Post it Notes Flashcards
Diagnosis and management of placenta accretta
MRI
Deliver at 35-36 weeks
Scan dates for placenta praevia
Identify at 20wk
If major, rescan at 32wk
If minor, rescan at 36wk
If symptomatic, deliver 34-36 weeks (corticosteroids)
If asymptomatic, deliver 36-37 weeks
What would you see on biopsy of Crohn’s
non caseating granuloma
intraepithelial lymphocyte infiltration
transmural inflammation
skip lesions
What would you see on biopsy of UC
neutrophils forming crypt abscesses
continuous circumferential inflammation
Early CT signs of a CVA
hypodense basal ganglia
hyperdense MCA
loss of white/grey matter differentiation
loss of sulci
Describe malignant MCA sydrome
stroke followed by rapid neurological decline and headache
Ix: midline shift and displaced lateral ventricles
Rx: craniotomy
O/E for TGA
no murmur
loud S2
cyanosis
Management of nappy rash
Child asymptomatic: barrier cream
Child >1mo in discomfort: topical hydrocortisone 1% 7 days
Persistent rash/Candida: topical azole plus barrier cream
Bacterial infection: PO flucloxacillin 7 days
Which tracts are affected in anterior cord syndrome? What pattern does this produce?
Spinothalamic and corticospinal
Bilateral paralysis
Loss of pain/temp
Autonomic dysfunction
UTI management in children
Lower:
<3mo, IV amoxicillin + gentamycin
>3mo, PO trimethoprim
Upper
PO cefalexin
IV coamoxiclav
Caput seccundem vs cephalohaematoma
caput saccadenim = immediate, crosses sutures, ventouse, resolves quickly (think hickey)
Cephalohaematoma - takes a few days to show, doesn’t cross sutures, instrument delivery, resolves in 3-4 months
Which side does the uvula deviate to
contralateral
When to do lithium levels
one week after starting treatment, one week after every dose change, and weekly until the levels are stable. Once levels are stable, levels are usually measured every 3 months.
Always measure 12 hours after the last dose
What areas of the brain cause expressive and receptive dysphasia?
expressive: Brocas, frontal, left
receptive: Wernickes, temporal, sylvian fissure
What types of ovarian tumours are most common
young women: dysgerminoma, terratoma
older women: serous adenocarcinoma (epithelial)
secondary: breast, GI
3 symptoms of peroneal nerve palsy
2 symptoms of L5 palsy
peroneal - foot drop, weak dorsiflexion, weak eversion
L5 - weak inversion, weak hip adduction
FBC and LFT results in GCA
NN anaemia
high plts
high ALP
Who gets a statin?
10yr CVD risk >10%
T1DM and >40yo
CKD
Abx for NEC
ampicillin/gentamycin + metronidazole
Breast cancer FU
annual mammograms until they enter the routine screening programme. if they are already in the screening programme, offer annual mammogram for 5 years then back to routine recall
What measures are used for pregnancy dating and at what times?
6-12 weeks: crown rump length
14-20 weeks: biparietal
At what gestation should monoamniotic twins be born and by what route?
32-33 weeks
CS
Abx for toxic shock?
vancomycin and clindamycin
Pattern in anterior cord syndrome
loss of pain, temperature and motor
preserved touch
How does varenicline work?
partial nicotinic receptor agonist to reduce euphoria
How does inclusion body myositis present?
50yo
weak quads/finger/throat
How does myotonic dystrophy present?
20-40yo Distal weakness and weak sternocleidomastoids Myotonia Haggard face Cataracts Small testes/atrophic ovaries LD cardiomyopathy
Treatment of myotonic dystrophy
mexilitine
1st and 2nd line treatment of vertigo in MS
1: gabapentin
2: memantine
What sounds does mitral valve prolapse (Fragile X) make?
mid systolic
opening click
bowel cancer screening programme
55yo one off flexisig
60-74, home kit every 2 years
describe C diff
gram +ve bacilli
How do you difference E.coli/Klebsiella from Proteus and pseudomonas?
MacConkey/XLD agar
E.coli/Klebsiella are lactose fermenters
How often should prolactin be checked on SGA?
Initiation
6 monthly
Yearly
How often should fasting BM be checked on SGA?
baseline
1 month
6 monthly
(more with olanzipine)
How often should HbA1c be checked?
3-6 monthly then 6 monthly once stable
length of latent first stage for
a. nulli
b. multip
nulli - 10 hours
multip - 6 hours
length of 2nd stage for
a. nulli
b. multip
nulli - 3 hours
multip - 2 hours
school exclusion for impetigo
48hrs after starting abx
until lesion have crusted if untreated
school exclusion for chickenpox
5 days and all lesions crusted
Vision loss - where is the lesion for
a. contralateral loss
b. ipsilateral loss
c. macular sparing loss
a. optic tracts
b. optic radiation
c. occipital lobe
1st, 2nd and 3rd line treatments of painful periods
- mefenamic acid
- COCP
- both
Describe intranuclear ophthalmoplegia
affected eye can’t adduct
other eye gets nystagmus on abduction
diplopia
Articles 2, 3, 8, 12
2 - right to life
3 - right to be free from inhumane and degrading treatment
8 - right to privacy/family
12 - right to marry and found a family
Where does the jaw deviate in trigeminal damage?
towards the lesion
myoclonic seizure EEG
normal background with generalised polyspike and wave
how do thiazides work
inhibit Na+/Cl- channel in DCT
how do loop diurectics work
inhibit Na+/Cl-/K+ channels in ascending limb
how do carbonic anhydrase inhibitors work
inhibit bicarb secreiton in PCT
how does spironalactone work
aldosterone antagonist (competitive binding) in DCT
which cranial nerves are midline and how does a midline stroke present
3,4,6,12 corticospinal weakness medial lemniscus (prop/vib) medial fasiculus (eye) motor functions of those CNs
what cranial nerves are lateral (side) and how does a side stroke present
5,7,8,9,10,11 spinothalamic (pain.temp) syndrome (horners) spinocerebellar (apraxia) sensory of those CNs
how does ACE-i affect potassium
high
how do thiazides affect potassium and sodium
low
how do sulphonylureas work
increase insulin relase from pancreas
how do DPP4i work
increase incretin levels to indirectly increase insulin
how do thiazolidinediones work
increase peripheral insulin sensitivity
decrease FFA release causing weight gain and fluid retention
how does metformin (biguanide) work
increase peripheral insulin sensitivity
increase glucose uptake in liver
decrease gluconeogenesis in liver
name 2 features of ASD/VSD on CXR
cardiomegaly
enlarged pul arteries
what will ASD show on ECG
partial RBBB
what will VSD show on ECG
biventricular hypertrophy
upright t waves
how will ToF look on CXR
small boot heat with uptilted apex
pul artery bay
how will TGA look on CXR
narrow mediatinum
egg on side cardiac shadow
increased pul vascular marking
what is the suffix for quinolones
-ofloxacin
name 2 macrolides
erythromycin
clarithryomycin
name 3 aminoglycasides
gentamycin
streptomycin
neomycin
name 2 glycopeptides
vancomycin
teicoplanin
which DM drugs cause weight gain?
pioglitazone
glicazide (sulphonylurea)
which DM drug is CI in HF?
pioglitazone
which DM drug causes bladder cancer
pioglitazone
which DM drug causes hypoglycaemia
sulphonylurea
who is metformin CI in
very elderly
liver/renal failure
alcholism
management of hyperosmolar hyperglycaemic state
IV saline to drop by by 5mmol/L/hr
then low dose insulin to target
