PPQ Flashcards
1
Q
conservative vs medical management of ectopic pregnancy
A
conservative: bhcg <200, adnexal <30mm
medical:bhcg <1500, adnexal< 35mm NO SIG PAIN
Salpingostomy if signs of shock
2
Q
Management of patient in 1st stage of labour with previous child with GBS
A
Intrapartum benzylpenicillin
3
Q
32 week pregnant, painless bleeding bright red, foetal movements unchanged. visiting from another country
A
placenta praevia
vasa praevia would have foetal Brady and RoM
4
Q
uterine adhesions after intrauterine procedures or endometrial infection
A
asherman syndrome
5
Q
endometrial tissue in the lining of the uterus to grow into the muscular wall of the uterus
A
adenomyosis
6
Q
types of FMJ
A
type 1: part or total removal of the clitoris or clitoral hood.
type 2: part or total removal of the clitoris and the lbia minora
type 3: narrowing of the vaginal opening.
type 4: all other harmful procedures to the female genitalia for non-medical purposes.
7
Q
56 yo/ itching and burning of vulva, some white discolouration w/ lumps and ulcers. Multiple sexual partners. Cx and Dx
A
Human Papilovirus
Vulval carincoma
8
Q
epiglotitis manegment
A
visulization under GA
Intubation and high flow oxygen
IV ceftriaxone
Axe the cuff around you throat
9
Q
anti-phospholipid syndrome autoantibodies
A
-anti beta 2 gylcoprotein I
-lupus anticoagulant
-anticardiolipin
10
Q
Whooping cough name and test
A
Bordatella Pertusis
Nasopharangeal Swab
11
Q
5 yo, itchy rash on nape of neck, just started school. Papular red rash spread across base of neck and into hairline
A
Head lice - Padiculus capitus
Tx: topical malathion
12
Q
ringworms treatment
A
ketoconozol
13
Q
Rheumatic fever
A
J - Joint disease
❤️ Carditis
N - Nodules (subcut)
E - Erythema Marginatum
S - Sydenham Chorea
14
Q
OCPD other name
A
Anankastic Personality Disorder
15
Q
Edinburgh PND sclae time scale
A
Previous week
16
Q
What drug causes dark strae, weight gain, round plethoric face
A
prednisalone
17
Q
SSRI electrolyte abnormality
A
hyponatremia
18
Q
Drug that causes high prolactin
A
atypical antpsychotics (e.g ariprazol)
19
Q
laxative abuse, calorie counting normal bmi
A
bullaemia nervosa
20
Q
Hypomania vs mania
A
hypo - remains ‘productive’
if sectioned then not hypo
21
Q
after removal of simple cyst how long beofre discharge
A
4-6h
22
Q
colzopine s/e
A
myocarditis
agranulocytosis
23
Q
Tx for parkinsonism Sx in schizophrenia
A
procycladine (anticholanergics)
24
Q
conversion vs somatisation
A
conversion = neuro
25
when should you ont give anticholanergics to someone on atypical anti pscychotics
Triadive dyskinasia (jaw)
Parkinsonism can give
26
most common sti
chlamedia
27
PE in pregnanct inversitation
ventilation/perfusion (V/Q) scan
28
Stages of labour
1st - Latent <4cm
UPTO 20h
1/2:10
Active 4-10cm
1 to 1.5cm/h
3/5:10
2nd - 10cm till baby
3rd: placenta
29
Chlamydia vs Gonorrhoea conjunctivits & treatment
Chlamedia (MC): 5d-2w old, erythromycin 14d
Ghonorrea: <24, upto5d, IV cefotaxime
tax the man who did that to your eye
30
Hischsprung disease Tx
anorectal pullthrough
31
maltrotation Tx
Ladd procedure
32
atresia Tx
duodenoduodenostomy
33
what blood group does mum need to be to need Rhesus prophalxis
Rhesus negative
34
Hrschsprung Ix
Diagnostic: full thickness rectal biopsy
contrast enema - transition zone
lack of air in rectum X ray
35
malrotation Ix
GI contrast study GOLD: double bubble
X-ray 1st line
US: whirlpool sign (also in ovar torsian)
volvulus - corckscrew
36
Atresia Ix
Xray - double bubble or air fluid levels, abscent gas in distal bowel
GS: upper GI contrast study
37
MC primary and secondary PPH
Primary: <24h, uterine atony
Secondary: 24h-12w, endometritis
38
Which of the findings would be considered 'high risk' according to the NICE traffic light
system for identifying serious illness in children?
-Nasal Flaring
-Oxygen Saturation of 93%
-Respiratory Rate of 64 breaths/min
-Dry Mucous Membranes
-Temperature of 39C
Resp rate of over 60
39
obstruction that occurs when the meconium in your child's intestine is even thicker and stickier than normal meconium
meconium ileus, T21
40
Neonate, constipated for 3 days, reduced feed and fluid, vomitted green substance, distended abdo, delayed meuconium passing
Dx and Ix to confirm diagnosis
Hirschsprung disease
Full thickness rectal biopsy
Xray would show obstruction
contrast enema revelas transition zone
41
UK immunisation at 8 weeks
-DTaP/IPV/Hib/HepB (6-in-1 vaccine): Diphtheria, Tetanus, acellular Pertussis, inactivated Poliovirus, Haemophilus influenzae type B, and Hepatitis B.
Rotavirus
MenB: Meningococcal group B
Male Rats
Run
Marketing Ploys
8 12 16
42
Vaccine At 12 weeks
DTaP/IPV/Hib/HepB (second dose).
Rotavirus (second dose).
Male Rats
Run
Marketing Ploys
8 12 16
43
Vaccine At 16 weeks
DTaP/IPV/Hib/HepB (third dose).
MenB (second dose).
PCV: Pneumococcal conjugate vaccine.
Male rats
Run
Marketing Ploys
8 12 16
44
5 y/o labia partially fused
Asymptomatic - reassure and follow up
symptomatic - topical oestrogen
Surgery if that fails
45
7-year-old boy presents to A&E with a swollen, painful left knee along with irritation
and redness of his eyes and pain on urination. He has otherwise been well apart from an
episode of diarrhoea and vomiting 2 weeks ago that affected the entire household.
cant pee cant see cant climb a tree
following GI infection
REACTIVE ARTHERITIS
Discharge with pain relief
46
A small head, widely-spaced eyes and a rounded sole of the foot (rocker bottom feet)
Dx and assositaed heart condition
Edwards syndrome
T18
Ventricular septal defect (VSD)
Edward scissor hands, looks like a V
47
Di George assosiations
+ heart
Cardiac abnormalitis
Abnormal facies
Thymic aplasia
Cleft palate
Hyp0calcemia
0
22.11.2q deletion
Tetralogy of Fallots
Fall out George (flying)
48
4 y/o boy, short stature, a webbed neck, and widely spaced nipples. His facial features include hypertelorism (widely spaced eyes), low-set ears, and a high-arched palate.
Dx + heart condition
What would you expect his chest to look like?
Noonan syndrome
Atreial septal defect
Pulmonary valave stenosis
Pectus excavatum
Undecended testies
49
Turners heart defect
coraction of the aorta
Strangled aorta
50
Matfans syndrome heart defect
atrial regurgitation
Tall, blood falling out of both atria
51
Downs syndrome heart defect
atrioventricular septal defect
52
what anatomical structure is affected in a testicular hyrocele
Tunica vaginalis
Under 2 y/o resoloves spontaniously
53
Sporadic vs Varient CJD
Sporadic - 60-65 y/o, neuro symptoms
Varient - younger individulas (37), psych symptoms
54
75 yo: Confusion, agitation, generalized muscle rigidity, profuse sweating, and a high temperature, combined with a history of Parkinson's disease
Neuroleptic Malignant Syndrome (NMS)
55
40 y/o w vulvovaginal candidaisis Tx
Clotrimazol pessary
Nystatin in women over 60
56
EDD
+1y, -3m, add 1 wekk +/- any extra dayss
57
rapid deterioration of a preg woman being induced, ballon insitue, hypoxia, low bp
hat is the most appropriate next step in her management?
A) Emergency C-section
B) Call the ITU Registrar
C) 500 ml Bolus of 0.9% Sodium Chloride
D) Removal of Balloon
E) IV Oxytocin 5 U
+ diagnosis
amniotic fluid embolism
CALL ITU
58
35 y/o asymptomatic mechels diverticulum
Tx
regular monitoring for complications
59
unilatral vs bilatral undecended testies
uni, assess at 6w and at 4-5m, then refferal
bilateral is urgent referal within 24h
60
3 y/o 1 day Hx of breathlesssness and coughing started during breakfast. Unilateral wheez, reduced air entry on LHS
CXR normal?
Inhaled forign body
XR: increased volume and translucency on affected side, valve mechanism
most FB are radiolucent
main site is Right main bronchus
61
A 16-month-old is seen in the GP surgery with a three-day history of a mild cough and
runny nose. He is discharged home with conservative management but returns several
days later with a red rash on his torso, upper arms and face, particularly prominent on
his cheeks and around the mouth. The child is afebrile and has no other symptoms.
What is the most likely diagnosis?
A) Systemic Lupus Erythematosus
B) Rubella
C) Measles
D) Roseola Infantum
E) Erythema Infectiosum
Erythema inectiosum - PVB10, slapped cheek
Roseola infantim, HHV 6, fever abruptly ends, 4 days later macularpaular rash on trunk
62
Tetralogy of fallots treatment
Balock Taussig shunt
BT shunt
63
Children above 3 months with acute pyelonephritis or upper UTI Tx
7-10 day course of oral cephalexin or co-amoxiclav
64
3 month old with thick yellow flakey rash top of head, greasy and red over eyebrows Dx and Tx
Infentile seborrheic dermatitis
Emoliants and shampoo
hydrocortison in severe
65
bowed legs in child over 3-4y normal vit d
blount's disease
66
bowed legs in child under 2
Genu Varum
67
3 y/o cataracts, sensoneural deafness and congenital heart defect
congenital rubella
(patent ductus arterious)
68
when to administer activated charcole
less than 1 h
69
what tests are offered at 14 weeks
quadrople test
head surcumfrance uesd for gestational age
70
quadroople test
alpha fetoprotein, bhcg, inhibin a, uncongugated estriol
71
wernicks encapelopathy and Tx
confusion, ataxia, opthalmoplegia
iv thiamine
72
SSRI used in heart disease
Setraline
73
Beckers Vs Duchenne muscular dystrophy
Beckers more mild, present 5-20yo
duchenne wont live past 20
74
1 y/o with tight balooning for foreskin Mx
watch and wait
75
gold standard Ix for cerebral palsy
MRI head
76
Mesenteric adenitis vs acute pancreatitis
proceeded by an URTI, cerviacal lymphandopathy, less sever pain
does not start in the umbilical and localize to RLQ (McBurney's point)
77
Boy w/ myoclonic OR tonic-clonic OR generalized sezires
sodium valproate
78
catatonia Tx
Benzoziazapines (e.g lorozopam)
2nd line - electroconvulsive therapy
79
Pre menstrual syndrome with difficulties in life
COCP
80
Urge incontiance 2nd line for elderly
Mirabegron due to fall risk (beta 3 agonist)
Otherwise: antimusinerics e.g oxybutinin
81
Haem changed in pregnancy
Volume ↑ 50% > Net dilution
RBC↑ 20-30% > mild anaemia
HB↓
WBC ↑
Plts↓
Macrocytosis (with/without B12/folate) deficiency
82
Resp changes in pregnancy
Tidal volume increase by 40%
83
Hsv in pregnancy
Presenting w primary infection in 1st and 2nd T: oral acilovire from 36w until vaginal birth
Presenting w primary infection in 3rd T, oral acilovire asap until delivery, c section
Recurrent ep do not need c section but acilovire from 36w
84
Meds contraindicated in breast feeding
Aspirin, lithium, benzos, methotrexate, carbemazole
Sodium valproate, ibuprofen, paracetamol, salbutamol OK
85
Fever, breast pain, red warm swollen breast (breastfeeding Hx) Dx and Cx
Mastitis , staphylococcus aureus
86
6 month old cold, fever & cough for 48h, drinking half as usual, grunting, flared nostrils, sub and intracostal recessions, dry and cold peripheries, fine end inspiritory crackles, exp wheeze. Rr 65, 94 o2
Dx, red flags
RSV, common in 3-12m
RF:
Apnoeic
Central Cynosed
O2<92
Several rep distress, rr >70
Mx:supportive
87
Cf manegment
Chest physio twice DAILY
Pancreatic enzyme replacement- creon
88
Achondroplasia gene
FGFR3
89
Increased Rx of febrile seizure
Complex focal seizure
90
Upgaze in Parkinson’s
Parkinson’s plus, progressive supranuclear palsy
