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Medecine - As PACES > Shorts > Flashcards

Shorts Flashcards

1
Q

Feature of marfans

A 
Hands 
- archnodactyly 
- hyperextensible joint 
- long arms 
General - tall 
Face 
- high arched palate 
- retroganthia - recessed lower mandible 
- flat malar prominence 
- microganthia - small chin 
- long narrow skull - doliocephaly 
Eyes 
- upwards dislocation of ocular lens 
- hypo plastic iris 
- myopia 
- visual field loss - retinal detachment, glaucoma, cataracts 
Chest 
- pectus carinatum or excavatum 
Cardiovascular
- coartication - radial- radial delay 
- aortic regurgitation 
- mitral valve prolapse 
- aortic root anneyeursm
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2
Q

Genetic basis of marfans

A

Chr 15

Fibrillin 1 - FBN1

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3
Q

ABCDE of malignant melanoma

A 
Asymmetry 
Border - irregular 
Colour- not uniform 
Diameter - >6mm 
Evolving/elevation
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4
Q

Features of tuberous sclerosis

A 
Skin: facial adenoma sebaceous, periungual fibroma, shargreen patches, ash-leaf macula, cafe au lait spots 
Eyes: retinal phakomas
Lungs: cystic lung disease 
Abdo - renal cysts 
Neuro: tuberous masses in cortex
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5
Q

Differential of cafe au lait spots

A

Neurofibromatosis
McCune Albright
Tuberous sclerosis

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6
Q

Features of McCune Albright

A

Cafe au lait spots
Polyostotic fibrous dysplasia
Endocrinopathy - precocious puberty

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7
Q

Features of peutz-Jeghers

A

Mucocutaneous Macules

GI hamartomatous polyps

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8
Q

Complication of peutz jeghers

A 
GI hamartomas 
- Intussusception 
- GI bleeding 
Pacreatic endocrine tumours 
Increased risk of cancer - paticualry colorectal cancer
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9
Q

Cause of erythema multiforme

A

Infection: HSV, Mycoplasma
Drugs: sulfonamides, NSAID, Allopurinol, penecillin, phenytoin
Idiopathic

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10
Q

Causes of erythema nodusum

A

Systemic disease: sarcoidosis, bechets, IBD
Infection: EBV, mycoplasma, histoplasmosis, TB, Strep
Drugs: sulphonamide, OCP, salicylates
Pregnancy

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11
Q

Causes or secondary Raynauds

A

Connective tissue disease e.g. Sceleroderma
Vascular disease: thromboembolic disease, atherosclerosis
Drugs: amphetamine, b-blockers, ergot alkaloids, cytotoxic
Heam: cryoglobulinemia, hyperviscosity syndrome, coagulopathies
Frostbite
Cervical rib

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12
Q

Define swan neck deformity

A

Hyperextension of PIP with flexion of DIP

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13
Q

Define boutonaire derformity

A

Flexion at PIP joint with extension at DIP

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14
Q

Extra-articular manifestation of rheumatoid arthritis

A

Resp: pleurisy, fibrosing alveoltitis, pleural effusion
CVS: pericarditis, valvular heart disease, increased risk of IHD, pericardial effusion
Occular: episclerritis, scleritis, sjogrens
Immune: autoimmune haemolytic anaemia, anaemia of chronic disease, vasculitis, Amylodidosis
Abdo: spleenomegaly - felty syndrome
Tenosynovitis: de querverian and Atlanto-axial sublaxation
Msk: osteoporosis, carpal tunnel syndrome

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15
Q

X-Ray changes of RA

A 
Soft tissue swelling 
Periarticular osteopenia 
Loss of joint space 
Periarticular erosion 
Defromity
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16
Q

American college of rheumatology criteria for the diagnosis of RA

A

4/7 of

  1. Morning stiffness - greater than 1hr
  2. Arthritis in 3+ joint areas
  3. Arthritis of the hands
  4. Symmetrical
  5. Rheumatoid nodules
  6. Positive RF
  7. Radiographic changes of RA
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17
Q

Diagnosis of SLE

A

Need 4/11 of American college of rheumatology criteria and serological evidence to diagnosis

Serositis - pleuritis or pericarditis
Oral ulcers
Athritis - non erosive peripheral joints
Photosensitivity
Blood dyscrasias e.g. AIHA, low WCC
Renal involvement - high BP and proitienuria
ANA positive
Immune phenomena: DS-DNA, anti-sm
Neurological: seizures, psychosis
Malar rash: facial erythema sparing naslab folds
Discoid rash

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18
Q

Definition of SLE

A

Multi system inflammatory disease characterised by a T3 hypersensitivity reaction against circulating immune complexes

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19
Q

Radiological feature of gout

A

Punched out peri-articular lesions

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20
Q

Radiological features of OA

A 
Loss of joint space 
Osteophytes 
Subchondral sclerosis 
Subchondral cyst 
Deformity
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21
Q

Causes of macroglossia

A

Acromegaly
Amyloidosis
Hypothyroidism
Down’s syndrome.

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22
Q

Cause of Acanthosis Nigrcians

A 
Endocrine 
- obesity and metabolic syndrome 
- diabetes melitus 
- cushings 
- acromegaly 
Malignancy 
- gastric cancer 
- pancreatic cancer
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23
Q

Complications of acromegaly

A

Impaired glucose tolerance and diabetes melitus
CVS: high BP, LVH, cardiomyopathy, arrthythmias, increases stroke and IHD risk
Increase risk of colorectal cancer
Sleep apnea
OA

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24
Q

Cause of swan neck deformity

A

Due to rupture of the lateral slips - leads to PIP hype extension

25
Q

Cause of boutoinaries deformity

A

Rupture of central slip of extensor tendon lead to PIPJ prolapse through button hole created by the lateral slips

26
Q

Felty syndrome

A

RA spleenomegaly neutropenia

27
Q

Risk factors for pseudogout

A 
Increased age 
OA 
Diabetes melitus 
Hypothyroidism 
Hyperparathyroidism 
Herditary heamachromatosis 
Wilson
28
Q

Preciptiants for gout

A

Surgery
Infection
Fasting
Diuretics

29
Q

Cause of gout

A

Hereditary
Drugs - diuretics, NSAIDS, Cytotoxics, Pyrazinamide
Decreased excretion - renal impairment
Increased cell turnover - lymphoma, leukemia, psoarasis, tumour lysis syndrome
Purine rich food - beef, pork

30
Q

X-Ray change in gout

A

Punched out erosion in juxt-articular bone

Decreased joint space

31
Q

Defenition of seronegative spondyloathropathies

A

Group of inflammatory athridities affecting the spine and peripheral joints without production of rheumatoid factor and assoicated with HLA - B27

32
Q

Definition of ankylosining sponylitis

A

Chronic Disease of unknown aetiology characterised by stiffening and inflammation of the spine and sacroiliac joints

33
Q

Complications of ankylosing spondylitis

A 
Apical fibrosis 
Anterior uveitis 
Aortic reggurgitation 
Achilles tendonitis 
AV node block 
Amyloidosis
34
Q

Enteropathic athritis

A

Occur in 15% of patient with UC or chrons

Asymmetrical large joint oligoathrtis mainly affecting the lower limbs

May have sacroillitis

35
Q

Bechets disease

A

Systemic vasculitis of unknown cause leading to triad of oral aphthous ulcers, gential ulcers and uveitis

36
Q

Cause of sjogrens

A

Primary - idiopathic

Secondary: RA, SLE, Systemic sclerosis

37
Q

Signs of dermatomyositis

A

Heliotrope rash on eyelids and odema
Macular rash - shawl sign positive
Nail fold erythema
Gottrons papules
Mechanic hands - painfull rough skin cracking of finger tips
Retinopathy, hemaorrhages and cotton wool spot
Subcutaneous calcification

38
Q

Cause of drug induced lupus

A

Procinamide
Phenytoin
Hydralazine
Isoniazid

39
Q

Feature of antiphospholipd syndrome

A 
CLOTS 
coagulation defect - increased APTT 
Livido reticularis 
Obstetric complications e.g. Recuurent 1st trimester miscarriages 
Thrombocytopenia
40
Q

Definition of polymyalgia rheumatica

A

Inflammatory rheumatological syndrome that manifest as pain and morning stiffness involving the neck, shoulder girdle and pelvic girdle in an individual over 50

41
Q

Classification of diabetic retinopathy

A
  1. Background retinopathy: microanneysursm, blot heamorrhages, hard exudates - yellow lipid patches
  2. Pre-proliferative retinopathy: heamorrhages in all 4 quadrants, venous abnormalities in more than 2 quadrants, cotton wool spots
  3. Proliferative retinopathy: new vessel formation, pre-retinal or vitreous haemorrhage, retinal dettachment
  4. Maculopathy: hard exudates within one disc width of the macula, macula odema, decreased visual acuity
42
Q

Esotropia

A

Convergent squint - eye turns inward

Hypermetropia is a risk factor

43
Q

Exotropia

A

Divergent squint - eye turns outward

44
Q

Manifest squint

A

Normally visible

45
Q

Latent squint

A

Eye only turns when when unaffected eye is closed

46
Q

Myopia

A

Short sightedness - distant object appeared blurred

47
Q

Hypermetropia

A

Long sightedness - close objects appeared blurred

48
Q

Cataracts

A

Opacifaication of the crystalline lens which affects how the lens refracts light and its clarity therefore decreasing visual acuity

49
Q

Cause of cataracts

A

Increased age
Diabetes
Steroids
Congenital: idiopathic, rubella, Wilson, galactosemia, myotonic dystrophy

50
Q

Indication for cataract surgery

A

Cataracts is causing other Occular disease
Cause functional impairment of vision despite correction with glasses
Opacification prevents visuluisation of the fundus if active posterior segment disease

51
Q

Age related macular degeneration

A

Dry: Drusen- fluffy white spots around the macula, Degeneration of macula, slow visual decline
Wet: subretinal neovascularisation - rapid visual decline with distortion

52
Q

Features of optic neuritis

A 
Decreased acuity 
Decreased colour vision 
Enlarged blind spot 
Optic disc may be normal, swollen or blurred 
RAPD
53
Q

Cause of onycholysis

A

Psoarasis
Fungal infection
Trauma
Thyrotoxicosis

54
Q

Cause of pitting in the nails

A

Psoarasis
Fungal infection
Lichen planus

55
Q

Cause of Kobers phenomena

A 
Psoarasis 
Lichen planus 
Viral warts 
Vitiligo 
Sarcoid
56
Q

Histopatholgical features of psoarasis

A

Hyperkeratosis
Parakeratosis
Intra-epidermal microabcess of Munro

57
Q

Features of pappilodema

A 
Elevation of the optic disc 
Venous engorgement 
Loss of venous pulsation 
Blurring of the optic disc margin 
Paton lines: concentric radial retinal line cascading from the optic disc 
Loss of the optic cup
58
Q

Rheumatoid factor high titre assoicated with

A

More severe disease
Erosions
Extra-articualar manifestation.

Medecine - As PACES (6 decks)

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