Short cases FYI Flashcards

1
Q

Peripheral Vs. Central Cyanosis

A

< 80% oxygenated Hb

Peripheral - vascular constriction in Raynaud’s, cryoglobulinaemia, frost bite, circulatory failure

Central - inadequate oxygenation such as respiratory failure or mixture of Venous and Arterial blood

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2
Q

Koilonychia

A

Spoon shaped nails secondary to Fe deficiency

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3
Q

Onochylysis

A

Separation of the nail from bed
- Psoriasis (also with nail pitting)
- Fungal infection
- Thyrotoxicosis
- Trauma

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4
Q

Arachnodactyly

A

Marfans syndrome

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5
Q

Description of acromegaly hands

A

Large “doughy” hands

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6
Q

Differing causes of Anaemia

A

Heart failure - Lower limb predominant with raised JVP and pulsatile liver
Liver Failure. -Ascites
Nephrotic - often periorbital

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7
Q

Causes of Oedema

A

Non-pitting
- Lymphoedema
Pitting
- CCF
- Hypoalbumin due to CLD, Nephrotic syndrome
- DVT
- Myxoedema with hypothyroidism
- Drugs; CCB, NSAIDS

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8
Q

Causes of Lymphadenopathy

A
  1. Viral infection i.e EBV, CMV, HIV
  2. Local bacterial infection with reactive hyperplasia
  3. Tb
  4. Haematological - Lymphoma (usually Hodgkins), Leukaemia (depending on age), solid organ mets (L) supraclavidular - Troisier)
  5. Sarcoidosis
  6. Brucellosis or Pasturella
  7. Connective tissue diseases i.e. RA (Feltys syndrome), SLE
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9
Q

Lymphadenopathy with Splenomegaly

A
  1. Lymphoma
  2. Chronic Lymphocytic Leukaemia
  3. Acute Lymphocytic leukaemia
  4. RA with Feltys syndrome
  5. HIV
  6. Disseminated Tb
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10
Q

Causes of Gynaecomastia

A
  • Puberty
  • Chronic liver disease
  • Kleinfelters syndrome (16 x more likely to get male breast cancer), Kallmans syndrome with anosmia (hypogonadotropic, hypogonadism)
  • Testicular failure
  • Sprinolactone use for CLD, CCF, Addisons disease requiring mineralocorticoid replacement
  • Digoxin
  • Oestrogen therapy
  • Bronchial carcinoma

** Cushings get Lipomastia!**

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11
Q

Causes of Hirsutism

A
  • Cushings
  • PCOS (oligomenorrhoea, hyperandrogism, polycystic ovaries)
  • Congenital adrenal hyperplasia
  • Phenytoin
  • Ciclosporin
  • Androgen secreting ovarian malignancy

** Hypertrichosis is generalized excess hair growth in any sex, which is nonandrogenic in origin**

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12
Q

Rx Hirsutism

A
  • Weight loss
  • Cease offending drugs
  • OCP
  • Metformin
  • Sprinolactone
  • Laser hair removal
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13
Q

Causes of leg ulcers

A
  • Trauma
  • Arterial insufficiency - lateral aspect - loss of hair, absent pulses, painful
  • Venous insufficiency - medial aspect
  • Mixed venous and arterial
  • Neuropathic - at pressure points
  • Autoimmune (pyoderma gangrenous, Feltys syndrome, SLE)
  • Burgers disease - young patient with smoking Hx
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14
Q

Causes of gum hypertrophy

A
  • Phenytoin
  • Ciclosporin
  • Myelomonocytic leukaemia
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15
Q

Describing pulse

A
  • Slow rising = anacrotic, plateau = MR, AS, MS
  • Collapsing = water hammer pulse = AR
  • Jerky pulse = HOCM
  • Dancing carotids = Corrigans sign = AR
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16
Q

Describing JVP

A
  • Double flicker = normal JVP
  • Prominent V wave = TR
  • Loss of A wave = AF
  • Cannon A wave = CHB, Junctional rhythm
17
Q

Normal apex beat

A

5th intercostal space at mid-clavicular line, of normal character

18
Q

Describing apex beat

A
  • Thrusting, Volume loaded = MR, AS
  • Heaving, Pressure loaded = AS
  • Tapping = MS
  • Double apex beat = HOCM
  • Missing apex beat - thick chest wall, apex behind rib, emphysema, dextrocardia
19
Q

Loud first heart sound

A
  • Mitral stenosis
20
Q

Loud second heart sound

A
  • Pulmonary stenosis
21
Q

Soft first heart sound

A
  • MR
  • TR
22
Q

Soft second heart sound

A
  • AS
  • PR
23
Q

Split second heart sound

A
  • Pulmonary hypertension
  • Atrial septal defect
  • RBBB
24
Q

Reverse splitting of second heart sound

A
  • Aortic stenosis
25
Q

Tracheal deviation

A

Towards side
- Collapse
- Pneumonectomy
- Fibrosis
Away from side
- PTX
- Pleural effusion

26
Q

Dullness to percussion

A
  • Stony dullness; effusion
  • Dullness; consolidation, mass, collapse
27
Q

Dullness to percussion

A
  • Stony dullness; effusion
  • Dullness; consolidation, mass, collapse
28
Q

Prolonged expiratory phase

A

> 6 seconds