One last push Flashcards
1
Q
What are Thrombolysis contraindications
A
- ICP neoplasm
- Active bleeding
- GI bleeding within 3 weeks
2
Q
How do triptans work ?
A
- 5-HT agonists
3
Q
What are contraindications for triptans ?
A
- IHD
- Cerebrovascular disease
4
Q
- What are common side effects of triptans ?
A
- Flushing
- Chest and throat tightness
- Tingling
5
Q
- What is ALL ?
A
- Acute lymphoblastic leukaemia
- The most common malignancy in children
6
Q
- ALL features that suggest bone marrow failure
A
- Anaemia – lethargy and pallor
- Neutropenia – frequent or severe infection
- Thrombocytopenia: easy bruising, petechiae
- Bone pain
7
Q
- Other features of ALL
A
- Bone pain
- Splenomegaly
- Hepatomegaly
- Fever
- Testicular swelling
8
Q
- Types of ALL
A
- Common ALL (75%) CD10 present, pre-B phenotype
- T-cell ALL (20%)
- B-cell ALL (5%)
9
Q
- Poor prognostic factors of ALL
A
- Age <2 or > 10 years
- EBC > 20*10(9)/l at diagnosis
- T or B cell surface markers
- Non-Caucasian
- Male sex
10
Q
- When is jaundice pathological in a newborn ?
A
- First 24 hours
11
Q
- Causes of pathological jaundice
A
- Rhesus haemolytic disease
- ABO haemolytic disease
- Glucose-6-phosphodehydrogenase
12
Q
- What could jaundice developing between 2-14 days be ?
A
- Physiological
- More fragile red blood cells
- Less developed liver function
- More common in breastfed babies
13
Q
- When does jaundice become prolonged ?
A
- 14 days in term
- 21 days in preterm
14
Q
- Prolonged jaundice investigations
A
- Conjugated and unconjugated bilirubin
- Coomb’s test
- TFTs
- FBC and blood film
- Urine
- U&E and LFTs
15
Q
- Causes of prolonged jaundice
A
- Biliary atresia
- Breast milk jaundice
- Prematurity
- Congenital infection
- UTI
16
Q
- What is a big worry with jaundice in newborns ?
A
- Kernicterus
- Bilirubin levels so high it becomes neurotoxic
17
Q
- Surgical management of biliary atresia
A
- Kasai procedure
18
Q
- What causes bronchiolitis ?
A
- MCC RSV
- Adenovirus
19
Q
- Features of Bronchiolitis
A
- Coryzal symptoms and fever precede
- Dry cough
- Increasing breathlessness
- Wheezing with find inspiratory crackles
- Feeding difficulties
20
Q
- Call 999 if
A
- Apnoea
- Child looks unwell to a HCP
- RR of more than 70
- Grunting or marked chest recession
- Central cyanosis
- Oxygen sats below 92%
21
Q
- Bronchiolitis investigate
A
- Immunofluorescence of nasopharyngeal secretions which will show RSV
22
Q
- Management of bronchiolitis
A
- Humidified oxygen given via a headbox if below 92%
NG feeding if child cannot take enough fluid - Suction for upper airway secretions
23
Q
- When is it more likely viral induced wheeze than asthma ?
A
- Presenting before 3
- No atopic history
- Only occurs during viral infections
24
Q
- What are fibroids ?
A
- Benign smooth muscle tumours of the uterus
- Develop in response to oestrogen
25
Q
- Features of symptomatic fibroids ?
A
- Menorrhagia
- Bulk related symptoms Lower abdominal pain, cramping pains
- Bloating and urinary symptoms
- Subfertility
26
Q
- Diagnosis of fibroids
A
- Transvaginal ultrasound
27
Q
- Management of symptomatic fibroids (typically menorrhagia
A
- Levonorgestrel intrauterine system
- NSAIDs e.g. mefenamic acid
- Tranexamic acid
- COCP
- Oral progesterone
- Injectable progesterone
28
Q
- Treatment to remove or shrink fibroids
A
- GnRH agonists
- Surgical – myomectomy
- Hysteroscopic endometrial ablation
- Uterine artery embolization
29
Q
- Endometriosis
A
- The growth of ectopic endometrial tissue outside the uterine cavity
30
Q
- Features of endometriosis
A
- Chronic pelvic pain
- Secondary dysmenorrhea – pain starts days before bleeding
- Deep dyspareunia
- Subfertility
31
Q
- Gold standard investigations
A
- Laparoscopy is gold standard
32
Q
- Management of endometriosis
A
- NSAIDs or paracetamol 1st line
- COCP or progesterone’s
33
Q
- Paed UTI management
A
- Less than 3 months then admit
- More than 3 months with upper UTI should be considered or given cephalosporin or co-amoxiclav 7-10 days
- More than 3 months and lower UTI then trimethoprim
- Bring back if still unwell 24-48 hours
34
Q
- Pathophysiology of VUR
A
- Ureters are displaced laterally entering the bladder in a more perpendicular fashion than at an angle
- Therefore shorter intramural course of the ureter
- Vesicoureteric junction cannot therefore function adequately
35
Q
- Vesicoureteric Reflux investigations
A
- Micturating cystourethrogram
- DMSA scan can look for scaring