Ken Shared "UGC rejected as of 20160909 10am" - 52 Picmonics
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UGC rejected as of 20160909 10am
Week 24
- Risk factors for Osteosarcoma
- Ewing's Sarcoma
- RF features of Osteosarcoma
- Imaging modalities for investigating bone lesions
- Classification of bone tumours
- Most common malignant bone tumours
- Most common benign bone tumours
- Benign versus malignant
- Radiology - age by growth plate closure
Cranial Nerve Examination
- CN I (Olfactory Nerve)
- Smell
- CN II (Optic Nerve)
- Inspect pupil size and symmetry
- Visual Acuity
- Accomodation
- Direct/Consensual Pupillary Reflex
- Swinging Light Test
- CN III, IV, VI
- H Test
- CN V (Trigeminal Nerve)
- Facial Sensation
- Clench jaw and Open against resistance (Motor)
- CN VII
- Facial Motor (Raise eyebrows, scrunch up eyes, purse lips, show teeth, puff out cheeks)
- CN VIII (Vestibulocochlear Nerve)
- Whisper
- Weber's Test
- Rinne's Test
- CN IX, X
- Cough and Swallow
- Say "Ahh" and inspect palate
- CN XI (Accessory Nerve)
- Turn head & Shrug shoulder
- CN XII
- Stick out tongue and press into cheek
Acute abdomen/ SBO LBO
- bowels: DPT VC FART
- imaging SBO signs / LBO signs - DANA DACS
- Investigations - Wee Goes In - LE CRAPA
- Managment - BO
- Obstruction complications - PIS
- General causes of abdo pain - HOT PI
- HACCA TOIS (SBO/LBO ) kids - AVAI
Seizure Questions
- Prodrome
- Unusual posturing?
- Jerking?
- Incontinence?
- Cyanosis during the episode?
- Memory of the episode afterwards?
- Confused after an episode?
- Muscle pain after an episode?
- Wake up with a cut tongue after the episode?
Seizure and epilepsy - Week 21
- Pathophys - epilepsy
- Causes of epilepsy
- Differentials for Eldery and adolescent
- Investigations of seizure
- Management - Short and long
- Pharmacological management
- Phenytoin adverse effects
- Newly diagnosed - subjects to discuss
- Diagnosis - EEG
- Febrile seizures
- Clinical features (differentiating from syncope)
Anaesthetics - GA and LA
- LA - chars and performance determined by..
- LA - contraindications
- Ideal GA
- Inhaled GA
- Side effects of GA
- Induction and recovery kinetics of GA depend on
- GA contraindications
- Stages of anesthesia
- IV anaesthetics
Werdnig Hoffman
- Werdnig-Hoffman
- Autosomal Recessive
- Congenital degeneration of anterior horns of spinal cord
- Symmetric weakness (vs. Poliomyelitis which has all the same symptoms, but asymmetric weakness)
- LMN lesions only
- Can cause polyhydramnios
- “Floppy baby” with marked hypotonia and tongue fasciculations (LMN!)
- Infantile type has median age of death of 7 months
Gynaecomastia
- Drugs
- Radiotherapy
- Cirrhosis
- Hypogonadism
- Renal Failure
- Hyperthyroidism
Squamous Cell Carcinoma (penis)
- Squamous Cell Carcinoma of Penis
- Associated with HPV
- Associated with lack of circumcision
- More common in Asia, Africa, South America
- Precursor in sit lesions
- Bowen disease-in situ carcinoma of the penile shaft or scrotum that presents as leukoplakia
- Erythroplasia of Queyrat - in situ carcinoma on the glans that presents as erythroplakia
- Bowenoid papulosis - in situ carcinoma that presents as multiple reddish papules (unclear malignant potential, may not progress to invasive
- Bowenoid Papulosis - Seen in younger patients (40s)
Medullary Carcinoma of Breast
- Medullary Carcinoma of Breast
- Characterized by large, high-grade cells growing in sheets with associated lymphocytes and plasma cells
- Fleshy, cellular, lymphocytic infiltrate
- Grows as a well-circumscribed mass that can mimic fibroadenoma on mammography
- Relatively good prognosis
- Increased incidence in BRCA1 carriers
Congenital Long QT Syndrome
- Defects in membrane K+ channel
- Defects in membrane K+ channel
- Sudden death
- Sudden death
- Romano ward syndrome
- Romano ward syndrome
- Jervell and Land-Nielsen syndrome
- Jervell and Land-Nielsen syndrome
- Treatment
- Treatment
- Refrain from vigorous exercise
- Refrain from vigorous exercise
- treat with beta blockers
- treat with beta blockers
- Calcium Supplements
- Calcium Supplements
- Potassium (K+)
- Potassium (K+)
- Magnesium (Mg2+)
- Magnesium (Mg2+)
- Symptomatic Stage
- Symptomatic Stage
- lightheadedness
- lightheadedness
- Palpitations
- Palpitations
- syncopal episodes
- syncopal episodes
- Seizures
- Seizures
- Treat with Pacemaker
- Treat with Pacemaker
Acute Mastitis and Periductal Mastitis
- Acute Mastitis
- Acute Mastitis
- Bacterial infection of the breast, usually due to Staphylococcus aureus
- Associated with breast-feeding
- Fissures develop in the Nipple providing a route of entry for microbes
- Presents as an erythematous breast with purulent nipple discharge; may progress to abscess formation
- Treat with antibiotics and continue breastfeeding (to drain the boob)
- Periductal Mastitis
- Periductal Mastitis
- Inflammation of the subareolar ducts
- Presents with nipple retraction
- Usually seen in smokers
- Relative vitamin A deficiency results in squamous metaplasia of lactiferous ducts, producing duct blockage and inflammation
- Both: Lactiferous Sinus/Major Duct
Ductal Carcinoma in Situ
- Fills ductal lumen
- Arises from ductal atypia
- Often seen early as microcalcifications on mammography
- Malignant
- No basement membrane penetration
- Comedo Type (Comedocarcinoma): Ductal with central necrosis
- Tx: Lumpectomy
Dorsal Column
- proprioception
- Touch
- Pressure
- Pressure
- Vibration
- Decussate at Medulla
- Vitamin B12 Deficiency
- Neurosyphilis
Hydatidiform Mole
- Hydatidiform mole
- Cystic swelling of chorionic villi and proliferation of chorionic epithelium (only trophoblast)
- Presents with vaginal bleeding, uterine enlargement more than expected, pelvic pressure/pain
- hCG much higher than expected for date of gestation.
- hCG is produced by Syncytiotrophoblast of placenta
- Classically presents in the second trimester as passage of grape-like masses through the vaginal canal
- Associated with hCG-mediated sequelae: early preeclampsia (before 20 weeks)
- Risk factors: Extremes of age (40), diet deficient in folate or B-carotene
- Associated with: hyperemesis gravidarum
- Associated with hyperthyroidism
- Associated with Theca Lutein Cyst
- Tx: Dilation and Curettage (DandC)
- Tx: Follow with weekly B-HCG
- Tx: Methotrexate
- Complete Mole
- Complete Mole
- 46,XX; 46,XY
- Most villi are hydropic
- Most commonly enucleated egg + single sperm (subsequently duplicates paternal DNA)
- Heavily increased hCG
- Imaging: “Honeycombed” uterus or “clusters of grapes”
- “Snowstorm” on ultrasound
- Higher risk of malignancy (15-20%) and choriocarcinoma (2%)
- Partial Mole
- Partial Mole
- 69,XXX; 69,XXY; 69,XYY
- 2 sperm + 1 egg (normal ovum)
- Fetal Parts
- No change in uterus size
- Some villi are hydropic, and some are normal
Acute (Allergic) Interstitial Nephritis
- Causes
- Allergic reaction to drugs
- Infection
- Autoimmune disorders (SLE, Sjogren, Sarcoidosis)
- Presentation
- Fever
- Rash
- Arthralgias
- Investigations
- FBC (show eosinophilia)
- UEC (Urea, electrolytes and creatinine)
- Urinalysis (shows eosinophiluria, Blood)
- Treatments
- Stop drugs
- Control (Stop) infection
- Corticosteroids (Prednisone, Hydrocortisone, Methylprednisolone)
- Dialysis (if severe)
Atheroembolic Disease Tests and Treatments
- full blood count (shows eosinophilia)
- Elevated ESR
- Complement
- U&E
- LFT
- Urinalysis (eosinophiluria if kidney is affected)
- Biopsy (to distinguish from vasculitis)
Other forms of Amyloidosis
- Amyloidosis
- Dialysis-related
- Fibrils composed of β2-microglobulin in patients with ESRD and/or on long-term dialysis
- B2 microglobulin is in MHC I, doesn't get filtered in dialysis
- B2 Microglobulin deposits in the joints; May present as carpal tunnel syndrome
- Heritable
- Heterogeneous group of disorders, including familial amyloid polyneuropathies due to transthyretin gene mutation
- Age-related (senile) systemic
- Due to deposition of normal (wild-type) transthyretin (TTR)
- TTR is predominantly deposited in cardiac ventricles
- Familial amyloid cardiomyopathy is also caused by Wild TTR and causes restrictive cardiomyopathy
- Slower progression of cardiac dysfunction relative to AL amyloidosis
- Isolated atrial amyloidosis due to atrial natriuretic peptide is common in normal aging
Asbestosis
- Asbestosis
- Associated with shipbuilding, roofing, plumbing
- Affects lower lobes
- Can be unsymptomatic for 20-30 years after exposure
- Bibasilar inspiratory crackles and fingernail clubbing as the disease progresses
- “Ivory white,” calcified, supradiaphragmatic and pleural plaques
- Risk of bronchogenic carcinoma > risk of mesothelioma
- Asbestos (ferruginous) bodies are golden-brown fusiform rods resembling dumbbells , found in alveolar septum sputum sample, visualized using
- Increased ÂŹrisk of pleural effusions
- Risk of cor pulmonale, cancer, and Caplan syndrome (rheumatoid arthritis and pneumoconioses with intrapulmonary nodules)
- Dx: Biopsy or BAL
- Mesotheliom
- Mesothelioma is a malignancy of the pleura associated with asbestosis.
- Malignant mesothelioma has Psammoma bodies
- Mesothelioma may results in hemorrhagic pleural effusion (exudative) or pleural thickening
- Mesothelioma is cytokeratin and calretinin positive (negative in most carcinomas)
Paget Disease
- Eczematous patches on nipple
- Results from underlying DCIS or invasive breast cancer
- Paget cells = intraepithelial adenocarcinoma cells
- Presents as nipple ulceration and erythema
- Occurs in the Major Duct
