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Thurs Flashcards

1
Q

cluster headaches symptoms

A

unilateral headache

worse around eye

bloodshot eye

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2
Q

heavy bleeding during period treatment

menorragia

A

mirena coil

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3
Q

Temporal Lobe Epilepsy symptoms

A

Fumbling, picking, fidgeting

Chewing, lip smacking, swallowing

wide-eyed motionless stare which can last for 1-2 minutes

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4
Q

Multiple Sclerosis- what happens

A

degeneration of the insulating covers of nerve cells in the brain and spinal cord

demyelination and axonal loss.

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5
Q

Multiple sclerosis symptoms

A

patchy paraesthesia

Optic neuritis

Internuclear ophthalmoplegia

cerebellar ataxia

Spastic paraparesis

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6
Q

Optic neuritis

A

loss of central vision and painful eye movements

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7
Q

Internuclear ophthalmoplegia

A

lesion in the medial longitudinal fasciculus of the brainstem

blurry vision or diplopia or dizziness on lateral gaze

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8
Q

Spastic paraparesis

A

weakness and stiffness in the leg muscles

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9
Q

signs of MS

A

periventricular white matter lesions

Oligoclonal bands in the CSF

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10
Q

acute management of MS

A

1g of intravenous methylprednisolone every 24 hours for 3 days

plasma exchange

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11
Q

relapsing remitting multiple sclerosis management

A

First-line injectables - beta-interferon

oral dimethyl fumarate, teriflunomide

biologics

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12
Q

fatigue medication for MS

A

Modafinil

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13
Q

medication for bladder dysfunction in MS

A

Anticholinergics - Oxybutinin or Tolterodine

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14
Q

erectyle dysfunction medication in MS

A

Sildenafil

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15
Q

medication for tremor in MS

A

Clonazepam

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16
Q

signs of infection post chemo

what do you do?

A

refer to hospital

could be neutropenic sepsis

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17
Q

GAD management

A

sertraline

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18
Q

Shoulder dystocia

A

obstructed labour foetal anterior shoulder becomes lodged behind the maternal pubic symphysis

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19
Q

signs of shoulder dystocia

A

difficulty in delivering the foetal face or chin

retraction of the foetal head

failure of restitution

descent of the shoulders following head delivery

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20
Q

risk factors for shoulder dystocia

A

Maternal gestational diabetes/obesity

Macrosomia

Advanced maternal age

Maternal short stature or small pelvis

Post-dates pregnancy

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21
Q

management for shoulder dystocia

A

Do not apply fundal pressure as this may lead to uterine rupture

no maternal pushing as this may exacerbate shoulder impaction

McRoberts manoeuvre

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22
Q

McRoberts manoeuvre

A

Hyperflexion and abduction of the mother’s legs tightly to the abdomen

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23
Q

when do you do an episiotomy

A

cut when baby is in distress and needs to be born quickly

there is a need for forceps or vacuum delivery (ventouse)

there is a risk of a tear to the anus.

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24
Q

Left internuclear ophthalmoplegia

A

ipsilateral impairment of the adducting eye and nystagmus in the abducting eye

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25
Q

Fibroadenomas arise from

A

arise from the breast lobule stroma

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26
Q

Breast cysts causes

A

overgrowth of glandular and connective tissue, leading to blocked breast ducts and subsequent fluid accumulation.

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27
Q

Intraductal papilloma

A

benign tumour of the breast ducts

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28
Q

Fibrocystic breast disease cause

A

due to an exaggerated hormonal response causing inflammation, fibrosis, cyst formation, or adenosis
(lobules are enlarged, and there are more glands than usual. )

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29
Q

Mammary duct ectasia cause

A

inflammation and dilation of the large breast ducts.

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30
Q

indications for induction of labour

A

> 41 weeks gestation

Preterm prelabour rupture of membranes

Intrauterine foetal death

Abnormal CTG

Maternal conditions such as pre-eclampsia, diabetes, cholestasis

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31
Q

when do you not do induction of labour

A

Placenta praevia

vasa previa

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32
Q

management of labour induction

A

Membrane sweep

Vaginal prostaglandins (PGE2)

Amniotomy: Artificial rupture of membranes.

Balloon catheter- dilate

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33
Q

Placenta praevia

A

placenta blocks uterus neck

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34
Q

Placenta praevia symptoms

A

painless bleeding after 24 weeks

35
Q

vasa previa

A

foetal vessels are too near internal cervical os

36
Q

symptoms of vasa previa

A

Painless vaginal bleeding

Rupture of membranes

Foetal bradycardia

37
Q

management for vasa previa

A

c section arranged for 35-36 weeks or emergancy

38
Q

Prelabour rupture of membranes

A

rupture of the amniotic membranes before the onset of labour after 37 weeks

39
Q

Prelabour rupture of membranes symptoms

A

Foul-smelling or greenish amniotic fluid

Maternal fever

Reduced foetal movements

40
Q

management of Prelabour rupture of membranes

A

lif no labour within 24 hours, induction of labour

signs of infection, immediate induction and antibiotics

40
Q

medications not in pregnancy

A

Chloramphenicol.

Cipro and levofloxacin.

Sulfonamides.

Trimethoprim

Codeine.

Ibuprofen

Warfarin

LABA

carbemazipine

41
Q

medication for bipolar pregnant lady

A

Switch gradually to an antipsychotic from lithium

41
Q

management for breech presentation

A

ECV (EXTERNAL CEPHALIC VERSION)

turn the baby using their hands on the abdomen

42
Q

HOWELL JOLLY BODIES

A

hyposplenism

43
Q

Schistocytes

A

microangiopathic haemolytic anaemia

haemolytic uraemic syndrome and thrombotic thrombocytopenia purpura) or disseminated intravascular coagulation (DIC).

44
Q

Haemophilia A

A

X-linked recessive deficiency in clotting factor VIII

45
Q

Haemophilia B

A

X linked recessive

clotting factor 9 no

46
Q

bloods in Haemophilia A

A

Clotting profile - APTT is elevated

vWF antigen is normal

Defective platelets

47
Q

management of Haemophilia A

A

minor- desmopressin

major- recombinant factor VIII or IX

48
Q

Von Willebrand Disease

A

reduced quantity or function of von Willebrand factor (VWF)

49
Q

what is the most common inherited bleeding disorder

A

VWD

50
Q

clotting tests results of von willebrand disease

A

normal PT and TT, and prolonged APTT

51
Q

Multiple myeloma

A

plasma cell dyscrasia by abnormal clonal proliferation of plasma cells

52
Q

epidermiology of multiple myeloma

A

afro carabbean

second most common haem malignancy

men

53
Q

multiple myeloma symptoms

A

CRAB HAI

HyperCalcaemia
renal
anemia
bone/back pain
Hyperviscosity- visual, headache, thrombosis
Amyloidosis- cardiac, neuropathy
infefction

54
Q

diagnostic investigations of multiple myeloma

A

Serum and/or urine electrophoresis
IgG

high Serum free light chain

bone marrow- >10% plasma cells

55
Q

treatment of hypercalcaemia

A

bisphosphonates

56
Q

treatment of Hyperviscosity

A

plasmapheresis

57
Q

treatment of MM under 70

A

Haematopoietic stem cell transplantation

induction therapy -
bortezomib/thalidomide/dexamethasone + Daratumumab

58
Q

treatment of MM over 70 yo

A

melphalan, prednisolone and thalidomide

59
Q

symphysis-fundal height after 16 weeks

A

same roughly as gestation week

60
Q

oligohydramnios

A

not enough amniotic fluid

61
Q

polyhydramnios

A

too much amniotic fluid

62
Q

polyhydramnios symptoms

A

maternal discomfort, difficulty in palpating the foetus, and a larger uterus

63
Q

causes of oligohydramnios

A

Fetal renal agenesis
reduced fetal urine production and thus reduced amniotic fluid

prostaglandin inhibitors and ACE-inhibitors.

pre-eclampsia, maternal smoking and placental abruption.

64
Q

Motor neuron disease

A

destroy motor neurons

misfolding of the TDP-43 protein

65
Q

genes related to MND

A

SOD1, FUS and C9ORF72

90% random
10% genetic

66
Q

management of MND

A

Riluzole

extends life by 3 months

5 years after diagnosis

67
Q

asymptomatic bacteriuria in pregnancy

A

antibiotics

68
Q

Sideroblastic anaemia

A

produces ringed sideroblasts - red blood cells with iron-loaded mitochondria.

69
Q

Sideroblastic anaemia signs and symptoms

A

symptoms same as iron deficiency anemia but

high serum ferritin, high iron levels and a microcytic anaemia

70
Q

Sideroblastic anaemia treatment

A

Chelation therapy

Vitamin B6 (pyridoxine) with X linked patients

71
Q

diagnosis of gestational diabetes

A

oral glucose tolerance test at 24-28 weeks

72
Q

nucleated red blood cells, immature neutrophils and tear drop poikilocytes on blood film

spenomegaly

A

Primary myelofibrosis

73
Q

grade 3 and 4 perineal tears management

A

repair in theatre and discharge with laxitives so no constipation

74
Q

MS epidermiology

A

caucasian

75
Q

umbilical cord prolapse

A

umbilical cord comes out during labour before baby

76
Q

umbilical cord prolapse sign

A

sudden change in the fetal heart rate pattern

77
Q

what drug stops uterine contractions

A

tocolytics, such as terbutaline

78
Q

venthouse delivery

A

3 pulls only then lower section cesarian

79
Q

normal pressure hydrocephalus symptoms

A

wet

wacky

wobbly - broad based shuffling gait
(narrow in parkinsons)

80
Q

treatment of normal pressure hydrocephalus

A

Ventriculo-peritoneal shunt

81
Q

pain relief in labour

A

paracetamol

Oral Codeine Phosphate and IV/IM Diamorphine

epidural

82
Q

most common cause of secondary postpartum haemorrhage

A

postpartum endometriosis

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