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3A :0 > Passmed :0 > Flashcards

Passmed :0 Flashcards

1
Q

estational diabeties test results and treatment plNS

A

fasting plasma glucose of <7 needs a trial of diet and excercise. if this doesn twork fr 2 week start metformin

> 7 start insulin immediatly

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2
Q

perthes disease key presentaion and what is it

A

avasucalr necrosis of teh femoral head. 5x more common in boys

presents with progressive hip pain, limo and stiffness

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3
Q

how long do teh different contraceptives take to become effective

A

Contraceptives - time until effective (if not first day period):
instant: IUD
2 days: POP
7 days: COC, injection, implant, IUS

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4
Q

PCOS medication and treatment

A

For endometrial canre- IUS or COCP

for infertiloty:
Clomifene - increases chace of ocultion
Laparoscopic ovarian drilling
In vitro fertilisation (IVF)

spiranalactone to block angrogen conversion!!!

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5
Q

menopaue ages and contraceptons

A

menopause - 12 months after no period
perimonopause - teh sime surrounding menopasue tat leds to smptoms

normal is over 45
FSH test neeed in women under 40 - this is premature

contracetio needed 1 years after menopause in over 50 and 2 years for under 50

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6
Q

what is teh apgar scoring process

A

Appearance
Pulse
Grimace
Activity
Respiratory

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7
Q

alchollwthdwarl sezzures onset tmes

A

symptos - 6-12 hours
sezures 36 hours
delerum tremens 72 hours

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8
Q

treatment for stress and urge ncontnance

A

stress - pelvc floor excercses
urge - bladder retranng nd then oxybutynn (antmuscnarc)

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9
Q

deine and name a tocolytc and one tme you may use it

A

reduces contracions

terbutalne
umblcal cord prolapse

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10
Q

lst DOACs and LMWH

A

DOAC:
rvoroxban
apxaban
edoxban

LMWH:
daltaparn
enozaparn
tnzaparn

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11
Q

whats fluid bolus is given in diabeties

A

Start IV fluid resuscitation in children or young people with a bolus of 10 ml/kg over less than 10 minutes

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12
Q

what are teh dfferent types of psorass

A
  • Plaque - most common from in adults
    • Guttate - small raised papules, most commn in children and is triggerd by strep throat infection, stress or medication. Resolve in 3-4 months
    • Pustular - pustules form under erythematous skin, medicla emergany
      Erythrodermic - the skin comes away coepleyelt - admit emergancy
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13
Q

what are the 2 signs of porass

A
  • Auspitz sign- small point of bleeding when the plaueq is scraped off
  • Koebner phenomenon - psoriatic lesions in area of skin affected by trauma
    Residual pigmentation of eth skin once the lesion resolves
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14
Q

what s teh sterod ladder names

A

Steroid ladder:
* Hydrocortisone (1)
* Eumavate (2.5)
* Betnovate (10)
Dermavate (50)

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15
Q

blood marer for rheumatod arthertis

A

ant CCP - ant cyclc ctrullnated peptde

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16
Q

extra astro features of chrons

A

fnger clubbng
erythema nodosum
pyoderma ganerenosm
epsclerts
nflamatry artherts

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17
Q

remsson and mantndanct for UC and chrons

A

chronns - oral pred or IV hydrocortisone then zathioprine
UC - msalazine ot sulfasalazine

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18
Q

When should maternal steroids be given

A

between 24-35 weeks

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19
Q

what what pont whould lochia get an ultrasond

A

6 weeks

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20
Q

medcal treatment for stress adn urge ncontance

A

urge:
bladder retrangn
Anticholinergic medication: for example, oxybutynin, tolterodine and solifenacin
Mirabegron (a beta-3 agonist) has no antcholngergc afects.

Stress:
pelvc floor excercse
Duloxetine is the agent of choice for stress incontinence.

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21
Q

what s teh SSRi of choce n those wth recent myocardal nfarcaton

A

Sertralne

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22
Q

when should an ectopc be managed surgcally

A

All ectopic pregnancies >35 mm in size or with a serum B-hCG >5,000IU/L should be managed surgically

or heartbeat presatn

heamodynamcally unstable

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23
Q

wbat s frst lne SSR n chldren and young people

A

Fluoxetne

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24
Q

what are teh red nce guodlines

A

blue
not responding or doesnt wake
grunting
tachyopnea >60
chest indrawing
reduced skin turgour
age <3 with temp >38
non blanching rash
bulgign fontanelle
neck stiffness
status epilepticus
focal neurological signs
focal seizures

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25
Q

risk factors for PPH

A

Previous PPH
Multiple pregnancy
Obesity
Large baby
Failure to progress in the second stage of labour
Prolonged third stage
Pre-eclampsia
Placenta accreta
Retained placenta
Instrumental delivery
General anaesthesia
Episiotomy or perineal tear

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26
Q

what are teh the mechanical and surgical treatment for PPH

A

Mechanical treatment options involve:

Rubbing the uterus through the abdomen to stimulates a uterine contraction (referred to as “rubbing up the fundus”)
Catheterisation (bladder distention prevents uterus contractions)

Intrauterine balloon tamponade – inserting an inflatable balloon into the uterus to press against the bleeding
B-Lynch suture – putting a suture around the uterus to compress it
Uterine artery ligation – ligation of one or more of the arteries supplying the uterus to reduce the blood flow
Hysterectomy is the “last resort” but will stop the bleeding and may save the woman’s life

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27
Q

medcnla management of PPH

A

Oxytocin (slow injection followed by continuous infusion)
Ergometrine (intravenous or intramuscular) stimulates smooth muscle contraction (contraindicated in hypertension)
Carboprost (intramuscular) is a prostaglandin analogue and stimulates uterine contraction (caution in asthma)
Misoprostol (sublingual) is also a prostaglandin analogue and stimulates uterine contraction
Tranexamic acid (intravenous) is an antifibrinolytic that reduces bleedi

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28
Q

defne antepartm and postpartum heammorage

A

a - bleedng from the gental tract after teh 24th wee of pregnancy

p - greater than 500 mls blood loss from teh gental tract (1000 s c sectons)
(wthn 24 hours fr prmar y and 12 wees for secondary)

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29
Q

what is HELLP syndroem

A

complication of preeclampsia

Heamolysis
Elevated Liver enzymes
Low Platelets

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30
Q

what are the timmings for alcoho withdawsl

A

6-12 - tremor, sweating, headache, craving, anxuety
12-24- hallucinaions
24-48 - seizures
24-72 - delerium tremenes

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31
Q

what crusttams mae up gout and dney stones

A

gout - monosodum urate
S - calcum oxelate

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32
Q

what bloods are taen at a a pregancy boong appontment

A

blood group and rhesus d status
FBC - for anaeam
screenn for thalaseama (some women also screended for scle cell dsease)

HV
hepatts B
syphylss

33
Q

colposcopy stans

A

acetc acd and iodene

acetic acid makes teh cells white
then add iodene and the healthy ones will turn brown

punch biopsy or large loop excision of teh ransformational zone

34
Q

what cervcal cancer type causes

A

squamous cell
adenoarcnoma

35
Q

what are the gudlnes for smear testng tmeframes

A

25-49 every 3 years
50-64 evey 5 years

f nadequate seample - repeast after 3 months
HPV postve and abnormal cytology- refer for colposcpy

HPV potetve - repeat HPV after 12 months
- if after 12 months HPV s negatve return to normal screening
- if after 12 onths its posirive and cytology normla screen again in 12 months

  • once at 24 months if its still potiivet refer to colposcopy
36
Q

treatment of aacute dystona

A

procycldnie

37
Q

treatment of tardve dyskinesia

A

tetrabenzine

38
Q

treatment of akathia

A

propanalol

39
Q

what medicaton for meningitis in under 3 months and over 3 months

A

under - cefotaxime
over - cefriaxone

40
Q

presentation of compartement syndreom

A
  • Pain
    • Paresthesia
    • Pale
    • Pressur e
    • Paralysis

Pain is out of proportion with the injury!!!!!

41
Q

what s the koebner phenomenon

A

when there id damage to the skin adn after its healed a psoriatic plaque forms ontop

42
Q

treatement for gout

A

initial - allopurinol + colchaine for 4 weeks

then allopurinol and diet changes

43
Q

prophyacis for menieres

A

betahistine

44
Q

define and list causes of multiple miscarrage

A

> 3 miscarrges

SLE
antiphospholypid syndrome

diabtties
thyroid issues - especialy high TSH

malformed uters - unicornate, bicornate
fibroids

PCOS

chromosoal abnormalaties

45
Q

how to wor out GCS

A

eyes -
4 - alert
3- respone to speech
2 - pain

speech
5 - oriantated
4 - confused
3 - inaproptiate
2- incomprehensible

Movemnt
6 - obeys comans
5 - moves to pain
4- withdraws from pain
3 - abnorml felxtion
2 - abnormla extention

46
Q

what is lhermitts sign

A

ms

electric shock on felxtio of neck

47
Q

what is the treatment for personality disorders

A

dialectical behaviour therapy

48
Q

stroke in basialr artery

A

locked in sndroem

49
Q

middle cereberal artery stroke

A

contralateral hemipareseis and sensorhy loss

homynous hemianopia

50
Q

posterior cereberal artery

A

Contralateral homonymous hemianopia with macular sparing
Visual agnosia

51
Q

webbers syndrome

A

Ipsilateral CN III palsy
Contralateral weakness of upper and lower extremity

52
Q

wallenburgs syndrome

A

ipsilater fiacila paib and temp loss

contralateral limb and tors pain and temp loss , ataxia and nystagmus

  • decussates in the medula??
53
Q

classification of stroke

A

oxford -

54
Q

triad of shaken babay

A

encephalopathy
subdural heamatom a
retinal heamoorage

55
Q

brain scan of acute and chronic subdural heamoatoma

A

chonic - hypodense
acute - hyperdense

56
Q

treatment for chornic subdural heamatoma

A

decompression with burr holes

57
Q

treatment of extradual hemoatoma

A

observation

craniotomy and evaculation

58
Q

medications for palliative care

A

analegesia - morphine sulphate
antiemetic - haloperidol
anxiotyliti - midazolam
antisecretory - hyoscien butylbromide

59
Q

heart faliure calssifications

A

new york heart assocaition classifiaction

1 - normal
2 - symtpms on acitiity
3 - symotoms with eerything
4 symptoms at rest -

60
Q

what dugs cause idopathc ntracranal hypertenton

A

combined oral contraceptive pill
steroids
tetracyclines
retinoids (isotretinoin, tretinoin) / vitamin A
lithium

61
Q

Antemetcs n chemo

A

For patients at low-risk of symptoms then drugs such as metoclopramide may be used first-line. For high-risk patients then 5HT3 receptor antagonists such as ondansetron are often effective, especially if combined with dexamethasone

62
Q

anti emetics for hypermesis gravidum

A
  1. cycclzine or promethazine
    2 chlorpromazine
  2. ondansetron
  3. metoclopramide
63
Q

what medication is given in subarachnodi heamorage

A

nimodipine

64
Q

where is teh damae nomally with an extradural heamorage

A

pterion - frontal, temoporal, pariatal and sphenoid

65
Q

what are teh signs for meningitis

A

kernigs - knee externtion causes pain
brudinski - neck felxtion causes knee flextion

66
Q

what medicationi for idiphatic intrecranial hyperentison

A

acetazolamide - carbonc anhydrase inhibitor

67
Q
A
68
Q

gllick competancfraser guidelines

A

UPSII

understand the conseauences,
paretns - encourage to tell them
Suffer if you dont [rescribe
Intercourse anyway
Interes - best interests of eth child

69
Q

testing for down syndrome

A

Combined test - betweenn 11-13+6 weeks

HCG up
pregancy associated plasma protien down
Nuchal translucnecy - increased

if beyong this gestation offer teh quadruple test

HCG up
Inhibin A up
AFP donw
uncinjugated oestriol down

70
Q

quadruple test results for downs, edwads and neural tube defect

A

DOWNS:
HCG, inibin A up
AFP
unconjucages oestriol down

HCG, AFP, oestiol down
inhibin a normal

NT:
AFP up
all rest normla

71
Q

what s the bran scan and resulrs for parnsons

A

DAT scan - atropgy of teh basal gangla - dots nto commas

72
Q

what are etn frstran symsotms of sczphrena

A

auftory hallucnnatons
passvty phenomenn
thought dsorder
delusotnal perceptonn

73
Q

neagtove symtpms of schozp[hrena

A

incongruity/blunting of affect
anhedonia (inability to derive pleasure)
alogia (poverty of speech)
avolition (poor motivation)
social withdrawal

74
Q

nactvated vaccne

A

Inactivated virus

Killed version of the pathogen

  • Polio
  • Flu
  • Heppatitis A
  • Rabies
75
Q

subunt and conjugated vaccne

A

Subunit and conjucaged

Only the part of the orgausm used to stimulate an immue respone hence are safe for imunocompramised patients

  • Pneimococcus
  • Meningiococcus
  • Hep B
  • H influenzae B
  • HPV
  • Herpes-zoster (shingles)
76
Q

lve attunated vaccne

A

Lve attenuated vaccines

Weakened live pathogen

  • MMR
  • BCG
  • Chicempox
  • Nasal influenza
  • Rotavirus
77
Q

toxn vaccne

A

Toxin vaccines

Cause immunity to the txin and not the pathogen

  • Diptheria
  • Tetnus
78
Q

wbat are teh bases taht affect screenng programs

A

length tome - slower growng cancer are more lely to be pced up so peole beeb taht thye have a better prognss due to screengn bt just becasue ther dsease s lessa greessve

lead tme bas - screegng can pc up non curabe dsease earler whch gves the mpressron taht pepe ahev survved longer form dsase todeath but really they were just dagnosed earler - for examoe n dementa.

79
Q
A

3A :0 (8 decks)

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