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Revmed + PPQs > PPQs + Related > Flashcards

PPQs + Related Flashcards

1
Q

A low risk woman would like to have epidural anaesthesia but is concerned about the risks. What is the risk of permanent paralysis (give as 1:X)

A

~1:140,000 it is so rare it is difficult to put a number on it

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2
Q

Drug given to women to prevent expression / stop expression of breast milk?

A

Cabergoline

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3
Q

49 y/o woman has heavy, irregular menstrual bleeding. TVUSS shows a thickened endometrium with cystic spaces. What investigation would be diagnostic in this scenario?

A

Pipelle biopsy - irregular periods likely suggesting peri/menopausal –> ?endometrila ca

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4
Q

Naegles rule for EDD?

A

(1y+7d) - 3m

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5
Q

Most common cause of vaginal discharge in children?

A

Vulvovaginitis (or Foreign body)

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6
Q

What type of discharge in TV?

A

frothy and thin offensive yellow vaginal discharge

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7
Q
  1. 22 y/0 woman is planning a water birth. She is low risk with no medical problems. What complication of normal delivery is increased by a water birth?
A

Umbilical cord avulsion / snapping

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8
Q

Medication of choice in mx of anorexia?

A

Fluoxetine (most effective in co-morbid depression)

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9
Q

What is this describing?

“experiences where she thinks she isn’t real”

A

Derealisation can be seen in schizophrenia

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10
Q

What cardiac condition are children born to SLE mums at increased risk of?

A

Congenital heart block

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11
Q

Differences between periorbital and orbital cellulitis?

A

Peri = infectious process occurring in the eyelid tissues, superficial usually due to superficial tissue injury (can progress to orbital)

Orbital = - infection affecting the muscles and fat within the orbit, posterior/ deep to the orbital septum usually due to underlying bacterial sinusitis

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12
Q

Complications of orbital cellulitis?

A

Abscess formation, meningits, cavernous sinus thrombosis, infection of optic nerve which can lead to visual defects

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13
Q

Mx of peri/ orbital cellulitis?

A

Urgent hospital admission, prompt mx w/ empirical IV Abx (eg ceftriaxone)

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14
Q

Imaging of choice for suspected paeds raised ICP?

A

Brain MRI

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15
Q
  1. 36 y/o woman sees GP for routine appointment at 32 weeks pregnancy. This is her first pregnancy and has so far been uncomplicated. She has normal fetal movements and is generally well with temperature 36.3, HR 90, BP 128/82, RR 13, O2 sats 96% on room air. Fundal height is 32cm and fetal HR is normal. Urine dipstick shows ++ protein but no other abnormalities. What is the most appropriate management?

a. Immediate referral to obstetrics
b. Repeat urinanalysis in 1 day
c. Repeat urinanalysis in 1 week
d. Send urine for MC&S and start Nitrofurantoin
e. Send urine for MC&S and start Trimethoprim

A

A - “If there is [2+] protein or more on dipstick testing, arrange urgent secondary care assessment, even if there is evidence of a possible UTI”

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16
Q
  1. 37 y/o woman has her anomaly scan at 20+3 weeks of pregnancy, and it reveals echogenic bowel. What is the most likely cause?
A

Trisomy 21 (out of the options given - not sure if overall most likely)

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17
Q
  1. 41 y/o women attends her dating scan. LMP dates make her 12 weeks pregnant. An intrauterine pregnancy is seen with no fetal heartbeat. CRL is equivalent to a fetus of 9 weeks gestation. What is the best next step?
    a. Admit her for laparoscopy
    b. Counsel her on management options for miscarriage
    c. Offer her a repeat USS in 1 week
    d. Offer treatment with methotrexate
    e. Serum beta-hCG now and repeat in 48 hours
A

Counsel her on management options for miscarriage

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18
Q

Describe the obstetric pain ladder.

A
  1. Non-pharmalogical methods:
    - Exercise/movement
    - Heat e.g. warm bath, heat pack
    - TENs stimulation
    - Acupuncture
    - Hypnosis
    - Massage
  2. Nitrous Oxide (Entonox or ‘gas and air’)
  3. Simple analgesia
    Paracetamol (REMEMBER NO NSAIDs)
  4. Opiate analgesia
    - Oral codeine phosphate
    - IV /IM Diamorphine
  5. Epidural analgesia - not usually sited until the woman is in ‘established labour’
  6. Pudendal nerve block - used when you need rapid regional anaesthesia such as episiotomy or operative vaginal delivery
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19
Q

Mx of pt w/ prolonged tampon insertion but assymptomatic?

A

Reassure and discharge

No point doing high vaginal swabs as toxic shock is caused by staph aureus hence isnt tested for by these swabs

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20
Q

When can a woman expect periods to return post-partum?

A

Cannot be preducted

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21
Q

What additional testing is requried in a pregnant woman w/ previous cocaine use?

A

Hep C

Nb: this is an additional infection screen done in high risk individuals

22
Q

A woman is having a repeat USS at 32 weeks gestation for a previously low-lying placenta. The USS shows the placenta is clear of the cervical os and an additional succenturiate lobe is seen.

Which condition needs to be excluded in the USS?

A

Vasa praevia -???

23
Q

How long after methotrexate can couples safely conceive?

A

3m

24
Q

Mx of urogenital prolapse?

A

Conservative - those that can cope with mild symptoms
- Pelvic floor muscle training (16w) + lifestyle changes

Symptomatic:
- Vaginal pessary (every 4m change it)

25
Q

What are the different types of prolapse and what do they mean?

A

ANTERIOR VAGINA:

  • Cystocele- if in the upper half of the vagina
  • Urethrocele- if in the lower half of the vagina

POSTERIOR VAGINA:

  • Enteroceleif in the upper third of the vagina
  • Rectocele- if in the lower two-thirds of the vagina
26
Q

What is a velamentous cord insertion?

A

where the cord inserts into the membranes and travels within the membranes before joining the placenta (the cord should insert straight into the placenta)

27
Q

Examples of atypical antipsychotics?

A

clozapine
olanzapine: higher risk of dyslipidemia and obesity
risperidone
quetiapine
amisulpride
aripiprazole: generally good side-effect profile, particularly for prolactin elevation

28
Q

What is bacterial tracheitis caused by?

A

Staph aureus - presents similar to epiglottitis w/ progressive airway obstruction + thick airway secretions

29
Q

What congenital disorders are associated w duodenal atresia?

A

Prader-Willi + Downs syndromes

30
Q

Mx of cerebral venous thrombosis?

A

1st Line = IV heparin

Followed by catheter guided local thrombosis

F/U = 3-6m anticoagulation (LMWH or NOACs)

31
Q

ToP - surgical options?

A

Before 14w = suction curettage

After 14w = dilation and evacuation

32
Q

MUST score is used to..

A

scale risk of refeeding syndrome

33
Q

torticollis, opisthotonus, dysarthria and oculogyric crises are examples of what type of reaction? mx?

A

Acute dystonic reactions usually seen w typical antipsychotics

Reduce dose / change to atypical -> procyclidine if this isnt working

34
Q

FBC abnormality in Lithium users?

A

Benign leukocytosis

35
Q

Centor criteria?

A

1+ tonsillar exudate
1+ cervical lymphadenopathy / adenitis
1+ fever / hx of
1+ no cough

36
Q

Pre-eclampsia order of drugs to use for BP control?

A

Labetalol
Nifedipine
Methyldopa

37
Q

Woman had some intrauterine growth and endometrial thickness. What was the diagnosis

A

Fibroids

38
Q

Pregnant woman with Gram negative bacilli in urine microscopy. What do you do?

A

Gram -ve rod = e coli hence give amoxicillin

39
Q

What do you do in a woman in labour after 4 hours of checking, she’s 4cm.

Vaginal prostaglandin, Cervical sweep, Oxytocin, Ergometrine, ARM

A

Oxytocin

40
Q

What is CI in mx of PPH in HTN pts?

A

Ergometrine

41
Q

Foetus with transverse lie, recent SROM, CTG shows fetal distress. Most likely cause?

A

Cord prolapse

42
Q

What’s the management for DVT risk in a pregnant woman after an elective Caesarean?

LMWH, LMWH and Ted stockings, Ted stockings, Warfarin or something, Aspirin, Aspirin and Ted stockings

A

LMWH + Ted stockings = 10day regimen

43
Q

What do you measure at booking for hepatitis b?

A

Hep B surface antigen

44
Q

What is the most common cause of subfertility?

A

Unknown cause - normal bloods + 30% all subfertility

45
Q

Hysterectomy yesterday. How long to stay off work for:

48 hours/ 1 week/ 4 weeks/ 3 months

A

4 weeks

46
Q

What extra testing is needed a mother that smokes during pregnancy?

A

Serial growth scans if >10 cigarettes a day

47
Q

UTI in first trimester of pregnancy. What would be the safest and most effective treatment?

Trimethoprim, Ciprofloxacin, Doxycycline, Cefalexin, Meropenem
Cefalexin

A

Cefalexin

48
Q

Amenorrhoea for 4 months – what is the best initial investigation?

A

URINARY b-HCG

49
Q

Effect of paroxetine during pregnancy?

A

1st trimester = Small risk of congenital heart defects

3rd trimester = Risk of persisten pulmonary HTN

50
Q

Woman with a slow growing painless lesion on labia

A

Bartholin’s cyst

51
Q

Woman with tender lump inside her vagina

A

Vaginal cancer

52
Q

Blue specks on cervix?

A

Nabothlian cyst

Revmed + PPQs (10 decks)

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