year 2 pastest Flashcards
what is the honeymoon period in type 1 diabetes
a time where the disease has been identified and is being treated with exogenous insulin, but there is still some residual insulin production as not all beta cells have been destroyed
patients insulin requirements are very low
which organism is most commonly found in diabetic foot ulcers
pseudomonas aeruginosa
what clinical feature is most suggestive of a diabetic neuropathy
sensory loss in stocking distribution
treatment for postural hypertension in diabetes
increasing dietary sodium chloride
HbA1c target for type 2 diabetes
48
which drugs that a diabetic patient may take is related to erectile dysfunction
beta blockers
what is a reg flag for diabetic feet (neuropathy)
pain in the foot at rest and at night
are ACE inhibitors safe in pregnancy
no
first line treatment for prolactinomas
dopamine agonist
which hormones are reduced in stress response
- insulin
- testosterone
- oestrogen
side effect of SGLT-2 inhibitors
necrotising fasciitis of the genitals
what is PTH’s role in calcium regulation
causes indirect osteoclastic activation via RANK-L
what does a positive McMurrays test suggest
meniscal tear
what diseases is pyoderma gangrenosum associated with
- HIV
- inflammatory bowel disease
- hepatitis
- haematological diseases
HIHH
where is bursa found
between the tendon and the bone and lined by the synovium
what are the two types of bursae
anatomical or adventitious
what signalling pathway does GH use
a tyrosine kinase receptor that uses the JAK/STAT pathway
what is diabetic maculopathy
when there are any features of diabetic retinopathy but existing at the macula?fovea
if a female patient has sudden onset hair growth with raised testosterone level, what is first line management
refer to endocrinology for suspected cancer
which diabetes has association with hepatocellular carcinoma
MODY 3
side effects of systemic retinoids
- teratogenic
- dry mucous membrane
- headaches
- hair thinning or loss
- should be avoided in hepatic impairment
a boy has a butterfly rash, oval white macules across his body, and a leathery plaque on his sacrum thats like orange peel
what is the diagnosis
tuberous sclerosis
what is staphylococcus scalded skin syndrome
its a result of a staphylococcus skin infection from an injury
- results in large blisters that cover most of the skin and eventually burst
- very painful
what would the diagnosis be for target-like lesions on peripheries that can eventually blister
erythema multiforme
which skin condition is hypothyroidism associated with
asteatotic eczema
are mucous membranes involved in bullous pemphigoid
no not usually
what skin condition is linked with sarcoidosis
erythema nodosum
what is lichen sclerossus
pain around vulva
itchy white patches around genitals
treatment for acne vulgaris in pregnancy
oral erythromycin
An elderly short-sighted man presents with flashing lights which are worse on eye movement and are located in the temporal visual field. He also describes some upper visual field loss ‘like a curtain coming down’
retinal detachment
An elderly man presents an acute, painful red eye associated with decreased visual acuity. His symptoms are worse in the dark. On examination he has a semi-dilated non-reacting pupil
acute angle closure glaucoma
A young man presents with an acute, painful red eye associated with photophobia and blurred vision. On examination the pupil is small and irregular
anterior uveitis
Flashes of light (photopsia) - in the peripheral field of vision
Floaters, often on the temporal side of the central vision
posterior vitreous detachment
Dense shadow that starts peripherally progresses towards the central vision
A veil or curtain over the field of vision
Straight lines appear curved
Central visual loss
retinal detachment
Large bleeds cause sudden visual loss
Moderate bleeds may be described as numerous dark spots
Small bleeds may cause floaters
vitreous haemorrhage
a woman with a history of rheumatoid arthritis presents with severe, constant pain in her right eye. On examination the right eye is red and there is a degree of photophobia. Visual acuity is normal
scleritis
a woman with a history of rheumatoid arthritis presents after developing a red right eye. There is no pain, discharge or photophobia although the eye is tearing. Visual acuity is normal
episcleritis
an elderly short-sighted man presents with a floater on the temporal field of vision. Visual acuity is normal for the patient
posterior vitreous detachment
an elderly short-sighted man presents with flashing lights which are worse on eye movement and are located in the temporal visual field. He also describes some upper visual field loss ‘like a curtain coming down’
retinal detachment
A patient presents with an acute, painful red eye associated with photophobia and epiphora. Fluorescein staining reveals a ragged area on the cornea
herpes simplex keratitis
a man who is on treatment for HIV presents with a painful, vesicular rash on the right side of his face around the eye. Fluorescein staining reveals multiple small defects on the right cornea
herpes zoster opthalmicus
A patient presents with a ‘droopy eyelid’. On examination they have unilateral miosis, ptosis and narrow palpebral aperture giving the appearance of enophthalmos
horner’s syndrome
treatment choice for moderate to severe acne rosacea
oral oxytetracycline
which drugs may aggravate psoriasis
- beta blockers
- lithium
- chloroquine
- hydroxychloroquine
- NSAIDs
- ACEis
- infliximab
treatment for acne step by step
- topical retinoids/benzoyl peroxide
- topical combination therapy (add topical antibiotic)
- oral antibiotics (tetracyclines)
- oral contraceptive for women
- oral isotretinoin
what antibiotic should be prescribed for acne vulgaris in pregnancy
erythromycin
what should always be co-prescribed with oral antibiotics in acne
topical retinoid or benzoyl peroxide
an elderly woman presents with an itchy lesion on her vulva. started as a red patch but has now turned into a white plaque
diagnosis?
lichen sclerosus
a man presents with an itchy purple papular rash on the palms and flexor surfaces of his arms, the lesions are polygonal and covered in a white lace
diagnosis?
lichen planus
what would you prescribe for seborrhoeic dermatitis on face and body
topical ketoconazole
which paraneoplastic syndrome is gastric cancer associated with
acanthosis nigricans
what drugs cause Stevens-Johnson syndrome
- penicillin
- sulphonamides
- lamotrigine, carbamazepine, phenytoin
- allopurinol
- NSAIDs
- oral contraceptive pill
most common side effect of isotretinoin
dry skin, eyes and lips/mouth
raised papules on trunk and limbs in a teenager after having a sore throat is most likely to be what
guttate psoriasis
can type 2 diabetes cause acanthosis nigricans
yes
coeliac disease with itchy skin lesions
dermatitis herpetiformis
treatment for mild acne rosacea
topical metronidazole
if TSH high and T4 normal, diagnosis?
subclinical hypothyroidism
TSH low, T4 low
secondary hypothyroidism
TSH high, T4 low
primary hypothyroidism
in a pituitary adenoma, what are the results in a high dose dexamethasone test
cortisol suppressed
ACTH suppressed
in an adrenal adenoma what are the results of a high dose dexamethasone test
cortisol not suppressed
ACTH suppressed
where there is ectopic ACTH what are the results of a high dose dexamethasone test
cortisol not suppressed
ACTH not suppressed
anti-TPO antibodies are seen in around 90% of patients with what?
hashimotos
best investigation for addison’s disease
ACTH stimulation test
what does it mean if nuclear scintigraphy reveals patchy uptake in the thyroid
toxic multinodular goitre
TSH low, T4 high
thyrotoxicosis
side effects of insulin
- hypoglycaemia
- weight gain
- lipodystrophy
best investigation for phaechromocytoma?
24 hr urinary collection of metanephrines
best investigation for acromegaly
serum IGF-1 measurements
what diseases cause a goitre
- hashimotos
- subacute thyroiditis
- riedel’s thyroiditis
what nerve injury is associated with a fracture of the surgical neck of the humerous
axillary nerve injuries
C5 and 6
first line treatment for fibromyalgia
aerobic exercise
which renal disorder is associated with sickle cell anaemia
renal papillary necrosis
would urine calcium excretion be reduced in hyperparathyroidism
no
what disease does episodes of pancreatitis with hypercalcaemia indicate
familial hypocalciuric hypercalaemia
hypokalaemia and hypertension indicates
Conn’s
does a left intertrochanteric fracture cause external or internal rotation of the leg
external
what does swan neck deformity indicate
rheumatoid arthritis
arthritis mutilans is associated with which type of arthritis
psoriatic
isolated raised ALP
paget’s disease
what does high haemoglobin in a patient with ADPKD indicate
polycythaemia
do thiazide diuretics cause gout
yes
what promotes secretion of renin in the kidneys
a fall in the renal perfusion pressure detected by baroreceptors at the arterioles
what is the classic triad of grave’s disease
- pretibial myxoedema
- thyroid opthalmology
- thyroid acropachy
if someone has a family history of MEN which type of thyroid cancer are they most likely to get
medullary
first line treatment for pagets
bisphosphonates
what does painless haematuria in a smoker suggest
transitional cell carcinoma of the bladder
if there is chondrocalcinosis does this indicate pseudogout or gout
pseudogout
what is the first line test for acromegaly
serum IGF-1
complications of rheumatoid arthritis
ischaemic heart disease
if an older patient has dermatomyositis which condition could be underlying it
internal malignancy
