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Aaska's specialities > ANNOYING TOPICS > Flashcards

ANNOYING TOPICS Flashcards

1
Q

what are the 4 developmental domains

A

gross motor
fine motor+vision
hearing+speech+language
social+emotional+behavioural

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2
Q

whats the limit age for sitting unsupported

A

9 months

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3
Q

what age do children crawl

A

8-9 months

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4
Q

whats the limit age for fixing and following

A

3 months

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5
Q

whats the limit age for reaching out for toys

A

6 months

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6
Q

when do children develop palmar grasp

A

4-6 months

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7
Q

whats the limit age for transferring toys from one hand to another

A

9 months

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8
Q

whats the limit age for mature pincer grip

A

12 months

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9
Q

when do children start drawing with crayons

A

16-18 months

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10
Q

and what age can a child build
a tower of 3
a tower of 6
a tower of 8 or train of 4
a bridge
steps after demo

A

a tower of 3- 18 months
a tower of 6- 2 years
a tower of 8 or train of 4- 2.5 yrs
a bridge- 3 yrs
steps after demo- 4yrs

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11
Q

when will a child be able to draw
a line
a circle
a cross
a square
a triangle

A

a line- 2 yrs
a circle- 3 yrs
a cross- 3.5yrs
a square- 4 yrs
a triangle- 5 yrs

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12
Q

when do babies have a polysyllabic babble

A

7 months

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13
Q

when do babies say mama and dada

A

7 months

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14
Q

when do babies say 2-3 words other than mama and dada

A

12 months

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15
Q

when do children understand 2 word commands eg name drink

A

12 months

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16
Q

when can children say 6-10 words

A

18 months

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17
Q

when can children point to body parts

A

18 months

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18
Q

whats the limit age for a child to smile

A

6 weeks

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19
Q

when can a child drink from a cup with 2 hands

A

12 months

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20
Q

when can a child successfully feed themself with a spoon

A

18 months

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21
Q

whats the limit age for symbolic play

A

2-2.5yrs

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22
Q

when should a child be dry by day

A

2 yrs

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23
Q

whats the difference between derealisation and depersonalisation

A

depersonalisation= when you are outside yourself and looking at your own actions/feelings/thoughts

derealisation= when you feel like the world isnt real

this are both a form of dissociative disorder

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24
Q

when can you use expectant management for pregnancy of unknown location

A

when the women is less than 6 weeks GA, not in pain

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25
Q

expectant management for pregnancy of unknown location

A

return in pain starts
do a pregnancy test in 7-10 days
return if positive
if negative pregnancy has miscarried

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26
Q

whats the definition of pregnancy of unknown location

A

positive pregnancy test but no visible pregnancy on TVUS

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27
Q

how to differentiate between downs and edwards on quadruple screen

A

in downs inhibin a will be high
in edwards it will be normal

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28
Q

which conditions are screened for in quadruple test

A

downs syndrome

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29
Q

what do you need to initially exclude when suspecting hyperprolactinaemia

A

hypothyroidism
chronic renal failure

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30
Q

otitis media safety net

A

come back if symptoms dont improve within 3 days

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31
Q

antibiotics given immediately when in otitis media when

A

sx >4 days not improving
systemically unwell
immunocompromised
<2yrs and bilateral
perforated

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32
Q

otitis media abx if given

A

amoxicillin 5-7 days

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33
Q

worldwide schizophrenia prevalence

A

1%

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34
Q

risk of getting schizophrenia if a parent has it

A

10%

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35
Q

when does frenotomy require general anaesthesia

A

when over 3 months

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36
Q

why do pregnant women feel breathless

A

tidal volume increases
minute ventilation increases
this causes breathlessness

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37
Q

what happens to neutrophils in pregnancy

A

neutrophilia

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38
Q

what happens to platelets during pregnancy

A

reduced platelets

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39
Q

what happens to resp rate in pregnancy

A

stays the same!!!

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40
Q

what form of oestrogen increases in pregnancy

A

oestriol (E3)

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41
Q

what change to bowel movements is seen during pregnancy

A

contipation as less peristalsis

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42
Q

whats comes first out of metaplasia and dysplasia

whats the difference between them

A

metaplasia= external stressors cause change from one cell type to another

dysplasia= internal change in cell development causes transformational change

therefore metaplasia has to come before dysplasia

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43
Q

out of c4 and c3 what is likely to be lower in lupus

A

c4
c3 is low in severe disease

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44
Q

treatment for human tapeworms

A

praziquantel

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45
Q

when to give ganciclovir/valaciclovir

A

CMV
HHV6

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46
Q

what stain to use for fungi that arent cryptococcus

A

methanamine silver

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47
Q

how to differentiate SS and NMS

A

SS=hyperreflexia

NMS= slower reflexes, leadpipe rigidity

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48
Q

NMS mx

A

stop antipsychotic
hydrate
may use dantrolene

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49
Q

SS mx

A

stop SSRI
hydrate
may use benzodiazepine

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50
Q

in what overdose will you get
dilated pupils (mydriasis)
pinpoint pupils
nystagmus

A

dilated pupils (mydriasis)= TCA OD
pinpoint pupils= opiate OD
nystagmus= benzo OD

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51
Q

what is mydriasis

A

dilated pupils

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52
Q

how does alcohol affect GABA and NMDA

A

enhances GABA
reduces NMDA

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53
Q

in alcohol withdrawal what happens to GABA and NMDA

A

reduced GABA
increased NMDA

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54
Q

how do benzodiazepines effect GABA

A

increase it

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55
Q

peak incidence of seizures in alcohol withdrawal

A

36 hrs

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56
Q

how long after last drink do alcohol withdrawal sx start

A

6-12 hrs

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57
Q

peak incidence of delirium tremens in alcohol withdrawal

A

48-72hrs

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58
Q

what class of medication is used in alcohol withdrawal and why

A

benzodiazepines
they enhance GABA

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59
Q

when might you not use chlordiazepoxide and what will you give instead

A

when there is liver failure
give lorazepam

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60
Q

first line mx for delirium tremens

A

oral lorazepam
IV thiamine

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61
Q

first line mx for alcohol withdrawal seizure

A

oral lorazepam

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62
Q

GAD mx 1/2 line and 1/2/3 medications

A

1= 4-12 week course CBT
2= medical
1. sertraline
2. other SSRI/SNRI
3. pregabalin

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63
Q

baby blues vs postnatal depression time onset

A

baby blues= onset within 2-3 days of birth, resolves by day 10

postnatal depression= onset within first month of birth, 2 weeks of continual depressive symptoms

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64
Q

medication advice for bipolar disorder in pregancy

A

you cannot change or stop medication without specialist advice

sodium valproate is not recommended

mood stabiliser may be switched to an antipsychotic

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65
Q

non hormonal management of women with symptomatic fibroids includes

A

NSAIDs
tranexamic acid

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66
Q

what is uterine artery embolisation

A

a form of radiological intervention used to treat fibroids in women not desiring fertility

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67
Q

what to do if a pregnant women has proteinuria +1

A

if she has no sx of pre eclampsia and normal BP, call her back in a week to reassess

if persistent +1 on dip, quantify the proteinuria using urine albumin:creatinine or protein:creatinine ratio

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68
Q

what is significant proteinuria in pregnancy defined as

A

albumin:creatinine >8mg
protein:creatinine >30mg

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69
Q

if a women has +2 proteinuria what do you do

A

arrange urgent secondary care assessement

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70
Q

what are the triads for nephrotic and nephritic syndrome

A

nephrotic= oedema, proteinuria, hypoalbuminaemia

nephritic= oedema, haematuria, hypertension

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71
Q

what are the 3 causes of nephrotic syndrome

A

minimal change disease
membranous glomerulonephropathy
focal segmental glomerulosclerosis

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72
Q

what are the 5 causes of nephritic syndrome

A

post streptococcal glomerulonephritis
IgA vasculitis (bergers)
rapidly progressive
alports syndrome
thin basement membrane

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73
Q

SNRI side effect

A

high blood pressure

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74
Q

sertraline side effect

A

hyponatraemia

75
Q

citalopram side effect

A

qt prolongation

76
Q

tamoxifen use causes what cancer

A

endometrial

77
Q

what therapy is useful in schizophrenia

A

CBT

78
Q

3rd degree vs 4th degree prolapse

A

3rd= cervix and uterus
4th= cervix, uterus and vaginal wall, bleeding and ulceration possible

79
Q

what degree of prolapse does stuff start going out of the interoitus

A

3rd

80
Q

when to start compressions in a neonate

A

after 10 resus breaths and 30 seconds of effective ventilation if the HR is <60

81
Q

genetic condition wherein there is a large head and relatively short limbs

A

achondroplasia

82
Q

what does the mutation in achondroplasia affect

A

fibroblast growth factor 3

83
Q

how often are contractions assessed in labour

A

every 30 mins

84
Q

how often is pulse assessed in labour

A

hourly

85
Q

what is assessed every 4 hrs in labour

A

temp
BP
resp rate
vaginal exam
bladder exam (output, fluid balance)

86
Q

delay in the first stage of labour is

A

dilation <2cm in 4 hrs

if suspected do a vaginal exam in 2 hrs and if <1cm dilation diagnose delay

87
Q

how long after ROM should you assess a women

A

2 hrs

88
Q

what rate of contractions means you should stop oxytocin

A

more than 4 in 10 mins

89
Q

second stage of labour
passive vs active

A

passive= when fully dilated before pushing
active= fully dilated and pushing

90
Q

duration of active 2nd stage of labour in nullip vs mutlip

A

nullip= 3 hrs
multip= 2 hrs

91
Q

offer instrumental delivery when

A

second stage of labour is prolonged
woman requests it

92
Q

how does previous perineal trauma affect future births

A

risk is not increased at all because of previous trauma

93
Q

advice on water births nhs

A

no conclusive evidence to support or not support water birth

94
Q

what drug is recommended for active management of third stage of labour

A

oxytocin plus ergometrine

95
Q

when should the cord be clamped in active management of the 3rd stage of labour

A

after one minute
before 5 minutes

96
Q

polyhydramnios diagnostic criteria

A

amniotic pool >8cm
amniotic fluid index >95th percentile expected at the gestational age

97
Q

what can you not take on tamoxifen

A

SSRIs

98
Q

when is anterior colporrhaphy used

A

cystourethrocele

99
Q

when is sacrocolpopexy used

A

for vaginal vault prolapse in women who have had a hysterectomy

100
Q

when is sacrospinous fixation used

A

to give support to the uterus

101
Q

age for croup

A

6 months- 6 years

102
Q

adjustment disorder time scale

A

doesn’t last for longer than 6 months after the stressor

103
Q

how do patients react to their symptoms in conversion disorder

A

unbothered

104
Q

what is low birth weight

A

<2500g

105
Q

breastfeeding advice for LBW infants

A

start breastfeeding as soon as possible
exclusive breastfeeding for 6 months is recommended
if breastfeeding not possible, donor milk is recommended
if donor milk not possible, formula

106
Q

what gynae cancers metastasise to the paraaortic nodes

A

endometrial
ovarian

107
Q

what gynae cancers metastasise to the inguinal nodes

A

cervical
vulval

108
Q

bicornuate or septate uterus is due to failure of fusion of what ducts

A

paramesonephric

109
Q

low serum progesterone causes miscarriage when

A

first trimester

110
Q

what is the embryogenic mechanism for ToF

A

anterosuperior displacement of the infundibular septum

111
Q

complicated otitis media mx

A

oral antibiotics
follow up at 6 weeks in primary care

112
Q

what abx are given in otitis media

A

amoxicllin

113
Q

what cell produces androgen binding hormone

A

sertoli

114
Q

what does NSAID use after 20 weeks GA cause

A

oligohydramnios
premature closure of the PDA
increases risk of persistent pulmonary hypertension

115
Q

when in pregnancy is NSAID use absolutely contraindicated

A

after 28 weeks

116
Q

what is first line analgesia in pregnancy

A

paracetamol

117
Q

what type of nsaid is completely contraindicated throughout pregnancy

A

cox 2 inhibitor

118
Q

smoking is protective in which gynaecological cancer

A

endometrial

119
Q

what condition in the mother increases risk of neonatal respiratory distress syndrome?

A

diabetes

120
Q

what 2 drugs cause foetal hyantoin syndrome

A

phenytoin
carbamazepine

121
Q

when is meconium ileus more common

A

post term

122
Q

when a pregnant mother is given steroids for preterm labour what might happen

A

hyperglycaemia- need to carefully monitor her

123
Q

what might infants get after gastroenteritis transiently that also causes diarrhoea

A

lactose intolerance

124
Q

what are maternal causes of cleft palate

A

anti epileptic use
benzo use
rubella infection
smoking

125
Q

hep b breastfeeding rules

A

safe to breast feed

126
Q

how does smoking affect hyperemesis gravidarum

A

reduces risk

127
Q

when is gestational age calculated by CRL vs head circumference

A

head circumference if the CRL is >84mm

128
Q

when questioning how can you differentiate dementia and depression

A

depression= patient will be less likely to answer qs or will say i dont know

dementia= patients will attempt to answer all qs

129
Q

can you do ECT in pregnant women

A

yes

130
Q

what type of memory impairment do you get with ECT

A

retrograde (difficulty remembering what happened before ECT)

131
Q

lithium therapeutic range

A

0.6-1.0

132
Q

what are rf for VTE in pregnancy

A

age over 35
smoker
parity >3
BMI >30
pre eclampsia
immobility
IVF pregnancy
multiple pregnancy
pre eclampsia
low risk thrombophilia

133
Q

when is VTE prophylaxis given in pregnancy

A

if there are 4 or more rf immediately
if 3 start at 28 weeks

134
Q

how long is anticoagulation continued for if DVT is near term

A

3 months after term

135
Q

when is foetal fibronectin used and when is igf1/ placental alpha microglobulin used

A

foetal fibronectin= used if membranes are intact and preterm labour is suspected

igf1/ placental alpha microglobulin is used when membranes have reuptured to assess likelihood of progression to labour

136
Q

if amniotic fluid pooling is seen in pprom what tests need to be done to confirm?

A

none, you manage the women as suspected going into labour

137
Q

how does TGA affect pulse

A

causes thready/weaker pulse

138
Q

what urine study uses dye

A

MCUG

139
Q

what is done for opiate substitution therapy during pregnancy and breastfeeding

A

if established on buprenorphrine or methadone continue

dont encourage switch to buprenorphrine

can safely continue on these during breastfeeding

140
Q

what are the recommendations on opiate detoxification during pregnancy

A

in small amounts can be done in second trimester

not recommended in third trimester

141
Q

what is the best way for a baby to present

A

occiput anterior

142
Q

describe occiput anterior

A

when the occiput (at base of skull on side of spine) is on the same side as mums tummy/front

143
Q

how long do women stay in hospital for after a hysterectomy?

A

2-4 days

144
Q

how long do women have a catheter in after hysterectomy

A

24hrs

145
Q

what PV bleeding might occur after hysterectomy

A

light PV bleeding
1-2 weeks

146
Q

how soon after hysterectomy can someone have sex

A

4-6 weeks

147
Q

how long after hysterectomy can you shower

A

24hrs

148
Q

how long after hysterectomy can someone go back to work

A

usually around 6-8 weeks

149
Q

when should women with single pregnancies be offered IOL if they havent gone into labour

A

41+0 weeks

150
Q

what is klinefleters syndrome

A

when a boy has an extra chromosome (47 XXY)

151
Q

how does klinefelters syndrome present

A

taller than average
small testes
infertile
lack of secondary sexual characteristics
gynaecomastia

152
Q

what are gonadotrophin and testosterone levels in klinefelters

A

gonadotrophin= high
testosterone=low

153
Q

lymph nodes in what location are more likely to be malignant

A

supraclavicular and posterior triangle of neck

154
Q

where is a branchial cyst found

A

lateral aspect of neck at the anterior border of sternocleidomastoid

155
Q

what are the 2 midline cysts in a child

A

branchial
thyroglossal

156
Q

what is lymphadenitis

A

swelling of lymph nodes due to infection

157
Q

what is left shift

A

increased number of immature neutrophils which occurs in infection

the neutrophils will be hypogranular and hypolobulated

158
Q

when is chlordiazepoxide not given and whats given instead

A

if they have liver impairment
give lorazepam

159
Q

if a child has congenital heart disease and is cyanosed what are the 2 conditions they could have? how do you differentiate them

A

ToF= they will have a murmur
TGA= they will not have a murmur

160
Q

what congenital heart condition in a child will lead to lack of femoral pulse but normal other pulses

A

coarctation

161
Q

what congenital heart condition in a child will lead to lack of femoral pulse and absent left carotid

A

interrupted aortic arch

162
Q

what congenital heart condition in a child will lead to lack of all pulses

A

hypoplastic heart or critical aortic stenosis

163
Q

what congenital heart condition in a child will lead to carotid thrill

A

aortic stenosis

164
Q

how does assisted vaginal birth affect risk of tears

A

increases

165
Q

how does IOL affect risk of shoulder dystocia in macrosomic babies

A

reduced risk

166
Q

when is placenta praevia/low lying placenta usually picked up

A

at foetal anomaly scan 18-20+6 weeks GA

167
Q

what scans are done for placenta praevia/low lying placenta

A

picked up at anomaly scan (18-20+6 GA)

rescan at 32 weeks to check

if still low lying rescan at 36 weeks

168
Q

when should you aim for delivery in placenta praevia/low lying placenta?

A

36-37 weeks GA

169
Q

how does placenta praevia/low lying placenta affect chances of preterm birth?

A

increased

give steroids at 34-35 weeks GA

170
Q
A
171
Q

What is diffuse white out and air bronchograms on a CXR

A

Acute real distress syndrome

172
Q

What is diffuse white out and air bronchograms on a CXR

A

Acute resp distress syndrome

173
Q

MMSE dementia

A

o Mild AD: 21-26
o Moderate AD: 10-20
o Severe AD: < 10

174
Q

wernickes triad

A

opthalmoplegia/nystagmus
ataxia
confusion

175
Q

wernickes encephalopathy mx

A

IV thiamine urgent replacement

176
Q

PTSD cardinal features

A
  1. traumatic event
  2. intrusion sx (flashbacks/nightmares etc)
  3. avoidance sx
  4. hyperarousal
  5. negative association
  6. exclusion (not drugs/alcohol etc)
  7. functional impairment

present for 1 month

177
Q

naloxone vs naltrexone

A

naloxone= used to reverse opioid overdose
naltrexone= used long term to prevent opioid relapse as reduces craving

178
Q

what is 99 technetium used for

A

meckels diverticulum

179
Q

surgery options for cytsocele

A

anterior colporrhapy
colposuspension

180
Q

surgery options for uterine prolapse

A

hysterectomy
sacrohysteropexy

181
Q

surgery options for rectocele

A

posterior colporrhapy

182
Q

what is each part of the bishop score score out of

A

3

accept position (0=posterior, 1=intermediate, 2=anterior) and consistency (0=firm, 1=intermediate, 2=soft) which are score out of 2

183
Q

how do you identify meningococcal septicaemia?

A

non blanching rash
(sign of DIC)

184
Q
A

Aaska's specialities (7 decks)

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