10 Flashcards by Erin Prentice

what drugs are contraindicated in breast feeding

ciprofloxacin, tetracycline, chloramphenicol, sulphonamides (eg co-trimaoxazole), aspirin, carbimazole, methotrexate, sulphonylureas, cytotoxic drugs (eg some chemo drugs) amiodarone

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what is the hoffmans reflex

shows UMN dysfunction and points to a disease of central nervous system
to elicit, examiner should flick patients distal phalynx (usually middle finger) to cause momentary flexion, a +ve sign is exaggerated flexion of thumb

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which demographic is neuroleptic malignant syndrome more common in

young males

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when is neuroleptic malignant syndrome most common

in patients who have just commensed treatment-within first 10 days

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what are the symptoms of neuroleptic malignant syndrome

renal failure-secondary to rhabdomyloysis 
pyrexia
rigidity
tachycardia 
increased CK in most cases 
leucocytosis may also be seen

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what is the management for neuroleptic malignant syndrome

stop antipsychotic
IV fluids to prevent renal failure
dantrolene-may be useful
dopamine agonists eg bromocriptine

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what are the examination findings in neuroleptic malignant syndrome

decreased reflexes, lead pipe rigidity, normal pupils

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what can trigger a cluster headache

alcohol

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what tool is used to screen for post natal depression

Edinburgh Postnatal depression score

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what happens in the secretory phase of endometrial cycle

progesterone is released this usually lasts 14 days

increased tortuosity and luminal secretions

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TVUS thickness of how much is indication for biopsy in premenopausal women

> 16 mm

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what is DUB mostly due to

anovulatory cycles

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when is anovulatory DUB most commone

at either end of reproductive life

corpus luteum doesn’t form so continued growth of functionalis layer

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when are endometrial polyps most common

usually asymptomatic but may present with bleeding or discharge often around and after menopause
almost always benign

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what does a complete mole only contain

paternal DNA

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what type of DNA is contained within a partial mole

maternal and paternal DNA

69XXY-triploid

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is GBS picked up on an incidental swab in pregnancy a cuase for concern

no this is a commensal in 20-40% of women

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when should you give abx for GBS

maternal IV antibiotic prophylaxis should be offered to women with previous baby with GBS
maternal IV antibiotics in preterm labour regardless of GBS status
women with pyrexia in labour >38 degrees given IV abx
BENZYLPENICLLIN

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describe discharge after delivery

this is called lochia
in the first 3-4 days it is red rubra
then up to 10 days it is brown-serosa
then up to 4 weeks white-alba

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what about discharge after birth is concerning

large clots-about size of golf balls
reddining in colour after lightening
needing to change your pad every hour
abdominal pain and fever

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describe what can happen to fibroids in pregnancy

sensitive to oestrogen and can therefore grow in pregnancy, if growth outstrips blood supply, they can undergo red or carneous degeneration
get low grade fever pain and vomit
condition usually managed conservatively with rest and analgesia and resolve within 4-7 days

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what is retinopathy of prematurity

disorder of developing retina
abnormal fibrovascular proliferation or retinal vessels may lead to retinal detachement and visual loss
large fluctuations in PaO2 thought to cause this

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treatment of retinopathy of prematurity

diode laser therapy

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what is PAF

population attributable risk

proportion of disease caused by a particular risk factor

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what does PAF measure

burden of disease

what percentage of breast cancers are thought to be preventable

42%

the 42% of preventable breast cancers are because of

lack of physical activity 12%, alcoholic drinks 22%, body fatness 16%

what is the increase of breast cancer and weight

5% increase of breast cancer with every 2kg/m2 increment eg a woman weighing 30kg/m2 has a 12.5% increased risk compared to a woman with a BMI 25kg/m2

what are some of the risk factors for preterm labour

x9 if multiple pregnancy if 2 previous preterm deliveries 70% if abnormally shaped uterus increase 19% hypertension, IUGR, IVF, smoking, <6 months between previous pregnancy

how long do depressive symptoms need to be present for

at least 2 weeks for most of day

what is the most effective way of screening for downs, Edwards and patau

combined test looks fluid from back of fetus neck using nuchal translucency blood test-free hcG and PAPP-A between 10 and 14+1 weeks

what is done in first booking visit

maternal BMI, general info about diet, alcohol, smoking, folic acid, vitamin D, antenatal class, BP, urine Bloods-FBC, blood group, rhesus status, red ell antibodies, haemoglobinopathies, syphilis, rubella HIV offered urine culture for asymptomatic bacteraemia

in antenatal care when is the first scan done

between 10-13+6 weeks | to confirm dates and exclude multiple pregnancy

how is pregnancy usually dated

crown-rump length between 6-12 weeks | 14-20 weeks can use biparietal diameter

in terms of blood markers what has an increased risk of downs

low aFP and increased HcG

what is the receptor field of an afferent neurone

the region that when stimulated with an adequate stimulus causes a response in that neurone

for primary afferent neurones the receptor field is location of what

peripheral terminal

a patch of skin contains many overlapping RFs innervated by

primary afferent fibres

describe the 2 point discrimination in finger tip, palm and forearm

2mm, 10mm, 40mm

what trisomy is in Edward syndrome

trisomy 18

what features are present in Edward syndrome

heart problems, unusal head and facial features, unable to stand and walk

what is trisomy in patau syndrome

trisomy 13

what problems are present in patau

heart problems, cleft lip and palate, growth problems, poorly formed eyes and ears, problems with kidneys, unable to stand and walk 2 in 10,000

below above what is classed as low risk for chromosomal abnormalities

1 in 150

what is a robertsonian translocation

2 acrocentric chromosomes stuck end to end

what does aCGH locate

an imbalance

if think there is a balanced chromosomal abnormality what would you do

full karyotype of FISH

how is DNA testing in pregnancy usually done

PCR

what can DNA in maternal serum help with

X linked diseases-if no Y chromosome then can reassure if Y chromosome then can proceed to more invasive testing

if already diabetic and get pregnant what do you need to check

RETINA

why do you get GORD in pregnancy

progesterone mediated pyloric sphincter relaxation

what is the usual cause of hyperemesis gravidarum

increased hcg from multiple pregnancy or mole

what is the treatment for hyperemesis gravidarum

aggressive fluid replacement | glucose can precipitate Wernicke's encephalopathy

what happens to D2 receptors in addiction

they are decreased

how do addictive drugs affect PFC

potent signal that disrupts normal dopamine related learning in PFC

what is the orbitofrontal cortex

key creator of motivation to act | addicts get increase activation when they see drugs

what are the resp physiological changes in pregnancy

resp rate increase, tidal and minute volume increase by 50%, vital capacity and po2 don't change, pco2 decreases

physiological cardio changes in pregnancy

HR increases up to 90min to increase CO CO is increased by 30-50% and increased by 30% in labour BP decreases until 2nd trimester as circulation expands and peripheral resistance decreases

where does lower visual field project to

gyrus superior to calcarine sulcus

where does upper visual field project to

gyrus inferior to calcarine sulcus

where does macula project to

posterior pole of visual cortex

describe how fibres of geniculocalcarine tract work

the fibres of geniculocalcarine sulcus form part of internal capsule, those carrying visual info from upper 1/2 of visual field first loop anterior around temporal part of lateral ventrile in Meyers loop ending below calcarine sulcus

does visual cortex or frontal eye fields track moving objects

visual cortex tracks moving objects-this tends to be smooth

what do frontal eye tracts do

movements of command-independent of moving visual stimuli

name 3 types of fibres in white matter

association, commissural and projection

what do association fibres do

connect cortical sites in the same hemisphere

what do commissural fibres do

connect one hemisphere to the other-usually have similar function

what do projection fibres do

connect hemispheres to deeper structures including thalamus, corpus striatum, brainstem and spinal cord