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Medecine - As PACES > Shorts > Flashcards

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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
Cause of boutoinaries deformity
Rupture of central slip of extensor tendon lead to PIPJ prolapse through button hole created by the lateral slips
26
Felty syndrome
RA spleenomegaly neutropenia
27
Risk factors for pseudogout
``` Increased age OA Diabetes melitus Hypothyroidism Hyperparathyroidism Herditary heamachromatosis Wilson ```
28
Preciptiants for gout
Surgery Infection Fasting Diuretics
29
Cause of gout
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
X-Ray change in gout
Punched out erosion in juxt-articular bone | Decreased joint space
31
Defenition of seronegative spondyloathropathies
Group of inflammatory athridities affecting the spine and peripheral joints without production of rheumatoid factor and assoicated with HLA - B27
32
Definition of ankylosining sponylitis
Chronic Disease of unknown aetiology characterised by stiffening and inflammation of the spine and sacroiliac joints
33
Complications of ankylosing spondylitis
``` Apical fibrosis Anterior uveitis Aortic reggurgitation Achilles tendonitis AV node block Amyloidosis ```
34
Enteropathic athritis
Occur in 15% of patient with UC or chrons Asymmetrical large joint oligoathrtis mainly affecting the lower limbs May have sacroillitis
35
Bechets disease
Systemic vasculitis of unknown cause leading to triad of oral aphthous ulcers, gential ulcers and uveitis
36
Cause of sjogrens
Primary - idiopathic | Secondary: RA, SLE, Systemic sclerosis
37
Signs of dermatomyositis
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
Cause of drug induced lupus
Procinamide Phenytoin Hydralazine Isoniazid
39
Feature of antiphospholipd syndrome
``` CLOTS coagulation defect - increased APTT Livido reticularis Obstetric complications e.g. Recuurent 1st trimester miscarriages Thrombocytopenia ```
40
Definition of polymyalgia rheumatica
Inflammatory rheumatological syndrome that manifest as pain and morning stiffness involving the neck, shoulder girdle and pelvic girdle in an individual over 50
41
Classification of diabetic retinopathy
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
Esotropia
Convergent squint - eye turns inward Hypermetropia is a risk factor
43
Exotropia
Divergent squint - eye turns outward
44
Manifest squint
Normally visible
45
Latent squint
Eye only turns when when unaffected eye is closed
46
Myopia
Short sightedness - distant object appeared blurred
47
Hypermetropia
Long sightedness - close objects appeared blurred
48
Cataracts
Opacifaication of the crystalline lens which affects how the lens refracts light and its clarity therefore decreasing visual acuity
49
Cause of cataracts
Increased age Diabetes Steroids Congenital: idiopathic, rubella, Wilson, galactosemia, myotonic dystrophy
50
Indication for cataract surgery
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
Age related macular degeneration
Dry: Drusen- fluffy white spots around the macula, Degeneration of macula, slow visual decline Wet: subretinal neovascularisation - rapid visual decline with distortion
52
Features of optic neuritis
``` Decreased acuity Decreased colour vision Enlarged blind spot Optic disc may be normal, swollen or blurred RAPD ```
53
Cause of onycholysis
Psoarasis Fungal infection Trauma Thyrotoxicosis
54
Cause of pitting in the nails
Psoarasis Fungal infection Lichen planus
55
Cause of Kobers phenomena
``` Psoarasis Lichen planus Viral warts Vitiligo Sarcoid ```
56
Histopatholgical features of psoarasis
Hyperkeratosis Parakeratosis Intra-epidermal microabcess of Munro
57
Features of pappilodema
``` 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
Rheumatoid factor high titre assoicated with
More severe disease Erosions Extra-articualar manifestation.

Medecine - As PACES (6 decks)

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