extra passmed questions 5 Flashcards
36 y/o female
30 weeks pregnant
pc: severe lower abdo pain.
oe: uterus is tender and hard, fetal lie normal
indicative of:
woody uterus
placental abruption
what is the threshold for starting immediate insulin in a patient with a diagnosis of gestational diabetes:
fasting glucose level is >= 7 mmol/l
first line treatment for stress incontinence
pelvic floor muscle training
first line for urge incontinence
bladder retraining
which of the following is associated with endometrial hyperplasia:
a) tamoxifen
b) >30 years
c) alcohol
d) COCP
e) late menarch
a) tamoxifen
endometrial hyperplasia caused by oestrogen which is unopposed by progesterone.
other risk factors
- obesity
- late menopausea
- early menarche
- aged over 35
- nulliparity
- smoking
most appropriate choice for menorrhagia (first line)
mirena coil (IUS)
what might be given to a patient who suffered pre-eclampsia, in future pregnancies, to reduce risk of developing pre-eclampsia again?
low dose aspirin
investigation of placental praevia:
transvaginal ultrasound
midwife takes blood to screen for HIV, rubella and syphillis. MSUS also sent for culture to screen for asymptomatic bacteria.
what other infectious disease is also screened for:
hep B
most common site of ectopic pregnancy:
ampulla of fallopian tube
three causes of increased nuchal translucency:
- downs syndrome
- congenital heart defects
- abdominal wall defects
32 y/o female 34 weeks gestation first pregnany.
pc: seizure following a 1 day period of severe abdominal pain, nausea, vomiting, and visual disturbance.
fh: epilsepsy
oe: hyperreflexia noted
likely diagnosis
eclampsia
what is oligohydraminos and possible cause:
deficiency in amniotic fluid.
renal agenesis can cause this, as amniotic fluid mainly derived from foetal urine.
27 y/o female
pc: 6 month hx spasmodic pains in LIF. sometimes radiate to back, bloated particularly around period. stubbprn bowels recently.
oe: abdo and vaginal examination normal.
diagnosis:
IRRITABLE BOWEL SYNDROME
classic ABC features
A-abdo pain
B-bloating
C-change in bowel habit
Cervical cancer screening: if smear inadequate:
then repeat within 3 months
patient presents with breast cancer. what form of contraception if most appropriate:
Copper IUD
- breast cancer CONTAINDICATION to all hormonal forms of contraception
what is advisable for all postmenopausal women with atypical endometrial hyperplasia:
due to risk of malignant progression
total hysterectomy w/ bilateral salpino-oophorectomy
Bladder still palpable after urination:
retention with urinary overflow incontinence
Women who have been treated for CIN II should be offered cervical screening at :
6 months
The combination of menorrhagia, subfertility and an abdominal mass in this patient points towards:
fibroids = benign tumours of the myometrium
- menorrhagia
- pain with torsion
- subfertility
haemophilia mode of inheritance
x-linked
mothers –> sons
6 y/o girl
pc: fever , lethargy
no vaccinations
oe: not talking, leaning forward with hands on knees, breathing loudly, drooling. febrile.
likely diagnosis:
acute epiglottis
haemophilus influenza type b
Acute epiglottitis is characterised by rapid onset fever, stridor and drooling
management of acute epiglottis
- senior involvement (anaesthetics, ENT)
- endotracheal intubation - do not examine throat
- oxygen
- IV ABX