Ques med mix Flashcards
What virus can cause hydrops fetalis on ultrasound?
Parvovirus B19 (slapped check syndrome)
What is the rotterdam diagnostic criteria?
PCOS can be diagnosed if at least two of the follwing criteria are met:
1. Polycystic ovaries (>12 cysts seen on imaging or ovarian volume >10 cubic cm)
2. Oligo-/anovulation
3. Clinical or biochemical features of hyperandrogenis
What is the onset of vascular dementia like ?
-A progressive stepwise deterioration in cognition
-Patient present with a history of strokes accompanied by stepwise cognitive decline or sudden changes in cognitive function
what are the signs and symptoms of vascular dementia?
Visual disturbance
Sensory or motor symptoms
Difficulty with attention and concentration
Seizures
Memory disturbance
Gait/speech/emotional disturbance
How can you differentiate Alzheimer’s from vascular dementia?
There is less impairment in episodic memory and more in visual skills, semantic memory and executive functioning.
What will be seen on CT/MRI scan of a patient with vasucalr dementia?
The hallmark of vascular dementia is extensive white matter change and infarcts evident on MRI imaging.
How does a Wilms tumour present?
-Mass that does not cross the midline (but bilateral in 5% cases)
-Distention
-Haematuria
What test are important to do in a woman presenting with pre-eclampsia?
FBC and liver fucntion test - it is important to screen for HELP syndrome
What is HELP syndrome?
Haemolysis, elevated liver enzyme, and low platelets
What are the symptoms of congenital rubella syndrome?
-Sensorineural deafness, congenital cataracts, retinopathy and heart disease
-Other features also include microcephaly, low birthweight and organ dysfunction
To what depth should the parents be advised to aim for when performing chest compressions?
One-third of the chest depth
What medications are used in women with PCOS who wish to conceive?
-Clomiphene - induces ovulation and enhances conception rates
-Metformin can be used alone or in combination to improve chances of pregnancy
-Gonadotrophins can be utilized if clomiphene and metformin prove ineffective
-Ovarian drilling is second line (this damages hormone producing cells of ovary)
What are the risk factors for ectopic pregnancy?
Previous ectopic pregnancy
Pelvic inflammatory disease
intrauterine contraceptive device or system in situ
Assisted conception e.g. IVF
Pelvic surgery
Smoking
Endometriosis
Age older than 35
What is alogia?
paucity of speech. This is a common negative symptom of schizophrenia.
When do babies start responding to own name?
9-12 months
When should babies turn head towards loud sounds?
6 motnhs
-alongside understanding bye bye and babbling
What is section 136?
-Allows police to bring an individual who appears to have a mental disorder from a public place to a place of safety
Who si reuwired to detain a patient under section 3?
An AMHP and two doctors (doctors must see patient in 24 hours)
What is section 3 ?
-Section 3 allows for a person to be admitted to hospital for treatment if their mental disorder is of a nature and/or degree that requires treatment in hospital.
-Section 3 is used where the person is already well known to psychiatric services or following an initial assessment under Section 2.
What is vasa praevia?
where the foetal vessels, unprotected by the umbilical cord or placental tissue, run dangerously close to or across the internal cervical os. These vessels are prone to rupture during the rupture of membranes, which can result in foetal haemorrhage and potentially foetal death.
What si the classic triad of vasa praevia?
-Painless vaginal bleeding
-Rupture of membranes
-Foetal bradycardia (or resulting foetal death)
Whta is polymorphic eruption of pregnancy?
-Pruritic urticarial papules and plaques of pregnancy (PUPPP) typically present in the third trimester
What is refeeding syndorme?
- A potentially fatal disorder that occurs when nutritional intake is resumed too rapidly after a period of low caloric intake
What are the symptoms of refeeding syndrome?
odema, confusion and tachycardia
Treatment for acute manic episode?
-Stop antidepressant, start oral anti-psychotic
(antipsychotics are superior to lithium in acite manic episode)
What is used to keep PDA open?
Prostaglandin E1 - alprostadil
What is used to close the PDA?
Indomethacin
What si the finding on a blood gas in a patient wit pyloric stenosis?
ave a hypokalaemic, hypochloraemic metabolic alkalosis due to vomiting and loss of protons
What is Orbital cellulitis?
Red, swollen eye that is painful on movement and affecting vision
What is the treatment for orbital cellultis?
IV clindamycin
What is lichen sclerosis?
-Lichen sclerosis is an chronic inflammatory skin disorder, thought to be autoimmune in nature
-presents as a white, shiny, raised patch of skin commonly occurring on the labia, perineum and perianal skin in women. It can be asymptomatic or can be associated with itching, skin tightness, superficial dyspareunia and Koebner’s phenomenen (symptoms are made worse by friction to the skin caused by things such as tight underwear)
What is the treatment for lichen sclerosis?
Clobetasol propionate
What is first line fertility investigation to check ovulation in a women with regular periods?
Measure serum progesterone on day 21
What is an appropriate fertility investigation for women with irregular menstrual cycles?
Measure luteinising hormone day 2 of cycle
What emerging test is most specific to bacterial sepsis?
Procalcitonin
What is atrophic vaginitis?
Inflammation and thinning of genital tissues due to reduced oestrogen levels, most commonly seen after menopause
What are the signs and symptoms of atrophic vaginitis?
Thinning of vaginal mucosa, loss of pubic hair, narrowed introitus, and vaginal dryness, among others. The primary differentials range from malignancies, endometrial hyperplasia, sexually transmitted infections (STIs), and various skin conditions
What is the management of atrophic vaginitis?
-Hormonal replacement to replace oestrogen
-Lubricants and mositurisers
When to refer if child has squint?
> 8 weeks old
What bacteria is a patient with sickle cell susceptible to?
Salmonella osteomyelitis
What does aspirin in infection cause?
Reyes syndrome
What is Reyes syndrome?
Reye’s syndrome is acute liver failure and non-inflammatory hepatic encephalopathy which occurs in children under 12 who are given aspirin during the acute phase of a viral infection.
How is Reyes treated?
Treatment is supportive, and often requires ITU admission. Lactulose can be used to lower ammonia levels
When are antibiotics indicated in ear otitis media?
tympanic membrane is perforated, the child is under 3-months old, the child is under 2 and the infection is bilateral, and if symptoms are present for 4 or more days.
what is intramural fibroid?
most common
what helps to improve the effectiveness of McRoberts manoeuvre?
Suprapubic pressure
