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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
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Cranial Nerve Examination
CN I (Olfactory Nerve)
CN II (Optic Nerve)
Inspect pupil size and symmetry
Visual Acuity
Direct/Consensual Pupillary Reflex
Swinging Light Test
H Test
CN V (Trigeminal Nerve)
Facial Sensation
Clench jaw and Open against resistance (Motor)
Facial Motor (Raise eyebrows, scrunch up eyes, purse lips, show teeth, puff out cheeks)
CN VIII (Vestibulocochlear Nerve)
Weber's Test
Rinne's Test
Cough and Swallow
Say "Ahh" and inspect palate
CN XI (Accessory Nerve)
Turn head & Shrug shoulder
Stick out tongue and press into cheek
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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
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Seizure Questions
Unusual posturing?
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?
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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)
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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
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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
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Renal Failure
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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)
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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
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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
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
syncopal episodes
syncopal episodes
Treat with Pacemaker
Treat with Pacemaker
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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
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Ductal Carcinoma in Situ
Fills ductal lumen
Arises from ductal atypia
Often seen early as microcalcifications on mammography
No basement membrane penetration
Comedo Type (Comedocarcinoma): Ductal with central necrosis
Tx: Lumpectomy
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Dorsal Column
Decussate at Medulla
Vitamin B12 Deficiency
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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
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Acute (Allergic) Interstitial Nephritis
Allergic reaction to drugs
Autoimmune disorders (SLE, Sjogren, Sarcoidosis)
FBC (show eosinophilia)
UEC (Urea, electrolytes and creatinine)
Urinalysis (shows eosinophiluria, Blood)
Stop drugs
Control (Stop) infection
Corticosteroids (Prednisone, Hydrocortisone, Methylprednisolone)
Dialysis (if severe)
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Atheroembolic Disease Tests and Treatments
full blood count (shows eosinophilia)
Elevated ESR
Urinalysis (eosinophiluria if kidney is affected)
Biopsy (to distinguish from vasculitis)
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Other forms of Amyloidosis
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
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
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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 risk of pleural effusions
Risk of cor pulmonale, cancer, and Caplan syndrome (rheumatoid arthritis and pneumoconioses with intrapulmonary nodules)
Dx: Biopsy or BAL
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)
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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
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