Starting again :( Flashcards
MMSE score indicating cognitive decline
<27
toxoplasmosis symptoms
parasitic
headache
focal neuro deficit
confusion
seizures
behaviour change
toxoplasmosis signs
ring-enhancing lesions in the basal ganglia, frontal lobe and parietal lobe.
toxoplasmosis investigations
CSF immunofluorescence
CT/MRI
Friedreich’s ataxia
autosomal recessive
GAA repeat on frataxin gene
neurodegenerative
10-20 yo
Friedreich’s ataxia symptoms
ataxia
weakness
falls
sensory symptoms
high arch of foot/palate
visual, cardio, diabetes T1, deafness
alzheimers meds mild- moderate
drug class
rivastigamine
galantamine
donpezil
cholinesterase inhibitors
alzheimers severe medication and drug class
NMDA inhibitor (receptor of glutamate)
memantine
severe dementia score
<10
moderate dementia score
10-20
Pneumocystis jiroveci
HIV
Mycobacterium tuberculosis
alcoholics
young
Legionella pneumophila
CAP
low serum Na
lyme disease organism
how spread
Borrelia burgdorferi
woods
spread by ticks
lyme disease symptoms
Erythema chronicum migrans rash - centre red then ring of red outside it
flu
late- neuro, arthritis, cardio symptoms
lyme disease investigations
serology as can’t be cultured
lyme disease treatment
removal of tick
doxyclycline if symptoms
3 weeks
Myasthenia Gravis symptoms
eyes- diplopia, ptosis
limb weakness
speech/swallow
Lambert-Eaton syndrome vs Myasthenia Gravis
LES weakness comes and goes
better with exercise
prophylaxis for chemo
allopurinol for hyperuricaemia
furosomide side effect
postural hypotension
which meds can make parkinsons worse
haloperidol- antipsycotic
metoclopramide
side effects of l dopa
postural hypotension
nausea and vomiting- domperidone
parkinsons drugs other than l dopa
dopamine agonists
MAO- B inhibitors
COMT ihibitors
Amantadine- dyskinesia
dopamine agonists
Ropinirole
rotigotine
Apomorphine
MAO-B Inhibitors
-giline
used with levodopa later
COMT Inhibitors
-capone
extend levodopa
bishop score
used to see if spontaneous vs induction of labour
5 or less - induction
fibroids in pregnancy
abdo pain
vomiting
supportive treatment
Parkinson-plus syndromes
lewy body
cortico basal degeneration
multiple system atrophy
progressive supranuclear palsy
progressive supranuclear palsy
Parkinisonism and vertical gaze palsy
cognitive
postural instability
Parkinisonism
triad of resting tremor, hypertonia, and bradykinesia
multiple system atrophy
postural hypotension, incontinence, and impotence
parkinisonism
cortico basal degeneration
parkinisonism
spontaneous activity of affected limb
OR
rigidity of limb
lewy body
parkinisonism
fluctuations of cognitive impairment
visual hallucinations
Delayed puberty
no period and secondary sexual characteristics by 13
or
no period but normal secondary sexual characteristics by 15.
Hyperemesis gravidarum
severe nausea and vomiting before 20 weeks
can have some blood in vomit
needs admission
Hyperemesis gravidarum treatment
fluids
potassium chloride
cyclizine - 1rst line
ondansetron
metoclopramide- 2nd line
thiamine and folic acid
how to treat mania in bipolar
quetiapine
olanzapine
risperidone
haliperidol
Gonorrhoea infection
pus oozing from his urethra
dysuria- painful urination
Gonorrhoea investigation
NAAT- nucleic acid amplification
Gonorrhoea management
Ceftriaxone
whooping cough treatment
clarithromycin
motor neurone disease medication and what does it do
riluzole
extends life for 3 months
shingles presentation
blisters in dermatomal distribution
fever
first line for delirium
haloperidol and fast acting and short half life
quetiapine if parkinsons
rhesus negative in pregnancy management
anti d at 28 weeks
1 dose 1500IU
gas gangrene
Clostridium perfringens
penicillin and clindamycin with surgical debridement
active PID and contraception
no IUD or IUS
when to do induction of labour
41-42 weeks
induction of labour method
membrane sweep - finger put in cervix
after 1-2 days then try again
then prostaglandin pessary
Staphylococcal scalded skin syndrome (SSSS) symptoms and signs
fluid-filled blisters
crusting
+ve nikolsky sign (skin peeling off)
fever
Pemphigus vulgaris
fluid filled blisters
+ve nikolsky sign
mucous membranes
Staphylococcal scalded skin syndrome (SSSS) treatment
IV flucloxacillin
Cellulitis
infection of the dermis and subcutaneous tissue.
Erysipelas
infection of the dermis and upper subcutaneous tissue
Erysipelas symptoms and signs, organism
butterfly rash on cheeks and nose
strep - alpha beta haemolytic
Erysipelas and cellulitis treatment
flucloxacillin + benzylpenicillin severe
flucloxacillin mild-moderate
penicillin allergy then clarithromycin- cellulitis
erythromycin - erysipelas
Phyllodes tumour
interlobular stroma
smooth rapid growing mobile mass
abnormal stroma
ductal cancer on mammography
micro calcifications
when should gestational diabetic mums give birth by
40+6 weeks
side effct of lamotrigine for epilepsy
Stevens-Johnson syndrome
Large blistering rash throughout the body
withdrawl of opiods
herion
GI upset
tachy
hypertension
alcohol withdrawls
GI
sweating
insomnia
irritablity
hallucinations
tremors
Myotonic Dystrophy
Trinucleotide repeat expansion
DMPK gene
Autosomal Dominant
Myotonic Dystrophy symtoms
top to bottom
frontal balding
long face
neck muscle wasting
weak hands
unable to release grip on shaking hand
haemophillia B
X linked recessive
factor 9
haemophillia A
factor 8
X linked recessive
treatment of minor bleeds in haemophilia A and mechanism of action
desmopressin
Releases von Willebrand factor from its storage sites in endothelial cells
ciprofloaxin side effect
can induce seizures
most common ovarian tumour
epithelial
but most common in post menopausal
Germ cell ovarian tumour
younger women
can feel mass- risk of torsion
Osteomyelitis signs
diabeties high risk
MRI- periosteal elevation of bone
staph aures
gram +ve
staph
strep
gram +ve clusters
staph
gram +ve chains
strep
alpha hamolysis
strep pneumoniae and viridans
beta haemolysis
strep pyogens
polycythaemia rubra vera
JAK 2
raised cell mass
high Hb and platelets
low serum erythropoetin
splenomegly
secondary causes of polycythaemia rubra vera
COPD
Erb’s palsy cause
damage of the brachial plexus
Erb’s palsy symptoms signs
babies with shoulder dystocia
limp upper limb, flexed wrist and fingers
waiters tip
Shoulder dystocia treatment
McRobert’s manoeuvre
flexing the mother’s thighs towards her shoulders while lying supine
CAP causes
Streptococcus pneumoniae
Haemophilus influenzae
Myelodysplastic Syndrome (MDS) what is and RF
group of bone marrow disorders
ineffective haematopoiesis
chemo and radio- RF
blood film features of Myelodysplastic Syndrome
nucleated RBCs
Howell-Jolly bodies
large agranular platelets
megakaryocytes,
ringed sideroblasts
hypolobulated or unlobulated neutrophil nuclei
basophilic stippling
Myelodysplastic Syndrome treatment
blood transfusions
stem cell transplant
Aplastic Anaemia vs myelodysplastic syndrome
both have pancytopenia
but MDS has more specific bloods
leukaemia vs aplastic anemia
both have pancytopenia but leukaemia has high WBC
Tuberculosis (TB) Meningitis signs and symptoms
headache
fever
cough
haemoptysis
lesions seen on CT
Cryptococcal meningoencephalitis
most common in immunocomprimised, HIV
abducens nerve palsy
slightly elevated protein, lymphocytes
what test don’t you do when have catheter
urinanysis as will already have bacteria
muscles for flexion of hip
iliopsoas
psoas major
rectus femoris
what innervates first web space
deep fibular nerve
midshaft fracture of humerus
radial nerve
posterior forearm paresis
can’t extend wrist
surgical neck of humerus fracture
axillary nerve
abduction
deltoid muscle
what do you go through on laminectomy
ligamentum flavum
laminectomy
removal of vertebral bone
inversion injury to ankle affects
anterior tibiofibular lig
sciatica sign
decreased plantar flexion
cubital tunnel
wasting muscle between metacarples
flattening of anteromedial border of forearm
ulnar nerve
foot drop
neck of fibula fracture
spinothalamic tract
sensory - from skin to somatosensory
nociceptive- pain
temperature
crude touch- can feel touch but don’ t know where
pressure
dorsal column
fine touch - feel and localise
2 point discrimination - can feel 2 close areas
proprioception - ability to sense mov and location
vibration
lateral corticospinal tract
voluntary mov of limbs
Ventral corticospinal tract
controls proximal muscles like trunk
rubrospinal tract
flexor muscles
Pontine reticulospinal tract
locomotion - change positon like running, walking, swimming
postural control.
Medullary reticulospinal tract
locomotion
reaching
posture
Tectospinal tract
reflexes
Medial longitudinal fasciculus
eye mov and reflexes
Lateral vestibulospinal tract
posture and balance
