mock paper 2 Flashcards
hiccups in pallaitive care
chlorpromazine or haloperidol
lateral epicondylitis worse when
worse on resisted wrist extension/suppination whilst elbow extended
how does anoxeria tx differ from children to adults
Anorexia focused family therapy is the first-line treatment for children and young people with anorexia nervosa
adults is individual therapy
acute flares of rheumatoid arthritis managed how
oral or IM steriods
when prescribing allopurinol what else should you prescribe as cover
NSAID or colchicine ‘cover’ should be used when starting allopurinol
Management of placental abruption when the fetus is alive,
<36 weeks and not showing signs of distress is to admit and administer steroids
fetal distress: immediate caesarean
Fetus alive and > 36 weeks
fetal distress: immediate caesarean
no fetal distress: deliver vaginally
Fetus dead
induce vaginal delivery
what contraceptive method associated with wieght gain
injectable
what does the progesterone compoent in HRT cause icnreased risk of
breast cancer
cervical cancer screening post pregnancy how long
3 motnhs
increase temp, pyrexia, low blood pressure, crackles on lungs ( misleading) what is it
TRALI
OM with perforation in a child what is mx
oral abx
how do we manage premenstrual syndrome - mood and irritable before period
sertrlaine
typical blood picture of DIC
DIC typical blood picture:
↓ platelets
↓ fibrinogen
↑ PT & APTT
↑ fibrinogen degradation products
uterine fibroids what xan shirnk them
GnRH agonists such as triptorelin
post op ileus what is importnat to check
UandE
how long do you stop methotrexate pre conception
6 months
On writing this prescription, which of the following should be printed in both figures and words?
quantity of tablets prescribed
first line acute stress disorder
Trauma-focused cognitive-behavioural therapy (CBT) should be used first-line for acute stress disorders
agent for ansethesia best in truama as does not cause drop in BP
ketmaine
after membrane sweep what is next in terms of induction of labour
vaginal prostoglandin
volatile liquid anaesthetics( urane) can cause what
malignant hyperthermia
CML - esoinohlia and basophilia with immature ganulocytes tx
imatinibb
preamture ovarian failure means
means post menopuausal so would have anastrzole
A woman gives birth via normal vaginal delivery. The midwife notices the baby has an umbilical hernia, a large, protruding tongue, flattened face, and low muscle tone.
Down’s syndrome is suggested by ↑ HCG, ↓ PAPP-A, thickened nuchal translucency
his patient is presenting in early labour at 36+4 weeks gestation with a transverse foetal lie. Despite the patient being in the early stages of labour - amniotic sac in tack whaat can you offer
extenral cephalic version
Hyoscine hydrobromide or hyoscine butylbromide is generally used first-line to manage secretions in a palliative care setting what class
muscariinc receptor antagonist
schizophrenia illness now well how long till can drive
Patients with schizophrenia must not drive and must notify the DVLA, until stable and well for 3 months and following a suitable psychiatristy report
anti-emetic for intracranial causes of nausea and vomiting
cyclizine
All breech babies at or after 36 weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery
true
mum with maternal diabetes what should be offered post preg
Mum will require repeat testing of her blood glucose at 6-13 weeks post-birth due to her gestational diabetes. This is done using a fasting plasma glucose test
athetoid movements and oro-motor problems what cp
dyskinetic cerebral palsy
spastic most common
rare complication of VZR
nec fasc
psych disorder with typically involves loss of motor or sensory function
conversion disorder
dpression first line in kids
Fluoxetine is the SSRI of choice in children and adolescents
post c section at what date do you dliver another c section
Planned Vaginal birth after Caesarean (VBAC) is an appropriate method of delivery for pregnant women at >= 37 weeks gestation with a single previous Caesarean delivery
preterm prelabour rupture of membranes, what should be give
iM steriods
sickle cell managemetn indicated in ciriss
exchange transfusion
indications include: acute vaso-occlusive crisis (stroke, acute chest syndrome, multiorgan failure, splenic sequestration crisis
rapidly reduce the percentage of Hb S containing cells
polymyalgia rheumatica ck is normal what are other reuslts
ESR ↑, CRP ↑, anti-CCP normal, CK normal
Failure of adequate uterine contractions
uterine atony
are oral antifungals ci in preg so what do you give instead for cnadia
pessary
pseduomonas in CF what do you prescribe to treat
Prescribe oral ciprofloxacin
reduced foetal mvoemetn
handhled doppler 1st line then USS if no headbetat , if heartbeat then CTG
1st line tx for endometriosis
nsaid
Low serum calcium, low serum phosphate, raised ALP and raised PTH
osteomalacia
chronic sx in vestibular neurontis what do you give
vestibular rehab
contaception post birth
3week unless breasfeeding then 6 weeeks as woman takes longer to ovulate
consetn for child 1 or 2 parents
1
bowel colic palliative tx
hyoscine butylbromide
osteomalacia fatures of bone pain, waddling adn weka how do we treat
start vitamin D3 supplementation
is trimehtoprim saf ein preg
yes
causes of cyanosis in neonatal period how do yhey differ
tetralogy of Fallot (TOF)
transposition of the great arteries (TGA)
tricuspid atresia
TOF - VSD 4 things total - Ejection systolic mumru
tanposition - single s2 sun , prminent right ventrilce , egg on side
clomipramine is a TCA - what is side effects fo thsi
weight gain
dry mouth
blurred vsion
UR
increased urianry freq and thirst side effects of what drug
lihtium
atypical endometrial hyperplasia tx
total hysterectomy with bilateral salpingo-oophorectomy,
acute haemolytic reaction
fluid resus and termiante transfusion
difference between anaplyxia and acute haemolutci reation
anaphlaxia - iga deficiecnt- low BP , wheezing and angioedem needing oxygen fluids and adrenaline
acute haemolytic reaction - abo - fever abdo pain and low BP - stop - send blood and supportive care through fluid resus
chemo pts are at increased rate of what condtion to formation of urate
gout
CLL can change too
non-hodgkins
non hodgkins features compared to hodgkins
non-h - painless lyphadenopahtet , nin tender and rubbery
b sx and extradnoldal disease
h - alcohol induced pain
b sx earlier
before starting rituximab what should pt be screened for
hep b
acute sinusitis when are steriods offered after pain relief and nasal decognestatns
10 days
ectopic pregnancies where are at increased risk of rupture
isthmus
how does lidocaine work
blocks Na channels
foetal heart beat on USS how should we manage ectopic
laproscopic surgery and surgical mx
first line OE
Topical antibiotics with or without steroid
dantrolene treats what
malignant hyperthermia
all post tonsillectomy haemorrhaes should be assessed by
ENT
infectio - abx and admission
why do women with postiive preg test or cervical motion tenderness need to be assessed immedeiayty
rule out ectopic
Cyanosis or collapse in first month of life, hypercyanotic spells. Ejection systolic murmur at left sternal edge
tetrallogy of fallot
stressincontince mx
stress - gonna shit yourslef so need to do pelvic floor exercises to strenghtening - if dose not work - need dulex - duloxetine
expectant management is not suitable if evidence of infection or increased risk of haemorrhage in miscarriage so what do you do
dilation and curretaeg
whooping cough tx
macrolides if within 3 w
polycythaemia tx for reeduced thrombotic events
aspirin
itp tx
pred
what diabetic drugs can be taken as nomral during the whole peri-operative period
Surgery / diabetes: DPP IV inhibitors (-gliptins) and GLP-1 analogues (-tides) can be continued on the day of surgery
DIC is associated with what on film
schistocyts as microangiopathic haemolytic anaemia
how long should anti-depressants be continued following remission of sx
6 months
Dyskinetic cerebral palsy results from damage to the
basal ganglia and the substantia nigra
medial thalamus and mammillary bodies of the hypothalamus affected in
wernickes and korsakoffs( antero-retrogrdade amnesia)
ndifferent to praise or criticism, emotionally cold and has a lack of desire for companionshi
schizoid personality disorder
Antisocial personality disorder is incorrect. Characteristics associated with antisocial personality disorder are failure to conform to social norms and laws, deception, impulsiveness, and aggressiveness. He does not have any of these features.
avoidnt fear of rejection or critisicim
schizotypal - odd beliefs
previous c section scar at - when should next c eciton be
37weeks
persistent foetal bradycardia, in the context of a frequency of contractions that is higher than expected. This represents a foetal compromise, what category c esction
30 mins cat 1
placenta preavia when do you rescarn after 20w scan
32w nd if still every 2 weeks then c section at 37-38
over 60 resp rate at any age
refer into hosp as abnormal
what alternative drug can be used in OCR for mod/severe OCD
For moderate/severe OCD, clomipramine may be used as an alternative first-line drug treatment to an SSRI if the person prefers clomipramine or has had a previous good response to it, or if an SSRI is contraindicated
