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RANDOM FACTS Flashcards

1
Q

Hx of eczema -> Painful + itchy rash on face/neck. Punched out lesions.

A

Eczema herpetiformis
HSV 1 or 2

Tx = Oral aciclovir

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2
Q

16yo girl with short stature, short ring finger, webbed neck, high-arched palate, widely spaced nipples.
NO breast development or periods.

O/E Crescendo-decrescendo ejection systolic murmur, radiates to carotids. OR peripheral pulses absent/ radio-femoral delay/ ‘click’ over aortic valve/

A

Turner’s syndrome 45X (Deletion of an X)

Murmur is due to Bicuspid aortic valve causing aortic stenosis

Peripheral pulses absent = Co-arctation of aorta (less common than bicuspid)

Associated with Gastroschisis/Omphalocele

Tx = oestrogen replacement, Growth hormone replacement

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3
Q

Causes of delayed puberty with short stature

A
  • *Turners** - 45X
  • *Prader-Willi** (Imprinting - Fat & floppy - obesity + hypotonia)
  • *Noonan’s** (AD condition - Web neck, pectus excavatum, pulmonary stenosis - ESM louder on inspiration)
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4
Q

Causes of delayed puberty with normal height

A

PCOS
Androgen insensitivity
Kallman’s
Klinefelters

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5
Q

How do you differentiate the causes of normal-stature delayed puberty?

A

Klinefelter’s - 47 XXY. Lack of secondary sexual characteristics, small firm testes. HIGH LH + LOW testosterone.

Kallman’s (X-linked) = LOSS OF SMELL (anosmia). Hypogonadotrophic so LOW LH + low testosterone

Androgen Insensitivity (X-linked) = Resistance to testosterone. ‘Girl’ presents with delayed puberty and bilateral groin masses = undescended testes. HIGH LH + Normal/high testosterone.

Testosterone-secreting tumour = LOW LH + High testosterone

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6
Q

Rheumatic fever

A

Group A b-haemolytic Strep (GAS) or Scarlet Fever

5-15yo

2-6wks post-throat infection

Then you get triad of PPE:

  • Polyarthritis (joint swelling or pain)
  • Pericarditis (endo/myo/pericarditis)
  • Erythema marginatum (map-like outlines)

Major criteria = CASES
Carditis, Arthritis, Subcutaneous nodules, Erythema marginatum, Sydenham’s chorea

Minor criteria = FRAPP

Fever, Raised ESR/CRP, Arthralgia, Prolonged PR, Previous Hx

Diagnosis = 2 major OR 1 major + 2 minor

Mx:

  • 1st line = High-dose aspirin
  • Amoxicillin if evidence of persistent infection
  • Corticosteroids if fever/inflammation doesn’t resolve rapidly

Prophylaxis after the episode = Benzathine penicillin

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7
Q

Infective Endocarditis

A

Most common cause WITH heart abnormality = Strep viridans

Most common cause WITHOUT heart abnormality = Staph aureus

Tx = IV amoxicillin for 4-6wks (initial)

BenPen (if you know its viridans)

Fluclox (if you know its Staph aureus)

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8
Q

Fragile X

A

Long, thin face + Macrognathia (large mandible)

Associated with mitral valve prolapse

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9
Q

GORD Tx

A
  1. Small frequent feeds
  2. Thicken feeds
  3. Alginate trial
  4. PPI trial
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10
Q

Physiological changes in pregnancy

A

CVS = CO increase

Renal = GFR increases 30-60%, meaning glucose and protein losses in urine

Liver = Raised ALP, low albumin

Haem = Hb + Pt decreases (dilutional).

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11
Q

Cyst in midline of neck/ external angle of eye/ posterior pinna of ear with hair follicles visible in it?

A

Dermoid cyst

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12
Q

Ondansetron use in pregnancy?

A

Small risk of cleft palate if used in first trimester

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13
Q

Commonest cause of ovarian enlargement in women of reproductive age

A

Follicular cyst

  • Commonest type of ovarian cyst
  • due to non-rupture of the dominant follicle or failure of atresia in a non-dominant follicle
  • commonly regress after several menstrual cycles
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14
Q

Mx of Perthes?

A

<6yo = Observe - good prognosis

>6yo = Surgery

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15
Q

Define Oligoarticular (pauciarticular) JIA

A

Affects up to 4 joints

Typically large joints (Knee, elbow, ankle)

Systemic JIA = FEVERS

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16
Q

Otitis media

A

Admit if:

  • Severe systemic infection
  • Complications: Meningitis, Mastoiditis, facial nerve palsy
    • Mastoiditis = “Honeycomb” structure + discharge behind ear

Without effusion:

  • Paracetamol/ibuprofen, should resolve in 1wk
  • Immediate Amoxicillin if sytemically unwell or <2yo

With perforation = PO Amoxicillin 5 days, review in 6wks

With effusion “Glue ear”

  • Conductive hearing loss
  • Can interfere with speech development
  • Otoscopy: Eardrum is dull + retracted ± fluid level visible
  • Ix
    • Tympanometry, Pure tone audiometry
  • Mx
    • Co-existing cleft palate, Down’s, hearing loss = Refer to ENT
    • Otherwise:
      • Active observation for 6-12wks
      • 2x Pure tone audiometry tests (3 months apart)
      • Persisting past 6-12wks = Refer to ENT
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17
Q

Developmental milestones referral points

A
  • Doesn’t smile at 10 weeks
  • Can’t sit unsupported at 12 months
  • Can’t walk at 18 months

Hand preference before 12 months = ?Cerebral palsy

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18
Q

Which ovarian cancer increases risk of endometrial hyperplasia?

A

Granulosa-theca cell

Secretes oestrogen

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19
Q

Rubella in pregnancy

A

Risk high (90%) in first 8-10wks GA

Low risk to foetus after 16wks

Congenital Rubella = CHD (PDA), Eye problems (cataracts, “salt & pepper” chorioretinitis, Deafness

Suspected cases of rubella in pregnancy should be discussed with the local Health Protection Unit

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20
Q

Williams syndrome

A

Elfin facies

Bubbly outgoing personality

Learning difficulty

Short stature

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21
Q

Shaken baby syndrome triad?

A

Retinal haemorrhages

Subdural haematoma

Encephalopathy (Seizures, LOC)

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22
Q

When is the booking visit and what is usually done?

A
  • 8-12wks (ideally <10wks)

Consists of:

  • General info e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
  • BP, urine dipstick, check BMI
  • Booking bloods/urine:
    • FBC, ABO blood group, Rhesus status, red cell alloantibodies, haemoglobinopathies
    • HIV, Hep B, Syphilis
    • URINE CULTURE for asymptomatic bacteriuria (even if dipstick is normal)
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23
Q

Medical management of miscarriage?

A

Vaginal misoprostol ONLY

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24
Q

Baby born to mum with Hep B surface antigen +ve OR high risk.

What is Tx for baby?

A

Hep B vaccine + 0.5ml HBIG within 12hrs of birth

Hep vaccine at 1-2 + 6 months

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25
Q

Drugs contraindicated in breastfeeding?

A
  • Abx: Ciprofloxacin, Tetracycline (Doxycycline), Chloramphenicol, Sulphonamides
  • Psych: Lithium, BDZs, Clozapine
  • ASPIRIN
  • CARBIMAZOLE (hyperthyroidism)
  • AMIODARONE
  • Methotrexate
  • Sulphonylureas
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26
Q

Whooping cough

A
  • Cough for 2wks or more
  • Vomiting after coughs
  • Inspiratory whoop
  • Apnoeic attacks in infants
  • ADMIT if:
    • <6m
    • Apnoea, cyanosis, severe paroxysms
    • Complications: Seizures, pneumonia

Cough onset within 21 days = MACROLIDE (Azithromycin or Clari)

Return to school 48hrs after commencing Abx

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27
Q

Measles vs Rubella vs Roseola

A
  • Measles
    • Prodrome = Fever + Conjunctivitis (±febrile convulsions)
    • Rash starts BEHIND THE EARS
    • KOPLIK SPOTS (white)
    • NO lymphadenopathy
  • Rubella
    • Prodrome = MILD fever
    • PINK rash
    • Suboccipital/Post-auricular Lymphadenopathy
    • Forcheimer spots (Red spots on soft palate)
      • Roseola
    • Classically HIGH Fever (3 days) THEN RASH appears
    • PINK macular rash
    • FEBRILE CONVULSIONS
    • Nagayama spots (uvula + soft palate
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28
Q

You are called to assist in the resuscitation of a neonate who has just been born at 38 +6 weeks but is showing signs of respiratory distress. On auscultation of the precordium you note the heart sounds are absent on the left hand side but can hear tinkling sounds. The infant is also cyanosed.

A

Left-sided congenital diaphragmatic hernia

Left sided = most common

Tinkling sounds = BOWEL sounds

Immediate Mx = INTUBATE + VENTILATE

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29
Q

beta hCG facts

A
  • Hormone first produced by the embryo and later by the placental trophoblast
  • Main role = to prevent the disintegration of the corpus luteum
  • Doubles every 48hrs in first few wks of pregnancy
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30
Q

Eclampsia: when should magnesium be stopped?

A

24hrs after last seizure

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31
Q

Neonatal resus steps

A
  1. Dry baby and maintain temperature
  2. Assess tone, respiratory rate, heart rate
  3. If gasping or not breathing give 5 inflation breaths
  4. Reassess chest movements
  5. If the heart rate is not improving and <60bpm start compressions and ventilation breaths at a rate of 3:1
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32
Q

Head lice

A
  • pediculosis capitis
  • Diagnosis = Fine-tooth combing of hair
  • Treatment = ONLY if living lice are found
    • 1st line = Malathion
    • Household doesn’t need Tx unless they are also affected
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33
Q

Stress Incontinence

A
  1. Pelvic floor exercises

Medical = Duloxetine

Surgical = Retropubic mid-urethral tape procedures

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34
Q

Urge incontinence

A
  1. Bladder retraining
  2. Anti-muscarinics: Oxybutynin, Tolterodine, Darifenacin

IN FRAIL ELDERLY WOMEN: Mirabegron (Beta-3 agonist)

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35
Q

Retinoblastoma

A

Autosomal dominant

Sx: Absence of red reflex, strabismus, visual problems

>90% survive into adulthood

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36
Q

A mother brings her 5-week-old newborn baby to see you. She reports that she has noticed that his belly button is always wet and leaks out yellow fluid. On examination, you note a small, red growth of tissue in the centre of the umbilicus, covered with clear mucus. The child is otherwise well, apyrexial and developing normally.

A

Umbilical granuloma

Overgrowth of tissue which occurs during the healing process of the umbilicus. It is most common in the first few weeks of life.

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37
Q

Immunisation schedule at 12 months?

A

Hib/Men C + Men B + MMR + PCV

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38
Q

When is Men B vaccine given?

A

2, 4, 12 months

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39
Q

Neonatal blood spot screening (heel prick)

A

At 5-9 days of life

  • congenital hypothyroidism
  • cystic fibrosis
  • sickle cell
  • phenylketonuria
  • medium chain acyl-CoA dehydrogenase deficiency (MCADD)
  • maple syrup urine disease (MSUD)
  • isovaleric acidaemia (IVA)
  • glutaric aciduria type 1 (GA1)
  • homocystinuria (pyridoxine unresponsive) (HCU)
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40
Q

Phimosis Mx?

A

<2yo = NORMAL

i.e. Review at 2yrs if present

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41
Q

Pathological CTG findings

A

Late decelerations = doesn’t return to normal until 30s after end of contraction. Indicates foetal distress. Need foetal blood sampling

Variable decelerations = ?Cord compression

Early deceleration = Innocuous, indicates head compression

Bradycardia (<100) = Maternal b-blocker use, increased foetal vagal tone

Tachycardia (>160) = Maternal fever, chorioamnionitis, hypoxia, premature

Loss of baseline variability (<5) = Prematurity, hypoxia

42
Q

Endometriosis diagnosis and management?

A

Dx = Laparoscopy

Mx:

  1. NSAIDS ± paracetamol (1st line)
  2. COCP
  3. GnRH analogues - ‘pseudomenopause’

Fertility is an issue -> SURGERY (e.g. laparoscopic excision)

43
Q

Placental abruption RFs mnemonic

A

ABRUPTION

Abruption (previous)

BP (HTN, pre-eclampsia)

Ruptured membranes (premature/prolonged)

Uterine injury (Trauma)

Polyhydramnios

Twins (multiple pregnancy)

Infection (chorioamnionitis)

Old age >35

Narcotics (COCAINE, speed, smoking)

44
Q

Pregnant woman with BP >160/110. No proteinuria

A

IMMEDIATE assessment + ADMIT

45
Q

Precocious puberty + small testes in a boy is likely to be?

A

Adrenal cause - tumour or Adrenal hyperplasia

46
Q

Precocious puberty + enlarged testes?

A

Bilateral = Gonadotrophin dependent (LH/FSH)

Unilateral = Gonadal tumour

47
Q

Cause of precocious puberty in girls?

A

McCune Albright syndrome

48
Q

Undescended testicle Mx?

A

Unilateral = Review/refer at 3m, ideally seen by surgeon before 6m. Orchidoplexy around 1yo

Bilateral = Paediatric review within 24hrs, may need urgent endo/genetic investigation

49
Q

Placental abruption mx?

A

Fetus alive <36wks:

  • Fetal distress = Immediate C-section
  • No distress = steroids

Fetus alive >36wks

  • Fetal distress = Immediate C-section
  • No distress = Vaginal delivery

Fetus dead = Induce vaginal delivery

50
Q

Important NICE paediatric red flags

A
  • Pale, mottled, cyanotic
  • Appearing unwell to paediatric healthcare professional
  • High-pitched/weak cry
  • Grunting
  • RR >60
  • Reduced skin turgor
  • Age <3m with temp. ≥38
51
Q

When can you do expectant Mx for ectopic?

A
  • Unruptured embryo (no Sx of pain/bleeding)
  • <35mm in size
  • NO fetal heartbeat
  • Asymptomatic
  • B-hCG <1,000 and declining
52
Q

Endometritis Mx?

A

Puerperal pyrexia = >38C in the first 14 days post-partum

ADMIT + IV Clindamycin + gentamicin

53
Q

Causes of meconium ileus?

A
  • Hirschprung’s
  • Cystic Fibrosis
54
Q

Causes of bilious vomiting in neonate?

A
  • Very premature baby (At least <37wks or 3wks before EDD) with Fever + abdo distension = NEC
  • <6hrs after birth = Duodenal atresia (Abdo XR -> “double bubble”)
  • <24hrs = Jejunal/ileal atresia
  • 1-2 days = Meconium ileus (think Cystic fibrosis or Hirschprung’s)
  • 3-7 days = Malrotation/volvulus (Urgent Upper GI contrast + USS)
55
Q

How long can urine pregnancy test be positive for after TOP?

A

4 weeks

>4 weeks indicates incomplete TOP or persistent trophoblast

56
Q

What factor is associated with decreased incidence of hyperemesis?

A

Smoking

57
Q

RFs for hyperemesis?

A
  • multiple pregnancies
  • trophoblastic disease
  • hyperthyroidism
  • nulliparity
  • obesity
58
Q

Hyperemesis Mx?

A
  1. Anti-histamine - Cyclizine or Promethazine PO
  2. Anti-emetic - Ondansetron or Metoclopromide PO
    • Ondansetron = Small risk of cleft lip/palate in 1st trim
    • Metoclopramide = Risk of EPSEs. Do not use >5 days

ADMIT if:

  • Continued N+V and is unable to keep down liquids or oral antiemetics
  • Continued N+V with ketonuria and/or >5% weight loss despite anti-emetics
  • A confirmed or suspected comorbidity (for example she is unable to tolerate oral antibiotics for a urinary tract infection)​
59
Q

Which SSRIs are recommended in breastfeeding? (post-natal depression)

A

Sertraline and Paroxetine

60
Q

When do you refer/urgently assess a kid with a new onset limp?

A

<3yo

61
Q

Umbilical cord prolapse mx?

A
  1. Push presenting part of foetus head in
  2. Go on all fours + prepare for C-section
62
Q

Differences between the types of miscarriages?

A
63
Q

Investigation pathway for gestational sac with no fetal heartbeat?

A

.

64
Q
A
65
Q

UTI imaging <6m

A

Responds to Abx in 48hrs = USS 6wk

Atypical OR Recurrent = Immediate USS + DMSA 4-6m + MCUG

66
Q

UTI 6m-3yo

A

Responds to Abx in 48hrs = Nothing

Atypical = Immediate USS + DMSA

Recurrent = USS 6wks + DMSA

67
Q

UTI imaging >3yo

A

Responds to Abx = nothing

Atypical = Immediate USS

Recurrent = USS 6wks + DMSA

68
Q

Cyanotic heart conditions

A

NO murmur + Loud S2 sound = TGA (hrs after birth)

ESM ULSE + MINTUES after birth = Tricuspid atresia

ESM ULSE + ANY AGE + tet spells = Tetralogy (surgery at 6m)

Cyanotic at 10-15yo = Eisenmenger

Cyanosis at 2-3wks + Down’s = AVSD

All of these need ABCDE approach + PROSTOGLANDIN

69
Q

Acyanotic heart conditions

A

Breathless baby

Continuous machine-like murmur = PDA (Tx = Indomethacin)

ESM + Fixed split S2 = ASD

LOUD Pan-systolic = Small VSD

SOFT Pan-systolic = LARGE VSD -> Risk of Eisenmenger, needs surgery at 3-6m

70
Q

Difference between endometritis vs RPOC

A

Endometritis = Constant pain + Tender uterus + CLOSED OS

RPOC = Crampy pain + LARGE uterus + OPEN OS

71
Q

UTI Mx for <3m

A

ADMIT + IV Co-amox/Cephalexin 5-7days + Paeds referral

72
Q

UTI Mx >3m

A

LOWER UTI (dysuria + no fever) = PO Nitrofurantoin/Trimethoprim 3 days

UPPER UTI (Bacteriuria + Fever OR loin pain) = Consider admitting + IV Abx OR PO Nitro/Trim 7-10 days

73
Q

Cyanotic + ESM ULSE

A

Mins after birth = Tricuspid atresia

Any age = Tetralogy

74
Q

Cyanotic few hours after birth, with no murmur but a loud S2 heart sound?

A

TGA

Tx = Immediate prostaglandin + surgery

75
Q

Breathless baby, ESM ULSE with fixed split S2

A

ASD

76
Q

Breathless baby, soft pan-systolic murmur

A

Large VSD

Needs surgery 3-6m to prevent Eisenmenger

77
Q

Breathless baby, loud pan-systolic murmur

A

Small VSD

Risk of endocarditis

Self-limiting

78
Q

Breathless baby, Left subclavicular thrill, large volume bounding collapsing pulse, heaving apex beat, continuous machine-like murmur in ULSE

A

PDA

Tx = Indomethacin or ibuprofen

79
Q

DKA Mx

A

Triad: Glucose >11, Ketones >3 (or ++ on dipstick), pH <7.3

  1. Initial bolus of 0.9% saline
    • 20ml/kg over 15mins if SHOCKED
    • 10ml/kg over 1hr otherwise
  2. Deficit correction = Fluid deficit x weight (kg) x 10 - (initial bolus if non-shocked) over 48hrs
  3. Maintenance (over 24hrs)
    • ​​First 10kg = 100ml/kg
    • Next 10kg = 50ml/kg
    • Every kg after 20kg = 20ml/kg
  4. Requirement (Ensure 40mmol/litre of KCl included)
    • Calculate ml per hour for both deficit and maintenance
    • Combine
  5. IV 0.05-0.1U/kg/hr insulin (after 1-2hrs of fluids)
    • Start 5% Dextrose infusion when glucose <14mmol/L
  6. Change to SC insulin
80
Q

Asthma stepwise management

A

1.

81
Q

Hereditary angioedema - what is the immune mediator?

A

C1 esterase inhibitor deficiency

82
Q

A 2-week-old boy is admitted with a 3-day history of vomiting and increasing lethargy. Physical examination is normal except for increased pigmentation of the areolar and nipples bilaterally. Laboratory findings include plasma sodium = 126 mmol/L; plasma potassium = 6.8 mmol/L; and plasma glucose = 5.9 mmol/ L. What is the most likely diagnosis?

A

Congenital Adrenal Hyperplasia

90% 21-hydroxylase deficiency

Salt-losing crisis often the 1st sign in boys in week 1-3 + ambiguous genitalia

HYPERKALAEMIC metabolic acidosis

Initial Ix = USS examine for internal genitalia, electrolytes, rapid ACTH sitmulation test

DIAGNOSTIC = Serum 17a-hydroxyprogesterone (but CAN’T do in a newborn)

83
Q

A post-term infant is delivered by emergency Caesarian section for a moderate placental abruption. On examination the infant’s oxygen saturation is 85% in air and there is marked respiratory distress. A CXR reveals bilateral patchy infiltrates. What is the most likely diagnosis?

A

Meconium aspiration

Greater GA (post-term) = higher risk

84
Q

An infant of 31 weeks gestation was born via an emergency section because of foetal decelerations noted on CTG. The birth weight was 1100g and the infant required intubation but was difficult to ventilate. A CXR shows diffuse whiteout of both lungs with air bronchograms. What is the most likely diagnosis?

A

Respiratory Distress Syndrome (Hyaline disease of newborn)

Classic pre-term baby + LBW + intubation/ventilated

Diffuse whiteout with air bronchograms = Typical “Ground glass” appearance found in RDS

85
Q

“Irreducible firm lump which extends from the inguinal canal to the scrotum”

A

Incarcerated inguinal hernia

At high risk of strangulation

Need IMMEDIATE Referral to paediatric surgeon

Strangulation Sx = Fever, peritonitis, bowel obstruction Sx, bloody stool

86
Q

Hypospadias management?

A

Refer to specialist services

Surgery around 12 months

Hypospadias is CONTRAINDICATED for circumscision

87
Q

Phimosis

A

<2yo =

88
Q

Phimosis management?

A

<2yo - reassure and review in 6m

>2yo - CIRCUMCISION (Gold standard)

89
Q

Two unrelated infants are born at 36 weeks’ gestation. One infant weighs 2600g at birth and the second infant weighs 1600g. Which of the following conditions is the second baby more likely to have?

A

Congenital malformations

90
Q

A 2 year old presents with frank haematuria, some abdominal pain and rigors. Which investigation is most likely to reveal the underlying diagnosis?

A

Urine MC&S

91
Q

A 3-month-old breast-fed girl presents with a 3 day history of increasing breathlessness and difficulty with feeding. On examination she is tachypnoeic and hypoxic with no crepitations or wheeze and no abnormal upper airway signs. Her mother declined antenatal blood tests. What is the most likely underlying cause of this child’s respiratory illness?

A

HIV

92
Q

A ten-year-old girl presents with recurrent abdominal pain. Of the following symptoms, which is most suggestive of an organic aetiology?

A

She wakes from sleep with pain at night

93
Q

An eight year old girl is seen with a second episode of cervical abscess in three months. The first culture grew Klebsiella pneumoniae. On this occasion Staphylococcus aureus was cultured. What is the most likely immunological mediator?

A

Neutrophils

Recurrent pneumonias and abscesses, particularly due to catalase-positive bacteria (e.g. Staphylococcus aureus) and fungi (e.g. Aspergillus)

94
Q

A previously healthy 2-year-old child presents with a 24 hour history of diarrhoea and vomiting. Which of the following is the single, most accurate method for assessing the degree of dehydration?

A

Calculate the difference between the current weight and the predicted weight from the child’s growth records

95
Q

A 3-year-old boy attends the Paediatric A+E Department because he has developed an itchy rash whilst at a birthday party. Of the following features, which requires immediate treatment with 0.01 ml/kg of 1:1000 adrenaline i.m.?

Blood pressure of 88/50, Generalised urticaria, Lip swelling, Respiratory rate of 22/minute, Wheeze on auscultation

A

Wheeze on auscultation

96
Q

A 6 yr old male born in the UK to Iraqi parents, develops sudden onset very dark red urine with no dysuria. He has a intercurrent viral infection. On examination; slightly jaundiced, no liver or spleen; urine – blood ++++. There was a history of prolonged neonatal jaundice. Which investigation is most likely to reveal the underlying diagnosis?

A

G6PD level, now and in one month’s time

97
Q

An eight year old boy presents with nocturnal cough and early morning tiredness. He has a past history of serous otitis media. On examination, he has noisy breathing, is overweight and is inattentive during consultation. What is the most likely diagnosis?

A

Obstructive sleep apnoea

98
Q

An 18 month old boy is seen with a history of recurrent oral candidiasis. He developed tetany in the newborn period and had cardiac surgery for a complex heart defect. What is the most likely immunological deficiency?

A

T-cells

This is probably DiGeorge syndrome (hypocalcaemia, cardiac abnormalities, thymic aplasia -> recurrent infections)

99
Q

Mx when a CTG is suspicious during labor?

A
  1. Turn woman into left lateral position
  2. Turn down oxytocin level to ensure uterus is not being overstimulated
  3. Fetal blood sampling
100
Q

Neonate with red sticky eyes, purulent discharge 2wks post birth, likely organism

A

<48hrs = Gonorrhoea (Ceftriaxone)

1-2wks = Chlamydia (Erythromycin)

101
Q

Flu-like symptoms, mydriasis, ‘Runs’ (D&V, lacrimation, rhinorrhoea), ‘Goose-flesh’ (Piloerection)

What is this?

A

Opiate withdrawal

Mx = Methadone or buprenorphine

102
Q

COCP contraindications

A
  • >35 years old + Smoking >15 a day
  • Migraine with aura
  • Hx of thomboembolic disease
  • Hx of stroke or ischaemic heart disease
  • breast feeding < 6 weeks post-partum
  • Uncontrolled hypertension
  • Current breast cancer
  • major surgery with prolonged immobilisation
  • positive antiphospholipid antibodies (e.g. in SLE)

Increased risk of breast + cervical cancer

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