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Phase 2a flashcards (Alec's) > Stuff I can never remember > Flashcards

Stuff I can never remember Flashcards

1
Q

Where are Fe, B12 and folate absorbed in the gut?

A

Iron first bro
So Fe in duodenum, folate in jejunum and B12 in ileum (terminal)

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2
Q

What is the acronym for crohns and what does it stand for?

A
  • No blood or mucous
  • Entire GI tract
  • Skip lesions on endoscopy
  • Terminal ileum + transmural inflammation
  • Smoking (sets the nest on fire)
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3
Q

What is the acronym for UC and what does it stand for?

A
  • Continuous inflammation
  • Limited to colon and rectum
  • Only superficial mucosa
  • Smoking is protective
  • Excrete blood and mucous
  • Use aminosalicylates
  • Primary sclerosing cholangitis
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4
Q

How is a remission of Crohns induced?

A

First line = steroids (oral prednisolone/ IV hydrocortisone)

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5
Q

How is remission of Crohns maintained?

A

Azathioprine (only if needed/ wanted)

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6
Q

How is remission induced in mild/ moderate UC?

A
  • First = aminosalicylate
  • Second = steroids
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7
Q

How is remission induced in severe UC?

A
  • First = steroids (IV)
  • Second = ciclosporin
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8
Q

How is remission of UC maintained?

A
  • Aminosalicylate
  • Azathioprine
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9
Q

Give an example of an aminosalicylate?

A
  • Mesalazine
  • Sulphasalazine
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10
Q

Side effects of steroids acronym and meaning?

A
  • Cataracts
  • Ulcers
  • Striae/ skin thinning
  • Hypertension/ hirsutism
  • Immunosurpression
  • Necrosis of femoral heads
  • Glucose elevation
  • Osteoporosis
  • Impaired wound healing
  • Depression/ mood changes/ diabetes
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11
Q

Where are muscarinic receptors 1, 2 and 3 found?

A
  • 1 = Brain
  • 2 = Heart
  • 3 = Lungs
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12
Q

Where are adrenergic receptors found?

A
  • Alpha 1 = vessels + sphincters (e.g. bladder)
  • Alpha 2 = smooth muscle (mixed effects)
  • Beta 1 = heart
  • Beta 2 = lungs
  • Beta 3 = adipose (cause lipolysis), bladder relaxation
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13
Q

What is the pre and post synaptic connections in parasympathetic neurones?

A
  • Pre = nicotinic receptor
  • Post = muscarinic receptor
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14
Q

What is the pre and post synaptic connections in sympathetic neurones?

A
  • Pre = nicotinic
  • Post = adrenergic receptor (except sweat glands = muscarinic receptor)
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15
Q

What is the pre and post synaptic connections in motor neurones?

A

NO pre synaptic
@ muscle = nicotinic receptor

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16
Q

What is the medication order for diabetes type 2?

A
  • First = metformin
  • Second/ third = sulfonylurea, pioglitazone, DPP-4 inhibitor, SGLT-2 inhibitor
  • Then … insulin
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17
Q

What are some side effects of metformin?

A
  • Lactic acidosis
  • GI symptoms
    Does not cause hypoglycaemia
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18
Q

Which diabetes medication increases glucose excretion in the urine?

A

SGLT-2 inhibitors (therefore increases the risk of UTIs)

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19
Q

What are the function of the first 6 interleukins?

A

Hot T-Bone** stEAK
* 1 = hot (fever)
* 2 = T cell stimulation
* 3 = bone marrow stimulation
* 4 = IgE production, B cell growth
* 5 = IgA production, eosinophils
* 6 = aKute inflammation

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20
Q

What are the 3 types of T cells?

A
  • T - cytotoxic (CD8), interact with MHC1
  • T - helper (CD4), interact with MHC2
    Helper 1 = help cytotoxic T cells
    Helper 2 = help B cells
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21
Q

What is the acronym for myeloma and what does it stand for?

A
  • OLD people
  • Calcium (high)
  • Renal failure
  • Anaemia
  • Bone lesions/ pain
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22
Q

What feature is diagnostic of myeloma?

A

Bence jones proteins in urine

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23
Q

What are the two precursors of myeloma called?

A

Smouldering myeloma … then … MGUS (monoclonal gammopathy of undetermined significance)

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24
Q

What is smouldering myeloma with lots of IgM specifically called?

A

Waldenstroms macroglobulinaemia

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25
Q

What blood cancer causes gum infiltration?

A

AML

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26
Q

What is the key diagnostic feature in each blood cancer?

A
  • AML = Auer rods
  • CML = Philadelphia chromosome
  • ALL = nothing really
  • CLL = smudge cells
  • Hodgkins lymphoma = reed Sternberg cells
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27
Q

What can CML and CLL progress to?

A
  • CML –> AML
  • CLL –> richter transformation to aggressive lymphoma
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28
Q

What ages are the leukaemia most common and which ones are most common in certain age groups?

A
  • ALL = in kids
  • AML, CML = in adults
  • CLL = older people, most common OVERALL
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29
Q

Where does an atherosclerotic plaque form, and what is in it?

A

Intima/ media
* Lipids
* Smooth muscle
* Macrophages
* Foam cells
* Platelets
* Firboblasts

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30
Q

What are the stages of an atherosclerotic plaque formation?

A
  1. Fatty streak
  2. Lipid accumulation
  3. Platelet aggregation
  4. Fibrin mesh + RBC trapping
  5. Fibrous cap
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31
Q

Functions/ features of the immunoglobulins?

A
  • G = most common in blood, can cross the placenta
  • A = most common in body, found in mucosa
  • M = acute, faster acting than G
  • E = allergic responce, histamine release, parasite protection
  • D = basophil activation, parasite defence?
32
Q

Cancer of smooth and striated muscle names?

A
  • Smooth = leiomyoma/ sarcoma
  • Striated = rhabdomyoma/sarcoma
33
Q

What are the symptoms of brown sequards syndrome and what tracts are involved?

A
  • Ipsilateral = weakness, proprioception, vibration and fine touch (DCML and corticospinal)
  • Contralateral = pain + temperature (spinothalamic)
34
Q

Where does DCML and spinothalamic decussate?

A
  • DCML = medulla oblongata
  • Spinothalamic = after entering spinal cord
35
Q

Causes of hyperthyroidism?

A
  • Graves disease
  • Inflammation (thyroiditis)
  • Toxic multinodular goitre
  • Solitary toxic thyroid nodule
36
Q

What are 2 causes of thyroiditis?

A
  • De Quervain’s (after infection)
  • Hashimotos (autoimmune)
37
Q

Genes associated with key diseases (HLA ones)?

A
  • HLA-B27 = Seronegative arthropathies, IBD
  • HLA-DR2 = SLE
  • HLA-DR3 = autoimmune hepatitis, sjogrens, DMT1, SLE
  • HLA-DR4 = RA, DMT1
  • HLA-DQ2, DQ8 = coeliacs, DMT1
38
Q

Medications used for parkinsons disease?

A
  • Levodopa = for severe disease
  • Dopamine agonists e.g. bromocryptine
  • MOA-B inhibitors e.g. selegiline
39
Q

Hereditary diseases and how they are inherited?

A
  • Autosomal dominant = cardiomyopathies, colorectal cancer (FAP/ Lynch), Von hippel Lindau, hereditary spherocytosis, vWF disease, marfans, EDS, Alzheimers, frontotemporal, Huntington’s, Charcot Marie tooth,
  • Autosomal recessive = thalassaemias, sickle cell, haemochromatosis, Wilsons, Gilberts, cystic fibrosis
  • X-linked recessive = G6PDH, haemophilia, duschenne muscular dystrophy,
  • X-linked dominant = nothing
  • Co-dominant = A1ATD
40
Q

What is a tumour in the apex of the lung that causes ptosis called?

A

Pancoast tumour –> Horner syndrome

41
Q

What are the sepsis 6?

A
  1. 100% Oxygen
  2. IV fluids
  3. Blood cultures
  4. IV Abx
  5. Lactate measurement
  6. Monitor urine output
    BUFALO
42
Q

What is given for angina symptomatic relief?

A
  • CCBs
  • Beta blockers
  • GTN spray
43
Q

What are 3 locations kidney stones can become stuck?

A
  • Pelviureteric junction
  • Pelvic brim
  • Vesicoureteric junction
44
Q

Where is a biopsy taken from in coeliacs disease?

A

Duodenum

45
Q

What are the first two blood tests done to investigate coeliacs?

A
  • Total IgA
  • Tissue transglutaminase IgA
    Endomysial and IgG can be measured, but not first line
46
Q

What are the two signs for meningitis and what do they show?

A
  • Brudzinskis sign = neck flexion causes knee + hip flexion
  • Kernig sign = knee + hip flexion causes pain/ neck flexion
47
Q

What is the sign for pancreatic cancer and cholangiocarcinoma and what does it show?

A

Courvoisiers sign = painless jaundice + palpable gall bladder

48
Q

What is the triad of symptoms for gall stones and their complications?

A

Charcot triad = RUQ pain + fever + jaundice
Biliary colic –> cholecystitis –> ascending cholangitis

49
Q

What extra 2 symptoms can be added to charcots triad, what are they and what are these 5 called?

A

Reynolds pentad = charcot + hypotension + altered mental state

50
Q

What is a sign for cholecystitis?

A

Murphies = pressing in RUQ when patient breaths in causes pain

51
Q

What are 2 signs of acute pancreatitis?

A
  • Cullen sign = periumbilical bruising
  • Grey turners sign = flank bruising
52
Q

What is the sign for cardiac tamponade?

A

Becks triad = hypotension, elevated JVP, muffled heart sounds

53
Q

What are 3 signs for appendicitis?

A
  • Rosvings sign = push on LLQ causes RLQ pain
  • Psoas sign
  • Obturator sign
54
Q

What are two signs to do with the testicle?

A
  • Phren’s sign = pain relief on elevation of testicle (suggestive of epididymitis)
  • Cremesteric reflex loss = testicular torsion
55
Q

What are two signs of hypoparathyroidism/ hypocalcaemia?

A
  • Trousseau’s sign = wrist flex when BP cuff put on
  • Chvosteks sign = facial nerve spasm when CN7 tapped over parotid gland
56
Q

What is a sign suggestive of superior vena cava obstruction?

A

Pembertons sign = arms in air causes facial congestion (redness)
Can suggest lung tumour near apex of lung

57
Q

What sign is suggestive of high intracranial pressure?

A

Cushing’s reflex = bradycardia + irregular breathing + hypertension/ large pulse pressure

58
Q

What is a triad associated with meningitis?

A

Meningism triad = photophobia + neck stiffness + headache

59
Q

What triad is associated with reactive arthritis?

A

Reiters triad = cant see (conjunctivitis), cant pee (urethritis), cant climb a tree (arthritis)

60
Q

What triad is associated with MS?

A

Charcot neurological triad = nystagmus, intention tremor, staccato speech

61
Q

What two triads are associated with asthma?

A
  • Samters triad = asthma, aspirin sensitivity, nasal polyps
  • Atopic triad = asthma, eczema, rhinitis
62
Q

What triad is associated with a lung tumour near the apex?

A

Horners triad = ptosis, anhydrosis, miosis (all unilateral)
pacoast tumour

63
Q

What triad of symptoms are associated with RCC?

A

Haematuria, flank pain, palpable abdo mass

64
Q

What symptoms are associated with hypercalcaemia?

A

Stones, bones, groans, moans, thrones

65
Q

What is a sign associated with duschennes muscular dystrophy?

A

Gowers sign = difficulty getting up/ climb up legs with hands

66
Q

What are two signs associated with MS?

A
  • Lhermittes sign = electric shock like sensation with neck flexion
  • Uhthoffs phenomenon = worse after shower
67
Q

Is CT scan used in dementia diagnosis?

A

No, but lumbar puncture, MRI, MMSE, confusions assessment are.

68
Q

What test can be used to investigate ankylosing spondylitis?

A

Schober test

69
Q

How can alcohol affect bones?

A

Causes osteoporosis (not osteomalacia)

70
Q

What vasculitis is associated with pANCA and which with cANCA?

A
  • Granulomatosis with polyangitis = cANCA
  • Eosinophilic granulomatosis with polyangitis = pANCA
    pANCA is also in UC and PSC
71
Q

What deformity is associated with granulomatosis with polyangitis?

A

Saddle shaped nose

72
Q

What does pagets disease cause a raise in?

A

ALP in increased

73
Q

How is AKI staged?

A

1 to 3
* Stage 2 = creatinine 2-3 times baseline or urine <0.5 ml/kg/h for 12 or more hours or urine <0.3 ml/kg/h for 6 or more hours

74
Q

What blood marker is raised in seminoma vs teratoma?

A
  • Teratoma = alpha feto protein
  • Seminoma = beta human chorionic gonadotropin
75
Q

How is prostate cancer graded?

A

Gleason grading system

76
Q

What is the first line investigation for acromegaly?

A
  • Serum insulin like growth factor - 1
    Then OGTT
77
Q

What is the most common cause of liver cirrhosis?

A

Chronic alcohol abuse

Phase 2a flashcards (Alec's) (13 decks)

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