Year 2 Passmed Mix Flashcards by Joanne McEwan

what type of drug is octreotide and what is it used to treat?

somatostatin analogue
used to treat acromegaly
- somatostatin directly inhibits growth hormone release

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what pathology is seen in the thyroid gland in hashimotos thyroiditis (hypothyroidism)?

lymphocytic infiltration of the thyroid gland and formation of germinal centres

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what is de quervains thyroiditis?

subacute thyroiditis

patient may initially have hyperthyroidism then progress to hypothyroid

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what pathology occurs in de quervains thyroiditis?

disruption of thyroid follicles with patchy inflammatory infiltrate and some follicles containing multinucleated giant cells

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hashimotos thyroiditis is associated with which genotype?

HLA DR3 and HLA DR4

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what biochemistry would be seen in addisons disease?

low sodium

high potassium

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what is a boxer’s fracture?

minimally displaced fracture of the 5th metacarpal

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describe type 1 skeletal muscle

slow conduction
red in colour (due to presence of myoglobin)
main function = prolonged contraction
fuel = triglycerides
dense with mitochondria

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describe type 2 mitochondria

fast conduction
white (due to absence of myoglobin)
main function = short, sudden movement
fuel = ATP
Thinly dispersed mitochondria

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from which structure does the long head of the triceps arise?

infraglenoid tubercle

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what nerve innervates the triceps?

radial nerve

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what nerves innervate the knee?

femoral
common fibular and tibial branches off the sciatic
obturator (allows for referred pain from the hip)

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what arteries supply the knee?

genicular branches of femoral artery
anterior tibial artery
popliteal artery

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pneumonic for the carpal bones?

Some Lovers Try Positions That They Cannot Handle
Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezioid
Capitate
Hamate

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injury to what nerve can cause a positive trendelenberg gait?

superior gluteal nerve

innervates gluteus medius which is responsible for thigh abduction

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injury to what nerve causes foot drop?

common fibular

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what is denosumab and how is it given?

RANKL antagonist used to treat osteoporosis (not first line)

given as either a 6 monthly or 4 weekly subcutaneous injection

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give 4 common side effects of denosumab

osteonecrosis of the jaw
diarrhoea
hypocalaemia
dyspnoea

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give 4 common features of ehlers danlos syndrome

joint hypermobility
flexible skin
easy bruising
heart valve problems

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patients with ehlers danlos syndrome are prone to what?

subarachnoid haemorrhage (due to rupture of a berry aneurysm in cerebral circulation)

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rheumatoid arthritis can cause what respiratory disease?

pulmonary fibrosis

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how may a vitreous haemorrhage present?

arc of white light and cobwebs in vision with movement of the eye
reduced visual acuity
vie of the fundus blocked by grey and red matter on fundoscopy

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what scan is performed in suspected vitreous haemorrhage and why?

US
all vitreous haemorrhage is retinal detachment until proven otherwise
- US can exclude retinal detachment

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name a risk factor which causes elevated serum urate and can lead to gout?

chronic haemolytic anaemia

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where do salivary stones usually occur and how does this present?

submandibular gland intermittent painful swelling below the jaw worse on eating

how are salivary stones diagnosed?

sialogram

how does optic neuritis present?

``` painful loss of vision over few hours reduction in acuity loss of colour vision Pain worse on movement RAPD ```

MS can cause optic neuritis, how can this be confirmed?

normal optic discs on fundoscopy white matter lesions/plaques on MRI oligoclonal bands on lumbar puncture and CSF

giant cell arteritis is associated with what eye condition and how does this present?

anterior ischaemic optic neuropathy (AION) | RAPD and reduction in visual acuity

MS causes what other disease as well as optic neuritis?

internuclear opthalmoplegia

how can myasthenia gravis affect the eyes?

variable diplopia or ptosis

describe the general nerve supply to the larynx?

innervation to larynx and trachea below the vocal folds = recurrent laryngeal all muscles of the larynx except cricothyroid = recurrent laryngeal superior laryngeal pierces the thyrohyoid membrane and branches into an external laryngeal branch supplying the cricothyroid and an internal laryngeal branch supplying larynx above the vocal cords

what medication can be used for a prolactinoma and why?

dopamine agonist (e.g bromocriptine, cabergoline)

how does seborrhoeic dermatitis generally present?

fine greasy scales | itchy, ill-defined, pruritic, erythematous rash involving scalp, nasolabial folds or post auricular skin

in which direction is the leg rotated in a hip fracture?

externally

what causes an internally rotated femur?

posterior dislocation of the hip

how does the leg appear in a hip fracture?

shortened and externally rotated

what is an intracapsular femoral fracture?

occurs between the edge of the femoral head and the insertion of the capsule of the hip joint

what are the 2 types of extracapsular femoral fractures and what separates them?

``` trochanteric = above the lesser trochanter subtrochanteric = below the lesser trochanter ```

what are the components of the garden classification of hip fractures?

``` 1 = stable fracture with impaction in valgus 2 = completed fracture, but undisplaced 3 = displaced fracture, usually displaced and angulated but still has bony contact 4 = complete bony disruption ```

blood supply is most commonly disrupted in what types of hip fracture?

garden types 3 and 4

how is an undisplaced intracapsular hip fracture managed?

if fit = internal fixation | unfit = hemiarthroplasty

how is a displaced intracapsular fracture managed?

young and fit = ORIF | older/unfit = hemiarthroplasty or total hip replacement

how is an extracapsular hip fracture managed?

dynamic hip screw | if transverse, oblique or subtrochanteric = intramedullary device

which nerves innervate each of the 3 leg compartments?

``` anterior = deep fibular lateral = superficial fibular posterior = tibial ```

how does phaeochromocytoma affect BP and blood glucose?

hypertension | hyperglycaemia

what causes familial phaeochromocytomas?

usually MEN2

how is phaeochromocytoma managed?

alpha then beta blockade fluids adrenalectomy

neutrophil infiltration of the stratum corneum is classically seen in which skin condition?

psoriasis

na,e a common cause of secondary SIADH?

paraneoplastic syndrome due to small cell lung carcinoma

how does SIADH cause low sodium?

increased resorption of water in the kidneys via insertion of aquaporin 2

what type of hormone is insulin?

protein

what areas are supplied by the posterior tibial artery?

posterior leg | plantar surface of foot

describe the path of the posterior tibial artery?

originates from popliteal artery (larger terminal branch) | terminates by dividing into medial and lateral plantar arteries

why are measurements of GNRH not useful in investigation of growth hormone deficiency and what is measured instead?

growth hormone releasing hormone (GNRH) is released in a pulsatile manner

what is tinea and what are the 3 main types?

term used for dermatophyte fungal infections - tinea capitis = scalp - tinea corporis = trunk, legs or arms - tinea pedis = feet

most common cause of tinea capitis?

trichophyton tonsurans

how is tinea capitis managed?

``` oral antifungals (terbinafine) ketoconazole shampoo ```

2 common causes of tinea corporis?

``` trichophyton rubrum trichophyton verrucosum (from cattle) ```

how is tinea corporis managed?

oral fluconazole

what colour does trichophyton fluoresce under woods lamp?

none | does not fluoresce under woods lamp

2 functions of biceps brachii?

elbow flexion | supination

what nerve supplies the lateral foot?

sural nerve

what nerve supplies the sole of the foot?

branches of tibial nerve - medial calcaneal - medial and lateral plantar nerves

what nerve supplies the dorsum of the foot?

mostly the superficial fibular nerve

what nerve supplies the web space between the 1st and 2nd toes?

deep fibular nerve

what nerve innervates the interossei and what do they do?

ulnar 3 palmar interossei = adduct the fingers 3 dorsal = abduct the fingers PAD and DAB

what is the function of the lumbricals?

flex MCP joints | extend IPJs

what nerves innervate the lumbricals?

1st and 2nd = median nerve | 3rd and 4th = deep branch of ulnar nerve

what ligament separates the IV discs from the spinal cord?

posterior longitudinal ligament

what does leptin do?

produced by adipose tissue and acts on satiety centres in the hypothalamus and decreases appetite