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Extra Questions MedEd > Year 3 > Flashcards

Year 3 Flashcards

1
Q

Chronic multi-system disease with unknown aetiology.

  • Lymphadenopathy - enlarged, non-tender (typically cervical and submandibular)
  • CXR: bilateral hilar lymphadenopathy
  • Elevated calcium and serum ACE
  • Erythema Nodosum, lupus pernio
  • Weight loss, low grade fever
  • Treatment: corticosteroids if severe
A

Sarcoidosis

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2
Q

Cholestatic liver disease

  • Bile duct destruction, cirrhosis, end stage liver disease
  • Predominantly young, middle aged men
  • Obstructive jaundice, priuritis
  • Link to IBD (UC>CD)
  • No specific auto-antibodies, but ANCA often present
  • Tx: Liver transplant
  • Leading cause of dead is liver failure and cholangiocarcinoma
A

Primary Sclerosing Cholangitis

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3
Q

Constant aching pain around eye, radiating to forehead

  • Reduced vision, N&V, haloes
  • Red congested eye
  • Cloudy cornea
  • Dilated non-responsive pupil
  • Attacks precipitated by sitting in the dark, dilating eye drops or emotional upset
  • Tx: acetazolamide
A

Acute Glaucoma

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4
Q 
Tight band around head
- Dull pulsatile constricting bilateral pain
- Related to stress, commonest headache
- Worsens as day progresses
- F>M, lower SES
Tx: rest and simple analgesia
A

Tension headache

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5
Q

Headache lasting a few weeks

  • Tender thickened pulseless temporal artery
  • Jaw claudication, especially on chewing
  • Associated with PMR
  • Can -> blindness
  • Ix: raised ESR and CRP
  • Tx: Steroids
A

Giant cell (temporal) arteritis

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6
Q

Rapid onset, severe headache

  • Same time each time 15mins-3hours
  • Often begins around eye, occurs in cluster periods
  • Eye redness, rhinorrhea
  • Due to hypothalamic activation with secondary autonomic and trigeminal activation
  • Lacrimation, rhinorrhoea, nasal congestion, partial Horner’s
  • Tx: 100% O2 (acute)
  • Preventers: verapamil, lithium, steroids,
A

Cluster Headache

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7
Q

Idiopathic disorder

  • Paroxysms of intense sharp stabbing pain in CNV distribution
  • Triggered by touching affected area (eating, chewing, hair brushing, shaving)
  • Causes: Aneurysm, tumour, chronic meningeal inflammation, MS, zoster
  • Ix: MRI to rule out secondary cause
  • Tx: carbamezapine, lamotrigine, phenytoin
A

Trigeminal Neuralgia

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8
Q

LOC due to transient arrhythmia (decreased CO)

  • Often post MI
  • Palpitations
  • Pale before, flushed after
  • Recovery in seconds
  • Tx: pacemaker
A

Stokes-Adams Attack

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9
Q

Hereditary Neuropathy beginning in puberty with weak legs and foot drop, with variable loss of sensation and reflexes

  • Pes Cavus, high foot arches
  • Areflexia, hammer toes
  • Distal atrophy hands and legs, champagne bottle appearance
  • May need to excessively lift legs to clear the toes
  • Tx: Rehab and orthototics
A

Charcot-Marie-Tooth Disease

- CMT1A: atrophy hand and arm muscles - mutation PMP22 myelin gene

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10
Q

TRIAD: Opthalmoplegia, mental change, gait dyfunction

A

Wernicke’s Encephalopathy: due to acute thiamine deficiency

RFs: alcoholics, malnutrition, GIT surgery, AIDS, Cancer, Chemotherapy

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11
Q

Demyelinating CNS condition, Characterised by:

- 2 or more episodes of neurological dysfunction distinct in both time and space

A

MS: white woman, 20-40years

  • Temporary visual/sensory loss usually
  • MRI sensitive, but not as specific as spinal MRI
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12
Q

Frontotemporal denegeneration

  • Disruption personality and social conduct
  • Primary language disorders
  • Components of dys-executive syndrome
  • Many display Parkinsonism and subset also have MND
A

Pick’s Disease

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13
Q

Loss of vision in a normal eye due to damage to visual area of occipital cortex = Cortical blindness
Often lack of insight into condition and confabulate sight
Pupillary light reflex intact as doesn’t involve cortex
Normal fundoscopy

A

Anton’s Syndrome

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14
Q

Insidious onset gait apraxia (falls).

  • Cognitive impairment, urinary problems
  • Dilated ventricles on CT
  • Periventricular leukomalacia
  • Cerebral infarction
A

Normal pressure hydrocephalus

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15
Q

AD defect in haem synthesis

  • Abdo pain, vomiting, tachycardia, confusion, motor neuropathy
  • Precipitated by alcohol and OCP
A

Porphyria

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16
Q

Mixed neuropathy and CCF (SOB, peripheral oedema, motor and sensory)
- Vitamin B1 (thiamine deficiency)

A

Beri-Beri

17
Q

Raccoons sign: periorbital bruising
Battle’s sign: Mastoid bruising
Bloody otorrhoea, CSF otorrhoea/rhinorrhoea
Hearing impairment (sensorineural due to CN VIII damage or conductive due to haemotympanium)

A

Base of skull fracture

18
Q

Streptococcus
Staphylococcus
Enterococcus

A

Gram positive cocci

19
Q

Clostridium

Listeria

A

Gram positive bacilli

20
Q

Neisseria

Haemophilis

A

Gram negative cocci

21
Q 
Salmonella
Shigella
Pseudomonas
Legionella
Vibrio
ESBL
Proteus
A

Gram negative bacilli

22
Q

Tick borne infection caused by spirochete Borrelia burgdorferi

  • Erythema migrans, arthritis
  • Tick bite -> Bull’s Eye appearance
A

Lyme disease

23
Q

Popliteal cyst: synovial fluid from a knee effusion escapes in a subgastrocneumius bursa.

  • Usually in response to injury/inflammation (arthritis)
  • Sudden onset pain behind knee
A

Baker’s Cyst

  • Tx: Rest, Ice, Compression, elevation, gentle mobilisation, analgesia.
  • If severe corticosteroid (intra-articular) injections/surgery
24
Q
  • Frank haematuria post URTI/gastroenteritis
  • IgA nephropathy: commonest glomerulonephritis causing renal failure
  • Increased IgA titre
A

Berger’s Disease
Dx: renal biopsy - focal/diffuse mesangial proliferation and extracellular expansion. IF: diffuse mesangial IgA
Tx: ACEI to decrease proteinuria, early corticosteroids can delay renal failure

25
Q

Hemisection/Unilateral cord lesion

  • Ipsilateral UMN weakness below lesion (severed corticospinal tract -> spastic paraparesis, brisk reflexes, extensor plantars)
  • Ipsilateral loss of proprioception and vibration (dorsal columns)
  • Contralateral loss of pain and temp sensation (spinothalamic)
A

Brown-Sequard Syndrome

26
Q

Hepatic vein obstruction by thrombosis or tumour -> ischaemia and hepatocyte damage

  • Liver failure or insidious cirrhosis
  • Abdo pain, hepatomegaly, ascites, increased ALT
  • Chronically: portal hypertension
A

Budd-Chiari Syndrome
Due to hyper coagulable states (OCP, pregnancy, malignancy, PN haemoglobinuria, polycythaemia rubra vera, thrombophilia), liver, renal or adrenal tumour

27
Q

Thromboangitis Obliterans

- Smoking related inflammation of veins, nerves and middle sized arteries, which thrombose -> gangrene

A

Buerger’s Disease

28
Q

Multiple lung nodules in coal worker’s with RA

  • Due to an inflammatory reaction to external allergen
  • CXR: bilateral nodules
  • Dx: CT (needle biopsy)
A

Caplan’s Syndrome

RFs: Silica, asbestosis, anthracite exposure

29
Q

TRIAD: late onset asthma, eosinophilia, granulomatous small vessel vasculitis affecting lungs, nerves heart and skin (vasospasm, MI, DVT)

A

Churg-Straus Syndrome: can cause septic shock/systemic inflammatory response
Tx: steroid, INF-alpha

30
Q

Progressive dementia, focal CNS signs, myoclonus (95%), depression,
- Eye signs: diplopia, supra nuclear palsies, homonymous field defects, hallucinations, cortical blindness

A

Creuzfeldt-Jakob Disease (CJD): transmitted via meat contaminated by tissue affected by bovine spongiform encephalopathy.
- Prion -> spongiform changes in the brain

31
Q

Inherited cause of unconjugated hyperbilirubinaemia.

  • Presents in 1st days of life with jaundice and CNS signs
  • Mutation-> abolished bilirubin UDP-glucoronosyltransferase activity
A

Crigler-Najjar Syndrome: requires liver transplant before irreversible kernictus develops

32
Q

Defective hepatocyte excretion of conjugated bilirubin (point mutation in gene coding for a canalicular transport protein)

  • Intermittent jaundice and pain R hypochondrium
  • No hepatomegaly
  • Normal ALP
  • Bilirubinuria
  • Liver biopsy = diagnostic pigement granules
A

Dubin-Johnson Syndrome - AR disorder

33
Q

RA, neutropenia, splenomegaly

A

Felty’s Syndrome

Extra Questions MedEd (3 decks)

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