SAQ book Flashcards
Investigations after APH?
USS, FBC, clotting profile, G&S/crossmatch, Kleihauer, CTG
Why can you not see the bleed in palcental abruption?
concealed bleed - retroplacental
What may you see on clotting profile after APH?
low fibrinogen - DIC causes fibrinogen to be used up
From when is the fetus first palpable?
12 weeks
What blood tests should be offered in pregnancy?
FBC, blood group and rhesus status
rubella
HIV
syphilis serology
When does puerperal psychosis typcially come on? Risk of recurrence?
Within 2 weeks
50%
When does postpartum depression come on? How common is it?
3 months
5-15%
Risk factors for pre-eclampsia?
fam hx
nulliparity
increasing maternal age
pre-existing diabetes / hypertension
What makes up the Bishop Score?
cervical dilation
station of foetal head
cervical position, effacement and consistency
Why is DVT in pregnancy more likely to occur in the left leg?
Gravid uterus puts more pressure on the left iliac vein
Give pre-labour and intrapartum risk factors for shoulder dystocia
pre labour: diabetes, macrosomia
intrapartum: prolonged second stage, oxytocin augmentation
Risk factors for cord prolapse?
prematurity
abnormal lie
polyhydramnios
artificial rupture of membranes
Should you be worried about an ejection systolic murmur in a pregnant woman?
No because of hyperdynamic circulation
What makes a CTG reassuring?
foetal heart rate from 110-160
baseline variability 5-25
preseence of accelerations
absence of decelerations
Give 2 contraindications to foetal blood sampling
maternal infection
foetal bleeding disorder
Besides fluids, what can be given to women with hyperemesis?
thiamine to prevent Wernicke’s encephalopathy
LMWH
anti-emetics
What testing can be done on expelled POC after a miscarriage?
histology and karyotyping
What is CIN?
presence of dysplastic cells that have not invaded beyond the basement membrane
Markers associated with ovarian cancer?
CA-125, AFP
Give 2 sites of endometriotic lesions
uterosacral ligaments, pelvic peritoneum
Give 2 contraindications to coil insertion
pregnancy
STI
Complications of PID?
peri-hepatitis
tubo-ovarian abscess
chronic pelvic pain
infertility
ectopic pregnancy
What can be used to distinguish delirium from dementia?
Confusion Assessment Method - CAM
Give some changes in dementia aside from memory loss
personality change
inattention
language / communication issues
How does duloextine work for stress incontinence?
SNRI- increase NA at the synapse and increases tone of the IUS
What can be used to assess risk of stroke post TIA?
ABCD2 score
What is the MCA a branch of?
the internal carotid
What is the difference between T score and Z score?
T score is compared against healthy young adult bone, Z score is age adjusted
What should be tested for in suspected myeloma?
urinary Bence Jones protein
serum electrophoresis
Pathophysiology of PD?
neuronal degeneration in the substansia nigra meaning less dopamine in basal ganglia
Tests to do before starting lithium?
ECG - Qtc prolongation
TFTs
U&Es
Why are subjective scoring sxs useful in mental disorders?
diagnosis, monitoring, research
Risks of sedatives in the elderly?
Increased confusion
Increased falls risk
Resp depression and hypotension
Recommended alcohol intake?
14 units per week, 2-3 in one sitting
Intervetions in alcohol abuse?
Refer to AA
Disulfiram, acamprosate
benzos
How can someone appeal a section?
Writing to a tribunal within 14 days
How does N-acetylcysteine work in overdose?
Provides the liver with enough glutathione to break down NAPQI
Limitation of behavioural change model?
assumes people always act in the same, rational way
Cause of bronchiolitis? Finding on CXR?
Respiratory syncytial virus
Hyperinflation
Main cause of croup? Signs of croup other than cough and SOB?
Parainfluenza virus
hoarse voice, stridor
What can you give croup that doesn’t respond to steroids?
nebulised adrenaline
Peak age of SUFE? RF?
10-17
obesity, GH deficiency, male, trauma
Risk of untreated jaundice? Mx of jaundice?
Kernicterus
phototherapy, exchange transfusion
Signs of decompensated congential heart disease
dyspnoea
poor feeding
lethargy
cold peripheries
hepatomegaly
What causes an increased risk of respiratory distress syndrome?
maternal diabetes
C section
second twin
Sign of IRDS on CXR?
ground glass shadowing
Define cerebral palsy. Give 2 types
chronic disorder of movement and posture due to non-progressive brain abnormalities before the brain is fully developed
spastic
ataxic
