9 Flashcards
what does naltrexone do
opiod antagonist-prevents euphoria in former addicts to prevent relapse
what is the treatment for opiod detoxification
a2 adrenergic agonists eg LOFEXIDINE
or can use opiod subsititue therapies-OST eg methadone or Buprenorphine
what is buprenorphine
synthetic partial agonist at u-opiod receptors
what does HCS do
produced form week 5 of pregnancy
GH like effects
decrease insulin sensitivity in mother-more glucose for fetus
involved in breast development
what are the side effects of carbamazepine
SIADH, leucopenia, ataxia, blurred vision, drowsiness, diplopia and can cause agranulocytosis
what are the side effects of carbamazepine in pregnancy
Neural tube defects, facial dysmorphism, cardiac anomalies, fingernail hypoplasia, VIT K DEFICIENCY
what is Uhthoff’s phenomenon
worsening of vision following increase in body temperature in MS
what is Lhermitte’s phenomene
paraesthesia in limbs on neck flexion
if get nausea with parkinsons medication what should you use to treat
DOMPERIDONE
nb metoclopramide can worsen PD, cyclizine and prochlo
what is mefenamic acid
NSAID-avoid in pregnanacy
in antipsychotics why do you get sedation
secondary to the blockage of histamine
what are accelerations in CTG
abrupt increase in BHR for >15bpm for >15s
how can you treat hypersalivation caused by clozapine
HYOSCINE
what is treatment for mastitis
flucloxacillin
what is breast thrush treatment
miconazole
if long term treatment with carbamazepine, phenytoin, sodium valproate what vitamin supplementation is needed
vitamin D
can you breast feed if on AEDs
yes and should be encouraged to help with withdrawl if they were continued in pregnancy
why do you need to stay in hospital for 24 hours if history of epilepsy
greatest risk of seizures in first 24 hours
diagnosis of gestational diabetes
fasting >5.6mmol 2hr random or after 75g oral glucose tolerance test >7.8
can you use NSAIDs in pregnancy
no they should be avoided as thought to be a link with miscarriage, paracetamol should be used instead
what is Charcot Marie-Tooth syndrome
type of hereditary sensorimotor peripheral neuropathy
no UMN signs
can present with LMN in all limbs and decrease sensation
high stepping gait, wasting of lower legs and high arches
which TCA antidepressants are most dangerous in overdose
amitryptylline and dosulepin
most sedative TCas
amitrypylline, clomipramine and dosulepin
what is the denticulate made of
arachnoid and pia tissue
what are the types of longitudinal artery
1 anterior and 2 posterior
what is todds paralysis
prolonged weakness after a seizure
what is a conus lesion
presents as cauda equine-do MRI
what is lateral medullary syndrome
stoke in posterior inferior cerebellar artery
what is another name for lateral medullary syndrome
Wallenbergs syndrome
what does lateral medullary stroke cause
ipsilateral ataxia, nystagmus, dysphagia, facial numbness, CN palsy eg horners
contralateral limb sensory loss
what are the 4 types of MS
relapsing remitting, primary progressive, secondary progressive, progressive relapsing
what is a weber stroke
ipsilateral III palsy
contralateral weakness
what is great anterior segmental artery also known as
ADAMKIEWICZ
this reinforces circulation to inferior 2/3 of spinal cord found on LEFT in many individuals
what does tectospinal tract do
input mostly to cervical segments
thought to mediate reflex head and neck movments due to visual stimuli
what does reticulospinal tract do
reticular formation forms central core of brainstem
many nuclei and receives input from virtually all parts of CNS
influences voluntary movement
what are the risk factors for endometrial cancer
early menarche, late menopause, nulliparity, obesity, tamoxifen, PCOS, unopposed oestrogen, diabetes mellitus
the COCP has protective effects to which cancers
endometrial and ovarian
COCP increases risk of
breast and cervical cancer
what investigation is to be done if there is suspicion of ovarian cancer
blood test for CA125 and If this is above 25 urgent ultrasound of abdomen and pelvis
treatment for endometrial cancer
for localised disease-total abdominal hysterectomy with bilateral salpingo-oophrectomy
patients with high risk disease may also have post operative radio
progestogen therapy sometime used in frail elderly women who are not suitable for surgery
whats the first line investigation for ?endometrial cancer
transvaginal ultrasound <4mm is a good negative prognostic indicator but if >4mm then do hysteroscopy with endometrial biopsy
how does lactation prevent against pregnancy
sucking reduces release of gonadotrophins which suppress ovulation and as sucking reduces ovulation returns
how effective is lactational amenorrhoea
if all 3 criteria fulfilled 98%
what are criteria for lactational amenorrhoea
less than 6 months postpartum
amenorrhoeic-no vaginal bleeding after 56 days postpartum
fully breast feeding day-at least 4 hrly and 6 hrly night feeds
what is decorticate posturing
damage to one or both of the corticospinal tracts plantar flexion extension knees internally rotated legs flexion elbow, adduction shoulder
what is decerebrate posturing
damage to the upper brainstem-midbrain/pons
arms adducted and extended
wrists pronated and fingers flexed
legs stiffly extended with plantar flexion of feet
side effects for carbamazepine
SIADH, leucopenia, ataxia, blurred vision, drowsiness, diplopia agranulocytosis
