10/06 and 11/06 Flashcards
suspected aortic dissection invx
CT chest abdo pelvis
bishop score <= 6
vaginal prostaglandins or oral misoprostol
if prev section or higher risk of hyperstimulation -> mechanical methods eg balloon catheter
bishop score >6
amniotomy and IV oxytocin infusion
expectant mx of an ectopic
1) An unruptured embryo
2) <35mm in size
3) Have no heartbeat
4) Be asymptomatic
5) Have a B-hCG level of <1,000IU/L and declining
when can trial of diet and exercise be offered in GDM
fasting glucose <7
secondary dysmenorrhea mx
refer to gynae
which anticoagulants are contraindicated in preg
NOACs and warfarin -> switch to LMWH
what increases risk of ovarian cancer
more hormone exposure eg early menarche, late meno, nulliparity
RF for placental abruption
A for Abruption previously;
B for Blood pressure (i.e. hypertension or pre-eclampsia);
R for Ruptured membranes, either premature or prolonged;
U for Uterine injury (i.e. trauma to the abdomen);
P for Polyhydramnios;
T for Twins or multiple gestation;
I for Infection in the uterus, especially chorioamnionitis;
O for Older age (i.e. aged over 35 years old);
N for Narcotic use (i.e. cocaine and amphetamines, as well as smoking)
when can hormonal contraception be taken after emergency contraception
levonelle -> straight away
ullipristal -> 5 days (breast feeding also delayed 1 week)
delivery in intrahepatic cholestasis of labour
increased risk of stillbirth so IOL at 37-38 wks
when can IUS/IUD be inserted after birth
within 48 hours or after 4 weeks
chalmydia tx where compliance concern
azithromycin 1g orally single dose then 500mg orally for 2 days
pansytolic murmur
ventricular septal defect
mesenteric ischaemia tx
laparotomy
right sided heart failure
pulmonary stenosis = systolic murmur in 2nd intercostal space left sternal edge
JVP, ankle oedema and hepatomegaly
which statin cannot be prescribed with amlodipine
simvastatin
which statin is better/higher intensity
atorvastatin
what suggests idiopathic parkinsons
asymmetrical symptoms
what needs to be checked before starting azathiprine tx
TPMT activity
which analgesics cause hyperkalaemia
saids
mx of pyloric stenosis (olive shaped mass)
Ramstedt pyloromyotomy
mx of bronchiolitis
supportive
mx of croup
single dose oral dex or pred
plummer vinson syndrome
Plummers DIE: Dysphagia, Iron deficiency anemia, Esophageal webs
an arhythmia and signs of decompensation eg hypotension, heart failure
DC cardioversion
first line primary dysmenorrhea
NSAIDs eg mefanemic acid
charcots triad of ascending cholangitis
RUQ pain
jaundice
fever
Acute heart failure not responding to treatment
CPAP
flashers and floaters
vitreous detachment which can lead to retinal detachment
somatisation disorder
multiple physical SYMPTOMS present for at least 2 years
patient refuses to accept reassurance or negative test results
illness anxiety disorder (hypochondriasis)
persistent belief in the presence of an underlying serious DISEASE, e.g. cancer
patient again refuses to accept reassurance or negative test results
conversion disorder
typically involves loss of motor or sensory function
the patient doesn’t consciously feign the symptoms or seek material gain
dissociative disorder
dissociation is a process of ‘separating off’ certain memories from normal consciousness
in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor
facticious disorder
also known as Munchausen’s syndrome
the intentional production of physical or psychological symptoms
malingering
fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain
inguinal hernia in infants
urgent surgery as high risk of strangulation
Wernicke’s encephalopathy features
CAN OPEN
confusion
ataxia
nystagmus
ophthalmoplegia
peripheral neuropathy
symptomatic bradycardia, atropine fails
external pacing
why does raised ICP cause a third nerve palsy (down and out)
transtentorial or uncal herniation
surgery to defunction colon to protect anastomosis
loop ileostomy
pt presents within 7 days of TIA
aspirin 300mg and specialist review within 24hr
ongoing jaundice and pain after cholecystectomy
common bile duct stone
acute liver failure triad
encephalopathy (confusion and flap)
jaundice
coagulopathy
Caput succedaneum
puffy swelling that usually occurs over the presenting part
2 words(legs) -> Crosses suture lines
cephalohaematoma
1 word -> DOES NOT cross suture lines
paed BLS pulse check
brachial and femoral arteries
mx of alcohol withdrawal
chlordiazepoxide
hypocalcaemia
prolonged QT
hypercalcaemia
shortening of QT interval
intertrochanteric (extracapsular) proximal femoral fracture
dynamic hip screw
reverse oblique, transverse, or subtrochanteric type extracapsular fracture
intramedullary nail
chronic sinusitis
intranasal steroids
secondary pneumothorax <1cm
admit and give oxygen for 24 hours and review
myxoedema coma tx
thyroxine and hydrocortisone
thyrotoxic storm tx
beta blockers, propylthiouracil and hydrocortisone
ectopic preg with foetal HB present
surgical management
drug causes of urinary retention
anti-cholinergics eg clozapine, TCAs (amitryptylline)
opioid analgesia eg morphine, tramadol
DKA insulin mx
fixed rate infusion
continue long acting, hold short acting
anterior uveitis tx
steroid + cycloplegic (mydriatic) drops
Hyponatraemia correction
osmotic demyelination syndrome
hypernatraemia correction
cerebral oedema
acute dystonia due to anti-psychotics
procyclidine
IV fluid resus in paeds
bolus of 20 ml/kg over less than 10 minutes
what should u prescribe in babies with CMPI
hypoallergic infant formula
calcium and vitamin D for mum
suspected AACG invx
tonometry and gonioscopy
temporal arteritis with visual loss tx
IV methylprednisolone
definitive mx of atrial flutter
radiofrequency ablation
black African/carribean pt with T2DM
arb eg irebsartan, losartan
TIBC in anaemia of chronic disease
low/normal
TIBC in iron deficiency anaemia
high
anti-mitochondrial antibodies
primary biliary cholangitis
common thyroid cancer with best prognosis
papillary
proliferative diabetic retinopathy tx
intra vitreal anti-VEGF injections
alcohol withdrawal
symptoms: 6-12 hours
seizures: 36 hours
delirium tremens: 72 hours
when is metformin contraindicated
EGFR<30
ipsilateral CN3 palsy and contralateral hemiparesis
webers syndrome
head bobbing murmur
aortic regurgitation
T1DM screening
ACR in early morning specimen
imagine in breast cancer
women <35 - USS
women >35 - mammogram
hormone therapy breast cancer pre and peri-meno
tamoxifen
hormone therapy breast cancer post-meno
aromatase inhibitor eg anastrazole
breast cancer screening
3 yearly mammogram to women aged 50-70
medial breast cancer lymphatic spread
internal thoracic or parasternal
winged scapula
serratus anterior/long thoracic nerve
biochem addisonian crisis
severe hypovolaemia and hyponatraemia
fragile X complications
mitral valve prolapse
autism
pes planus
memory problems
speech disorders
which diseases exhibit anticipation
trinucleotide repeat disorders eg huntingtons, myotonic dystrophy
head, shoulders, knees and toes 3 6 9 12.
3 months - control of head
6 months - sitting up
9 months - crawling
12 months - walking
localised signs on resp exam in paeds
?foreign body
roseola infantum
HHV6
high fever -> resolves -> maculopapular rash
paeds loss of internal rotation of the leg on flexion
SUFE
solitary cleft lip/palate assoc
maternal anti-epileptic use
laxative prescribing
osmotic initially (loosen stool) then stimulant
benign rolandic epilepsy
partial seizures at night
PDA pulse
collapsing
shaken baby syndrome triad
retinal haemorrhages
subdural haematoma
encephalopathy
hand foot and mouth disease cause
coxsackie A16
double bubble sign AXR
intestinal atresia
IM adrenaline
anterolateral aspect of the middle third of the thigh
squamous cell carcinoma assoc
hypertrophic pulmonary osteoarthropathy
T2DM drug when egfr<30
sulfonylureas
AOM with perforation tx
5 days amox and check up to ensure healed in 6-8 wks time
