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Aaska's specialities > PASSMED WRONG > Flashcards

PASSMED WRONG Flashcards

nice guidelines used

1
Q

how long after having a surgical termination can you have an IUD in

A

immediately

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2
Q

what does SSRI+NSAID increase risk of

A

GI bleed
give PPI as cover

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3
Q

ovarian cancer 2ww rules

A

immediate urgent 2w referral if there is a mass or ascites on examination

measure ca125 if suspicious sx

if ca125>35 refer for ultrasound

immediate 2w referral if ultrasound is suspicious

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4
Q

what level of ca125 is suspicious and what do you do

A

> 35
do a pelvic ultrasound

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5
Q

what cancers is OCP protective of vs increases risk of

A

protective of: breast and cervical
increases risk of: endometrial and ovarian

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6
Q

what to do if bilateral undescended testes

A

at birth= urgent 24hr referral
at 6-8 weeks= urgent 2ww referral

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7
Q

what to do if unilateral undescended testes

A

review at 6-8 weeks
if still undescended review at 4-5months
if still undescended referr

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8
Q

reduced foetal movements are concerning after what ga

A

28 weeks

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9
Q

what test is done for reduced foetal movement after doppler

A

ultrasound

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10
Q

if a women is on combined HRT what contraception can you give them

A

progesterone only
this can be pill, implant or injection

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11
Q

what is mirabegron and when is it given

A

for urge incontinence in older people
because duloxetine is an anticholinergic and can cause confusion

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12
Q

what class of drugs are used in urge incontinence

A

anti muscarinincs
aka anti cholinergics

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13
Q

how do gnrh agonists work

A

they increase gnrh production and shut down the gnrh axis

this reduces oestrogen and shrinks fibroids

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14
Q

what is a side effect of gnrh agonists and why

A

reduced bone mineral density

they shut down the gnrh axis and cause low oestrogen so bone density decreases

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15
Q

how long can you take a gnrh agonist for

A

6 monthd

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16
Q

SSRI plus what drug increases risk of serotonin syndrome

A

triptans
MAOIs

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17
Q

SSRI use in pregnancy effect

A

1st trimester= increased risk of congenital heart defect

3rd trimester= increased risk of persistent pulmonary hypertension

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18
Q

role of thiamine vs chlordiazepoxide in alcohol withdrawal

A

chlordiazepoxide= reduces the withdrawal sx
thiamine= reduces progression to wernickes encephalopathy, does not improve sx

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19
Q

paediatric red flag HR

A

> 140

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20
Q

what class of medication is duloxetine

A

SNRI

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21
Q

what class of medication is mirtazipine

A

noradrenaline and serotonin selective antidepressant

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22
Q

complete vs incomplete molar pregnancy

A

complete= egg has no genetic material, both sets of DNA from dad (remember like completely dad)

incomplete= egg has genetic material from mum but also 2 sets from dad

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23
Q

edinburgh depression scale over what indicates depression

A

10

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24
Q

what criteria is used for septic arthritis

A

kocher

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25
Q

what does kocher criteria use

A

non weight bearing joint
fever
WCC raised
ESR raised

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26
Q

patau syndrome

A

trisomy 13
small eyes
cleft palate
polydactyly

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27
Q

edwards syndrome

A

trisomy 18
micrognathia
low set ears
rocker bottom feet
overlapping fingers

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28
Q

noonan syndrome

A

short stature
webbed neck
pectus excavatum
pulmonary stenosis

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29
Q

pierre robertson syndrome

A

micrognathia
posterior tongue displacement
cleft palate

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30
Q

fragile x syndrome

A

large long head
large ears
large testes
learning difficulty

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31
Q

williams syndrome

A

friendly/extroverted
learning difficulty
transient neonatal hypercalcaemia
supravalvular aortic stenosis

32
Q

prader willi syndrome

A

hypotonia
hypogonadism
obesity

33
Q

what marker is raised in abdominal wall defects

A

alpha fetoprotein

34
Q

tamoxifen increases risk of what cancer

A

endometrial

35
Q

what is continuous incontinence after a prolonged labour suggestive of

A

vesicovaginal fistula

36
Q

how do you investigate vesicovaginal fistula

A

urinary dye studies
this dyes urine so will show a fistula

37
Q

antisocial vs schizoid personality disorder

A

schizoid= withdrawn, prefers to be alone, reduced interest in sex

antisocial= can develop form conduct, disruptive, agressive, doesnt conform to social rules etc (is more disruptive then schizoid)

38
Q

what medication may reduce risk of future febrile seizures

A

rectal diazepam

39
Q

how will paracetamol affect febrile seizures

A

while it may lower the fever, it does not reduce the incidence of seizures

40
Q

what are the 2 medications in orkambi
how do they work

A

ivacaftor and lumacaftor
ivacaftor= keeps CFTR channels open for longer
lumacaftor= increases amount of CFTR protein that is correctly synthesised

41
Q

mutation in what gene in cystic fibrosis?

A

delta F508

42
Q

how do you identify a benzodiazepine

A

ends in ‘pam’

43
Q

how do benzos work

A

enhance GABA

44
Q

where do babies get atopic eczema

A

face and trunk

45
Q

at what age should a child have palmar grasp

A

5-6 months

46
Q

at what age should a child build a tower of 3-4 blocks

A

18 months

47
Q

how do you differentiate between ITP and ALL on bloods

A

ITP= only platelets will be low
ALL= Hb, platelets will be low, WCC will be high

look at platelets first
then to differentiate check Hb and WCC

48
Q

what booking bloods are done

A

FBC, blood group, rhesus status

49
Q

how many routine antenatal appts will a nulliparous woman have

A

10

50
Q

how many routine antenatal appts will a multiparous woman have

A

7

51
Q

what 3 screening programmes are offered to women at booking

A

maternal infections: hep b, HIV, syphilis
haemoglobinopathy
fetal anomaly

note: all of these are optional

52
Q

dating scan date and purpose

A

11+2 to 14+1 weeks
date pregnancy
identify multiple pregnancy
fetal anomaly screen

53
Q

anomaly scan date and purpose

A

18+0 to 20+6 weeks
identify fetal anomalies
determine placental location

54
Q

what urine tests are done at booking

A

dip AND culture (even if dip is normal) to look for asymptomatic bactiuria

55
Q

when do most women with endometrial cancer present

A

stage 1

56
Q

in termination of pregnancy when is anti D given

A

for any termination after 10 weeks ga
for surgical terminations before 10 weeks ga

57
Q

how do you identify overflow incontinence

A

bladder outlet obstruction- signs are straining, poor flow, incomplete emptying

this all causes a high voiding pressure with a poor flow rate

58
Q

what are a gs and cs that rise in anorexia nervosa

A

gs:
growth hormone
glands (salivary)
glucose

cs:
cortisol
cholesterol
carotinaemia

59
Q

is HIV a notifiable disease

A

NO

60
Q

peak exp flow rate in life threatening asthma

A

<33%

61
Q

what antibiotic covers for listeria

A

amoxicillin
ampicillin
(penicillin)

62
Q

when adding insulin to metformin for gestational diabetes what is done to metformin

A

nothing- continue it alongside insulin

63
Q

how does cows milk protein allergy present

A

vomitting
mucus diarrhoea
colic episodes
hx of eczema/skin changes
might have lrti sx

64
Q

2 types of cows milk protein allergy and when they resolve

A

IgE mediated= resolves by 5 months
non IgE mediated= resolves by 3 months

65
Q

cows milk allergy mx

A

if breastfeeding: continue and mum exclude all milk from her diet, give her calcium supplements

if formula: use extensively hydrolysed formula

66
Q

what medication is a deterrant given in alcohol detoxification and causes agressive vomitting when someone drinks alcohol on it

A

disulfram

67
Q

out of caput succadaneum and cephalohaematoma what heals quicker

A

caput succadaneum (takes a few weeks)
cephalohaematoma (may take months)

68
Q

how are caput succadaneum and cephalohaematoma managed

A

conservatively

69
Q

when is 2 thumb encircling technique vs one hand on lower sternum used for paediatric BLS

A

2 thumb= under 1yr old
one hand on lower sternum= over 1 yrs

70
Q

what medication that an elderly person might be on causes anterograde amnesia that may cause a dementia like present

A

benzodiazepine

71
Q

how can you differentiate wernickes and korsakoffs

A

wernickes= triad of opthalmoplegia, confusion and ataxia

korsakoffs= additional anterograde amnesia and confabulation

72
Q

in alcohol withdrawal what is the role of
chlordiazepoxide
lorazepam
acamprosate
naltrexone
thiamine

A

chlordiazepoxide= first line for alleviating withdrawal sx, usually given over week with dose reductions to assist detox

lorazepam= first line for delirium tremens

acamprosate= anti craving medication to help with abstinence

naltrexone= anti craving medication to help with abstinence

thiamine= given in suspected wernickes encephalopathy to help reduce progression to korsakoffs syndrome

73
Q

link between malrotation and volvulus

A

volvulus is when a part of the malrotated bowel twists on itself

74
Q

out of duchenne and becker which is more severe

A

duchenne

75
Q

definitive diagnosis of duchenne/beckers

A

genetic testing

76
Q
A

Aaska's specialities (7 decks)

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