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Year 2 HD > HD OVERVIEW > Flashcards

HD OVERVIEW Flashcards

1
Q

Define fertility/subfertility

A

a

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2
Q

Primary vs. secondary infertility

A

a

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3
Q

Type 1 ovulatory cause of infertility

A

a

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4
Q

Type 2 ovulatory cause of infertility

A

a

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5
Q

Type 3 ovulatory cause of infertility

A

a

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6
Q

Cause of PCOS

A

a

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7
Q

Main cause of pelvic inflammatory disease

A

a

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8
Q

Endometriosis

A

a

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9
Q

Uterine fibroids

A

a

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10
Q

Three drugs associated with infertility in women

A

a

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11
Q

Three drugs associated with infertility in men

A

a

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12
Q

First line advice for couples worried about infertility

A

a

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13
Q

Reasons for an early referral

A

a

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14
Q

Primary care investigations for infertility

A

a

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15
Q

Secondary care investigations for infertilty

A

a

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16
Q

Ovarian reserve test

A

a

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17
Q

HSG test

A

a

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18
Q

Tests to asses ovulation

A

a

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19
Q

NICE guidelines for unexplained infertility

A

a

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20
Q

WHO sperm count volume

A

1.5ml LRL

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21
Q

WHO sperm count motility

A

32% LRL

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22
Q

WHO sperm count morphology

A

4% normal LRL

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23
Q

Treatment for type 1 ovulatory failure

A

a

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24
Q

Treatment for type 2 ovulatory failure

A

a

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25
Q

Treatment for type 3 ovulatory failure

A

a

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26
Q

IUI what is involved?

A

a

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27
Q

IUI who is this offered to?

A

a

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28
Q

IVF - what is involved?

A

a

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29
Q

Ovarian hyperstimulation syndrome

A

a

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30
Q

ICSI

A

a

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31
Q

Main symptom of pelvic inflammatory disease

A

Most asymptomatic

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32
Q

Most common STI in England

A

a

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33
Q

Pathogen responsible for chlamydia

A

a

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34
Q

What is ceftriaxone and what is this used for?

A

a

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35
Q

Which STIs have no effect on the neonate?

A

a

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36
Q

Which STIs can affect the neonate?

A

a

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37
Q

Cause of gestational diabetes

A

a

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38
Q

GDM - problem for the mother or the neonate?

A

Neonate

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39
Q

Four foetal complications from GDM

A

Macrosomia
Hypoglycaemia
Hyperbilirubiniea
Respiratory distress syndrome

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40
Q

Increased risk of non-viral infections during pregnancy - why? Risk to mother or neonate?

A

Neonate mainly

Waters break - pathway for bacteria to travel to the placenta through the cervix

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41
Q

What type of non-viral infection is most common during pregnancy and why?

A

Group B streptococcus - present in the normal flora of the vagina in 25% of women

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42
Q

Consequence of group B strep infection in neonate

A

Pneumonia
Meningitis
Non-focal sepsis
Death

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43
Q

Polyhydramnios - increased risk of what?

A

Excess amniotic fluid in the amniotic sac

GDM

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44
Q

Listeriosis

A

a

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45
Q

Polyhydramnios - increased risk of what?

A

Excess amniotic fluid in the amniotic sac

GDM

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46
Q

Infections in which trimesters are most harmful to a) mother and b) foetus?

A

a) most harmful to mother in the third trimester

b) most harmful to foetus in the first trimester - this is where all of the foetal development is occurring

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47
Q

Infections in which trimesters are most harmful to a) mother and b) foetus?

A

a) most harmful to mother in the third trimester

b) most harmful to foetus in the first trimester - this is where all of the foetal development is occurring

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48
Q

How to diagnose bacterial infection in pregnancy?

A

Swab/sample and culture this

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49
Q

How to diagnose viral infection in pregnancy?

A

Serology and pCR (very sensitive and very quick)

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50
Q

First antibody produced to infection

A

IgM

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51
Q

Second antibody produced to infection - when has the person contracted the infection if this antibody is present?

A

IgG - within the past 24 to 48 hours

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52
Q

Infections routinely tested for antenatally

A

Hep B
HIV
Syphilis
+ regular ultrasound to monitor foetal development

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53
Q

Viral infection affecting the blood is?

A

a

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54
Q

Virus that is the most common cause of congenital sensorineural deafness and treatment?

A

CMV - herpes virus

Treat with antiviral gancyclovir

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55
Q

More common names for VZV (varicella zoster virus) and treatment

A

Congenital/neonate/infants - chicken pox
Adults - shingles

Treatment is (val)acyclovir

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56
Q

Two type of Herpes and what they are most responsible for plus treatment

A

HSV1 - oral
HSV2 - genital

NOW evidence that they are both responsible for both

Treatment is acyclovir

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57
Q

What is the worst infection for a foetus to contract and why?

A

Rubella

Eye abnormalities leading to blindness, sensorineural deafness, congenital heart disease, death

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58
Q

What is the treatment for syphilis?

A

Penicillin

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59
Q

What viral condition does ‘blueberry muffin appearance’ describe?

A

CMV

Also appears in rubella

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60
Q

What is the most common congenital infection in developed countries?

A

Congenital CMV

61
Q

What viral infection is indistinguishable from glandular disease/fever?

A

CMV

62
Q

How can you recognise congenital rubella from looking in an infants eye?

A

Cataracts will be present - shine a light into their eye and it will appear white
Will not see a red reflex

63
Q

Which virus is responsible for gandular fever/disease?

A

Epstein Barr virus

64
Q

How do the presentations e.g. on a penis of HSV2 and HPV differ?

A

HPV - genital wart

HSV2 - genital sore

65
Q

What is septicaemia?

A

Blood poisoning i.e. infection of the blood

66
Q

What are the signs of septicaemia?

A 
Tachycardia
Tachypnoea
Rash
Prolonged capillary refill 
Low BP - late sign
67
Q

What is the definition/temperature for a fever?

A

Temperature greater than 37.5 (rectal temp)
Taken by mouth will be 0.5 degrees lower than rectal temp
Taken by armpit will be 1 degree lower than rectal temp

68
Q

Give the names of three organisms that will cause septicaemia and meningitis

A

Streptococcus pneumonia
Neisseria meningitidis
Haemophilus influenzae B

69
Q

What are the signs of meningitis?

A 
High temperature
Headache 
Vomiting
Cannot tolerate bright lights
Drowsy 
Stiff neck
70
Q

What is the problem with meningitis symptoms in infants?

A

Non-specific symptoms e.g. high temperature, sleepy, vomiting, blotchy skin

71
Q

What are the three most common bacterial infections in infants?

A

Group B strep
E. Coli
Listeria

72
Q

How will tetanus present in a neonate and how might this be contracted?

A

Weak
Lethargic
Poor suck
Muscle spasms

Contracted from bacteria getting into wound - bacteria from soil e.g. unclean blade used to cut the cord

73
Q

What is ALL and what is it’s relevance as a cancer in children?

A

Most common malignancy in children and most frequent cause of death in cancer children

74
Q

What are the signs of ALL?

A

Bruising/bleeding
Pallor and fatigue
Infection (due to neutropenia)

75
Q

Where will infiltration be seen in ALL?

A

Liver
Spleen
Lymph nodes
Mediastinum

76
Q

What glycoproteins on the surface of cells are associated with ALL?

A

CD19+

CD10+

77
Q

When is methotrexate used in the treatment of ALL/cancer?

A

Used in the treatment of tumours which have reached the brain

78
Q

What is Wilm’s tumour?

A

This is a tumour of the kidney

Aka. Nephroblastoma

79
Q

What is the cause of Wilm’s tumour?

A

Deletion of or part of chromosome 11

80
Q

How does Wilm’s tumour present?

A

Asymptomatic abdominal mass on the back

NO metastasis

81
Q

Is Wilm’s tumour genetic?

A

Both genetic and epigenetic

If present on multiple locations of the kidney then more likely to be genetic

82
Q

Why is the use of radiotherapy dangerous in children?

A

Because you want to preserve all the tissues

83
Q

What is a retinoblastoma?

A

Tumour of the retina - multifocal i.e. multiple tumours

84
Q

What are the origin cells of retinoblastomas?

A

Cone precursor cells

85
Q

Give two genes involved in the onset of retinoblastoma

A

Loss of RB1

Activation of MYCN

86
Q

What is a neuroblastoma in children and where is this present?

A

Tumour of the sympathetic NS

Present on the adrenal gland or at the sympathetic ganglia

87
Q

Three stages of pregnancy

A

Antepartum - prior to labour: early is <24 weeks and late is >24 weeks
Intrapartum - in labour: the first and second stages
Postpartum - from delivery of the foetus up to 6 weeks later

88
Q

Line between miscarriage and stillbirth

A

24 weeks

89
Q

Define spontaneous miscarriage

A

When a foetus dies/is delivered dead prior to 24 weeks

90
Q

Six types of spontaneous miscarriage

A 
Threatened
Inevitable 
Incomplete
Complete
Septic 
Missed
91
Q

Threatened miscarriage

A

Light and painless bleed, the foetus is alive and the uterus is at the expected size
Only 25% of these go on to miscarry

92
Q

Inevitable miscarriage

A 
Heavy bleeding
The foetus may be alive at this point
The cervical os is open 
Crampy pelvic pain will occur
The miscarriage is about to occur - it is inevitable
93
Q

Incomplete miscarriage

A

Only some parts of the foetus have passed
Bleeding continues
Cervical os is open
Requires medical aid for the removal of all foetal matter

94
Q

Complete miscarriage

A

All foetal tissue is removed
The uterus is small
The cervical os is closed

95
Q

Septic miscarraige

A

The contents of the uterus is infected and this causes endometritis
Tender uterus
Fever may be absent
May progress to a pelvic infection and this can cause abdominal pain and peritonism

96
Q

Missed miscarriage

A

The foetus has not developed or has died in utero
Only recognised later with bleeding or scans
Uterus is smaller than expected
Cervical os closed
Minimal abdominal pain and vaginal bleeding

97
Q

Presentation of missed miscarriage on a scan

A

Abnormally shaped amniotic sac with no embryo

Foetus with no heartbeat

98
Q

Define recurrent miscarriage

A

Woman has three or more consecutive miscarriages

99
Q

Define cervical incompetence

A

Where the cervix fails to retain the pregnancy

100
Q

Define ectopic pregnancy

A

Implantation of a fertilised ovum outside of the endometrium

101
Q

Pharmacological treatment for ectopic pregnancy

A

Methotrexate

102
Q

Define molar pregnancy

A

Where a non-viable, fertilised egg implants into the uterus

This egg will fail to come to term

103
Q

Explain molar pregnancy

A

Egg contains no maternal nucleus - entirely paternal in origin
The uterine trophoblast tissue differentiates and expands more aggressively than normal

104
Q

Define partial molar pregnancy

A

Some presence of foetal tissue but not complete presence

Will not come to term

105
Q

Define gestational trophoblastic disease

A

Pregnancy related tumours

The trophoblastic tissue

106
Q

Define antepartum haemorrhage

A

a

107
Q

Two types of antepartum haemorrhage

A

a

108
Q

Define antepartum

A

a

109
Q

Define placental abruption

A

a

110
Q

Symptoms of placental abruption

A

a

111
Q

Define placenta praevia

A

a

112
Q

Symptoms of placenta praevia

A

a

113
Q

What is a tense, ‘woody’ uterus characteristic of?

A

a

114
Q

Two types of placenta praevia

A

a

115
Q

How can you differentiate between placental abruption and placenta praevia if the patient has vaginal bleeding?

A

a

116
Q

Define pre-eclampsia

A

a

117
Q

Cause of pre-eclampsia

A

a

118
Q

When does pre-eclampsia occur?

A

a

119
Q

What is the main driving force for BHP (benign hypertrophy of the prostate)?

A

Testosterone

120
Q

Does BHP have hypertrophy or hyperplasma?

A

Has both despite name

121
Q

Why is there hypertrophy in BHP?

A

a

122
Q

Why is there hyperplasia in BHP?

A

a

123
Q

In which testicle does a variocele occur and why?

A

a

124
Q

Normal birthweight for infants

A

Just under 3.5kg

125
Q

Low birthweight for infant

A

<2.5kg

126
Q

Very low birthweight for infant

A

<1.5kg

127
Q

Extremely low birthweight for infant

A

<1kg

Generally not compatible with life

128
Q

Full term range of gestational age

A

37-42 weeks

129
Q

Preterm gestational age

A

<37 weeks

130
Q

SGA parameter

A

a

131
Q

What is IUGR

A

a

132
Q

Main concern with SGA neonate

A

Barker hypothesis - development of CVD, hypertension, type 2 DM

133
Q

Main concern with premature neonate

A

Neurological developmental issues

134
Q

Monochorionic vs. dichorionic twins

A

Monochorionic - twins share a placenta

Dichorionic - twins have their own placenta

135
Q

‘Twin-twin transfusion’

A

One twin receives more circulation than the other - grows larger

136
Q

‘Edwards syndrome’

A

Trisomy 18

137
Q

Foetus prioritises blood flow to which three regions?

A

Brain
Heart
Adrenal gland

138
Q

Two consequences of foetal hypoglycaemia

A

a

139
Q

Two presentations of feotal hypoglycaemia

A

a

140
Q

Three reasons temperature control is a problem in SGA baby

A

a

141
Q

‘Ductus arteriosus’

A

Between the aorta and pulmonary artery

142
Q

‘Ductus venosus’

A

Between the left umbilical vein and IVC

143
Q

‘Foramen ovale’

A

Between left and right atria

144
Q

Function of ductus venosus

A

Allows the blood circulation to bypass the liver

145
Q

Function of foramen ovale

A

Movement of blood from right atria to left atria

146
Q

Nerve roots of the pudendal nerve

A

S2, S3, S4

147
Q

Common pathology at the vesico-uterine pouch + presentation

A

Chronic endometriosis
Cyclical pain

NB. also important in retroversion of the uterus

148
Q

Ground glass shadowing in x-ray of infant is significant of what?

A

Respiratory distress syndrome - lack of surfactant production

149
Q

Presentation of necrotising enterocolitis

A

Tenderness
Discolouration
Distended abdomen
Generalised collapse

Year 2 HD (29 decks)

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