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10 Flashcards

1
Q

what drugs are contraindicated in breast feeding

A

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

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2
Q

what is the hoffmans reflex

A

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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3
Q

which demographic is neuroleptic malignant syndrome more common in

A

young males

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4
Q

when is neuroleptic malignant syndrome most common

A

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

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5
Q

what are the symptoms of neuroleptic malignant syndrome

A 
renal failure-secondary to rhabdomyloysis 
pyrexia
rigidity
tachycardia 
increased CK in most cases 
leucocytosis may also be seen
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6
Q

what is the management for neuroleptic malignant syndrome

A

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

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7
Q

what are the examination findings in neuroleptic malignant syndrome

A

decreased reflexes, lead pipe rigidity, normal pupils

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8
Q

what can trigger a cluster headache

A

alcohol

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9
Q

what tool is used to screen for post natal depression

A

Edinburgh Postnatal depression score

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10
Q

what happens in the secretory phase of endometrial cycle

A

progesterone is released this usually lasts 14 days

increased tortuosity and luminal secretions

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11
Q

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

A

> 16 mm

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12
Q

what is DUB mostly due to

A

anovulatory cycles

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13
Q

when is anovulatory DUB most commone

A

at either end of reproductive life

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

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14
Q

when are endometrial polyps most common

A

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

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15
Q

what does a complete mole only contain

A

paternal DNA

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16
Q

what type of DNA is contained within a partial mole

A

maternal and paternal DNA

69XXY-triploid

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17
Q

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

A

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

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18
Q

when should you give abx for GBS

A

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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19
Q

describe discharge after delivery

A

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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20
Q

what about discharge after birth is concerning

A

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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21
Q

describe what can happen to fibroids in pregnancy

A

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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22
Q

what is retinopathy of prematurity

A

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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23
Q

treatment of retinopathy of prematurity

A

diode laser therapy

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24
Q

what is PAF

A

population attributable risk

proportion of disease caused by a particular risk factor

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25
Q

what does PAF measure

A

burden of disease

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26
Q

what percentage of breast cancers are thought to be preventable

A

42%

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27
Q

the 42% of preventable breast cancers are because of

A

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

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28
Q

what is the increase of breast cancer and weight

A

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

29
Q

what are some of the risk factors for preterm labour

A

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

30
Q

how long do depressive symptoms need to be present for

A

at least 2 weeks for most of day

31
Q

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

A

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

32
Q

what is done in first booking visit

A

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

33
Q

in antenatal care when is the first scan done

A

between 10-13+6 weeks

to confirm dates and exclude multiple pregnancy

34
Q

how is pregnancy usually dated

A

crown-rump length between 6-12 weeks

14-20 weeks can use biparietal diameter

35
Q

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

A

low aFP and increased HcG

36
Q

what is the receptor field of an afferent neurone

A

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

37
Q

for primary afferent neurones the receptor field is location of what

A

peripheral terminal

38
Q

a patch of skin contains many overlapping RFs innervated by

A

primary afferent fibres

39
Q

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

A

2mm, 10mm, 40mm

40
Q

what trisomy is in Edward syndrome

A

trisomy 18

41
Q

what features are present in Edward syndrome

A

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

42
Q

what is trisomy in patau syndrome

A

trisomy 13

43
Q

what problems are present in patau

A

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

44
Q

below above what is classed as low risk for chromosomal abnormalities

A

1 in 150

45
Q

what is a robertsonian translocation

A

2 acrocentric chromosomes stuck end to end

46
Q

what does aCGH locate

A

an imbalance

47
Q

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

A

full karyotype of FISH

48
Q

how is DNA testing in pregnancy usually done

A

PCR

49
Q

what can DNA in maternal serum help with

A

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

50
Q

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

A

RETINA

51
Q

why do you get GORD in pregnancy

A

progesterone mediated pyloric sphincter relaxation

52
Q

what is the usual cause of hyperemesis gravidarum

A

increased hcg from multiple pregnancy or mole

53
Q

what is the treatment for hyperemesis gravidarum

A

aggressive fluid replacement

glucose can precipitate Wernicke’s encephalopathy

54
Q

what happens to D2 receptors in addiction

A

they are decreased

55
Q

how do addictive drugs affect PFC

A

potent signal that disrupts normal dopamine related learning in PFC

56
Q

what is the orbitofrontal cortex

A

key creator of motivation to act

addicts get increase activation when they see drugs

57
Q

what are the resp physiological changes in pregnancy

A

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

58
Q

physiological cardio changes in pregnancy

A

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

59
Q

where does lower visual field project to

A

gyrus superior to calcarine sulcus

60
Q

where does upper visual field project to

A

gyrus inferior to calcarine sulcus

61
Q

where does macula project to

A

posterior pole of visual cortex

62
Q

describe how fibres of geniculocalcarine tract work

A

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

63
Q

does visual cortex or frontal eye fields track moving objects

A

visual cortex tracks moving objects-this tends to be smooth

64
Q

what do frontal eye tracts do

A

movements of command-independent of moving visual stimuli

65
Q

name 3 types of fibres in white matter

A

association, commissural and projection

66
Q

what do association fibres do

A

connect cortical sites in the same hemisphere

67
Q

what do commissural fibres do

A

connect one hemisphere to the other-usually have similar function

68
Q

what do projection fibres do

A

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

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