Pass

Question 1

Normal collagen in the palmar fascia

Answer 1

Type 1

Question 2

Collagen in dupuytrens contracture?

Answer 2

Type 3

Question 3

What is erbs palsy? Which trunks are usually involved?

Answer 3

Paralysis of the arm caused by injuries to the brachial plexus
-particularly damage to C5 and C6 trunks

Question 4

What is erbs palsy associated with?

Answer 4

Commonly associated with schoulder dystocia during difficult labour

Question 5

Erbs palsy

Answer 5

Waiter’s tip

Question 6

Klmupke’s palsy

Answer 6

Handbag

Question 7

Which nerve is involved in wrist drop and what injuries could cause it?

Answer 7

• Radial nerve palsy

- It can occur in patients with stab wounds in the chest and fractures of the humerus

Question 8

Examination findings of Charcot Marie Tooth (hereditary sensorimotor polyneuropathy)?

Answer 8

Foot drop
Pescavus
Scoliosis
Stamping gait

Often have a strong family history

Question 9

This tract connects the primary motor cortex with the alpha motor neurons in the ventral horn of the spinal cord

Answer 9

Corticospinal tract

Question 10

Lesions in the corticospinal tract cause UMN or LMN lesions?

Answer 10

UMN

LMN lesions are lesions of the alpha motor neurones, not this tract

Question 11

Plexiform neuroma symtpoms?

Answer 11

LMN

Question 12

Mononeuritis multiplex symptoms?

Answer 12

LMN

Question 13

Vagus nerve palsy

Answer 13

Palatal weakness (this causes ‘nasal speech’)
Loss of reflex contraction of the palate in the gag reflex
Hoarseness of the voice (in a unilateral laryngeal lesion)
Bovine cough (with a bilateral recurrent nerve lesion)

Question 14

The 4 T’s that can cause PPH

Answer 14

Tone
Tissue (retained placenta)
Trauma
Thrombin (coagulation abnormalities)

Question 15

Most common cause of PPH?

Answer 15

Uterine atony (accounts for 90% of cases)

Question 16

What defines a PPH?

Answer 16

Blood loss more than 500mls

Question 17

Which vitamin can be teratogenic in high doses?

Answer 17

Vitamin A

Question 18

Key clinical feature of placenta praevia?

Answer 18

Painless (often bright red) bleeding after 24 weeks

Question 19

Eclampsia seizure management

Answer 19

IV magnesium sulphate, 4g over 5-10 minutes
Followed by infusion of 1g/hour

Urine output, reflexes, respiratory rate and oxygen saturations should be monitored during treatment

Treatment should continue for at least 24 hours after last seizure or delivery

Other important aspects of treating severe pre-eclampsia include fluid restriction to avoid the potentially serious consequences of fluid overload

Question 20

Why should you avoid cooked liver in pregnancy?

Answer 20

Contains high levels of vitamin A

Question 21

Definition of puerperal pyrexia?

Answer 21

Temperature of >38 degrees C in the first 14 days following delivery

Question 22

Most common cause of puerperal pyrexia?

Answer 22

Endometritis

Question 23

Management of endometritis?

Answer 23

Patient should be referred to hospital for IV antibiotics (clindamycin and gentamicin) until afebrile for greater then 24 hours

Question 24

Pleocytosis with “tumbling motility” on wet mounts

Answer 24

Listeria infection

Question 25

Diagnosis of listeria infection?

Answer 25

Diagnosis can ONLY be made from blood cultures

Question 26

Treatment of listeria

Answer 26

Amoxicillin

Question 27

Which UTI antibiotic should be avoided in the first trimester and why?

Answer 27

Trimethoprim (should be avoided as it is a folate antagonist)

Question 28

When do you avoid nitrofurantoin in pregnancy and why?

Answer 28

Avoid close to term (due to risk of causing neonatal haemolysis)

Question 29

Signs of labour

Answer 29

Regular and painful uterine contractions

A show (shedding of mucous plug)

Rupture of the membranes (not always)

Shortening and dilation of the cervix