2017 Flashcards
40 year old premature ovarian failure and wanted medication to deal with the symptoms of menopause. What would you prescribe her?
Combined HRT or COCP
Woman is pregnant and HIV negative at booking but her partner is HIV positive - what do you do?
Start her on antiretroviral therapy, retest her in 2 weeks
What signifies onset of active labour?
Os is 4cm
Woman has cervical cancer, is a smoker, hasn’t had a smear for 8 years - what is the most likely contributing factor?
Smokes 20 cigarettes a day
37 year old coming to the GP with a background of polycystic ovarian syndrome wanting to review her contraception. She wants to have the COCP. Which of the following is an absolute contraindication to the pill?
Passmed:
more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
current breast cancer
major surgery with prolonged immobilisation
Woman with white discharge and itch. Which treatment?
Oral Fluconazole, Topical Clotrimazole
Pregnant woman with itchy feet, what investigation?
Liver function tests/serum bile acids
Couple seen in subfertility clinic and the female and male investigations are given (with normal ranges for sperm count, FSH etc etc). Results show azoospermia. How should they be managed?
Intracytoplasmic sperm injection
Cyst contains hair and teeth
Teratoma
Ground glass appearance
Endometrioma
Woman has pain before periods and has been subfertile, cyst found on ovary
Endometrioma
Post menopausal woman has bleeding
Endometrial cancer
Green discharge
Trichomonas
White discharge
Candida
A newborn appears to be in severe respiratory distress and appears blue. Despite being given high flow O2, his saturations remain at 65%.
What is the next best step to take with regards to his management?
Infusion of Prostaglandin
Drug treatment for ADHD
methylphenidate
atomoxetine
dexamfetamine
3 months old baby with signs of HF, systolic murmur that radiates over the praecordium
VSD
What is the most important thing to look at in follow up of HSP?
Urine protein and RBC
15 year old boy with short stature. Passing urine 10 times a day with no dysuria. Pale with heart rate at 78bpm, blood pressure at 158/88 and respiratory rate at 14. What is the likely diagnosis?
Chronic renal failure
6 year old child with 24 hour history of left peri-orbital swelling. Had an upper respiratory tract infection last week. Left proptosis, visual acuity was normal and had a fever of 38.9. What is the best diagnostic investigation?
CT of nasal orbits
Boy with itchy bottom, what do you prescribe?
mebendazole
Child in A&E with asthma attack, was given puffs of salbutamol. Now has a quiet chest, what do you do?
Call for senior help
Child with 6m of loose stools. Passed one hard blood streaked stool 10 days ago. What investigation?
None
Infant with episodes of throwing arms forward with fists clenched.
infantile spasms
Mother worried about 2.5 or 3 year old child’s bed wetting. Dry by day, wets bed at night. What to do?
Reassure
Child with fever of 39, high resp rate, nurse says chest is clear, what investigation do you do?
Urinalysis
Child with fever, white exudate on one tonsil, diagnosis?
Quinsy (peritonsillar abscess)
Child with episodes of smelling strange things, hard to communicate with during these episodes, falls asleep for an hour after and doesn’t remember anything. Diagnosis?
Focal seizure
Mother worried 5 year old? son has autism. Which would most support a diagnosis of autism?
child didn’t speak first words until 2 years old and goes to a speech and language therapist
Mother complains her young child is a fussy eater. She eats soft foods and drinks a lot of milk. Also has been feeling tired recently. Diagnosis?
Iron deficiency anaemia
Baby is almost a month old and jaundiced. Parents say has been jaundiced since day 2. Stools are grey or white. Diagnosis?
Biliary atresia
4 year old girl with a high fever that was followed by a rash which has small white dots on a red base. What is the most likely Dx?
Chicken pox?
Nappy rash with satellite lesions
Topical clotrimazole
Nappy rash sparing flexures
Zinc and castor oil
Impetigo
Topical fusidic acid (local)
Oral antibiotic e.g. fluclox (extensive/bullous)
Chicken pox
Do nothing
Child suffers from fever. The fever disappears but she has now developed a rash. She subsequently has febrile convulsions.
Roseola
Mother with cold sores has been kissing her child who has a background of eczema?
HSV/eczema herpeticum
Child has an URTI 2 weeks ago. Has now developed a rash over the back of the legs along with joint and abdominal pain.
HSP
Post partum depression
Psychological therapies
16yo having sex with 12 yo
Call police
Woman comes in with a pneumothorax and said her husband kicked her and has previously hurt their baby too. Baby is currently at home with him - what do you do?
Call police
Woman who had FGM when she was 6 and is not pregnant and said she definitely won’t do on her daughter - what do you do?
Police – not necessarily, carry out risk assessment
Carry out a risk assessment
Refer to social services/police if 1+ are present from the following:
- Woman already has daughters who have undergone FGM
- Woman or woman’s partner/family requesting reinfibulation following childbirth
- Woman is considered to be a vulnerable adult and therefore issues of mental capacity and consent should be considered if she is found to have FGM
- Woman says that FGM is integral to cultural or religious identity
- Family are already known to social care services – if known, and you have identified FGM within a family, you must share this information with social services
Boy always playing video games from teenage years, not interested in other people threatening to kill himself?
Schizoid PD
