Extra PACES notes Flashcards
what to do in lithium toxicity?
- stop lithium
- do urgent lithium level
- encourage fluids, stop diuretics, monitor electrolytes/drug interactions
- seek specialist advice
- refer to secondary care if severe symptoms
what to do if >3mmol/l?
osmotic or forced alkaline diuresis
what to tell people if taking lethium?
- carry lithium card
- regular blood tests
- don’t take OTC NSAID
- if dose missed, take as soon as possible
- if yday dose missed, do not double todays dose
what conditions require serial USS?
- SGA
- pre-existing HTN
- pre-existing diabetes
- epilepsy
- smoker/ drug misuse
- maternal age 40+
- previous still birth
what appointments do non-primips have?
8-10w 11-13+6w 16w 18-20+6w 28w 34w 36w 38w 41w
what extra visits do primips have?
25w
31w
40w
(routine care)
paeds HR ref range
<1: 110-160
1-2: 100-150
2-5: 95-140
5-12: 80-120
paeds RR ref ranges
<1: 30-40
1-2: 25-35
2-5: 25-30
5-12: 20-25
NICE red flag system
- pale/mottled/ashen
- does not wake/stay awake
- weak, high-pitched cry
- grunting, RR >60, mod/severe chest indrawing
- reduced skin turgor
- age <3 months, temp 38
- non-blancing rash
- bulging fontanelle
- neck stiffness
- focal neuro signs
when is BP checked in women with pre-existing HTN?
weekly BP checks if poorly controlled
every 2-4 weeks if well controlled
what is the BP monitoring post-partum in mothers with pre-exisiting HTN?
Day 1
Day 2
Once on day 3-5
F/U with GP at 2 weeks
pre-existing DM extra scans
foetal cardiac scan at 20w
serial growth scans
retinal and renal screening at booking, repeat at 28w
scans in gestational HTN
weekly FBC, LFTs, U&Es
US foetal surveillance every 2 weeks
pre-existing cardiac disease scans
- appointment every 2 weeks until 24w
- weekly thereafter
- extra foetal cardiac scan at 22w
measurements in OC
weekly LFTs
doppler/CTG every 2 weeks
what to do if think SGA?
- confirm with fetal biometry at 20w
- if confirmed, uterine artery doppler at 20-24 weeks
- if abnormal, serial growth scans
CVS definition
biopsy of trophoblast cells from developing placenta
adv: earlier
disadv: higher miscarriage rate (2%)
when to do OGTT if Hx of GDM?
at 16-18 weeks
when to do OGTT if RFs of GDM?
OGTT at 28 weeks
planned C-section over breech?
decreased perinatal mortality
decrease early neonatal mortality
long term health of breech baby not affected by delivery
surgical TOP
<14 w = vacuum aspiration
>14 w = dilatation and evacuation
medications to give in med/surgical TOP?
- prophylactic Abx (met and doxy)
- NSAIDs
- anti-D
F/U from TOP
2 week after = check complete/no infection
contraception (start hormonal on day of abortion)
abortion legal statement
- carried out in first 24 weeks if certain criteria are met
- any abortion carried out in hospital/licensed clinic
- 2 drs must agree that the abortion would cause less damage to womens physical/mental health than continuing