Pick'n'Mix 3A (1) Flashcards
Management of PROM
Admit for 48hr Rule out choriorioamnionitis Take a swab with a steriles speculum Give steroids Erythromycin 500mg ODS
Outline the different types of hysterectomy
Total: hysterectomy, tubes, ovaries and cervix
Vaginal: hysterectomy, tubes, ovaries and cervix and top part of the vagina
Treatments for
i) Stress incontinence
ii) Overactive bladder
i) Stress incontinence Conservative Pelvic floor exercise Duloxatine ( lots of side effects) Surgery
ii) Overactive bladder
Reduce caffeine intake
Anticholinergics
Botox
Define HELLP syndrome
Haemolysis
Elevated liver enzymes
Low platelets
What does the combined test consist of
PAPPA
bHCG
Nuchael translucency
What are diabetic pregnancies at increase risk of
Miscarriage
Shoulder dystocia
Infection
Cord prolapse
What are the contraindications for synotometrin
HTN
Asthma
Active heart disease
What is a csytourethalcycle
Urethrocyle and a cystocyle
Descent of a proportion of tissue can lead to ulceration
List the risk of an ectopic
Prev ectopic Contraception Tubal surgery Other surgeries in the abdominal cavity Pelvic inflammatory disease Infertility
Define secondary infertility
Achieved at least one pregnancy ( regardless of the outcome)
Signs of red degeneration
Syphsis- fundal height greater than expected
Complication of a fibroid
Occurs usually in the middle trimester
Outline the pathology of Erb’s palsy
Occurs due to trama to the upper trunk C5,C6 of the brachial plexus
Occurs during obstructed labour
Muscles supplied by C5 and C6
- musclocutaneous
- radial
- axillary
Outline the criteria for normal sperm
Volume 2-3mL Count > 15,000,000 Progressive motility > 50% Morphology > 15% Progression> 25%
Outline the different types of rupture of membranes
SROM: Spontaneous rupture of membranes
AROM: Artificial rupture of membranes
PROM: Rupture of membranes prior to the onset of labour in >37weeks
PPROM: PROM prior to 37 weeks
Outline the care for an epileptic pregnant lady
- ANC
- Intra
- PNC
ANC
- Consultant led
- Pre conceptual care
- Folic acid 5mg
- Monotherapy if possible
- Vitamin K in the last few weeks
- Regular anomaly scans
Intra
- Vaginal delivery ( if possible)
- Lower seizure threshold during labour and postpartum
- If status epilepticcus give benzos
PNC
- Baby vit K
- Implement strategies to prevent dropping the baby
Causes/Risk of miscarriage
Multiple pregnancy Infections Cytotoxic drugs Cervical incompetence Anatomical anomaly Rising age of the mother Radiation Implementation Anti-phospolipid syndrome Genetic abnormalities Endocrine
Risk factors for placenta caret
Previous c-sections
Ashermann’s syndrome
Pelvic inflammatory disease
Post maturity pregnancy
Bishop’s score <6: vaginal PGE2
Reassess after 6hrs
Bishops’s score <7 administer further prostaglandins and reassess
Indications to induce FOETAL - >10 days post due date - Foetal growth restriction - GDM - Haemolytic disease of the newborn - Foetal abnormalities
MATERNAL
- Pre-eclampsia
- Worsening medical condition
- Malignancy
Mechanism of action of the copper coil
Inflammatory reaction in the endometrial cavity
Thicken cervical mucus
Inhibits sperm motility ( golgi apparatus)
Reduces the likelihood of implantation
Contraindications for receiving the coil
Pregnancy or 48hrs-4 weeks post part Undiagnosed irregular vaginal bleeding STI <3mnths ago Distorted uterine cavity Gynae cancer Copper allergy
Define maternal mortality ratio
Number of maternal deaths per live births per 1,000
Define infant mortality rate
Number of deaths amongst infants at 1 yr of age
Define neonatal mortality rate
Number of deaths amongst infants under 28 days over 1,000 live births
Define the still birth rate
Number of the foetus delivered after 24 weeks + who at that time did not breathe or show signs of life per 1,000 per total births
Signs of glactosomia in a neonate
Vomiting Seizure Decreased glucose HSM \+ve reducing substance in urine Jaundice
Management of kawaskis
Immuniglobin IV 2g one off
High dose aspirin
List the causes of delayed pubertal growth
Pituitary
- Tumours
- Sarcoidosis
- Tuberculosis
- Haemochromatosis
Gondal
- Testicular agensis
- Bilaterial testicular torsion
- Klenifleters
- Noonans
- Turners
Treatment of mild croup
Single dose of oral dexamethasone 0.15mg/kg
List the most common malignant breast tumour
Adenocarcinoma
What is the antidote to heparin
Protamine sulphate
Management of lithium toxicity
Stop Li
Fluids ( normal saline)
If very severe do haemodialysis
Management of trigeminal neuralgia
Carbamazepine
What is the defining features of 3rd degree heart block
no correlation between the P waves and the QRS complex
Features of premature ovarian failure
<40yrs old
Amenorrhea
Elevated gonadotrophins
oestrogen deficiency
Diagnosis the following clinical presentation
Syncopal episode associated with a seizures
Precede by minor head trauma “bump” or fear
Gasps, goes pale and loss of consciousness
Child experiences a convulsive phase
Quickly recovered
Reflex anoxic seizures
Under what circumstance would you investigation a UTI
Atypical bugs grown Take >48hrs to respond to abx Very ill child Poor urine output Increased creatine Septic
Name the following syndrome and how it is detected Cardiac defects Abnormal facies Thymic hypoplasia Cleft plate Hypocalcaemia
DiGeorge’s syndrome
Detections with cytogenic analysis by fluroscent in situ hybridisation
List the features of moderate dehydration
Restless Decreased urine output Irritability Sunken eyes Dry mucous membranes Tachycardia NORMAL cap refill
List the features of severe dehydration
Decreased level of consciousness Pale or mottled skin Cold extremities Increase HR Increase RR Weak peripheral pulse Prolonged CRT
Name the inheritance pattern of phenylketonuria
Autosommal recessive
Tested for on the Guthrie test
These babies lack melanin and often will have blue eyes and white hair
List the triad of symptoms seen in toxoplasmosis
Chorioentinitis
Hydrocephalus
Tramlike calcifications
What is seen on X-ray in nec
Dilated oedematous loops of bowel
Portal vein gas
What is the biochemical state of the body in pyloric stenosis
Hypokalaemic hypochoraemic metabolic acidosis
Clinical features of a baby with transposition of the great arteries
Single heart beat sound
Metabolic acidosis
Cyanosised
Severely unwell
What organism causes croup
Parainfluenza
What is the pattern of inheritance of marfan’s
Autosommal dominant
Chromosome 15
What are the clinical features of marfan’s
Long limbs and digits High arched palate Scoliosis Sternal defects Cardiac defects
What is the defining features seen with parvovirus
Slapped cheek
