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What is the syndrome? kyphosis, 90th percentile for height, and has long fingers, pectus excavatum and a systolic murmur
Marfan syndrome . The aortic media gradually stretches, resulting in aortic dissection in later age. Before this, valvular leaks, for example, floppy mitral valve may be present. There may be a high-arched palate and positive Steenburg sign, where the thumb folded in the palm protrudes beyond the other side of the palm.
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Cause of red eye? eye is irritable, with fine vertical streaks of corneal epithelial staining after the instillation of drops of fluorescein dye
Subtarsal foreign body causes photophobia and profuse lacrimation. Vertically linear corneal abrasions, as in this case, usually indicate the diagnosis
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cause of red eye? .. There is bilateral severe irritation and photophobia in a sheet metal worker, with diffuse corneal epithelial staining after the instillation of drops of fluorescein dye
Ultraviolet keratitis is caused by UV damage to the corneal epithelium. Sheet metal workers use welding equipment which is a source of artificial UV radiation. Fluorescein staining reveals superficial punctate epithelial surface irregularities.
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What is the dx in the eye? ... There is ciliary injection and a semi-dilated irregular pupil; the patient complains of nausea and local pain
Acute angle closure glaucoma usually presents with sudden onset of blurred vision and pain, with nausea and vomiting due to vagal stimulation. Acutely, there is corneal microcystic oedema, lid oedema, conjunctival hyperaemia, circumcorneal injection, with a fixed mid-dilated, often oval pupil. There may also be a relative afferent papillary defect, with a shallow anterior chamber, often with an inflammatory reaction.
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What is the dx in the eye? There is ciliary injection, hypopyon, and a small pupil; the patient complains of local pain, especially on reading.
Acute anterior uveitis is characterised by pain, photophobia and excess lacrimation. The hallmark signs are “cells and flare”- cells being leukocytes floating in the aqueous, and flare being the particulate, smoky appearance of the aqueous due to protein release from the inflamed iris or ciliary body.
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Causative agent of rheumatic fever?
Rheumatic fever results from immune-mediated post Group A streptococcal infection, Streptococcus pyogenesbeing a common pathogen
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What does congenital CMV infection cause?
Congenital CMV infection is associated with petechiae, choroidoretinitis, hepatosplenomegaly, intracerebral calcification which may lead to CNS damage with long term sequaelae
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What MI is particularly associated with complete heart block?
Inferior MIs in particular can have associated transient complete heart block, due to the right coronary artery supplying the AV node.
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What drug in overdose can cause hyperkalaemia?
Betablockers, particularly propranolol, in overdose can cause hyperkalaemia by transmembrane shifts. It is useful to think of the opposite - beta-agonists such as salbutamol are far more widely known to cause hypokalaemia.
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What genetic disorder is associated with polydactyly, scalp defects and micropthamlia?
Patau syndrome, also known as trisomy 13 and trisomy D
Affected individuals have a poor prognosis, with 80% dying within the first month of life. There is an incomplete development of the forebrain and optic nerves, and skull defects are common, e.g.cutis aplasia, microphthalmia, colobomata, cleft palate, polydactyly.Cardiac abnormalities are present in approximately 80% of babies with Patau's syndrome.
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features of a common peroneal nerve neuropathy (branch of sciatic nerve)
- Foot drop
- 'Slapping' gait
- sensory loos of lateral aspect of leg and dorsum of foot
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What are plethoric lung fields on CXR associated with?
Any L to R shunt, ie VSD, ASD, PDA
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What is the dx? A 24-year-old African student presents with a hard pelvic mass and is also felt to have bilateral flank masses. He admits to having painless terminal haematuria as a teenager and adds that this was a common feature in his village.
- Bladder Ca
- In developing countries, exposure to Schistosoma haematobium usually affects whole communities.There is an increase of developing squamous cell carcinoma of the bladder and very rarely transitional cell cancer.
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Cocaine use in pregancy is associated with what perinatal complications?
- Placental abruption - The idiosyncratic vasoconstriction and hypertensive action of cocaine may lead to abruption of the placenta.
- Low birth weight baby
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Theoretical risk of fetal VIIIth nerve damage is associated with what drug?
High dose maternal aminoglycoside administration
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Classic triad of Wernickes encephalopathy?
Ataxia, nystagmus, opthalmoplegia
Due to thiamine deficiency
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What does the drug Orlistat do?
- Anti-obesity drug
- Orlistat is a lipase inhibitor which is licenced for the treatment of morbid obesity. Patients should have loss 2.5 kg in weight before being considered for treatment.
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what type of drug is Doxazocin?
alpha adrenergic receptor blocker used in the management of hypertension. Doxazosin is a competitive inhibitor of post adrenergic alpha receptors which causes vasodilatation and decreases total peripheral vascular resistance.
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What does cabergoline do?
A long acting dopamine receptor agonist. Cabergoline has a high agonist affinity for the D2 dopamine receptor . It is used in the treatment of hyperprolactinaemic disorders and as an adjunct in the treatment of parkinson’s disease.
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What autoantibodies are associated with systemic sclerosis/ CREST?
- ANA, anti-U3 nucleolar ribonucleoprotein (anti-RNP) and Anticentromere antibodies
- Autoantibodies strongly associated with SSc include antinucleolar antibodies and anti-U3 nucleolar ribonucleoprotein (RNP).Anticentromere antibodies are strongly associated with CREST syndrome.
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What autoantibodies are associated with primary biliary cirrhosis?
Antimitochondrial antibodies are associated with primary biliary cirrhosis
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'strawberry' cervix with multiple petechial haemorrhages is seen. Identification of protozoa in a wet film. frothy offensive discharge usually greenish in colouration. What is the disease?
Trichomonas vaginalis
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true positive/ true positives + false negatives (all that have disease) =
sensitivity
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Treatment for TB?
- RIPE
- Rifampicin
- Izonizide
- Pyrazinamide
- Ethanbutol
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