year 2 more passmed Flashcards
first line investigation for a suspected osteoporotic vertebral fracture
x-ray
what is the electrolyte abnormality in cushings
hypokalaemia metabolic acidosis
how is treatment for addisons changed when the patient is systemically unwell
double the hydrocortisone dose, keep the same fludrocortisone doe
which drugs increase the risk of osteonecrosis
steroids
what do you think when a diabetic patient presents with erratic blood glucose control, vomiting and bloating
gastroparesis
drug treatment for parathyroid adenoma
cinacalcet
which thyroid cancer spreads mainly by blood
follicular
which type of thyroid cancer cannot be determined if its malignant or not by fine needle aspiration cytology
follicular
visual field defect with a pituitary tumour
optic chiasm compression
what bacteria causes necrotising fasciitis
panton valentine leukocidin
first line investigation for bile coloured vomit in babies
abdo x-ray
first line investigation for pyloric stenosis in a baby
abdo ultrasound
what is toxic epidermal necrolysis
severe, acute, superficial desquamating eruption often secondary to a drug
what is neurogenic pruritus
caused by an effect on the central nervous system receptors such as renal or liver failure, thyroid disease or in association with malignancy
absent red reflexes
cataracts
painful loss of central vision, large haemorrhage in the fovea
wet ARMD
what is a diagnostic sign of proliferative diabetic retinopathy
new vessel growth at disc
wrist drop is a response to damage of what nerve
radial
claw hand is a response to damage of what nerve
ulnar nerve
what pathway is responsible for ketone development in states of insulin depletion
lipolysis
function of melanocytes
DNA protection from ultraviolet irradiation
which hormone triggers ovulation
LH
what bacteria is croup caused by
para-influenzae virus
if someone presents with a non-blanching rash, headache, neck stiffness and a strong bounding pulse, what type of shock is this
septic
what type of hearing loss can congenital cytomegalovirus cause
sensorineural
what is finkelsteins test for
de quervains tensosynovitis
what is renal artery stenosis characterised by
refractory hypertension and worsening renal function after being started on an ARB or and ACEi
what is a contraindication for renal transplant
metastatic active cancer
what drugs should be stopped in AKI
- NSAIDS
- metformin
- ACEis
- gentamicin
- ARBs
- lithium
- digoxin
what are the indications for dialysis
Acidosis (severe metabolic acidosis with pH of less than 7.20)
Electrolyte imbalance (persistent hyperkalaemia of more than 7 mM
Intoxication (poisoning)
Oedema (refractory pulmonary oedema)
Uraemia (encephalopathy or pericarditis).
AEIOU
classic presentation of acute interstitial nephritis
- white cell casts are seen
- triggered by meds (antibiotics)
- non-oliguric
- rash
- fever
- eosinophilia
presentation of pyelonephritis
symptoms of lower UTI
- dysuria
- polyuria
- frequency
- chills
- fever
- flank pain
what does chronic kidney disease look like on USS
bilateral shrunken kidneys
treatment of refractory hyperkalaemia (hyperkalaemia that won’t go away)
haemofiltration
what can high levels of urea (ureamia) cause
- nausea
- vomiting
- confusion
- seizures
- coma
what is an indication for renal biopsy
proteinuria and haematuria (with casts) on urine microscopy
what is the commonest cause of peritoneal dialysis peritonitis
staph epidermis
when should you start dialysis in diabetic patients
when eGFR is less than 10 or 15
what does muddy brown casts in urine mean
acute tubular necrosis
what is used as a vitamin D supplement in end stage renal disease
alfacalcidol
what causes hypercoagulation in nephrotic syndrome
loss of antithrombin III and plasminogen via the kidneys
how can alcohol bingeing lead to polyuria
ADH suppression in the posterior pituitary gland leading to polyuria
what diuretics act on the proximal convoluted tubule
carbonic anhydrase inhibitor
treatment for anaemia in CKD
start oral iron replacement
-after this you can start erythropoietin
what does high phosphate levels in CKD cause
osteomalacia
management of CKD-mineral bone disease
low calcium high phosphate
low phosphate diet at first
what does a rise in urea but not creatinine indicate
dehydration
best screening for adult polycystic kidney disease
ultrasound
what acid-base disturbance does diarrhoea cause
normal anion gap metabolic acidosis
what acid-base disturbance does addisons cause
metabolic acidosis with normal anion gap
what does sepsis cause in terms of acid-base distribution
metabolic acidosis with raised anion gap
which diuretic for ascites
aldosterone antagonists
what is the commonest extra-renal manifestation of ADPKD
liver cysts
what does widespread effacement of foot processes indicate
minimal change GN
what does myeloma usually present with
anaemia, hypercalcaemia, bone pain, and AKI.
first line treatment for blepharitis
- hot compress
- mechanical removal of lid debris
- vesicular rash around the eye, which may or may not involve the actual eye itself
- Hutchinson’s sign: rash on the tip or side of the nose. Indicates nasociliary involvement and is a strong risk factor for ocular involvement
what do these indicate
ocular involvement of shingles
-herpes zoster opthalmicus
which eye condition is ankylosing spondylitis associated with
anterior uveitis
