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Medicine > Common Osce Review Questions > Flashcards

Common Osce Review Questions Flashcards

1
Q

Active mgt of 3rd stage of labor

A

1) Oxytocin 10 IU IM(5IU each buttock)
2) Uterine massage
3) Early cord clamping
4) Controlled cord traction

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2
Q

X-ray features of osteomyelitis

A

S3 C3 I P

Sinus tract
Sclerosis 
Sequestration 
Cloaca 
Cortical irregularity 
Cortical thickness 
Involucrum 
Periosteal elevation
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3
Q

Maternal mortality

A

Death of a woman while pregnant or within 42 days after termination of pregnancy, irrespective of the site and duration of pregnancy from any cause related to or aggravated by the pregnancy or its mgt and not from incidental or accidental causes.

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4
Q

Causes of maternal mortality

A

HITLA

Hemorrhage (APH,PPH)
Infection (malaria,SCD)
Toxemia (Pre eclampsia, eclampsia)
Obstructed labor
Unsafe abortion
Anemia
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5
Q

Delays in maternal mortality

A

Phase 1: from the woman and family at home

Phase 2: delay in Distance and bad road to health facilities

Phase 3: delay in the hospital, poor health care, insufficient staff and equipment, incorrect treatment and delayed tx

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6
Q

Methods of induction of labor

A

1) Medical: Oxytocin titration, misoprostol and prostaglandin
2) Surgical: Artificial rupture of membrane(Arom), Arom + oxytocin titration, extra-amniotic saline infusion.

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7
Q

Methods of Cervical ripening

A

1) trans-cervical extra amniotic foleys catheter
2) misoprostol
3) other prostaglandin analogue
4) oxytocin
5) estradiol/ estrogen
6) insertion of luminaria tents/ dilapan tru the cervix
7) membrane stripping/sweeping
8) castor oil
9) relaxin gel

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8
Q

Cardinal movements of labor

A

ED FIERES

Engagement 
Descent 
Flexion
Internal rotation 
Extension 
Restitution 
External rotation 
Shoulder rotation and delivery of baby.
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9
Q

Specific symptoms and tx of BV

A
  • Thin grayish white vaginal discharge
  • fishy vaginal smell especially after coitus and menstruation
  • burning while urinating
  • vag itchy

Treatment
1)Oral metronidazole 500mg BID for 7days for non pregnant women

2) clindamycin gel 2% intravaginally for 7days. At bed time

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10
Q

Characterise specific symptoms and tx for gonorrhoea

A

Mild in women some asymptomatic
-mucopurulent vag discharge

Treatment
Procaine penicillin, strep and genta IM for penicillin allergy

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11
Q

Risk factors of cervical cancer

A
  • HPV infection
  • herpes
  • Early coitarche
  • race (blacks and Caucasian )
  • in utero diethly stilbesterol
  • Advanced age
  • Immunodeficiency
  • Lack of regular screening
  • pervious hx of cervical displasia
  • family hx of cervical cancer
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12
Q

Treatment of cervical cancer

A

1) surgery alone (for stage 1-2a)
2) radialology alone (advanced lesions of stage 1a)
3) combined
4) chemotherapy

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13
Q

Pap smear

A

Papanicoliau test, developed 1940’s by georgios papanicoliau.

Involves: exfoliating from transformation zone if the cervix, to enable examination of the cells to detect pre cancerous or cancerous lesions.

Instrument: cervical brush

Recommended every 3yrs in women age 21-65, or earlier if the woman has been sexually active in earlier yrs.

Age 30-65 hpv every 5yrs

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14
Q

Symptoms of cervical cancer

A

Early stage: asymptomatic, or postcoital, post menopausal intermentraul vaginal bleeding

Advanced stage: pain(infiltration to sacral plexus) Diarrhea, constipation, urine and fecal incontinence, lymphedema

Terminal: oliguria, anuria, weight loss,

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15
Q

Characterise candidiasis

A

Whitish odourless vag discharge
Itchiness and painful sex

Tx : fluconazole

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16
Q

Characterise trichomoniasis

A

Yellowish greenish fishy smell vag discharge
Itchiness
Painful sex
Postcoital bleeding

Tx metronidazole

17
Q

X-ray features of Intestinal obstruction

A

Supine view: Gaseous dilated bowel loop, small intestine- dilated bowel is central

18
Q

McAfee regime (mgt of APH)

A

1) Admit pt
2) Strict bed rest and advice pt to avoid strenuous activity
3) Check PCV
4) blood grouping and cross matching then transfuse if necessary
5) perineal pad to monitor blood loss, check twice daily.
6) monitor vitals of mother and fetus

-give steroids if fetus <34wks

19
Q

Mgt of ruptured ectopic pregnancy

A
  • Admit pt
  • Call for help
  • 2 Wide bore cannula (one for fluid one for blood grouping and cross matching)
  • IV fluid resuscitation
  • urgent blood transfusion in case of severe blood loss
  • emergency exploratory larparotomy with any of the these:

salpingotomy
Milking of the tube
Salpingostmy
Saplingectomy

  • broad spectrum antibiotic and analgesics
  • monitor vital signs
  • irrigate abdominal cavity with warm normal saline.
  • pass catheter to drain and suture
20
Q

Cyanotic hrt diseases

A

A congenial hrt diseases causing oxygenated and non oxygenated blood to mix.

5 T’s

1) Truncus arteriosus (vessels join to form 1)
2) Transposition of great vessels ( 2 major vessels switch )
3) Tricuspid valve atresia (3 valves abnormally formed it not formed at all)
4) Teteralogy if fallot (4 abnormalities)
5) Total anomalous pulmonary Venus return (TAPVR) (5 letters)

21
Q

Radiological features tetralogy

A

1) Up turned apex if the hrt
2) Boot shaped hrt
3) Concave pulmonary artery segment

22
Q

A cyanotic hrt diseases

A

VSD
ASD
PDA
Coarctation of aorta

23
Q

Complications of blood transfusion (early and late)

A

Early

Reactions

Early Haemolytic rxn
Non hemolytic febrile rxn
Allergic reaction
Rxn secondary to bacteria contamination

Transfusion related injury
Circulatory overload 
Air embolism 
Hyperkalemia 
Hypothermia 
Clotting abnormalities (after massive blood transfusion)
Citrate toxicity

Late

Thrombophlebitis 
Post transfusion thrombocytopenia 
Iron overload 
CMV HIV MP HBV 
Immune sensitivity (rhesus d antigen)
24
Q

Side effects of Ace inhibitors

A

You can Use this mnemonic CAPTOPRIL

COUGH
ANGIOEDEMA
POTASSIUM ELEVATION
TERATOGENIC IN PREGNANCY 
OTHER( FATIGUE & HEADCHE) 
PROTEINURIA 
RENAL IMPAIRMENT
ITCHING 
LOW BP
25
Q

Features of Kwashiorkor

A 
1/ Always- G.O.M.M
   • Growth retardation 
   • Oedema
   • Metal changes 
   • Muscle wasting 
 2/  Usually- S.H.A.D
     • Skin changes 
      • Hair changes 
      • Moon face 
      • Diarrhea 
3 /  Occasionally- D.I.S.H
      • Dermatosis 
       • Infection 
        • Skin ulceration and fissuration 
        •  Hepato- splenomegaly.
26
Q

Contraindications of Ace inhibitors

A

PARK

Pregnancy
Allergy
Renal artery stenosis (bilateral)
K increase (hyperkalemia)

Others:
Hypotension
Renal failure
Stenosis or aortic or mitral valves

27
Q

Indications for forceps delivery

A 
Full cervical dilatation
Outlet adequate 
Ruptured membrane 
Cephalic presentation 
Engaged head
Pain relief
Surrounding viscera empty(bladder, rectum)
28
Q

Risk for dupuytrens contracture

A

We can use this mnemonic
SHAME

Smoking 
HIV/HEREDITARY 
Alcohol liver disease 
Manual labour 
ENDOCRINE (DM)

Medicine (15 decks)

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