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x2 - Second Year Misc. > Small conditions > Flashcards

Small conditions Flashcards

1
Q

functional obstruction of the LOS

Presentation + management

A

Achalasia

Presentation = progressive dysphagia, chest pain and regurgitation

Treatment = pneumatic balloon dilatation, surgical myotomy

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2
Q

failure of LOS mechanism

presentation

A

Oesophageal hypomotility

Presentation = reflux symptoms

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3
Q

overactive oesophageal muscles

presentation + management

A

Oesophageal hypermotility

Presentation = dysphagia + chest pain

Management = smooth muscle relaxants

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4
Q

allergen mediated infiltration of the oesophageal epithelium

presentation + management

A

Eosinophilic oesophagitis

Presentation = dysphagia

Management = prednisolone, dietary elimination, endoscopic dilatation

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5
Q

decreased blood supply to GI tract causing injury/ infarction

(presentation)

A

Ischaemic colitis/ enteritis

Presentation = IBD symptoms

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6
Q

bowel inflammation caused by exposure to ionising radiation

presentation

A

Radiation colitis/ enteritis

Presentation = IBD symptoms

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7
Q

excessive bacterial growth in the small intestine

diagnosis + management

A

Small bowel overgrowth

Diagnosis = H2 breath test
Management = rotating antibiotics
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8
Q

protrusion of the inner mucosal lining through the outer muscular layer of bowel forming a pouch

A

Diverticulosis

called diverticulitis when inflamed - causes rectal bleeding

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9
Q

enlarged vascular cushions around the anal canal

A

Haemorrhoids

can be removed by elective surgery

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10
Q

autoimmune driven liver inflammation

management

A

Autoimmune hepatitis

management = prednisolone

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11
Q

autoimmune granulomatous inflammation of intrahepatic bile ducts

A

Primary biliary cholangitis

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12
Q

autoimmune chronic inflammation of intra and extrahepatic bile ducts

A

Primary sclerosing cholangitis

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13
Q

inflammation of the gallbladder

A

Cholecystitis

can lead to peritonitis

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14
Q

Pre-malignant condition to oesophageal adenocarcinoma

pathophysiology + management

A

Barrett’s oesophagus

Pathophysiology = metaplasia of squamous to glandular epithelium

Management = endoscopic mucosal resection, radiofrequency ablation, oesophagectomy

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15
Q

stomach lining inflammation due to altered gastric acid production

(Bacterial pathophysiology)

A

Gastritis A, B & C

Bacterial: H. pylori produces urease (splits ammonia to form urea) –> alkaline environment –> increased acid production

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16
Q

bile duct cancer

presentation + management

A

Cholangiocarcinoma

Presentation = obstructive jaundice

Curative treatment= surgery
Palliation = stenting, bypass surgery, radio/chemo

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17
Q

localised/ generalised inflammation of the peritoneum

A

Peritonitis

a cause of ascites

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18
Q

Gastric outlet obstruction

bloods + management

A

Bloods: low Cl, Na, K

Management: endoscopic balloon dilatation, surgery

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19
Q

Perforation of the tympanic membrane

presentation + management

A

Presentation = recurrent infections, hearing loss

Management = myringoplasty (surgical closure), water precautions

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20
Q

inflammation of the external auditory meatus

management

A

Otitis externa

Management = antibiotic/ steroid ear drops

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21
Q

osteomyelitis (bone infection) of the temporal bone

presentation

A

Malignant otitis externa

Presentation = extreme pain, cranial nerve palsies

(common in elderly, diabetic patients)

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22
Q

calcification of the tympanic membrane/ middle ear

A

Tympanosclerosis

usually asymptomatic and requires no management

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23
Q

Sterile fluid in middle ear

presentation + management

A

Otitis media with effusion (glue ear)

Presentation = hearing loss

Management = observation for 3 months, otovent (blow up balloon with nose to open eustacian tube), grommet

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24
Q

Pus in middle ear

presentation + management

A

Acute suppurative otitis media

Presentation = otalgia (pain) and otorrhoea (discharge)

Management = observation, amoxycillin

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25
Q

persistent discharge of pus through a perforated tympanic membrane

complications

A

Chronic suppurative otitis media

Complications = dead ear, facial palsy, meningitis, brain abscess

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26
Q

Skin in the middle ear +/- mastoid air cells

presentation and management

A

Cholesteatoma

Presentation = persistent offensive otorrhoea

Management = mastoidectomy (surgical removal of skin cells)

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27
Q

fixation of the stapes due to abnormal growth of bone in the middle ear

Presentation and management

A

Osteosclerosis

Presentation = conductive hearing loss

Management = hearing aid, stapedectomy (artificial replacement of part of stapes)

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28
Q

vertigo caused by otoconia in the semi-circular canals

Presentation, diagnosis and management

A

Benign paroxysmal positional vertigo

Presentation = positional, rotatory nystagmus, no associated symptoms, precipitated by head movements

Diagnosis = Dix-Hallpike test

Management = Epley manoevure

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29
Q

vertigo due to reactivation of HSV infection of the vestibular ganglion

(presentation + management)

A

Vestibular neuritis/labyrinthitis (VIII nerve palsy)

Presentation = spontaneous, horizontal nystagmus towards affected ear, unilateral hearing loss

Management = benzodiazepines (vestibular sedatives), vestibular rehab

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30
Q

vertigo due to excessive build-up of endolymph in the inner ear

presentation + management

A

Meniere’s disease

Presentation = spontaneous, unilateral hearing loss

Management = Bendroflumethiazide, intratympanic dexamethasone, intratympanic gentamicin

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31
Q

a collection of blood between perichondrium and cartilage in ear caused by trauma

Management

A

Auricular haematoma

Management = incision + drainage, pressure dressing, prophylactic antibiotics

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32
Q

a collection of blood between the cartilage and perichondrium of the nasal septum caused by trauma

Management

A

Septal haematoma

Management = drainage

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33
Q

Nasal fracture

Management

A

Manipulation under general anaesthetic

immediate if bones broken, later if cartilage broken

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34
Q

inherited weakness of blood vessels in the nose

presentation + management

A

Hereditary haemorrhagic telangiectasia (HHT)

Presentation = recurrent epistaxis, telangiectasias in lips and nose

Management = laser coagulation, septodermoplasty

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35
Q

highly vascular benign tumours

Presentation, diagnosis and management

A

Angiofibroma

Presentation = unilateral epistaxis
Diagnosis = nasal endoscopy
Management = surgery

(common in young males)

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36
Q

cancer of the nasal cavity

presentation + management

A

Nasal malignancy

Presentation = unilateral mild epistaxis, unilateral hearing loss (blocked eustacian tube)

Management = radiotherapy, surgery

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37
Q

frontal sinusitis causing forehead swelling

presentation + management

A

Pott’s puffy tumour

Presentation = frontal headache + sinusitis symptoms

Management = endoscopic sinus surgery

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38
Q

dilatation of the thyroglossal duct

presentation + management

A

Thyroglossal cyst

Presentation = moves on tongue protrusion
Management = surgical removal

(may become infected)

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39
Q

neck swelling due to failure of branchial arch fusion

presentation + management

A

Branchial cyst

Presentation when infected = solid painless mass, anterior to sternocleidomastoid (asymptomatic until infected)

Management = conservative, excision

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40
Q

herniation of the pharyngeal mucosa between the inferior pharyngeal constrictors

A

Pharyngeal pouch

Presentation = hoarseness, dysphagia, regurgitation, weight loss

Management = excised if large

(food can lodge there and become infected)

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41
Q

surface of the eye has different curvatures so close and distant objects are blurry

management

A

Astigmatism

Management = cylindrical glasses (curved in one axis), toric lenses (weighted), laser eye surgery

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42
Q

inflammatory process on the cornea

Causes

A

Corneal ulcers

Causes: infection, trauma, corneal degenerations/ dystrophies

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43
Q

Corneal abrasion

presentation + management

A

Presentation = sharp pain, watering, blurred vision

Management = topical antibiotics, oral analgesia
topical anaesthetics delay healing

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44
Q

a group diseases affecting the cornea causing decreased vision

presentation

A

Corneal dystrophies and degenerations

Presentation = decreased vision

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45
Q

inflammation of the sclera

presentation + management

A

Scleritis

Presentation = pain, tenderness, redness, engorged + inflamed scleral vessels

Management = high dose systemic steroids

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46
Q

inflammation of the ciliary body

diagnosis + presentation

A

Intermediate uveitis

diagnosis = slit light examination

Presentation = floaters, hazy vision

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47
Q

Inflammation of the choroid

diagnosis + presentation

A

Posterior uveitis

diagnosis = slit light examination

Presentation = blurred vision (spreads to retina)

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48
Q

allergic inflammation of the conjunctiva

presentation + management

A

Allergic conjunctivitis

Presentation = itchy red eyes, watery discharge, chemosis (conjunctival oedema)

Management = topical antihistamine, mast cell stabilisers (preventative)

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49
Q

blocked sebaceous/ meibomian gland

cause

A

Stye/hordeolum

External = blocked sebaceous gland of an eyelash
Internal = blocked meibomian gland
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50
Q

common, mild primary headache

presentation + management

A

Tension-type headache

Presentation: mild, bilateral tightening

Abortive: aspirin, paracetamol, NSAIDs
Preventative: tricyclic antidepressants (e.g. amitriptyline) - rarely required

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51
Q

Headache on >15 days/ month which has developed/ worsened while taking regular medication

A

Medication overuse headache

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52
Q

inflammation of large arteries

presentation + management

A

Giant cell arteritis

Presentation: diffuse, persistent headache, prominent, beaded temporal artery, malaise

Prophylactic management: antiepileptics (e.g. lamotrigine, carbamazepine)

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53
Q

headache caused by dural CSF leak

presentation + management

A

Intracranial hypotension

Presentation: worsens on sitting/ standing
Management: fluid, analgesia, (IV) caffeine

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54
Q

total paralysis below level of 3rd nerve nuclei

A

Locked in syndrome

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55
Q

bacterial infection spread by ticks

agent, presentation + management

A

Lyme disease

agent: borrelia burgdorferi

acute presentation: erythema migrans (expanding rash at bite site), flu-like symptoms
chronic: encephalopathy, encephalomyelitis

Management: prolonged antibiotics

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56
Q

viral infection of anterior horn cells of lower motor neurons

(presentation + management)

A

Poliomyelitis

Presentation: (99% asymptomatic), asymmetric flaccid paralysis

Management: polio vaccine

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57
Q

acute viral infection of the CNS transmitted through contaminated saliva

(presentation + management)

A

Rabies

Presentation = paraesthesia at bite, ascending paralysis, encephalitis

Management = active/ passive immunisation, sedation

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58
Q

blocked inhibition of motor neurons at the NMJ by bacterial toxins

(agent, presentation + management)

A

Tetanus

Agent: clostridium tetani

Presentation: rigidity + spasm

Management: immunisation, penicillin

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59
Q

Blocked Ach release at NMJ and autonomic nerve junctions by bacterial toxins

(agent, presentation + management)

A

Botulism

agent: clostridium botulinum
(usually spread by injecting blood users)

presentation: descending symmetrical flaccid paralysis

Management: anti-toxin, prolonged antibiotics, radical wound debridlement

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60
Q

failure of closure of cranial neural tube meaning skull fails to form

A

Exencephaly

incompatible with life, no treatment

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61
Q

failure of closure of cranial neural tube causing herniation of cerebral tissue

Presentation

A

Encephalocele

Presentation = neurological deficits (depends on region of herniation, usually occipital)

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62
Q

gyri and sulci fail to develop

A

Lissencephaly (smooth brain)

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63
Q

congenital excess of small gyri

A

Polymicrogyria

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64
Q

failure of corpus callosum development

A

Agenesis corpus callosum

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65
Q

congenitally small head

A

Microcephaly

can be caused by zika virus

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66
Q

CSF filled cysts/ cavities in the brain of a neonate

cause

A

Porencephaly

Cause = postnatal stroke/ infection

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67
Q

large congenital clefts/ slits in the brain

cause

A

Schizencephaly

Cause = genetic, in utero stroke/infection

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68
Q

longitudinally split spinal cord due to vertebral bone defect

presentation

A

Diastematomyelia

Presentation: scoliosis, motor/ sensory deficit of lower limbs, hair tuft on lower back

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69
Q

progressive degenerative loss of the basal ganglia (loss of inhibitory effects)

presentation

A

Huntington’s disease

Presentation: characteristic chorea, dementia

(hereditary)

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70
Q

generalised epilepsy presenting in adolescence

Presentation

A

Juvenile myoclonic epilepsy

Presentation: absence/ tonic-clonic seizures, early morning myoclonus (drop things, brief limb jerks)

(often provoked by alcohol/ sleep deprivation)

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71
Q

prolonged/ recurrent tonic-clonic seizures for >30 minutes

A

Status epilepticus

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72
Q

chronic inability to obtain the necessary amount of sleep

management

A

Insomnia

Management: lifestyle changes, hypnotic drugs (all have side-effects)

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73
Q

partial waking in a terrified state with no recall on waking

A

Night terrors

occur in deep sleep, usually in 3-8yr olds

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74
Q

sleep walking

A

Somnambulism

occur in non-REM sleep (usually stage 4)

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75
Q

direct entry into REM sleep with little warning

A

Narcolepsy

linked to dysfunctional release of orexin

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76
Q

Spinal cord tumours

types, presentation, management

A

extradural, intradural and intramedullary

Presentation = pain, weakness, sphincter disturbance

Management = surgical decompression, radiotherapy

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77
Q

degenerative change in the cervical spine –> cord and root compression

(presentation + management)

A

Cervical spondylosis

Presentation = myelopathy/radiculopathy

Management = conservative/ surgery

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78
Q

spinal cord/root compression due to degenerative change in the lumbar spine

(presentation + management)

A

Lumbar spinal stenosis

Presentation = spinal claudication (pain down both legs, worse on standing, walking)

Management = lumbar laminectomy

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79
Q

infection in the epidural space

presentation + management

A

Epidural abscess

Presentation = back pain, pyrexia, focal neurology

Management = urgent surgical decompression, long term IV antibiotics

80
Q

intravertebral disc infection

A

Discitis

81
Q

infection within the vertebral body

presentation + management

A

Osteomyelitis

Presentation = fever, pain

Management = antibiotics, surgery if neuro signs

82
Q

temporary paralysis/weakness of the face

presentation + management

A

Bells (VII nerve) palsy

Presentation = LMN unilateral face weakness

Management = steroids, eyedrops (eye closure affected)

**The forehead is also affected

83
Q

LMN lesion in the medulla oblongata

presentation

A

Bulbar (IX, X, XI, XII nerve) palsy

Presentation = dysarthria (disordered articulation + slurring), dysphonia, dysphagia

84
Q

UMN lesion of the corticobulbar tract

presentation

A

Pseudobulbar palsy

presentation = spastic immobile tongue, brisk jaw jerk and gag reflex

85
Q

high risk of diabetes

A

Intermediate hyperglycaemia (IGT)

Fasting glucose: 6-7 mmol/l
OGTT: 7.8 - 11 mmol/l
HbA1c: 42 - 47 mmol/mol

86
Q

autosomal dominant gene defect impairing pancreatic beta cell function

A

Maturity onset diabetes in the young (MODY)

87
Q

increasing insulin resistance in the 2nd/3rd trimester of pregnancy

A

Gestational diabetes

88
Q

Hypoglycaemia management

A

15-20g simple CHO (if able)

If unable to take oral CHO:

  • 1mg i/m glucagon
  • glucogel/ dextrogel
  • IV glucose/ dextrose

Then follow up with long acting CHO

89
Q

retinal ischaemia due to diabetes, can stimulate growth of abnormal leaky vessels

(presentation + management)

A

Diabetic retinopathy

Presentation:
proliferative = black floaters in vision
non-proliferative = loss of vision

Management = intravitreal anti-vegf, pan-retinal photocoagulation

90
Q

kidney failure due to diabetic hypertension and ischaemia

diagnosis + management

A

Diabetic nephropathy

Diagnosis = urinalysis (increasing proteinuria), biopsy

Management = RAAS blockade (ACEIs, ARBs), RRT

91
Q

sensory/ autonomic loss (particularly in feet and lower limbs) in diabetes

(presentation + management)

A

Diabetic neuropathy

Presentation = sensory loss, paraesthesia, Charcot’s foot, autonomic neuropathy

Management = foot care

92
Q

ketones >3.0mmol/l

A

Diabetic ketoacidosis

Presentation = thirst, nausea + vomiting, abdominal pain, ketoic breath, drowsiness, rapid, sighing respiration, tachycardia, hypotension, coma

Management (risk of DKA) = oral fluids, insulin
Management (DKA) = IV saline with potassium, IV insulin

93
Q

benign pituitary tumour producing prolactin

presentation + management

A

Micro/macroprolactinoma

Presentation = galactorrhoea (milky secretions), amenorrhoea, infertility

Treatment = dopamine agonists (very effective)

94
Q

excessive GH due to pituitary tumour occurring BEFORE epiphysial growth plate fusion

(presentation + management)

A

Gigantism

presentation = may be >210cm but in proportion

Management = surgery, somatostatin analogues

95
Q

pubertal changes at an early age

management

A

Central precocious puberty
boys <9 - usually underlying cause e.g. tumour
girls <8 - usually idiopathic

management = GnRH agonists

96
Q

gonadotrophin independent abnormal sex steroid secretion

A

Precocious pseudopuberty

97
Q

Puberty commencing >14 (boys) / >13 (girls)

A

Constitutional delay of growth and puberty

98
Q

adrenal hyposecretion, usually due to 21-hydroxylase deficiency

neonatal presentation

A

Congenital adrenal hyperplasia

presentation: neonatal salt-losing crisis, ambiguous genitalia, precocious pseudo-puberty in boys, hirsutism in girls

99
Q

target organ (kidney and bone) unresponsiveness to PTH

A

Pseudohypoparathyroidism

100
Q

non-functioning thyroid tumour

A

Follicular (thyroid) adenoma

101
Q

virally triggered thyrotoxicosis followed by hypothyroidism

presentation + management

A

Subacute (de Quervain’s) thyroiditis

Presentation = painful goitre, fever, myalgia
3-6 months thyrotoxicosis –> 3-6 months hypothyroidism

Management = short term steroids, NSAIDs

102
Q

a group of conditions characterised by autoimmune activity against more than one endocrine gland

A

Autoimmune polyendocrine syndromes

APS-1: onset in childhood
APS-2: usually occurs in young adulthood

103
Q

hypersensitivity reaction of the skin triggered by infection or medication

presentation + management

A

Erythema multiforme

Presentation = target lesions common on palms, soles and mucosal surfaces

Management = symptomatic, treat cause

104
Q

Thyroid carcinoma

Diagnosis + management

A

Diagnosis: USS, FNA, TFTs

Management: total/ near-total thyroidectomy, high dose radioiodine

105
Q

Hypersecretion of aldosterone

Cause + diagnosis

A

Conn’s syndrome

Cause: adenoma, hyperplasia

Diagnosis: high plasma aldosterone + K, 24hr urine aldosterone, adrenal CT

106
Q

autosomal dominant condition causing growth of tumours/ hyperplasia in endocrine glands

A

Multiple endocrine neoplasia (MEN)

107
Q

Obesity management (4 tiers)

A

Tier 1: population-wide health improvement work

Tier 2: Primary care

  • healthy helpings/ football fans in training
  • Orlistat (lipase inhibitor)

Tier 3: specialist weight management
- weigh forward

Tier 4: specialist surgical service

108
Q

rash caused by staph infection

Presentation + management

A

Staphylococcal scalded skin syndrome

Presentation = diffuse erythematous rash (common in flexures), skin tenderness, blistering, fever

Management = admission, IV antibiotics

109
Q

rash caused by mild drug reactions

presentation

A

Morbilliform exanthem

Presentation = measles-like rash

110
Q

autoimmune skin disorder causing blistering between keratinocyte layers

Presentation + management

A

Pemphigus

Presentation = flaccid blisters (rarely intact), systemically unwell

Management = systemic steroids, dress erosions

111
Q

autoimmune skin disorder causing blistering at the dermo-epidermal junction

Presentation + management

A

Pemphigoid

Presentation = intact blisters, systemically well

Management = topical steroids (systemic if diffuse)

112
Q

type IV hypersensitivity reaction to allergens causing dermatitis

Investigation

A

Allergic contact dermatitis

Investigation = patch testing

113
Q

dermatitis caused by chemical and physical irritants

Causes

A

Irritant contact dermatitis

Causes = friction (e.g. nappy rash), environmental factors (e.g. hairdressers)

114
Q

contagious bacterial skin infection, common in children

agent, presentation + management

A

Impetigo

agent = staph aureus/ step. pyogenes

Presentation: macule –> vesicle –> pustule –> erosion with honey coloured crust

Management = local care, topical antibiotics

115
Q

bacterial infection of hair follicles

agent and management

A

Folliculitis

agent = staph aureus

Management = antibacterial washes/ ointments

116
Q

sexually transmitted bacterial infection

agent, presentation + management

A

Syphilis

agent = treponema pallidum

presentation:
primary = painless, red, papule at site of infection
secondary = widespread skin rash (no itch)
tertiary = asymptomatic/ neurosyphilis (infectious)

Management = high dose IV penicillin

117
Q

bacterial infection of the deep dermis and subcutaneous tissue

agent, presentation + management

A

Cellulitis

agent = strep pyogenes/ staph aureus

Presentation = ill-defined non-palpable inflammatory lesion (rubor, calor, tumor, dolor)

Management = antibiotics

118
Q

bacterial infection of the dermis and lymphatics

agent, presentation + management

A

Erysipelas

agent = group A streptococci

Presentation = well-defined, hardened inflammatory lesion (rubor, calor)

Management = penicillin

119
Q

viral infection of the orolabial and genital areas

presentation + management

A

Herpes simplex virus

Presentation = erythema multiforme

Management = topical/ systemic antiviral therapy

120
Q

rough papules/ plaques caused by HPV infection

presentation + management

A

Viral warts

Presentation = rough, painful, hyperkeratotic papules/ plaques

management = salicylic acid, wart paints, cryotherapy, curette (if severe)

(usually resolve spontaneously)

121
Q

firm, umbilicated papules caused by poxvirus infection

presentation + management

A

Molluscum contagiosum

Presentation = pearly + waxy, found in skin folds + genital region

Management = curettage, cryotherapy, chemovesicants (cause tissue necrosis)

122
Q

fungal infection of keratinised tissue

Presentation

A

Dermatophytoses (ringworm)

Presentation = red, itchy, scaly, circular rash

123
Q

opportunistic* fungal skin infection

*occur in immunosuppressed patients/ if broad spectrum antibiotics used/ DM etc

agent, presentation + management

A

Mucocutaneous candida infection

agent = candida albicans

presentation = erythematous patches +/- satellite pustules, found in flexures

management = topical/ oral antifungals

124
Q

non-inflammatory superficial fungal skin infection - common on oily, sweaty skin

agent + presentation

A

Pityriasis versicolor

Agent = malassezia sp

Presentation = oval/ round patches with mild scale

125
Q

benign warty “stuck-on” growths

management

A

Seborrhoeic keratoses

Management = (generally left untreated), cryotherapy, curettage

126
Q

encapsulated lesion containing fluid/ semi-fluid material

presentation + management

A

Cyst

Presentation = firm and fluctuant, dimples when squeezed

Management = (usually none), excision
If inflamed/ infected = drainage, antibiotics, topical steroid

127
Q

benign fibrous nodules formed by fibroblast proliferation

presentation + management

A

Dermatofibroma

Presentation = tethered to skin but mobile over fat, dimples when squeezed

Management = excision if concern/ symptomatic

128
Q

benign tumour of fat cells

A

Lipoma

129
Q

asymptomatic, benign tumours derived from overgrowth of vascular cells in the skin

examples

A

Angioma

E.g. cherry angioma, spider naevi, venous lakes

130
Q

rapidly enlarging vascular growth, often at site of trauma

presentation + management

A

Pyogenic granuloma

Presentation = red, raw, bleeds easily

management = curettage

131
Q

pre-malignant rough scaly patches on sun damaged skin

management

A

Acitinic keratoses

management = curettage, cryotherapy, diclofenac gel, imiquimod cream

132
Q

melanoma cells entirely confined to the epidermis

management

A

Melanoma in situ

management = excision

133
Q

variant of squamous cell carcinoma erupting from hair follicles in sun damaged skin

management

A

Keratoacanthoma

management = surgical excision

134
Q

malignant metastases to the skin

management

A

Cutaneous metastases

management = treatment of underlying malignancy, excision, localised radiotherapy, symptomatic treatment

135
Q

tender red nodules found on the shins in IBD

A

Erythema nodosum

136
Q

Deep ulcers, typically on the legs due to immune dysfunction

A

Pyoderma gangrenosum

137
Q

soft tissue swelling of the hands and finger clubbing seen in Grave’s disease

A

(thyroid) acropachy

138
Q

orange peel appearance and non-pitting oedema of lower legs occurring in thyroid disease

A

Pre-tibial myxoedema

139
Q

autoimmune connective tissue disorder affecting the skin

presentation

A

Cutaneous lupus

presentation = butterfly rash on face, plaques with clear margins, photosensitivity

140
Q

autoimmune rejection of hair

A

Alopecia

141
Q

autoimmune destruction of melanocytes

A

Vitiligo

142
Q

episodic flushing (without sweating) and facial telangiectasia linked to carcinoid tumours

A

Carcinoid syndrome

143
Q

Hyperpigmentation cause

A

increased ACTH

144
Q

eczematous plaque of the nipple, indicative of breast cancer

A

Paget’s disease

145
Q

eczematous plaques (often in the axilla/ anogenital areas) indicative of intraepithelial adenocarcinoma

A

Extramammary Paget’s

146
Q

autoimmune driven blistering of the skin due to underlying cancer

A

Paraneoplastic pemphigus

147
Q

acute onset of lanugo hairs due to underlying cancer

A

Acquired hypertrichosis lanuginosa

commonly colorectal, lung, breast

148
Q

concentric erythematous lesions due to underlying cancer

A

Erythema gyratum repens

commonly lung, oesophageal, breast

149
Q

symmetrical hyperkeratosis of extremities (resembling psoriasis) due to underlying adenocarcinoma

A

Basex syndrome

150
Q

acute onset of seborrhoeic keratosis due to underlying GI adenocarcinoma

A

Leser-Trelat syndrome

be suspicious in younger patients

151
Q

velvety brown/ black markings in flexures due to underlying diabetes/ gastric adenocarcinoma

A

Acanthosis nigricans

152
Q

inflammatory myopathy and rash due to underlying cancer

presentation

A

Dermatomyositis

presentation = periorbital pink/purple rash, red maculo-papules over bony prominences and upper back (shawl sign)

153
Q

Genetic disorder causing tumours to grow on nerve tissue and a predisposition to certain cancers (e.g. phaeochromocytoma, leukaemia)

A

Neurofibromatosis

presentation = neurofibromas (small rubbery tumours along nerves under skin), café au lait spots, freckles in axillae

154
Q

planto-palmar keratoderma (thickening of skin) and increased risk of oesophageal cancer

A

Howel-Evans syndrome

155
Q

Hypothermia

definition
management

A

Fall in core body temperature <35⁰C

Insulate to prevent further heat loss
Slow re-warming with blankets
Internal re-warming with hot drinks
Fast re-warming by immersion in water

156
Q

vascular and cellular response to extreme cold

A

Frostbite

157
Q

Heat exhaustion

definition + presentation

A

core body temperature 37.5 - 40⁰C

Profuse sweating (causing drop in circulating volume)
Headache 
confusion
nausea
tachycardia
weak pulse
hypotension, syncope, collapse
158
Q

Heat stroke

definition + presentation

A

core body temperature >40⁰C

Hot, dry skin (sweating ceased)
circulatory collapse

159
Q

any inflammatory disease affecting >90% of total skin surface

management

A

Erythroderma

Management:
treat cause
fluid balance, nutrition, temperature regulation50:50 emollient (liquid paraffin:white soft paraffin)
manage itch

160
Q

neurological deficit related to the spinal cord

presentation

A

Myelopathy

Presentation: UMN signs at affected lever + below, sensory deficits, bowel/bladder involvement + sexual dysfunction

161
Q

compression of a nerve root leading to dermatomal and myotomal deficit

presentation

A

Radiculopathy “pinched nerve”

presentation: LMN signs in corresponding myotome, sensory loss/pain in corresponding dermatome

162
Q

muscle weakness caused by inflammation

presentation + management

A

Inflammatory muscle diseases - e.g. polymyositis

presentation = painful weak muscles

management = high dose steroids + immunoglobulins

163
Q

genetic structural abnormalities of the contractile apparatus

A

Muscular dystrophies (e.g. Duchenne’s = absence of dystrophin)

(no treatments)

164
Q

irreversible kidney damage requiring renal replacement therapy (RRT)

indications for RRT and additional management of patients on dialysis

A

End-stage renal disease

Indications = severe/ treatment resistant…
- uraemia, acidosis, hyperkalaemia, fluid overload

management: fluid + dietary restrictions, heparin

165
Q

chronic kidney infection
(scarring + clubbing of calyces)

diagnosis

A

Chronic pyelonephritis

diagnosis = radiology

166
Q

kidney damage due to reflux of urine

diagnosis + management

A

Reflex nephropathy

diagnosis = micturating cystogram

Management = surgery

(a common cause of UTIs in children)

167
Q

reflux of urine into ureters due to ureters inserting into the bladder at an abnormally decreased angle

A

Vesicoureteric reflux

causes hydroureter + a common cause of UTIs in children

168
Q

cancer of plasma cells in bone marrow causing renal failure

A

Multiple myeloma

169
Q

vasculitis of small vessels in multiple systems (inc. kidneys causing focal necrotising glomerulonephritis)

presentation (in other systems)

A

Granulomatosis with polyangiitis (formerly Wegner’s granulomatosis)

Presentation = granulomatous inflammation in respiratory tract, arthralgia, myalgia, scleritis, fever, weight loss, vasculitic rash

170
Q

Lower urinary tract symptoms

A

Voiding/ obstructive:

  • hesitancy + poor stream
  • incomplete emptying + terminal dribbling

Storage/ irritative:

  • frequency
  • nocturia
  • urgency + urge incontinence
171
Q

cancer of transitional epithelium of the urinary tract

A

Urothelial cancer

172
Q

painful inability to void with a palpable and percussible bladder

management

A

Acute urinary retention

management = immediate urethral/ suprapubic catheterisation

173
Q

decreased ADH secretion (central) or sensitivity to ADH (peripheral)

presentation + management

A

Diabetes insipidus

Presentation = polydipsia, polyuria

Management:
central = ADH supplementation
peripheral = underlying cause (hypercalcaemia/ hypokalaemia)

174
Q

Management of hyperkalaemia

A

Calcium gluconate (stabilises myocardium)
Anion exchange resins (e.g. calcium resonium)
Salbutamol, insulin-dextrose (shift K intracellularly)
Diuresis
Dialysis

175
Q

Benign inflammatory growths in the nasal cavity

presentation, diagnosis + management

A

Nasal polyps

Presentation = pale

Diagnosis = Coronal CT, nasoendoscopy

Management = steroidal nasal sprays, polypectomy (gives nasal spray better access)

(strong association with asthma)

176
Q

management of epistaxis

A

anterior/ posterior nasal packing

Surgical management:

  • artery ligation
  • septodermoplasty (septal mucous membrane replaced)
  • embolization (material injected to block blood supply)
177
Q

Long/far sightedness

can’t see close objects well

A

Hyperopia
(eyeball to short/refractive power too weak - presbyopia)

presentation: convergent squint, eye strain after reading
management: biconvex (+ve power) lenses, laser eye surgery

178
Q

Inflammation of iris +/- ciliary body

presentation, diagnosis + management

A

Acute anterior uveitis

Presentation = pain, photophobia, red eye, small irregular pupil

diagnosis = slit light examination

management = topical steroids, dilating drops, oral analgesia

179
Q

Infection of orbital tissues

presentation, diagnosis, management + complications

A

Orbital cellulitis

presentation = pain, reduced eye movement, pyrexia, proptosis

diagnosis = CT

management = admit urgently, IV antibiotics

complications = cavernous sinus thrombosis/ orbital abscess

180
Q

self-limiting (bacterial/viral) infection + inflammation of the conjunctivae

presentation + management)

A

Infective conjunctivitis

presentation: red eyes, discharge (sticky=viral, gritty=bacterial)
management: antibiotic eye-drops (usually resolves spontaneously)

181
Q

central retinal artery occlusion

cause, diagnosis + presentation

A

(ischaemia –> loss of photoreceptor function)

cause: embolus (most commonly)
diagnosis: fluorescein angiography
presentation: complete, sudden loss of vision in affected eye

182
Q

central retinal vein occlusion

presentation, diagnosis + management

A

(blood seeps out into retina –> damages photoreceptors)

presentation: complete, sudden loss of vision
diagnosis: fluorescein angiography
management: intravitreal anti-vegf

183
Q

damage to the optic nerve as a result of insufficient blood supply due to atheroma

presentation + diagnosis

A

non-arteritic anterior ischaemic optic neuropathy

presentation: painless, visual field defect
diagnosis: fluorescein angiography

184
Q

damage to the optic nerve as a result of insufficient blood supply due to giant cell arteritis

(presentation, diagnosis + management)

A

arteritic anterior ischaemic optic neuropathy

presentation: complete sudden loss of vision, (+ other giant cell arteritis symptoms e.g. headache, pain on chewing, tenderness over superficial temporal arteries)
diagnosis: inflammatory markers, fluorescein angiography
management: high dose IV steroids

185
Q

stabbing face pain caused by the trigeminal nerve (mostly V2 + V3)

triggers, presentation + prophylaxis

A

Trigeminal neuralgia

triggers: wind, cold, touch, chewing
presentation: 3-200 attacks of 5-10 seconds per day, autonomic features uncommon
prophylaxis: carbamazepine (no abortive treatment)

186
Q

stabbing face pain caused by the trigeminal nerve (mostly V1)

triggers, presentation + prophylaxis

A

SUNCT (Short-lasting Unilateral Neuralgiform-headache w/ Conjunctival-injection + Tearing)

triggers: wind, cold, touch, chewing
presentation: 3-200 attacks of 10secs-4mins per day, autonomic features: eye-redness, lacrimation
prophylaxis: carbamazepine (no abortive treatment)

187
Q

high intensity headache peaking instantaneously (in < 1 minute)

A

Thunderclap headache

often due to SAH

188
Q

neither communicating or non-communicating hydrocephalus

presentation, diagnosis, management

A

Normal pressure hydrocephalus

presentation: urinary incontinence, gait disturbance, rapidly progressive dementia
diagnosis: LP = normal opening pressure
management: ventriculo-peritoneal shunt placement (symptoms improve w/ CSF removal)

189
Q

insufficient blood supply to the spinal cord

presentation

A

Spinal stroke/infarction

presentation: back pain, paraparesis(partial paralysis of lower limbs), numbness/paraesthesia, chronic urinary retention

190
Q

acute herniation of an IV disc causing spinal cord/root compression

presentation + management

A

Disc prolapse

presentation: pain, myelopathy/ radiculopathy/ cauda equina syndrome
management: rehab, corticosteroid nerve-root-block-injection, discectomy

191
Q

compression of all nerve roots in the lumbar spine (often due to lumbar disc prolapse)

presentation + management

A

Cauda equina syndrome

presentation: bilateral sciatica, saddle anaesthesia, urinary dysfunction
management: emergency lumbar discectomy

192
Q

progressive disorder of the anterior horn cell

presentation, diagnosis, management

A

Motor neuron disease

presentation: combination of UMN and LMN signs: weakness, wasting, fasciculations, brisk reflexes
no sensory involvement

diagnosis: electromyography (EMG)
management: supportive (PEG, ventilation, PT, OT, SALT), Riluzole

193
Q

skin condition consisting of itchy weals

causes, presentation, management

A

Urticaria

causes: idiopathic, infection, (rarely IgE mediated - drugs/food)
presentation: weals (central swelling surrounded by erythema), itching/burning
management: avoid triggers, oral anti-histamine, oral steroid

194
Q

a cutaneous T-cell lymphoma (abnormal neoplastic proliferation of lymphocytes in the skin) affecting skin of the entire body

presentation + diagnosis + management

A

Sezary syndrome

presentation: thickened scaly red skin, itch++, lymph node involvement
diagnosis: sezary cells in blood
management: topical steroids, photochemotherapy, radiotherapy, chemotherapy, extracorporeal photopheresis, bone marrow transplantation (same as mycosis fungoides)

195
Q

lens opacification

presentation + management

A

Cataract

presentation = gradual loss of vision, dazzle/glare by bright lights

management = cataract surgery (lens is removed by phacoemulsification and replaced with a plastic lens)

196
Q

Short/near sightedness
(can’t see distant objects well)

presentation + management

A

Myopia
(eyeball too long/ refractive power to strong)

Presentation: divergent squint, headaches

Management: biconcave (-ve power) lenses, laser eye surgery (to flatten cornea)

x2 - Second Year Misc. (4 decks)

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