Year 2 Passmed Mix Flashcards
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
what pathology is seen in the thyroid gland in hashimotos thyroiditis (hypothyroidism)?
lymphocytic infiltration of the thyroid gland and formation of germinal centres
what is de quervains thyroiditis?
subacute thyroiditis
patient may initially have hyperthyroidism then progress to hypothyroid
what pathology occurs in de quervains thyroiditis?
disruption of thyroid follicles with patchy inflammatory infiltrate and some follicles containing multinucleated giant cells
hashimotos thyroiditis is associated with which genotype?
HLA DR3 and HLA DR4
what biochemistry would be seen in addisons disease?
low sodium
high potassium
what is a boxer’s fracture?
minimally displaced fracture of the 5th metacarpal
describe type 1 skeletal muscle
slow conduction red in colour (due to presence of myoglobin) main function = prolonged contraction fuel = triglycerides dense with mitochondria
describe type 2 mitochondria
fast conduction white (due to absence of myoglobin) main function = short, sudden movement fuel = ATP Thinly dispersed mitochondria
from which structure does the long head of the triceps arise?
infraglenoid tubercle
what nerve innervates the triceps?
radial nerve
what nerves innervate the knee?
femoral
common fibular and tibial branches off the sciatic
obturator (allows for referred pain from the hip)
what arteries supply the knee?
genicular branches of femoral artery
anterior tibial artery
popliteal artery
pneumonic for the carpal bones?
Some Lovers Try Positions That They Cannot Handle Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezioid Capitate Hamate
injury to what nerve can cause a positive trendelenberg gait?
superior gluteal nerve
innervates gluteus medius which is responsible for thigh abduction
injury to what nerve causes foot drop?
common fibular
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
give 4 common side effects of denosumab
osteonecrosis of the jaw
diarrhoea
hypocalaemia
dyspnoea
give 4 common features of ehlers danlos syndrome
joint hypermobility
flexible skin
easy bruising
heart valve problems
patients with ehlers danlos syndrome are prone to what?
subarachnoid haemorrhage (due to rupture of a berry aneurysm in cerebral circulation)
rheumatoid arthritis can cause what respiratory disease?
pulmonary fibrosis
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
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
name a risk factor which causes elevated serum urate and can lead to gout?
chronic haemolytic anaemia
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
