30.5.2013(obstetrics,skin) 22 Flashcards by rakesh durai

Time between delivery of umbilicus to delivery of mouth in breech is

5-10 min

How well did you know this?

Not at all

Perfectly

Timing of episiotomy in breech

When breech is climbing the perineum

How well did you know this?

Not at all

Perfectly

Methods of delivery of after coming head

Marshall burns
Piper forceps
Mauriceau smellie veit

How well did you know this?

Not at all

Perfectly

Delivery of extended leg in frank breech

Pinnard manoeuvre -popliteal pressure

How well did you know this?

Not at all

Perfectly

Delivery of breech with extended arms

Lovset manoeuvre

How well did you know this?

Not at all

Perfectly

Reverse mauriceau smellie veit

Prague manoeuvre

How well did you know this?

Not at all

Perfectly

Screening of Gestational diabetes is done at

24-28wks

How well did you know this?

Not at all

Perfectly

Amount of glucose used in glucose challenge test

50grams

How well did you know this?

Not at all

Perfectly

Oral hypoglycaemic without fetal side effects

Glyburide

How well did you know this?

Not at all

Perfectly

Triple drug ART for pregnant women

CD4 count< 350 or

Stage 3 and stage 4

How well did you know this?

Not at all

Perfectly

Most common cardiac complication of gestational diabetes

1.VSD

TGA

How well did you know this?

Not at all

Perfectly

Most specific complication of gestational diabetes

Caudal agenesis

How well did you know this?

Not at all

Perfectly

Most common complication of gestational diabetes

CVS

How well did you know this?

Not at all

Perfectly

During pregnancy HIV transmission occurs mostly during

Labor

How well did you know this?

Not at all

Perfectly

Drug supplied by NACO for preventing HIV transmission to foetus

Nevirapine

How well did you know this?

Not at all

Perfectly

Factors increasing vertical transmission

Disease factors:
Maternal viral load
Advanced maternal disease
Seroconversion in pregnancy
Low CD4 count
Obstetric factors:
 Vaginal delivery
  Preterm delivery
 Coexistent STD
 Prolonged rupture of membranes
 Chorioamnionitis
 Low birth weight
Antepartum invasive procedures
Postpartum invasive procedures

How well did you know this?

Not at all

Perfectly

HIV testing in pregnant women

Opt out approach

How well did you know this?

Not at all

Perfectly

Prevention of vertical transmission

Caesarian section

ART

How well did you know this?

Not at all

Perfectly

Women with infertility.
B/L cornual block on HSG
Next step

Confirmation by hysteroscopy and laparoscopy

How well did you know this?

Not at all

Perfectly

False positive proximal tubal occlusion on HSG

Tubal spasm
Amorphous debris
Minimal adhesions
Extensive fibrosis or debris

How well did you know this?

Not at all

Perfectly

Management in HIV positive mother with no prior ART

Single dose nevirapine to mother at onset of labor

Single dose to infant within 72 hours after birth

How well did you know this?

Not at all

Perfectly

elective CS in HIV

All HIV positive women with RNA load> 1000 copies/ml

How well did you know this?

Not at all

Perfectly

Timing of elective CS in HIV positive women

38 wks to lessen chances of premature rupture of membranes

How well did you know this?

Not at all

Perfectly

Rx of HIV positive pregnant women who don’t meet ART criteria

Antepartum zidovudine at 14-34 wks
100mg 5 times a day
IV zidovudine during labor
2mg/kg orally is given to neonate every 6 hours for 6 weeks
Commencing at 8-12hrs after birth

How well did you know this?

Not at all

Perfectly

Early cord clamping is done in

HIV positive mothers

Postpartum hemorrhage in HIV positive women

Ergometrine is avoided,interaction with Protease and reverse transcriptase inhibitors to cause severe vasoconstriction Give oxytocin and prostaglandin

Disposal of HIV positive placenta

10% sodium hypochlorite bleach for 20min

Vaccines contraindicated in neonates born to HIV positive women

OPV | BCG

Surgery is effective in which type of tubal occlusion

Distal tubal occlusion

Distal tubal occlusion | Sx done

Fimbrioplasty | Neosalpingostomy

Treatment of choice in prenatal congenital adrenal hyperplasia

Dexamethasone

Prenatal steroid Rx for neonatal congenital adrenal hyperplasia should start at

At the time of first missed menstrual period

Type of inhibin more commonly elevated

InhibinB

Inhibin levels elevated in post menopausal women cause

Granulosa cell tumor | Mucinous cystadenocarcinoma

CK20 is associated with

Adenocarcinoma

CK 7 is associated with

Ovarian tumor

HRT in postmenopausal women is not given for

Prevention of CAD

Indications of HRT

Vaginal dryness Hot flushes Prevention of osteoporosis

Risk of HRT

CAD stroke VTE breast cancer

Benefits of HRT

Osteoporosis Ovarian and endometrial cancer Colorectal cancer Cognitive function and dementia

Prevention of postmenopausal osteoporosis

Raloxifen Bisphosphanates For Rx only bisphosphonates are used

Tumor markers in dysgerminoma

``` Placental alkaline phosphatase LDH Rarely Alpha fetoprotein hCG ```

Tumor markers positive in embryonal carcinoma

AFP | hCG

Benign conditions associated with increased CA125

``` Pregnancy PID endometriosis Uterine fibroid About 1% of normal females ```

Malignant conditions

``` Endometrial Ca Ca pancreas Ca colon Ca cervix Ca Fallopian tube Breast ca Lung ca Ovarian epithelial ca ```

Contraindications for forceps

Above +2 station | Rotation is more than 45 degrees

Presentations for which forceps delivery is applicable

Vertex Face where chin is anterior After coming head in breach

Prerequisites for forceps delivery

``` Delivery must be mechanically feasible Presentation must be suitable Head should be engaged and less than 1/5th palpable per abdomen Cervix must be fully dilated Bladder and rectum must be empty Uterine contractions should be present Membranes should have ruptured ```

Most common age of atopic dermatitis

5-7 yrs

Areas affected in infantile atopic dermatitis

Face | Extensor aspect

Diff between Infantile atopic dermatitis and scabies

Palms and soles are involved in scabies

Antigen in paraneoplastic Pemphigus

Desmoplakin

Factors deposited in Pemphigus vulgaris and Bullous pemphigoid

IgG | C3

Linear BM deposits

Bullous pemphigoid Epidermolysis bullosa acquisita Bullous SLE

Network pattern in IF

P.vulgaris IgA Pemphigus Paraneoplastic Pemphigus

Antigen in epidermolysis Bullous acquisita and Bullous SLE

Collagen 7

Granular deposit along BM

SLE

Granular papillary tip deposits along BM

Dermatitis herpetiformis

Ovoid bodies with ragged fibrin band along BM

Lichen planus

Peri vascular and basement membrane deposits

Porphyria

Globular deposits in tip of papillary dermis

Amyloid

Fibrin deposition is seen in which Bullous lesions

Porphyria | Lichen planus

Indications of steroids in psoriasis

Impetigo herpetiformis

Impetigo herpetiformis is associated with

Pregnancy

Impetigo herpetiformis

Pustular psoriasis of pregnancy

Sites not involved in impetigo herpetiformis

Face Hands Feet

Topical therapy for psoriasis

``` Emollients TOPICAL steroids VitD analogues calcipotriene,calcitriol Tar Tazarotene Calcineurin inhibitors (tacrolimus,pimecrolimus) Uv light ```

Systemic Rx of psoriasis

``` Methotrexate Retinoids Calcineurin inhibitors Hydroxy urea Azathioprine Paclitaxel Ethanercept Infliximab ```

Rx of psoriatic arthritis

mild-NSAID | severe-methotrexate

Rx of inverse psoriasis

Topical steroids alone Don't use high potency steroids

Rx of guttate psoriasis

Streptococcal infection should be treated first Later uv light

Hypoxia on EEG

Early hypoxia- excitatory Late hypoxia- depression Hypercapnia shows similar changes

Effect of hypocarbia on EEG

Slowing

Monophasic EEG depression seen with which anaesthetic agent

Opioid

Monophasic EEG excitation is seen with which anaesthetic agent

N2O | Ketamine

Somatic passivity is a feature of

Paranoid schizophrenia

``` Associated with panic disorders are all except Serotonin GABA CCK glutamate ```

Glutamate

Amygdala and panic attacks

Reduced activity of Amygdala

Panic disorder reduction in size of which brain structure

Right Anterior cingulate cortex

Neurotransmitters associated with panic disorders

``` Noradrenaline Endogenous opioids Serotonin GABA CCK Orexin ```

Panicogens

``` CCK Yohimbine Beta carboline Co2 Sodium bicarbonate Sodium lactate Caffeine ```

Type D personalities are at increased risk for

CAD

Bipolar 1 disorder

Atleast one episode of mania

Type 2 bipolar disorder

Atleast one episode of hypomania and one episode of depression

Unipolar mania

Type VI

Hypomania or mania precipitated by antidepressant drugs

Type IV

Depressed pts with family history of bipolar illness

Type V

Cyclothymic disorder

Type III

Functional somatic disorders

Somitization Chronic fatigue syndrome IBS Fibromyalgia is not included

Substance elevated in CSF of pts with fibromyalgia

Substance P

cis atracurium is preferred over atracurium

No histamine release,less laudanosine 4times more potent Longer duration of action

Laudanosine causes

Seizures Hypotension Bradycardia