SBA/SAQ stuff i didn't know Flashcards
haemolytic uraemic syndrome triad
- AKI
- normocytic anaemia
- thrombocytopenia
when do children receive the MMR vaccine
1 year and 3 years 4 months
metabolic changes in CAH
hyponatremia, hyperkalaemia, metabolic acidosis
chemo sanctuary sites in ALL
CNS and testes
haemophilia
- who is affected, why?
- which factor for A, which for B
- males, x-linked
- VIII, IX
abdo xray finding in biliary atresia
double bubble
complications of chlamydia in preg
a) mother
b) baby
a) chorioamnionitis, PROM
b) conjunctivitis, pneumonia
most common cause of meningitis in neonates
GBS
lithium toxicity presentation
ataxia, seizures, slurred speech, vomiting (SE = fine tremor)
stimulant vs hallucinogens
stimulants = cocaine, MDMA (ectsasy), khat, nicotine
hallucinogens = LSD, ketamine
bloods/metabolic findings in neuroleptic malignant syndrome
- raised creatinine kinase
- raised WCC
- deranged LFTs and U&Es
- metabolic acidosis (low pH, low HCO3)
management of mild-moderate PID if coil is in situ
UNLESS severe or does not respond to tx in 48-72h, leave coil in!
broad spec abx for 14 days
which class of antidepressants can you not have cheese with? give an example of one
MAOIs e.g. phenelzine, tranylcypromine, isocarboxazid
which class of antibiotics is safe in pregnancy at any stage?
cephalosporins e.g. cefotaxime, ceftriaxone
hospital indication for PID
fever >38
secondary syphilis presentation
- 6-8 weeks from infection
- rash, glomerulonephritis, neuro sx
migraine prophylaxis in women of child-bearing age
propranolol (topiramate is normal 1st line)
which antipsychotics cause parkinsonism/pyramidal sx?
TYPICAL e.g. haloperidol
features of non epileptic attacks (5)
- sudden drop
- arms flexing and extending, pelvic thrusting
- eyes closed
- prolonged seizures (>30m)
- symptoms wax and wane
1st line tx of pericarditis
NSAIDs
a) heparin reversal
b) warfarin reversal
a) protamine
b) vitamin K
joint fluid findings in
a) pseudogout
b) gout
a) Pseudo = Positively birefringent Rhomboid crystals (calcium Phosphate)
b) gout = Negatively birefringent Needle crystals (monosodium)
which enzymes are blocked with
a) aspirin
b) clopidogrel
a) COX-1
b) P2Y12
csf findings bacterial meningitis (4)
- turbid
- raised polymorphs (neutrophils)
- raised protein
- low glucose
what is given to help manage parkinsonism/anti-pyramidal SEs from antipsychotics?
procyclidine
what is the protocol for clozapine blood testing when a pt is first started on the med?
1 blood test per week for first 18 weeks
then fortnightly until 1 year
management of OCD if 12 weeks of SSRI and CBT are not working
either
- switch SSRI with another SSRI
- try clomipramine (TCA) if pt prefers/intolerant to SSRIs
1st line management of PTSD and another option
1 = trauma-focussed CBT
can use EMDR - if presenting between 1 and 3 months after a non-combat related trauma and refer EMDR
management of a woman with cervical intraepithelial neoplasia (CIN) I found at colposcopy
discharge and screen again (FU) at 12m in the community
list 4 meds that may cause delirium
- furosemide (diuretic)
- ramipril (anti-HT)
- oxybutynin
- propranolol (B blocker)
- ranitidine (H2 blocker)
what discharge may be present in cervical cancer
red-brown, purulent
most common type of vaginal cancer
secondary (metastatic)
a surge of what hormone triggers ovulation
LH
process of foetal descent (descent > delivery) (8)
- descent
- engagement
- flexion
- internal rotation
- crowning
- extension of presenting part
- external rotation of head
- delivery
management of pregnant woman with positive asymptomatic bacteriuria culture - what is done next?
confirm with second culture then begin culture dependent abx
amniotic fluid index (AFI)
a) polyhydramnios
b) oligohydramnios
a) >24cm
b) <5cm
most common cause of polyhydramnios
idiopathic!!!
what migraine prophylactic tx is contraindicated in asthma
propranolol
least common presentation in a pt with a middle cerebral artery stroke?
a) aphasia
b) headache
c) personality change
d) weakness/numbness
personality change! (more common in ACA)
4 features of horner’s
- miosis
- anhidrosis
- ptosis
- enophthalmos (sinking eyes)
young female with recurrent miscarriages and arthalgia
think rheum e.g. SLE
presentation of gastric ulcers
pain immediately after eating
tx of H.pylori
1 PPI and 2 abx (CAP)
clarithromycin + amoxicillin (or metronidazole) + PPI
aside from hyperglycaemia, acidosis and ketonaemia, which other abnormality may be seen on blood investigation of DKA prior to treatment?
mildly raised creatinine (sign of dehydration)
6 complications of chickenpox
- bacterial superinfection
- cerebellitis/encephalitis
- DIC
- progressive disseminated disease
- pneumonia
- nec fash (strep A)
gastroschisis vs exomphalos
gastroschisis - lateral to umbilicus, no layer, young mum
exomphalos - through umbilicus, in sac, older mum
interval between UTRI and infection: post strep glom vs IgA neph
post strep glom - interval e.g. days/weeks
IgA - little/no interval
atypical UTI features (6)
- no response to abx in 48 hours
- seriously unwell/septic
- not e.coli
- abdominal mass
- poor urine flow
- raised creatinine
drug for arresting paediatric narrow complex tachy
adenosine
most common organism causing IE in paeds
s.viridans
mitral regurg murmur
systolic murmur, left medial ICS
which CHD is egg-shaped on CXR?
transposition of great arteries
what criteria is used to grade rheumatic fever
Jones
HELPP syndrome triad
- haemolysis
- elevated liver enzymes (AST/ALT)
- low platelets
how is magnesium sulphate toxicity monitored in the management of eclampsia?
testing reflexes
RFs for DDH (5)
- breech presentation at 36w
- female
- 1st degree family hx of hip probs in childhood
- first born
- macrosomia
acute management of a patient with CAH in salt-wasting crisis (3)
- dextrose
- IV fluids
- hydrocortisone
mode of inheritance of
a) duchenne muscular dystrophy
b) noonan syndrome
a) x-linked
b) auto dominant
pathophys of muscular dystrophy
- gene mutation on Xp21
- reduced/abnormal dystrophin protein
- muscle lost and replaced by adipose tissue
tx of juveline myoclonic epilepsy in
a) boys
b) girls
a) sodium valproate
b) levetiracetam
MDT management of duchenne muscular dystrophy
- physio
- OT
- counselling
- corticosteroids
- respiratory support
conservative vs medical tx for recurrent ear infections in children
conservative - nasal saline irrigation
medical - antibiotics, grommets
cardiovasc complications of noonan’s
- pulmonary valve stenosis
- hypertrophic cardiomyopathy
- atrial septal defect
which 2 cancers are patients with noonan’s at risk of?
- leukaemia
- neuroblastoma
symptoms of neuroblastoma
- racoon eyes
- weight loss
- bone pain
- abdominal pain/mass
- lymphadenopathy
tx of lower UTI in children
oral nitrofurantoin 3 days
imaging choice with a child with a UTI who
a) is not responding to abx
b) has recurrent UTIs
a) USS urinary tract
b) DMSA scan
paeds UTI risk factors (7)
- structural abnormalities e.g. horseshoe kidney
- females
- white
- sexual abuse
- previous UTI
- poor hygiene
- age < 1 year
initial management of a child < 1 year with transient synovitis
refer urgently to paeds (rare under 1)
toddlers fracture - typical type and location
spiral fracture of tibia
RFs for necrotising enterocolitis (5)
- prematurity
- sepsis
- formula fed
- respiratory distress
- CHD
most common causative organism of HUS (in full)
Escherichia coli 0157 producing Shiga toxin
what is tumour lysis syndrome? what biochemical abnormalities occur?
- deadly complication of chemo due to breakdown of tumour cells and release of chemicals
- high uric acid, hyperkalaemia, high phosphate, hypocalcaemia
findings in coeliac disease on jejunal biopsy? (3)
- villous atrophy
- crypt hyperplasia
- intraepithelial lymphocytes
complications of coeliac disease (5)
- vitamin deficiency
- anaemia
- non-Hodgkin’s lymphoma
- osteoporosis
- small bowel adenocarcinoma
2nd line tx for ADHD
lisdexemfetamine
which medication is used to deter/’put people off’ alcohol?
disulfiram
phenelzine is what class of antidepressant?
MAOI-inhibitor (cheese!)
erb’s palsy nerve roots
c5-6
when are antenatal steroids used for maturing baby’s lungs?
after 24 weeks
weird gynae stuff
a) haematocolpos
b) ovarian hypercothis
a) accumulation of blood in vagina, often due to imperforate hymen
b) hyperandrogenaemia in postmenopausal women e.g. hirsutism in 75 year old
blood results in panhypopituitarism
production of all pituitary hormones is decreased»_space; low EVERYTHING
- TSH, free T4
- FSH, LH
- oestradiol
when is sumatriptan contraindicated?
hx of significant ischaemic disease/cardiovasc disease e.g. coronary artery disease
if cluster headaches, give O2 instead
hodgkin’s vs non-hodgkins
hodgkins in younger people
investigation of choice for acromegaly
OGTT - growth hormone should decrease in response to glucose but it won’t
blood results in PCOS
a) FSH
b) LH
c) prolactin
d) testosterone
e) sex hormone-binding globulin
a) raised LH
b) normal/low FSH (raised ratio)
c) normal/elevated prolactin
d) normal/elevated testos
e) low
presentation of
a) cholecystitis
b) cholangitis
a) biliary colicky pain, referred scapula pain, fever
b) triad of fever, RUQ pain, jaundice
what 3 blood tests are used in lithium monitoring?
- TFTs
- U&Es
- eGFR
(lithium is nephrotoxic and can cause hypo/hyperthyroid)
name of sign in shoulder dystocia when foetus’ head is delivered but retracts against perineum
turtle sign
RFs for shoulder dystocia
- macrosomia
- maternal diabetes
- maternal high BMI
- prolonged labour
describe McRobert’s position
mum’s hips are flexed and abducted
sertraline antagonists:
a) 5-HT3
b) 5HT2
a) ondansetron (anti-emetic)
b) LSD, risperidone, olanzapine, clomipramine
public health definition
the science and art of preventing disease, prolonging life and improving health through organised efforts of society
visual field defects: where in the eye would you expect to be affected if a patient presents with:
a) tunnel vision
b) bitemporal hemianopia
c) macular sparing
a) retina
b) optic chiasm
c) occipital cortex
define a seizure
transient episodes of abnormal electrical activity in the brain
FU for a child who has presented to ED following a seizure
urgent paediatrics neurology referral (within 2 weeks)
screening tools for depression (2)
- PHQ-9
- HADS
management of stage 1 endometrial cancer
total abdominal hysterectomy with bilateral salpingo-oophorectomy
