2022 Paper Flashcards
Widespread clustered blisters, sparing face
Lesions begin on abdomen
Presents in late 2nd or 3rd trimester
Diagnosis?
Pemphigoid gestationis
Rare pruritic AI bullous disorder
Needs use potent topical steroids or oral prednisolone
Presents in 3rd trimester or immediately post-partum
Begin on lower abdomen, involving pregnancy striae. Extends to thigh, buttocks, legs, arms, sparing umbilicus
Rarely involves face, hands, feet
Diagnosis?
Polymorphic eruption of pregnancy
Which is the same as pruritic urticarial papules and plaques of pregnancy
Rash present as excoriated papules on extensor limbs, abdo, shoulder
Diagnosis?
Prurigo of pregnancy –> common pruritic disorder
Affects 20% of normal pregnancies, do LFTs to exclude obstetric cholestasis
Pruritic follicular eruption with papules and pustules affecting trunk, can involve limbs
o 2nd or 3rd trimester, resolve a week after delivery
o SS: acne (considered a type of hormone-induced acne)
Pruritis folliculitis
Manage with topical steroids
Commonest pregnancy rash
Atopic eczema
–> emollients and bath additives
T1DM DKA first-line management?
Fluid Bolus
Child presenting with bump behind ear
Mastoiditis
Kid with 2cm mass (inframandibular) on left side, painful – blood film shows: toxic left shift with reactive neutrophilia.
Lymphadenitis
Child presenting with symptoms of muscular dystrophy, what should be measured?
Creatine Kinase
–>Duchenne Muscular Distrophy
Calf hypertrophy
Duchenne Muscular Distrophy
Worst prognostic factor of schizophrenia?
Gradual Onset
–> this is the worst one but other include:
strong family history
gradual onset
low IQ
prodromal phase of social withdrawal
lack of obvious precipitant
23 yo with depression, isn’t sleeping very well. What tx?
Mirtazapine
What effect does continued maternal use of sodium valporate have on the fetus?
Spina bifida, neural tube defect
What effect does continued maternal use of lithium have on the fetus?
Ebstein’s anomaly
Woman has an intrauterine device/system put in. How often does she have to check for the strings?
Every month
63 yo lady just had a vaginal hysterectomy, she works as a carer in a care home. How long does she have to take off work assuming she has no complications?
6 weeks
–> she does heavy lifting
Percentage increase chance of developing T2DM after having GDM
50%
Woman with controlled hypothyroidism presents to GP as just fell pregnant, what should be done about her levothyroxine during pregnancy?
Increase dose
Women recently underwent LLETZ for CIN(1 or 2?), when should next smear be?
6 months
Woman with bleeding, pain, and woody uterus. CTG showed fetal tachycardia. Dx?
Placental abruption
Best test for predicting preterm labour?
Cervical length
LH:FSH ratio 3:1
PCOS
Neonate, no femoral pulses, hepatomegaly, blue. Dx?
Coarctation of the aorta
Small child with UTI, name test where dye is injected into urinary tracts to visualise them
Micturating cystourethrogram
Girl with barking cough and stridor. What is the scoring system for this condition?
Westley croup score
Perianal itching especially at night. What’s the best treatment option?
Mebendazole
–> This is an imperial favourite if it doesn’t come up I will be mad
Head lice what do you suggest?
Head combing and Malathion
urinary incontinence
dementia and bradyphrenia
gait abnormality
Normal pressure hydrocephalus
Best opiate replacement (OST) for 6 week pregnant lady on a menagerie of other drugs?
Methadone or Buprenorphine
Lady w schizophrenia and actively psychotic declines some physical health intervention, which is the best framework (“act”) to provide treatment under?
Mental Capacity Act
–> you cannot treat physical health under the section
Pregnant woman had fall, fell on abdomen, Well in herself, no bruising or haemorrhage. Third pregnancy, is Rhesus negative.
What should be done before 12 weeks?
What should be done between 12-20 weeks?
What should be done after 20 weeks?
In pregnancies <12 weeks gestation, anti-D Ig prophylaxis is only indicated following ectopic pregnancy, molar pregnancy, therapeutic termination of pregnancy and in cases of uterine bleeding where this is repeated, heavy or associated with abdominal pain.
The minimum dose should be 250 IU. A test for fetomaternal haemorrhage (FMH) is not required.
For potentially sensitising events between 12 and 20 weeks gestation, a minimum dose of 250 IU should be administered within 72 h of the event. A test for FMH is not required.
For potentially sensitising events after 20 weeks gestation, a minimum anti-D Ig dose of 500 IU should be administered within 72 h of the event. A test for FMH is required.
Guy on drugs, depressed mood, paranoid, slow, etc. what drug?
Cannabis
Women presenting with hyperreflexia, tremor etc, what drugs did she likely overdose on?
Lithium
X-ray image shown of pneumonia.
5 y/o Child, had a fever and BP okay. What drug and what route?
Oral amocixillin
white itchy plaque rash
pain during intercourse or urination
Lichen Sclerosus
itchy, papular rash on genitalia
white-lace pattern on the buccal mucosa
lichen planus
Diagnostic test for Down’s at 15th week?
Amniocentesis
Diagnostic test for Down’s at <14th week?
Chorionic villus sampling
Mum comes in with a child, she saw him swallow a 20p coin in the garden 30 mins ago, but no choking, coughing, etc.
What’s the best investigation?
X-rays of neck, chest, abdomen
A 40 year old woman with uterine fibroids require the active management of the third stage of labour. At which point in labour should IM syntocinon (oxytocin) be administered?
NICE says when the anterior shoulder is out or immediately after birth.
However reg said because she had fibroids she would be inclined to give as soon as the shoulder is out
A 24-year-old woman with a BMI of 22 kg/m2, has an elective, uncomplicated laparoscopic procedure for removal of a 6 cm simple ovarian cyst. Assuming good postoperative recovery, after how long would she be appropriate to be discharged?
Reg said probably 6 hours after recovery from anaesthetic
Rcog says for procedural laparoscopy “If you have had a simple procedure as
part of an operative laparoscopy, you
may be able to go home on the same
day, though you may be asked to stay in
hospital overnight.”
Rcog says if diagnostic laparoscopy you should be able to go home between three and four hours.
