Final year‎ > ‎

14.03.24 Revision notes

Muscarinic antagonists 
  • Urinary incontinence
    • Tolterodine, oxybutynin, solifenacin
  • COPD
    • Ipratropium 
  • Parkinson's
    • Procyclidine

ITP
  • Acute
    • more commonly seen in children
    • equal sex incidence
    • may follow an infection or vaccination
    • usually runs a self-limiting course over 1-2 weeks
  • Chronic
    • more common in young/middle-aged women
    • tends to run a relapsing-remitting course

Systemic sclerosis / Scleroderma
  • Limited cutaneous systemic sclerosis (lcSSc), or limited scleroderma
    • 70% of SSc cases
    • Affects only the face, forearms and lower legs up to the knee
    • AKA CREST
  • Diffuse cutaneous systemic sclerosis (dcSSc), or diffuse scleroderma
    • 30% of SSc cases
    • Involves also the upper arms, thighs or trunk
    • May also affect internal organs
  • Diagnosis
    • Symmetrical skin thickening
    • Raynaud's
    • Nail-fold capillary changes 
    • Antinuclear antibodies
      • Antitopoisomerase (e.g. anti-scl70)
      • Anticentromere 
      • Anti-U3 
      • Anti-RNA polymerase

Knee injuries
  • Torn meniscus
    • Twisting sporting injuries followed by delayed onset of knee swelling and locking
    • Patient may develop "skills" to unlock the knee
  • PCL rupture
    • Tibia lies back on the femur and can be drawn forward during a paradoxical draw test
  • ACL rupture
    • High twisting force applied to a flexed knee
    • Loud crack
    • Rapid joint swelling


Notes
  • Common causes of urticaria
    • Aspirin
    • NSAIDs
    • Opioids
    • Penicillins
  • Loss of corneal reflex - think acoustic neuroma
  • Goitre
    • Hashimoto's: Non-tender
      • De Quervain's (subacute): Tender
  • Subclinical hyperthyroidism => AF + osteoporosis
  • Shagreen patch
  • G's and C's raised in anorexia
    • growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia
  • Tramadol => Lower seizure threshold in epilepsy / With other drugs lowering threshold (TCAs, SSRIs)
  • Spiculated = Needles
  • Spigelian hernia 
    • Hernia through the spigelian fascia (Aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally)
    • Should be repaired because of the high risk of strangulation
  • Chronic pancreatitis
    • Previous episode of pancreatitis plus one of:
      • Evidence of endocrine or exocrine insufficiency
      • Evidence of fibrosis on CT (calcium deposits)
  • Creon makes you constipated
  • Behcet's: Oral ulcers, genital ulcers and uveitis. Also VTE.
  • Preauricular lymph nodes are only a feature of viral or Chlamydial conjunctivitis

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