saturday 12th Flashcards
symptoms of acoustic neuroma
CN VIII - vertigo, hearing loss tinnitus
CN VII - facial palsy
CN V - loss of corneal reflex
is hearing loss in acoustic neuroma unilateral or bilateral
unilaterall
symptoms of viral labyrinthitis
vertigo, hearing loss (bilat) tinnitus
horizontal nystag
impaired vestibulo-ocular reflex
gait disturbance
shared symptoms of labyrinthitis and neuronitis
vertigo
horizontal nystag
what shoudl a differential be in neuronitis and what test can be used to distinguish
posterior circulation stroke
HiNTS exam
what diabetics drugs should be ommitted on the day of surgery
drugs that cause hypos- eg sulfy and SGlt-2
mid day metformin dose if take 3 doses
what shoudl be doen to long acting - once daily insulin doses the day before and day of surgery
reduce dose by 20%
what cancer is endometriosis assoc with
ovarian
how many fontanelles does a newbron have
6
what is a station of 0 in labour
ischial spines
spinal level of pain perception of superior pelvic organs
T11-L2
perineum pain spinal levels
pudendal nerve - s2,3,4,
level of spinal anasthesia
L3/4
what does spinal anasthesia pass through
supraspinatous lig
interspinatous lig
ligamentum flavum
epidural space
dura matar
arachnoid matar
into CSF
how does spinal anasthesia casue hypotension
all spinal nerves contain symp fibres
these supply arterioles and cause vasoconstriction
blocking cuases vasodilation therefore hypotension
when is implantation completed what day
day 12
what cells in embryo implantation are responsible for vili that invade endometrial wall
syncitiotrophoblasts
what electrolytes are unidirectional from mother to child across placenta
iron and calcium
role of HCG
prevents corpus luteum degen therefore promotes oe and prog stim
role of oestrogen adn progesterone in pregnancy
oestrogen -
- breast development
- enlarges uterus
-relaxes ligament
progesterone:
- decreases uterine contractibility
development of decidual cells
prep for lactation
how much should hcg increase by during preg
double every 48hours
why do GDM and hypertension occur in pregnancy
placenta porduces corticotrophic releasing hormone that sstims ACTH
normla HR in pregnancy
90 bpm
resp changes in pregnancy
decreased CO2
increased rr and tidal vol
role of oxytocin in labour
oxytocin stims uterus to ocntract adn the release of prostaglandins that cause positive feedback loop
what hormone stims milk production adn what stims it release
prolactin stims production
oxytocin stims release
when should folic acid be taken
pre-conception until 12 weeks
what vitamin is teratogenic
vitamin A
When do pregnant women get given anti-D
28 and 34 weeks
when is dating scan and downs screening scan
dating =10-13+6
downs 11-13+6
what are levels of AFP, P-APPA , oestrodiol and Inhibin A seen in downs syndrome
AFP - low
PAPPA_- low
Inhibin A - high
oestrodiol - low
how long after sensitising event should anti- d be given
within 72 hours
in foetal hyoxia what happens with resistance in the MCA and umbilical artery
the resistance in umbilica arteyr will increase
the resstence in MCA will decrease
when is a delivery classed as still birth and not miscarrigee
28 weeks
protein uria seen in pre-eclampsia
> 0.3g/24 hr
those at high risk of hypertensive disorders of pregnancy should take whta
aspirin 75-120mg from 12 weeks until delivery
what are high risk factors for hypertensive disorders of pregnancy
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
what BP in pre-eclampsia warrants admitting to hospital
160/110
tx and what shoudl be monitored in treatment of pre-eclampsia in preganncy
magnesium sulphate
urine output, reflexes, respiratory rate and oxygen saturations should be monitored during treatment
first line for magnesium sulphate resp depression
Calcium gluconate
method of induction if bishop <6 or >6
<6 - vag prostaglandin or orla misoprostol - balloon if high risk of hyperstim/prev section
.6 amniotomy and iv oxytocin infusion
first line screening test for gestational diabetes and diagnostic levels
OGTT
fasting 5.6
OGTT - 7.8
tx of gestational diabetes
if fasting< 7 then lifestyle- f after 2 wekstargets not met then metformin
if >7 at diagnosis then insulin -shortn not long acitng
fasting target in GDM
5.3
