178
Q

How is a tear of the long head of biceps tendon treated

A

Conservatively

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179
Q

How is a tear of the patellar tendon treated

A

Surgically repaired

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180
Q

What GCS score indicates a need to perform airway manoeuvres

A

8 or below

because this indicates loss of airway control

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181
Q

What are the 5 types of fractures

A 
Transverse 
Oblique 
Spiral 
Comminuted 
Segmental
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182
Q

How is a Transverse fracture described

A

Flat line

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183
Q

How is an Oblique fracture described

A

Diagonal break across bone

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184
Q

How is a Spiral fracture described

A

Rotational break due to twisting force

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185
Q

How is a Comminuted fracture described

A

3 or more pieces

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186
Q

How is a Segmental fracture described

A

Bone breaks in 2 places

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187
Q

What are the 3 classes of nerve injury from MOST severe to LEAST severe

A

Neurotmesis
Axonotmesis
Neurapraxia

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188
Q

Describe Neurapraxia

A

Conduction defect from compression/stretch

Full function returns in 28 days

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189
Q

Describe Axonotmesis

A

Death of axons distal to point of injury
Wallerian Degeneration
Axons regrow at 1mm/day

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190
Q

Describe Neurotmesis

A

Complete transection of nerve

Requires surgery for recovery

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191
Q

What is the Salter-Harris classification used for

A

Paediatric epiphyseal plate fractures

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192
Q

Which Salter-Harris fractures are intra-articular

A

Class 3 and 4

193
Q

What is a Bumper injury and which nerve is at risk of damage

A

A car hitting a pedestrian side on
Blow to the lateral knee
Common Peroneal nerve at risk

194
Q

Which nerve is at risk of injury from a posterior hip dislocation

A

Sciatic nerve

195
Q

Which nerve is at risk of injury from a supracondylar fracture of the humerus

A

Median nerve

196
Q

What is a Boxer’s injury

A

Fracture of the 5th metacarpal neck

197
Q

Deformity in which plane is tolerated in a Boxer’s fracture and up to what angle

A

Up to 45 degrees of flexion is tolerated

198
Q

Deformity in which plane is not well tolerated in a Boxer’s fracture

A

Rotational deformity

199
Q

Which direction is shoulder dislocation most common in

200
Q

What is the 1-year mortality post-hip fracture

201
Q

What is the most common site for a proximal humerus fracture

A

Surgical neck

202
Q

What is the management of a minimally displaced proximal humerus fracture

A

Conservative

203
Q

What is the pathology behind Mallet Finger and what does this result in

A

Avulsion of extensor tendon at DIPJ

Inability to extend at DIPJ

204
Q

Describe hammer toe

A

Flexion at PIPJ

205
Q

Describe mallet toe

A

Flexion at DIPJ

206
Q

Describe claw toe

A

Flexion at DIP & PIP joints

207
Q

Which structure is at risk after a displaced Colles Fracture

A

Median nerve

208
Q

What is a thoracolumbar wedge type fracture

A

A single column spinal fracture

209
Q

Where does the sphenoid sinus drain

A

Sphenoethmoidal recess

210
Q

Which cranial nerve has the longest course

A

CN VII - Facial

211
Q

Which structure does the facial nerve pass into

A

Parotid Salivary gland

212
Q

Which meatus, canal and foramen does the facial nerve pass through

A

Internal Acoustic Meatus
Facial canal
Stylomastoid foramen

213
Q

Which sinuses drain to the middle meatus

A

Frontal
Ethmoidal
Maxillary (antra)

214
Q

What drains into the inferior meatus

A

Nasolacrimal duct

215
Q

Which cranial fossa does the Internal Acoustic Meatus sit in

216
Q

Which two structures can a Le Fort 1 fracture damage

A

Maxillary sinus

Opening of the nasolacrimal duct

217
Q

Which opening can mastoiditis affect

A

Additus of mastoid air cells

218
Q

Which 4 structures pass through the jugular foramen

A

CN IX - Glossopharyngeal nerve
CN X - Vagus
CN XI - Spinal accessory
Internal Jugular Vein

219
Q

Which structure prevents anterior dislocation of the jaw

A

Zygomatic arch

220
Q

Which nerve has a geniculate ganglion part to it, in the petrous part of the temporal bone

A

Facial Nerve

221
Q

What pathology could be suspected with recurrent falls

A

Vestibular nerve pathology

222
Q

What makes up the skeleton of the external ear

A

Elastic cartilage

223
Q

What is Hordeolum Externa

A

Stye- inflammatory focus centred on a lash follicle

224
Q

Is a flame-shaped haemorrhage superficial or deep in the retina

A

Superficial

225
Q

Which cranial nerves carry parasympathetic outflow

A

CN 3, 7, 9, 10

226
Q

What types of axons does the long ciliary branch contain

A

Sympathetic and Sensory

227
Q

What types of axons does the short ciliary branch contain

A

Sympathetic and Parasympathetic

228
Q

Which branch of which cranial nerve supplies the Lacrimal gland

A

Parasympathetic fibres supplied by Greater Petrosal nerve

Branch of CN VII

229
Q

What is a scotoma

A

A gap in visual field

230
Q

What is amaurosis fugax

A 
Transient CRAO (central retinal artery occlusion)
Lasts around 5 mins
231
Q

What is a synechia

A

Irregular pupil shape

232
Q

What is Rubeosis Iridis and what does it indicate

A

Blood vessel growth on iris

suggests severe ischaemia

233
Q

What is a Symblepharon

A

Palpebral conjunctiva becomes stuck to bulbar conjunctiva

Causes turning in of the eyelid

234
Q

Which epilepsy medication can cause constriction of the visual field

A

Vigabatrin

235
Q

What is the tee-pee sign and what condition is it seen in

A

Eyelashes stick together due to oil and sebaceous matter

seen in Seborrhoeic Anterior Blepharitis

236
Q

What is chemosis

A

Conjunctival Oedema

237
Q

What does redness around the limbus suggest

A

Anterior Uveitis

238
Q

What is trichiasis

A

When the eyelashes grow abnormally and touch the eyeball

239
Q

Why is there pain in the presence of light when a patient has uveitis

A

The muscles of the iris are inflamed and cause pain when they try to constrict the pupil

240
Q

What is the Trousseau sign and what does it indicate

A

Inflation of the BP cuff causes flexion of wrist and fingers

Indicates hypocalcaemia

241
Q

What is the Chovstek sign and what does it indicate

A

Tapping on the parotid gland causes twitching of the mouth

Indicates hypocalcaemia

242
Q

What is Waterhouse-Freiderichson syndrome

A

Adrenal hypofunction due to bleeding into the gland

usually caused by a N. meningitidis infection

243
Q

What is Sheehan syndrome

A

Hypopituitarism due to ischaemic necrosis of the gland postpartum

244
Q

What is the 2nd line treatment for Hyperthyroidism and when is 1st line

A

PTU is 2nd line after Carbimazole

The 1st line drug only in the 1st trimester of pregnancy

245
Q

Why is carbimazole not used in the 1st trimester of pregnancy

A

Risk of aplasia cutis in early pregnancy

246
Q

What is the difference between a vocal chord and a vocal fold

A

Vocal fold has mucosal covering (squamous epithelium)

Vocal cord does not

247
Q

What kind of cartilage is the laryngeal inlet (aditus)

248
Q

Which muscle is being tested when you ask a patient to stick their tongue straight out

A

Genioglossus

249
Q

Which nerve is being tested when you ask a patient to stick their tongue straight out

A

Hypoglossal CN XII

250
Q

How can you tell which nerve (right or left) is injured when you ask a patient to stick their tongue straight out

A

The tongue tip will point to the side which is damaged/non-functional

251
Q

Which two muscles are being tested when you ask a patient to say “ahh” and what is their innervation

A

Tensor Veli Palatini (CN V3)

Levator Veli Palatini (CN X)

252
Q

How can you tell which nerve (right or left) is injured when you ask a patient to say “ahh”

A

The uvula is pulled away by the functioning side

i.e points away from the injured side

253
Q

During a Laryngoscopy, which space is the laryngoscope placed into

A

Vallecula (space between epiglottis and tongue)

254
Q

Which nerve supplies the Circular (constrictor) muscles of the pharynx

A

CN X (Vagus)

255
Q

What do the longitudinal muscles of the pharynx do

A

Elevate pharynx & larynx

256
Q

Where do all the longitudinal muscles of the pharynx insert

A

Onto posterior border of thyroid cartilage

257
Q

Where do all the Circular (constrictor) muscles of the pharynx insert

A

All insert onto the midline raphe

258
Q

Name the 3 longitudinal muscles of the pharynx

A

Palatopharyngeus
Salpingopharyngeus
Stylopharyngeus

259
Q

What is the innervation of the longitudinal muscles of the pharynx

A

CN X supplies Palatopharyngeus & Salpingopharyngeus

CN IX supplies Stylopharyngeus

260
Q

Which muscle does the parotid duct pierce to emerge into the oral cavity

A

Buccinator

261
Q

Which of the vocal cord muscles are not involved in whispering

A

Arytenoid muscles

262
Q

Names the muscles of the floor of the mouth

A

Digastric (anterior belly)
Mylohyoid
Geniohyoid

263
Q

Which vertebral level is the hyoid bone found at

264
Q

What is the lymphatic drainage for the tip of the tongue

A

Submental nodes

265
Q

What structure is pressed on to compress the oesophagus to allow ventilation

A

Lamina of the cricoid cartilage

266
Q

What is Dacrocystitis

A

Infection of the lacrimal sac

267
Q

How would Dacrocystitis typically present

A

Watery eye + swelling/erythema at inner canthus of eye

268
Q

What is the most common reason for revision surgery of of THR

A

Aseptic loosening of implant

269
Q

Which diabetes drug is contraindicated in heart failure and why

A

TZD’s

Cause fluid retention

270
Q

Treatment for infective conjunctivitis

A

Topical Chloramphenicol

271
Q

What are tatty’s 4 T’s of Type 1 Diabetes

A

Tired
Thin
Thirsty
Toilet

272
Q

Describe MODY

A

Symptoms of Type 2 diabetes in a young patient

273
Q

1st line treatment for lower back pain

A

NSAID (e.g Naproxen) rather than just paracetamol alone

274
Q

When is the commencing of uric acid lowering (uricosuric) drugs indicated

A

2 or more gout attacks in 12 months

275
Q

What is the alternative to Allopurinol

A

Febuxostat

276
Q

What is the mechanism of action of Allopurinol & Febuxostat

A

Inhibition of Xanthine Oxidase (enzyme)

277
Q

Which investigation must be carried out with a diagnosis of SLE and why

A 
Urine analysis (look for proteinuria) -> Renal Biopsy
To check for Lupus Nephritis
278
Q

Which thyroid condition is strongly associated with smoking

279
Q

Which antibody can be seen in Grave’s disease

A

TSH receptor antibody

(TRAb) stimulating*

280
Q

Which antibody can be seen Hashimoto’s thyroiditis

A

Anti-TPO

Thyroperoxidase

281
Q

Name the 3 longitudinal muscles of the pharynx

A

Stylopharyngeus
Salpingopharyngeus
Palatopharyngeus

282
Q

What is the innervation of the longitudinal muscles of the pharynx

A

CN X apart from Stylopharyngeus which is CN IX

283
Q

Name the 2 soft palate muscles

A

Tensor veli palatini

Levator veli palatini

284
Q

What is the innervation of the soft palate muscles

A

Levator veli palatini - CN X

Tensor veli palatini - CN V3

285
Q

Which muscles open (abduct) the vocal cords and what effect does this have

A

Posterior crico-arytenoid muscles

Makes voice louder

286
Q

Which muscles relax the vocal cords and what effect does this have

A

Thyroarytenoid muscles

Makes voice lower (lowers pitch)

287
Q

Which muscles close (adduct) the vocal cords and what effect does this have

A

Lateral crico-arytenoid & Arytenoid muscles

Makes voice quieter

288
Q

Which muscles tense the vocal cords and what effect does this have

A

Cricothyroid muscles

Makes voice higher (increases pitch)

289
Q

Name the 4 strap muscles

A

Sternothyroid
Thyrohyoid
Omohyoid
Sternohyoid

290
Q

Which fracture typically caused by a FOOSH always requires ORIF

A

Smith fracture

291
Q

Name the muscles which make up the floor of the mouth

A

Mylohyoid
Anterior belly of Digastric
Geniohyoid

292
Q

What gene mutation is linked to retinoblastoma

A

Rb-1 gene on chromosome 13

293
Q

Which marker is very high in Paget’s disease and why

A

Alkaline Phosphatase

Marker for bone destruction

294
Q

What does the JESS mnemonic stand for and what disease is it for

A 
Joint space loss
Erosion of joint
Synovial thickening 
Subluxation 
X-ray changes in rheumatoid arthritis
295
Q

What period of morning stiffness is associated with rheumatoid and osteoarthritis

A

OA - less than 30mins

RA - more than 30mins

296
Q

What is thyrotoxicosis factitia

A

Hyperthyroidism caused by ingestion of exogenous thyroid hormone

297
Q

What stimulates a salty taste

A

Chemical salts (esp. NaCl)

298
Q

What stimulates a sour taste

A

Free H+ ions

299
Q

What stimulates a sweet taste

A

A configuration of glucose

300
Q

What stimulates a bitter taste

A

Alkaloids
Toxic plant derivatives
Poison

301
Q

What stimulates a umami (meaty/savoury) taste

A

Amino acids

in particular glutamate

302
Q

Conn’s syndrome typical biochemistry and presentation

A

Relatively young patient with hypertension
Hypokalaemia and Hypernatraemia
(Aldosterone causes Na retention)

303
Q

Men1 is associated with which 3 tumours

A

Parathyroid gland
Islet cells of the pancreas
Pituitary gland

304
Q

What medications can exacerbate psoriasis

A

Anti-malarials

Beta-blockers

305
Q

What does the PCOS PAL mnemonic stand for, with regards to polycystic ovarian syndrome

A

Polycystic on ultrasound
Cycles erratic (menstrual)
Obesity + Hirsutism
Subfertility

Prolactin elevated
Androgens very elevated
LH grossly elevated

306
Q

What is the incretin effect and what causes it

A

Oral glucose triggers a greater insulin release than IV

This occurs due to oral glucose causing the release of GLP-1 and GIP (from Ileum & duodenum)

307
Q

What are the 2 ketones commonly measured and where are they found

A

Beta-hydroxybutyrate - in blood

Acetoacetate - in urine

308
Q

What are the two types of differentiated thyroid cancers

A

Papillary

Follicular

309
Q

How does papillary thyroid carcinoma spread

A

Tends to spread via lymphatics

310
Q

How does follicular thyroid carcinoma tend to spread

A

Via blood (haematogenous)

311
Q

Name an endocrine, cardio & MSK condition that Acromegaly is associated with

A

Diabetes Mellitus
Left Ventricular Hypertrophy
Carpal tunnel syndrome

312
Q

Is Psoriatic arthritis more similar to osteoarthritis or rheumatoid arthritis

A

Rheumatoid arthritis

313
Q

What is arthritis mutilans

A

A severe and highly destructive form of psoriatic arthritis

314
Q

Why cant testosterone be given IV

A

Is only available with an oily base, therefore, risk of embolus if given IV

315
Q

What condition is this a classic presentation of :

Halo around lights, ‘Frosted glass appearance’, pain & decreased visual acuity

A

Acute Angle Closure Glaucoma

316
Q

What are the Rotterdam criteria for Polycystic Ovarian Syndrome

A

2 out of 3 of :
Polycystic ovaries on ultrasound
Evidence of elevated androgens (hirsutism)
Menstrual irregularity

317
Q

What part of the body can Bisphosphonates cause side effects in

A

Oesophagus

318
Q

What is the most common cause of vertigo

A

Benign Paroxysmal Positional Vertigo

BPPV

319
Q

What is thought to be the cause of BPPV

A

Otolith material (calcium carbonate) displaced from utricle into semi-circular canals (usually posterior)

320
Q

What is the test to diagnose BPPV

A

Dix-Hallpike test

Classic Nystagmus is seen

321
Q

What manoeuvre is used to treat BPPV

A

Epley manoeuvre

Relocates displaced material to utricle

322
Q

What is the shawl sign and which disease is it seen in

A

Red Rash on back of neck like a shawl

Dermatomyositis

323
Q

What are the 3 endocrine receptor types

A

G-Protein coupled receptor
Receptor kinase
Nuclear receptors

324
Q

What are the 3 classes of hormones

A

Protein & peptide
Steroid
Tyrosine derivatives

325
Q

What is preproinsulin and what is it broken down into

A

Insulin precursor

Broken down into insulin + c-peptide

326
Q

Does insulin inhibit or stimulate lipolysis

A

Inhibit lipolysis

327
Q

Which glucose transporter is in pancreatic beta cells

328
Q

Which glucose transporter is in skeletal muscle cells

329
Q

Does water follow Na or the other way round

A

Water follows Na as a rule of thumb

330
Q

What does mineralocorticoid activity mean

A

Na retention in exchange for K+/H+ ions

331
Q

Concentrated urine has a high/low osmolarity

A

High osmolarity

332
Q

What is the HbA1c level in a normal person

A

Below 41mmol/L

333
Q

What HbA1c level diagnoses diabetes

A

48mmol/L and above

334
Q

What is the onset and peak action time of rapid-acting insulin

A

15min onset, 1-2 hour peak

335
Q

Give examples of rapid-acting insulin

A

Novorapid, Humalog

336
Q

What is the onset and peak action time of short-acting insulin

A

30-60min onset, 2-4 hour peak

337
Q

Give examples of short-acting insulin

A

Actrapid, Humulin S

338
Q

What is the onset of basal insulin

A

1-3 hour onset

339
Q

Give examples of basal insulin

A

Insulatard, Humulin I

340
Q

Give examples of long-acting insulin

A

Lantus (Glargine)

Levemir (Detemir)

341
Q

What are the pre-meal blood glucose targets

A

3.9 - 7.2mmol/L

342
Q

What are the 1-2 hour post-meal blood glucose targets

A

< 10mmol/L

343
Q

What effect does GLP-1 have on alpha-cells of the pancreas

A

Decreases glucagon release

344
Q

What 2 factors can be mutated in MODY

A

Transcription factor

Glucokinase

345
Q

Which type of MODY presents at birth

A

Glucokinase mutation

346
Q

Which type of MODY can sulphonylureas be useful for

A

Transcription factor MODY

347
Q

What level of ketonaemia is diagnostic of DKA

348
Q

What level of blood glucose is diagnostic of DKA

A

> 11mmol/L

349
Q

What level of bicarbonate & pH is diagnostic of DKA

A

Bicarbonate < 15mmol/L

pH < 7.3

350
Q

What type of breathing is associated with DKA

A

Kussmaul breathing

351
Q

What is the normal range of lactate

352
Q

What is the normal range of osmolality

353
Q

What is stored in thyroid colloids and released by follicular cells

A

Thyroglobulin

354
Q

What is the definitive test for Cushing’s

A

Low dose dexamethasone suppression test overnight

Cortisol < 50 = normal

355
Q

What are the Hypophysis and Neurohypophysis

A

Hypophysis - Anterior pituitary

Neurohypophysis - Posterior pituitary (extension of hypothalamus)

356
Q

What kind of cells does the adrenal medulla contain

A

Chromaffin cells

357
Q

Which two chemicals does ACTH mediate the release of from the adrenal cortex

A

Cortisol from Zona Fasiculata

Androgens from Zona Reticularis

358
Q

What does cortisol do to libido and proteins in the body

A 
Loss of libido 
Protein loss (muscle wasting &amp; osteoporosis)
359
Q

Why is Addison’s associated with dark/pigmented skin

A

Adrenal failure causes high ACTH

ACTH causes melanocytes to produce more melanin

360
Q

What are the levels of K+, Na+, ACTH, Renin & Aldosterone like in Addison’s

A 
High K+ 
Low Na+
High ACTH
Very High Renin
Low Aldosterone
361
Q

What is the diagnostic test for Addison’s

A

Short SYNACTHEN test

Cortisol > 550 = normal

362
Q

What is the treatment for Addison’s

A

Hydrocortisone (cortisol replacement)

Fludrocortisone (aldosterone replacement)

363
Q

What tests can be done to diagnose Conn’s syndrome

A

Aldosterone: Renin ratio
Saline suppression test
(failure to suppress aldosterone by 50% with 2L saline)

364
Q

Treatment for Conn’s syndrome

A

Adrenalectomy

Spironolactone if bilateral

365
Q

What are the cortisol, aldosterone & androgen levels like in congenital adrenal hyperplasia

A

Low cortisol
Low aldosterone
Very high androgens

366
Q

Which adrenal condition can present with ambiguous genitalia

A

Congenital Adrenal Hyperplasia

367
Q

What is the classic triad of symptoms for phaeochromocytoma

A

a headache
sweating
palpitations

368
Q

What is the treatment ladder for Phaeochromocytoma

A

Alpha blocker
Beta|-blocker
fluid replace
Surgical excision

369
Q

How is hypercalcaemia treated

A

Fluid replacement, loop diuretic, bisphosphonate

370
Q

What bone mineral density is considered normal

A

Within 1 standard deviation of the young adult-reference mean

371
Q

What bone mineral density is considered osteopenic

A

1-2.5 standard deviations below the young adult-reference mean

372
Q

What bone mineral density is considered osteoporotic

A

2.5 standard deviations or more below the young adult-reference mean

373
Q

How do bisphosphonates work

A

They are ingested by osteoclasts and cause cell death

This decreases bone resorption

374
Q

What are some side effects of bisphosphonates

A

Osteonecrosis of jaw

Oesophageal cancer

375
Q

Which hormone increases to cause follicle formation in the menstrual cycle

376
Q

Which cells around the leading follicle release which chemical

A

Granulosa cells release oestrogen

377
Q

Which hormone spikes just before the ovulation stage of the menstrual cycle

378
Q

How is oligomenorrhoea defined

A

Less than 9 periods a year

379
Q

Define primary and secondary amenorrhoea

A

Primary - Failure to have the first period by 16

Secondary - Cessation of periods for 6 months with previous periods

380
Q

Can high prolactin cause oligomenorrhoea or amenorrhoea

A

Amenorrhoea

381
Q

What is Kallman’s syndrome

A

Loss of GnRH secretion from hypothalamus

Accompanied by loss of smell

382
Q

Where is preproinsulin synthesised

A

Rough endoplasmic reticulum

383
Q

What do diazoxides do

A

Stimulate the K+ channel in beta cells
Cause repolarisation
Inhibit insulin release

384
Q

What are the subunits of the insulin receptor and how are they linked

A

2 extracellular alpha subunits
2 transmembrane beta subunits
Linked by disulfide bonds

385
Q

How does insulin have an effect on cells

A

Binds to extracellular alpha subunits
causes autophosphorylation of beta subunits
Causes gene expression via MAPkinase pathway
Causes uptake of glucose via GLUT4 -> glycogen synthesis

386
Q

Where and how are ketone bodies formed

A

In liver mitochondria vis beta-oxidation of acetyl-CoA

387
Q

What is smoky red urine caused by

A

Caused by intact red blood cells

388
Q

What is seen on the iodine uptake scan with acute thyroiditis

A

Reduced/ no uptake

389
Q

What are the two surgical approaches to the pituitary fossa

A

Trans-sphenoidal

Trans-cranial

390
Q

Describe the three Le Forte fractures

A

Le Forte 1 - Maxilla seprates from hard palate
Le Forte 2 - Maxilla seperates from zygoma + nasal bones
Le Forte 3 - Nuerocranium seperates from viscerocranium

391
Q

What is type 3 diabetes

A

Diabetes secondary to other disease/ cause

e.g. Cushing’s, Turner’s

392
Q

What are the two types of lactic acidosis and what are they associated with

A

Type A - Hypoxaemia of tissues

Type B - Diabetes

393
Q

What 4 pathologies does Wolfram syndrome give you

A

Diabetes mellitus
Diabetes Insipidus
Optic Atrophy
Deafness

394
Q

What is Type 4 diabetes and what causes it

A 
Gestational diabetes (in 3rd trimester)
Caused by placental hormones
395
Q

Which malignancy is associated with Hashimoto’s Thyroiditis

A

Papillary carcinoma

396
Q

When are T3 and T4 stopped before a full body iodine scan and why

A

T3- 2 weeks before T4- 4 weeks before

Stopped to allow TSH to be high

397
Q

Which two things does TRH stimulate the secretion of

A

TSH & Prolactin

That’s why hypothyroidism can also cause hyperprolactinaemia

398
Q

Does iodine deficiency cause hypothyroidism

A

yes, commonest cause in developing countries

399
Q

Why does goitre occur in hypothyroidism

A

Increased TSH causes gland enlargement

400
Q

How can a medullary thyroid carcinoma cause diarrhoea or Cushing’s

A

Paraneoplastic production of VIP or ACTH

401
Q

What is the Guthrie test and when is it done

A

Done on day 5 to screen for congenital thyroid disease

402
Q

What is Whipple’s triad and what does it indicate

A

Symptoms of hypoglycaemia
Documented low blood sugar
Symptomatic relief by glucose

Indicates an insulinoma

403
Q

What do the Centor criteria consist of

A

Fever (over 38)
Absence of a cough
Tonsilar exudate
Tender anterior cervical lymphadenopathy

404
Q

What does a Centor score of 3 or above indicate and what is the next step

A

Indicates Bacterial Tonsilitis

Penicillin V or Clarithromycin if allergic

405
Q

What is an Adie pupil

A

Tonically dilated pupil with a slow reaction to light
Seen in females with absent knee/ ankle jerk
occurs due to damage to parasympathetics of eye

406
Q

What is a Marcu-Gunn pupil

A

Relative afferent pupil defect

usually due to optic nerve damage

407
Q

What is a Hutchinson pupil

A

Unilateral dilated pupil with no reaction to light

usually due to oculomotor nerve damage

408
Q

What is an Argyll-Robertson pupil

A

Bilaterally small pupils
Accommodation reflex but no reaction to light
Seen in syphilis -> prostitute’s pupil

409
Q

What is the sensory organ of hearing and how does it work

A

Organ of Corti

Hair cells convert mechanical bending force into electrical impulses

410
Q

The basilar membrane is tonotopically arranged - what does this mean

A

The apex picks up low frequency sound

The base picks up high-frequency sound

411
Q

What does impedance matching refer to

A

The pressure gain of x22 from the tympanic membrane to the oval window

412
Q

Where is the auditory cortex located

A

Superior temporal gyrus

Broadmann area 41/42

413
Q

What is the lifespan of taste receptor cells and where are they renewed from

A

10 days

renewed from basal cells

414
Q

What are the three types of cell in the olfactory mucosa

A

Olfactory receptor cells
Supporting cells
Basal cells

415
Q

What are the early complications of Strep Throat

A

Quinsy
Otitis media
Scarlet fever

416
Q

What are the late complications of Strep Throat

A

Rheumatic fever

Glomerulonephritis

417
Q

What is the treatment for oral candidiasis

A

Topical nystatin suspension

418
Q

What antibiotics are given for complicated/ unresolving sinusitis

A

Penicillin

Doxycycline if allergic (Not in children)

419
Q

What is the treatment ladder for otitis externa

A

Topical aural toilet
Clotrimazole for fungal causes
Gentamicin for chronic (Pseudomonas)

420
Q

What is the classic triad of symptoms for glandular fever

A

Fever
Pharyngitis
Lymphadenopathy

421
Q

Name 4 complications of glandular fever

A

Splenic rupture
Thrombocytopenia
Lymphoma
Upper airway obstruction

422
Q

What 3 investigations can be done for glandular fever

A

IgM test
Paul-Bunnell test
Monospot test
(CRP will also be low)

423
Q

What actually is a cholesteatoma

A

The presence of keratin producing squamous epithelium in the middle ear

424
Q

What is a vestibular schwannoma and where are they typically found

A

A benign tumour of Schwann cells

usually found at the cerebellopontine angle

425
Q

What is the Battle sign and what does it suggest

A

Bruising behind the ear

Suggests a temporal bone fracture

426
Q

What are the two types of temporal bone fracture

A

Longitudinal (conductive hearing loss)

Transverse (sensorineural hearing loss)

427
Q

When is a barium swallow more useful than endoscopy

A

To visualise oesophageal dysmotility, an oesophageal stricture or a pharyngeal pouch

428
Q

What scans are done to investigate the two types of hearing loss

A

Conductive - CT scan

Sensorineural - MRI scan

429
Q

Which virus is associated with nasopharyngeal carcinoma

A

Epstein Barr virus

430
Q

Where is there a high incidence of Nasopharyngeal carcinoma

A

In the far east

associated with nitrosamines in food

431
Q

What is the histology of the palatine tonsils

A

Stratified squamous epithelium with crypts and a collagen hemi-capsule

432
Q

What is the histology of the adenoid tonsils

A

Respiratory epithelium with folds and a transition layer (antigen processing)

433
Q

Where is the infection in quinsy

A

In between the tonsil and the underlying muscle

434
Q

What type of cartilage makes up the nasal cartilage

A

Hyaline cartilage

435
Q

Which bones make up the septum of the nose

A

Perpendicular plate of the ethmoid

Vomer

436
Q

The nasal cavity is supplied by which three arteries

A

Facial
Maxillary
Ophthalmic

437
Q

What is Kisselbach’s area

A

Arterial anastomoses on nasal septum

438
Q

Which bone are the conchae a part of

A

Superior and middle are part of ethmoid

Inferior is a bone on its own

439
Q

What proportion of the external acoustic meatus is bone

A

1/3 cartilage 2/3 bone

440
Q

What structure forms the connection between the epitympanic recess and the mastoid process

441
Q

What is the promontory in the middle ear

A

Bony swelling on the medial wall of the middle ear cavity due to the cochlea

442
Q

What is the origin of the thyroid gland

A

Foramen caecum

443
Q

Where does the hypoglossal nerve lie in relation to the lingual artery

A

Lies lateral to the loop of the lingual artery

444
Q

Lymph drainage of the lateral surface of the superior half of the ear

445
Q

Lymph drainage of the cranial surface of the superior half of the ear

A

Mastoid (& deep cervical)

446
Q

Lymph drainage for majority of the ear

A

Superficial cervical

447
Q

What do the terms anotia and microtia mean

A

Anotia is the absence of an ear

Microtia is an ear which is not fully developed

448
Q

What are the ducts called in correspondence to the scala media, tympani and vestibuli

A

Scala media - cochlear duct
Scala vestibuli - vestibular duct
Scala tympani - tympanic duct

449
Q

What does tinnitus indicate damage to

A

Damage to the outer hair cells (modulate sound)

450
Q

What is sialolithiasis

A

Stones within the salivary glands

451
Q

What is herpetic whitlow

A

Herpes infection of the junction between nail and skin

452
Q

What is Carhart’s notch

A

A notch present at 2000 Hz on an audiogram

Otosclerosis

453
Q

What is the commonest cause of adult subglottic stenosis

A

Vasculitis

454
Q

What is the classic presentation of a thyroglossal cyst

A

Midline swelling which moves upwards on protrusion of the tongue

455
Q

What pathology can be described as a collection of dilated lymphatic sacs which are transilluminable

A

Cystic Hygroma

456
Q

How long must a mouth ulcer be present to warrant being referred to oral surgery

457
Q

What disease can present as a ‘flamingo tinge’ and what is this caused by

A

Otosclerosis

Caused by hyperaemia

458
Q

What 5 classes of drugs can be used to treat glaucoma

A 
Prostaglandin analogue
Beta blocker 
Sympathomimetics 
Carbonic anhydrase inhibitor 
Miotics
459
Q

What is a side effect of prostaglandin analogues

A

Brown pigmentation of iris

460
Q

When can beta blockers not be used to treat glaucoma

A

When the patient has asthma or heart block

461
Q

What is a side effect of sympathomimetics

A

Hyperaemia

462
Q

What is a side effect of CA inhibitors

A

Systemic Absorption

463
Q

What is a side effect of Miotic drugs

A

Blurry vision and headache due to constriction of pupil

464
Q

Which class of drug, also used for hypertension, can cause gingival hyperplasia

A

Calcium channel blockers

465
Q

What symptoms can a vestibular schwannoma cause in relation to cranial nerves

A

CN V - Absent corneal reflex
CN VIII - Vertigo, tinnitus, HL
CN VII - Facial nerve palsy

466
Q

What diagnosis would be suggested by night blindness and tunnel vision

A

Retinitis Pigmentosa

467
Q

What are the two tuning fork tests

A

Rinne’s test

Weber test

468
Q

What is the mnemonic for branches of the facial nerve

A

To Zanzibar By Motor Car

Temporal, Zygomatic, Buccal, Mandibular, Cervical

469
Q

What are the different types of Cerebral Palsy

A

one limb (monoplegic),
one ipsilateral upper and lower limb (hemiplegic)
both legs only (diplegic)
4 limbs usually with learning difficulties (Quadriplegic)

470
Q

What are the names of the ducts which drain the submandibular and parotid glands

A

Submandibular -> Wharton’s duct

Parotid -> Stensen’s duct

471
Q

Name 2 anti-folate antibiotics which shouldn’t be used with methotrexate and why

A

Trimethoprim
Co-Trimoxazole
(risk of severe bone marrow suppression)

472
Q

What is Pott’s disease

A

Tuberculosis in a site other than the lungs

often vertebrae

473
Q

Which TB drug can induce lupus

474
Q

What can happen to ligaments in osteoarthritis

A

Ligament hypertrophy

475
Q

Which organism causes ‘walking pneumonia’ and why is it called this

A

Mycoplasma Pneumoniae

Called this because patients often seem fine

476
Q

What is the only organism which is not a virus but is tested for using PCR

A

Mycoplasma Pneumoniae

477
Q

How is legionella pneumonia tested for

A

Urine sample

478
Q

What is the ideal treatment for someone with sepsis/ severe disease

A

IV Bacteriocidal antibiotics

479
Q

When should a baby be introduced to full fat, semi-skimmed and skimmed milk

A

Full fat - 1 year onwards
Semi-skimmed - 2 years onwards
Skimmed - 5 years onwards

Misc. Notes Year 2 (30 decks)

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