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Cross reference - year 5 > Last minute specialties > Flashcards

Last minute specialties Flashcards

1
Q

how can you confirm a miscarriage on TVUSS?

A

no FH and CRL >7mm

GS > 25m + no foetus

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2
Q

C-section layers

A
  • superficial fascia
  • deep fascia
  • anterior rectus sheath
  • rectus abdominis muscle
  • transversalis fascia
  • extraperitoneal connective tissue
  • peritoneum
  • uterus
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3
Q

frequent maternal risks of C-section

A
  • wound/abdo discomfort in first few months
  • inc risk of repeat C-section
  • readmission to hosptial
  • haemorrhage
  • infection
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4
Q

what do theca cells respond to? what do they produce?

A

respond to LH

produce androgen

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5
Q

what do granulosa cells respond to? what do they produce?

A

respond to FSH
produce aromatase (convert androgen to oestriol)
produce progesterone

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6
Q

management of children depression

A

self help = “youngminds.org”
mild = IPAT 6-8 sessions, psychoeducation
2nd line: CBT
needs not met = referral to CAMHS

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7
Q

investigations in biliary atresia

A

USS: triangular cord sign

gold standard: TIBIDA isotope scan, ERCP +/- biopsy

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8
Q

fluid given in paeds maintenance

A

5% dextrose and 0.9% NaCl

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9
Q

features of androgen sensitivity

A

S/S: feminisation, no internal male or female organs

XY genotype

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10
Q

17-alpha hydroxylase

A

S/S: feminisation, hypertensive

XY genotype

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11
Q

gene involved in achrondroplasia and hypochondroplasia

A

FGFR3 gene

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12
Q

unique features of congenital hypothyroidism

A

coarse features
macroglossia
umbilical hernia

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13
Q

cause of OS disease

A

osteochondritis of patellar tendon

insertion at knee

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14
Q

mutation in tuberous sclerosis

A

TSC1 or 2

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15
Q

neuro features of tuberous sclerosis

A

infantile spasm
developmental delay
epilepsy
intellectual disability

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16
Q

drug for recurrent Ovarian Ca

A

Bevacizumab

Ab against VEGF to inhibit angiogenesis

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17
Q

what ovarian tumours is chemo not useful?

A

sex cord stromal

surgery mainstay

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18
Q

investigation not to forget in ovarian torsion

A

urinalysis to exclude ureteric colic

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19
Q

urge incontinence management

A
  • conservative: lifestyle advice, avoid fizzy drinks, bladder training (6 weeks)
  • 2nd: oxybutyrin
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20
Q

overflow incontinence management

A

refer to urogynaecologist

1st treatment = timed voiding

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21
Q

3 structural causes of infertility in men

A

cryptochordism
CF
varicocele

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22
Q

extracampine hallucination

A

sense of presence in absence of stimulus

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23
Q

when can’t you have an Independent Mental Health Advocate?

A

4, 5, 135, 136

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24
Q

investigations in NMS

A

FBC (leucocytosis)

U&Es (high CK and AKI)

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25
Q

how is rapid tranq monitored?

A

ensure baseline taken

  • oral PRN: monitor hourly for minimum one hour on NEWS form
  • IM: monitor every 15 minutes for min 1 hour on rapid tranq form
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26
Q

role of noradrenaline

A

mood

energy

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27
Q

role of serotonin

A

sleep
appetite
memory
mood

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28
Q

role of dopamine

A

psychomotor activity

reward

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29
Q

depression treatment in children (5-11)

A

family therapy
IAPT/ individual CBT
referral made to CAMHS

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30
Q

depression treatment (12-18)

A
  • individual CBT
  • if bad = fluoxetine
  • CAMHS
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31
Q

manage BPAD with comorbid depression

A
  1. fluoxetine and olanzapine

2. quetiapine

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32
Q

rating scale in Schizophrenia

A

brief psychiatric rating scale

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33
Q

possible symptoms of GAD

A 
restlessness
irritability
fatiguability
muscle tension
sleep disturbance
poor concentration
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34
Q

panic disorder

A

recurrent attacks of severe anxiety

not restricted to any particular circumstance and so are unpredictable

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35
Q

part of the brain implicated in OCD

A

basal ganglia

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36
Q

seizure in alcohol withdrawal syndrome

A

grand-mal

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37
Q

symptoms of Korsakoff’s

A
  • anterograde amnesia
  • confabulation
  • peripheral neuropathy
  • cerebellar degeneration
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38
Q

length of opiate substitution therapy as outpatient

A

12 weeks min

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39
Q

opiate substitution therapy treatmetns

A

methadone, buprenorphine

offer naloxone to take home

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40
Q

recreational stimulant drug that can cause dependence

A

amphetamines

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41
Q

length of cocaine in urine

A

5-7 days

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42
Q

MoA of varenicline

A

partial nicotine receptor agonist

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43
Q

MoA of bupropion

A

selective DA and NA reuptake inhibitor

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44
Q

dissocial personality disorder

A 
fights but cannot maintain relationships
irresponsible
guiltless
heartless
temper easily lost
someone else's fault
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45
Q

axious/avoidant personality disorder

A 
avoids social contact
fears rejection/criticism
restricted lifestyle
apprehensive
inferiority
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46
Q

dissociation

A

immature ego defence

one assumes different identity to deal with situation

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47
Q

displacement

A

defence mechanism

someone takes out their emotions on neutral person

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48
Q

when should pharmacological management be used in AN?

A

physical symptoms
rapid weight loss
BMI <13.5

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49
Q

electrolytes low in refeeding syndrome

A

low K, P, Mg

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50
Q

trance and posession disorders

A

temporary loss of personal identity and full sense of awareness

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51
Q

4 subtypes of somatisation disorder

A

undifferentiated somatoform
hypochondrial disorder
somatoform autonomic dysfunction
persistent somatoform pain disorder

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52
Q

short term anti-psychotic in Alzheimer’s

A

risperidone

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53
Q

med management in Alzheimer’s

A

1 (mild-mod): anticholinesterases e.g. donezepil

2 (mod-severe): NMDA partial receptor agonist e.g. memantine

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54
Q

Lewy body distribution in LBD vs PD

A

LBD: brainstem, cingulate gyrus, neocortex
PD: just brainstem

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55
Q

how long should symptoms persist for diagnosis of conduct

A

6 months

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56
Q

MMSE no cognitive impairment

A

24-30

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57
Q

MMSE mild cognitive impairment

A

18-23

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58
Q

MMSE severe cognitive impairment

A

0-17

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59
Q

how do bromocriptine and dantrolene work to treat NMS?

A

Bromocriptine: reveres dopamine blockade
Dantrolene: reduced muscle spasm

60
Q

what patients need anticoag in pregnancy?

A

CHD
pulmonary HTN
artificial valves
inc risk of AF

61
Q

HTN in pregnancy / severe

A

HTN: 140/90
severe: >160/110

62
Q

major risk factors to give aspirin for

A
  • previous pre-eclampsia
  • CKD
  • AI disease
  • DM
  • Chronic HTN
63
Q

give if aspirin is have 2 of:

A
  • primigravida
  • age >40
  • preg interval >10 years
  • BMI >35
  • Pos FHx
  • Multiple pregnancy
64
Q

complications of delivery during viraemic period in VZV infection?

A
  • haematological: bleeding, DIC, thrombocytopaenia
  • hepatitis
  • VZV infection of new born
65
Q

management of maternal CMV

A
  • do not treat but if evidence of CNS damage to foetus = offer TOP
  • foetal USS every 2w following diagnosis
  • foetal MRI at 28 weeks
66
Q

2 milestones that should be reached by 2 years

A

link 2 words in sentences

understand 2 step commands

67
Q

milestones reached by 3 yeard

A

gross motor: hop on one foot, walk upstairs 1 foot per step, down 2 feet per step
fine motor: draws circle bricks in bridge
speech/language: understands negatives and adjectives
social: begin to share toys, eats with fork and spoon

68
Q

what age should children babble polysyllabically

A

5 months

69
Q

later complications of Down syndrome

A

secretory otitis media
OSA
learning difficulty
VI joint laxity

70
Q

metabolic diseases in Guthrie test

A 
PKU
MCABB
Maple syrup urine disease
isovaleric acidaemia
glutaric aciduria type 1
homocysteinuria
71
Q

first investigations in neonatal jaundice

A
  1. check transcutaenous or serum BR levels
  2. do split BR (check uBR/cBR)
  3. blood film analysis
72
Q

investigation in baby over 2 weeks

A

direct and indirect serum BR (split BR in over 2 week old)

73
Q

CXR in RDS

A

ground glass appearance

74
Q

important investigation in billous vomiting

A

AXR:
double bubble = duodenal atresia
Air fluid level = jejunal/ileal atresia
dilated bowel loops = NEC

75
Q

GOR cause

A

functional immaturity of LOS (inappropriate relaxation)

76
Q

intusseption investigations

A

Abdo USS = donut sign

AXR

77
Q

sign of volvulus on abdo exam

A

scaphoid abdo

78
Q

3 most common causative organisms in otitis media

A

H. influenzae
S. pneumonia
RSV

79
Q

complication of chronic otitis media

A

mastoiditis

80
Q

Ebstein’s heart abnormality

A

split 1st and 2nd heart sounds

81
Q

mangement of rheumatic fever

A

high dose aspirin (suppress inflammatory response)
Abx (if evidence of infection)
steroids (if not resolved rapidly)

82
Q

S/S of BXO

A 
haemtauria
painful erections
recurrent UTI
weak stream
swelling
83
Q

paraphimosis

A

emergency
foreskin becomes trapped in retracted position
= restriction of blood flow to head of penis

84
Q

2 most common causes of ARF in children

A

HUS ATN

85
Q

what syndrome is associated with pilocystic astrocytoma?

A

Neurofibromatous 1

86
Q

Ewing’s translocation

A

11;22

87
Q

tissue that neuroblastoma arises from

A

neural crest tissue in adrenal medulla and SNS

88
Q

benign tumour of same tissue as neuroblastoma

A

ganlioneuroma

89
Q

treatment of acute crises in sickle cell disease

A 
analgesia
hydration
Abx
oxygen
exchange transfusion
90
Q

treatment of chronic problems in SCD

A

hydroxycarbamide

HSCT if severe

91
Q

deficiency in Gaucher’s disease

A

beta - glucosidase

92
Q

management of Gaucher’s disease

A

splenectomy
bisphosphonates (due to BM suppression)
enzyme replacement
treat anaemia

93
Q

sepsis monitoring is 2+ risk factors or 1 red flag

A

abx (cefotaxime, amikacin, ampillicin) and septic screen

94
Q

what are the red flag symptoms?

A

seizure
resp distress
shock

95
Q

what is Rubin’s manoevure?

A

push anterior shoulder toward baby chest

96
Q

what is Wood Screw?

A

Rubin’s + push posterior shoulder towards baby back = rotation

97
Q

biggest risk factors for SGA

A 
previous stillbirth, 
ALPS, 
renal disease
chromosomal abnormalities
infection
multiple pregnancy
placental insufficiency
98
Q

identifying pregnancy on USS

A
  1. look for foetal heart beat
  2. find foetal poles for CRL
  3. if not foetal pole, look for gestational sac
99
Q

2 placenta and 2 amniotic sacs

A

25%

lambda scan

100
Q

oligohydramnios

A

<5th centile

deepest pool <2cm

101
Q

type 1 vasa praevia

A

velamentous cord insertion in a single/bilobed placenta

102
Q

type 2 vasa praevia

A

foetal vessels running between lobes of placenta with at least 1 accessory lobe

103
Q

secondary endometritis

A

24 hours to 12 weeks PP

104
Q

what medication in managing PPH to avoid in HTN/asthmatics?

A

ergometrine

105
Q

how can baby be monitored when a mother has anti-D Abs?

A

middle cerebral artery dopplers

106
Q

skin conditions of pregnancy

A 
pemphygoid gestationis
PUPPP
Prurigo of pregnancy
Pruritis follicultitis A
atopic eczema
107
Q

prurigo appearance

A

excoriated papules on extensor limbs, abdomen and shoulder

108
Q

how does smoking affect pregnancy?

A

damaged umbilical cord structure

increased risk of ectopic/placental abruption/miscarriage

109
Q

treatment of hyperthyroidism

A

propylthiouracil - 1st TM

carbimazole - 2nd/3rd

110
Q

most likely causative organism in asymptomatic bacteruria

A

GBS - streptococcus agalactiae

111
Q

foetal blood sampling

A

blood withdrawal from umbilical vein

112
Q

late decelerations

A

lags onset of contraction and dose not return to normal until after 30s following end of contraction

113
Q

indications for immediate CS

A
  • terminal bradycardia : FHR < 1000bpm for more than 10 mins

- terminal deceleration: FHR drops and does not recover for more than 3 mins

114
Q

what gets done at the booking visit?

A 
FBC
MSU
blood group and ab screen
rhesus status and atypical abs
haemaglobinopathy screen
infection screen (Hep B, syphillis, HIV)
115
Q

what is hPL?

A

homologue to GH

  • decreases insulin sensitivity
  • increases lipolysis to increase glucose availability for baby
  • decreases glucose utilisation
116
Q

mechanism of atosiban

A

inhibits oxytocin and vasopressin

117
Q

1st and 2nd degree tear

A

1: superficial damage with no muscle involvement

2. injury to perineal muscle, no anal sphincter involvement

118
Q

conversion disorder

A

typically involves loss of motor/ sensory function

119
Q

dissociative disorder

A

dissociation is a process of “separating off” certain memories from normal consciousness
in contrast to conversion disorder involves pyshiatric symptoms e.g. Amnesia, fugue, stupor

120
Q

localised non-bullous impetigo treatment

A

topical hydrogen peroxide

121
Q

moderate erythema nappy rash treatment

A

hydrocortisone 1% cream

122
Q

2nd line treatment in seborrhoeic dermatitis

A

if scalp is affected = topical imidazole cream

123
Q

treatment of non-capitits types of tinea

A

mild: topical terbinafine
mod: hydrocortisone 1%
severe: oral terbinafine

124
Q

brachial cleft/throglossal abnormality surgery

A

Sistrunk’s procedure

125
Q

cap glucose fasting and after meals

A

fasting: 4-7

after meals: 5-9

126
Q

2 biochemical definitions of DKA

A
  1. acidosis and bicarb < 15

2. pH < 7.3 and ketones > 3

127
Q

volume of fluid resus in DKA emergency

A

shocked: 20mls/kg bolus over 15 mins

if not shocked: 10mls/kg bolus over 60 mins

128
Q

deficit volume

A

weight x 10 x deficit %

129
Q

fluid maintenance in DKA specifically

A

<10kg: 2 ml/kg/hr
10-40kg: 1 ml/kg/hr
40+kg: 40 ml/kg/hr

130
Q

congenital causes of hypergonadotrophic hypogonadism

A

cryptoorchidism (absence of 1 or both testes from scrotum)
Kleinfelter’s
Turner’s

131
Q

premature thekarce

A

isolated breast development before 8 years

132
Q

what does small testes and precocious puberty indicate?

A

tumout of CAH (adrenal cause)

133
Q

medical treatment for gonadotrophin dependent precious pubertyy

A

GnRH agonist + GH therapy

134
Q

medical treatment for gonadotrophin-independent precious puberty

A

testotoxicosis: ketoconazole
CAH: hydrocortisone + GnRH agonist

135
Q

symptoms of achondroplasia (other than short stature)

A

hydrocephalus
depression of nasal bridge
marked lumbar lordosis
trident hands

136
Q

centiles for severely obese, obese and overweight

A

severely obese: 99th

obese: >95th
overweight: 85-94th

137
Q

what is the roll test?

A

patient supine
roll affected hip internally and externally
guarding or spasm in Perthe’s

138
Q

osteochondritis dissecans

A

reduced blood flow = avascular necrosis
results in fragmentation of bone and cartilage
= activity related joint pain

139
Q

septic arthritis vs osteomyelitis

A

infectious arthritis of synovial joint

vs osteomyelitis of bone

140
Q

septic arthritis vs osteomyelitis

A

infectious arthritis of synovial joint

(vs osteomyelitis of bone)type

141
Q

antiepileptic exacerbates myoclonic seizures

A

lamotrigine

142
Q

first line treatment of retinopathy of prematurity

A

laser photocoagulation

143
Q

germ cell ovarian tumours

A
  • teratoma
  • dysgerminoma
  • endodermal sinus tumour
  • choriocarcinoma
144
Q

sex-cord stromal tumours

A

fibroma
thecoma
granulosa cell tumour
sertoli-leydig cell tumour

145
Q

MOA of POP

A

thickens cervical mucous

146
Q

calculating a unit

A

volume x (% alcohol/1000)

147
Q

features of periventricular leukomalacia (PVL)

A

bilateral multiple cysts
periventricular white cell matter damage
80-90% risk of spastic diplegia

Cross reference - year 5 (22 decks)

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