saturday 12th

Question 1

symptoms of acoustic neuroma

Answer 1

CN VIII - vertigo, hearing loss tinnitus
CN VII - facial palsy
CN V - loss of corneal reflex

Question 2

is hearing loss in acoustic neuroma unilateral or bilateral

Answer 2

unilaterall

Question 3

symptoms of viral labyrinthitis

Answer 3

vertigo, hearing loss (bilat) tinnitus
horizontal nystag
impaired vestibulo-ocular reflex
gait disturbance

Question 4

shared symptoms of labyrinthitis and neuronitis

Answer 4

vertigo
horizontal nystag

Question 5

what shoudl a differential be in neuronitis and what test can be used to distinguish

Answer 5

posterior circulation stroke
HiNTS exam

Question 6

what diabetics drugs should be ommitted on the day of surgery

Answer 6

drugs that cause hypos- eg sulfy and SGlt-2
mid day metformin dose if take 3 doses

Question 7

what shoudl be doen to long acting - once daily insulin doses the day before and day of surgery

Answer 7

reduce dose by 20%

Question 8

what cancer is endometriosis assoc with

Answer 8

ovarian

Question 9

how many fontanelles does a newbron have

Answer 9

6

Question 10

what is a station of 0 in labour

Answer 10

ischial spines

Question 11

spinal level of pain perception of superior pelvic organs

Answer 11

T11-L2

Question 12

perineum pain spinal levels

Answer 12

pudendal nerve - s2,3,4,

Question 13

level of spinal anasthesia

Answer 13

L3/4

Question 14

what does spinal anasthesia pass through

Answer 14

supraspinatous lig
interspinatous lig
ligamentum flavum
epidural space
dura matar
arachnoid matar
into CSF

Question 15

how does spinal anasthesia casue hypotension

Answer 15

all spinal nerves contain symp fibres
these supply arterioles and cause vasoconstriction
blocking cuases vasodilation therefore hypotension

Question 16

when is implantation completed what day

Answer 16

day 12

Question 17

what cells in embryo implantation are responsible for vili that invade endometrial wall

Answer 17

syncitiotrophoblasts

Question 18

what electrolytes are unidirectional from mother to child across placenta

Answer 18

iron and calcium

Question 19

role of HCG

Answer 19

prevents corpus luteum degen therefore promotes oe and prog stim

Question 20

role of oestrogen adn progesterone in pregnancy

Answer 20

oestrogen -
- breast development
- enlarges uterus
-relaxes ligament

progesterone:
- decreases uterine contractibility
development of decidual cells
prep for lactation

Question 21

how much should hcg increase by during preg

Answer 21

double every 48hours

Question 22

why do GDM and hypertension occur in pregnancy

Answer 22

placenta porduces corticotrophic releasing hormone that sstims ACTH

Question 23

normla HR in pregnancy

Answer 23

90 bpm

Question 24

resp changes in pregnancy

Answer 24

decreased CO2
increased rr and tidal vol

Question 25

role of oxytocin in labour

Answer 25

oxytocin stims uterus to ocntract adn the release of prostaglandins that cause positive feedback loop

Question 26

what hormone stims milk production adn what stims it release

Answer 26

prolactin stims production
oxytocin stims release

Question 27

when should folic acid be taken

Answer 27

pre-conception until 12 weeks

Question 28

what vitamin is teratogenic

Answer 28

vitamin A

Question 29

When do pregnant women get given anti-D

Answer 29

28 and 34 weeks

Question 30

when is dating scan and downs screening scan

Answer 30

dating =10-13+6
downs 11-13+6

Question 31

what are levels of AFP, P-APPA , oestrodiol and Inhibin A seen in downs syndrome

Answer 31

AFP - low
PAPPA_- low
Inhibin A - high
oestrodiol - low

Question 32

how long after sensitising event should anti- d be given

Answer 32

within 72 hours

Question 33

in foetal hyoxia what happens with resistance in the MCA and umbilical artery

Answer 33

the resistance in umbilica arteyr will increase
the resstence in MCA will decrease

Question 34

when is a delivery classed as still birth and not miscarrigee

Answer 34

28 weeks

Question 35

protein uria seen in pre-eclampsia

Answer 35

> 0.3g/24 hr

Question 36

those at high risk of hypertensive disorders of pregnancy should take whta

Answer 36

aspirin 75-120mg from 12 weeks until delivery

Question 37

what are high risk factors for hypertensive disorders of pregnancy

Answer 37

hypertensive disease in a previous pregnancy
CKD
autoimmune disease, such as systemic lupus erythematosus or antiphospholipid syndrome
type 1 or type 2 diabetes
chronic hypertension

Question 38

what BP in pre-eclampsia warrants admitting to hospital

Answer 38

160/110

Question 39

tx and what shoudl be monitored in treatment of pre-eclampsia in preganncy

Answer 39

magnesium sulphate
urine output, reflexes, respiratory rate and oxygen saturations should be monitored during treatment

Question 40

first line for magnesium sulphate resp depression

Answer 40

Calcium gluconate

Question 41

method of induction if bishop <6 or >6

Answer 41

<6 - vag prostaglandin or orla misoprostol - balloon if high risk of hyperstim/prev section
.6 amniotomy and iv oxytocin infusion

Question 42

first line screening test for gestational diabetes and diagnostic levels

Answer 42

OGTT
fasting 5.6
OGTT - 7.8

Question 43

tx of gestational diabetes

Answer 43

if fasting< 7 then lifestyle- f after 2 wekstargets not met then metformin
if >7 at diagnosis then insulin -shortn not long acitng

Question 44

fasting target in GDM

Answer 44

5.3