28/4/22 Flashcards
When is ADH released?
When osmolality is high (high = concentrated = high amounts of Na+) to increase fluid levels and dilute blood again
Hypersegmented neutrophils are found in what kind of anaemia
B12 and folate deficiency
What is the usual rate of cervical dilation in the first stage of labour?
What is your next step if this is delayed?
1cm per hour
IV syntocinon
Remind - what is the FEV and FVC1 patterns in obstructive vs restrictive lung disease
Obstructive - reduced FVC + FEV1, reduced FVC/FEV1 and reduced PEF
Restrictive - reduced FVC + FEV1, normal FVC/FEV1 and reduced PEF
NOTE IN OBSTRUCTIVE - In asthma FVC is normal not reduced
What causes a right shift in the Hb-O2 graph?
Right shift means O2 is more readily released from Hb
- Increase in CO2
- Increase in H+ (acidosis)
- 2,3-DPG
- Increase in temp
Both PMR and polymyositis present with pelvic girdle pain - how can you differentiate them?
PMR doesn’t cause weakness unlike polymyositis
Neonatal jaundice before how many days is always pathological?
2 days
When does physiological jaundice most commonly occur?
How is it managed?
2-4 days - peaking at 7 days and then regressing
Use bilirubin chart
- Phototherapy treatment line
- Exchange transfusion line
What does OMFG stand for in pulmonary oedema management?
Oxygen
Morphine - reduces work of breathing
Furosemide
GTN - nitrates
What kind of jaundice would you expect in neonate with biliary atresia (obstructive)?
Conjugated jaundice
What is vital to include in child health comms?
Systemic review
- fever?
- behaviour change?
- weight loss?
- fatigue?
- eating okay - what are they eating?
- cough?
- vomitting?
- blood in poo/wee/vomit?
- constipation or diarrhoea?
- weeing or drinking a lot?
- any rash?
- if potentially infective - anyone in family/nursery had same thing?
Development + Immunisations
- immunisations all up to date - if not sure can check online
- anyone ever raised concerns about wee ones development?
- how are they doing at school or nursery?
BFGD (big friendly Giant develops)
= Birth, Feeding, Growth, Development + Immunisation
Birth - like obstetrics
- weight of baby?
- problems as a neonate/post natal problems for mother
Feeding
- breast or bottle fed?
- if 6-12months - started weening?
- if older run through what a typical day of eating looks like
Growth
- red book all up to date (should have weights recorded)
Social
- ask about childcare arrangements
Go over a suicide risk comms
BEFORE, DURING AND AFTER
BEFORE
- What happened on the lead up?
- Was it planned or impulsive?
- Did you write a note or a will?
- Before hand had you hoped you would have been found?
DURING
- How did you try to kill yourself?
- If drugs what drugs and how much? How did you get ahold of these
- Did you use alcohol or illicit drugs at the time?
- Were you alone?
- Where did this take place?
- Did you regret it once you had done it?
AFTER
- What can you remember of what happened straight after to you being here?
- Who found you?
- How do you feel about it now?
- Current mood?
- Are you still feeling suicidal?
- Do you feel as though you would do it again if similar circumstances arose again?
- What would make you stop?
- Do you think this can be helped if you get the right support - what does that support look like to you?
ICE
PMH
- psych history
- detention history
- history of self harm and suicide
Drugs and allergies
FH
- psych conditions
Social
- smoking
- alcohol
- drugs
- work
- home life
Go back over dates song
What is the only BBV that it is recommended mothers don’t breastfeed with?
HIV
Difference between schizoid and schizotypical?
Schizoid - prefer to be alone, don’t like relationships, low libido
Schizotypical - people with unusual beliefs and behaviours
