29/5 Flashcards
What is managemrnt of uterine fibroids?
no didtortion - ius
didtortion - surgery and gnrh agonidt in meantime
At what point does management of gestational diabetes go from diet and lifestyle/metformin to insulin commencing?
Fasting of 7
When are you infectious with chickenpox/shingles?
Until vesciles have crusted over
What are the options for breech babies?
After what point is it relevant?
36 wks
Before then likely to solve spontaneously
Options
1. ECV (try and move babies position manually)
2. C-section - better option
3. Try vaginal birth
Treatment of chickenpox in pregnancy?
No antibodies and exposed - oral aciclovir
Exposed and with symptpoms - IVIG
Acute limb ischameia invx and management
Invx
Bedside
- peripheral limb exam and compare to healthy limb
- ECG
- Doppler (if +ve = ABG)
Bloods
- Baseline + group/save + clotting
Imaging
- CTA
Management
ABCDE + vas review
Medically
- IV opiods and paracetomol
- IV HEPARIN
Surgically (I Saw A Big AMUPTATION)
Intra-arterial thrombolysis
Surgical emblectomy
Angioplasty
Bypass
AMPUTATION if irreversible ischaemia
with carotids assessment
Listen 1st THEN palpate
Go over peripheral vascular exam
What is the only reason you do a HINTS exam?
ONLY to assess for true nystagmus from posterior circulatory stroke
If you are given nebulised meds how do you give O2?
nasal cannula
Specific med for PTSD
Venflaxaine
Flax seeds all fall over me - giving me PTSD
What is the need for liver transplant post paracteomol induced liver failure?
pH <7.3, 24hrs post ingestion
Pt got manic on anti-depressants?
Stop antidepressant and start antipyschotic meds
Management of acute dystonia post anti-psychotics?
Procylidine (stuck and proc it out)
When should pts <30 starting SSRIs be assessed?
1 week post starting
Schizoid vs schiotypal
Schizoid = android = acting like a robot = cold, not intrested in relationships
SchioTypal = sTrange = strong interesrt in paranormal and magic
What can cause lithium toxicity?
MANTRA
Metronidazole
ACE-i
NSAIDS/no water (dehydration)
Thiazide direcutics
Renal failure
ARBs
Coarse tremor
Confusion
Polyuria
ABGs assoc with aspirin OD
0hrs = resp alkalosis as it stimualtes resp centre = high HR = resp alk
12hrs = met acidosis
To remember Wernicke’s encephalopathy
How is it treated? If not treated?
Wernicke’s = WEndy = Joe’s auntie = drunk
CONGed over the head
Confusion
Opthalmoplegia
Nystagmus
Gait ataxia
Thiamine replacement urgently
Can progress to Korsakoff syndrome (antero- and retrograde amnesia and confabulation)
Contact lens wearer?
Acanthamoebea keratitis
If B-blocker not managing angina - what next?
CCB
