10/6/22 Flashcards
What is a subgleal haemorrhage?
A subgaleal haemorrhage is a rare but serious
condition where a bleed occurs between the aponeurosis of the scalp and the periosteum
It forms a lump that crosses suture lines and it may cause lifethreatening blood loss
What causes large calves in DMD?
Large calves in DMD is called ‘pseudohypertrophy’ - This is when the atrophied muscles have been replaced by fat and fibrous tissue
What organism is the most common cause of meningitis?
Enteroviruses (Coxackie, Echovirus)
Viral meningitis is much more common than bacterial meningitis
Neiserria + S. Pneumoniae are the most common bacterial causes
What conditions are generally:
AR, AD, X-linked R, X-linked D?
AR = Affect metabolic pathways (CF, Sickle, Thal, PKU, Spinal musc atrophy)
AD = Affect structural proteins (Ehlers-Danlos, NF, Myotonic dystrophy, Tuberous sclerosis, Achondroplasia)
X-linked Recessive = DMD + BMD, Haemophilia A + B, G6PD
X-linked Dominant = Fragile-X + Rett syndrome
What is the management of DDH?
<6m:
Pavlik Harness
18m-6y:
Surgically via open
reduction - Any obstructing tissues are removed to allow the femoral
head to be relocated into the acetabulum
6y+:
May require a salvage
osteotomy - less amenable for open reduction + construction
Define:
- Hyaline degeneration
- Cystic degeneration
Hyaline degeneration = Asymptomatic softening and liquefaction of a
fibroid
Cystic degeneration = Asymptomatic central necrosis that leaves cystic
spaces at the centre of the fibroid
How would you distinguish this as being vasa praevia instead of placenta praevia?
Both cause painless vaginal bleeding
In vasa praevia - bleeding is foetal hence -> pathological CTG trace
In placenta praevia - bleeding is mainly maternal -> would not cause pathological CTG
What is the mangement of endometrial hyperplasia?
w/out atypia:
1st line = 6m Continuous progestogens (eg. Mirena) - regression of endometrium w/ endometrial surveilance (TVUSS + biopsy)every 6m
w/ atypia:
- No fertility requirements: Total hysterectomy, endometrial ablation in pts w/ HMB
- Fertility required: Progestogens + endometrial surveilance every 3m
What can occur in severe obstetric cholestasis and why?
In severe cases, the lack of bile in the intestines –> malabsorption of vitamin K (along with other fat-soluble
vitamins) which can –> derangement in coagulation
What investigation should be conducted in mothers that have previously presented with GDM?
Offer OGTT ASAP after booking test
If -ve for GDM, repeat OGTT @ 24-28w
When would you opt for surgical mx of ToP? Which option would you choose and when?
Surgical ToP is used after 10w
<14w = Vacuum aspiration (can use misoprotrol before for cervical ripening)
> 14w = Dilation + Evacuation (dilation needed to remove larger foetal parts)
What is the mx of Anorexia Nervosa in adults? in children?
Adults = Talking therapies: - Eating disorder-focused CBT - Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) - Specialist Supportive Clinical Management (SSCM).
If those 3 don’t work can try Focal Psychodynamic Therapy (FPT) - exploration of past experiences to see what might have caused this to develop
Chidren:
1st = Family therapy
2nd CBT
What type of drug is:
- Phenelzine
- Galantamine
- Mirtazapine
Phenelzine = MOAI
Galantamine = ACHase inhibitor (dementia)
Mirtazapine = noradrenergic and specific serotoninergic antidepressant (NaSSA)
What are the symptoms of serotonin syndrome?
Fever, hypertension, tachycardia, agitation, diarrhoea, hyperreflexia, and myoclonus
How can you distinguish between alcoholic hallucinations and delirium tremens?
Unlike DT, in alcoholic hallucinosis patients will be
aware that they are hallucinating and there is no clouding of consciousness or autonomic dysfunction
