U2 REPRO Flashcards
how long should you take levonelle one after UPSI?
within 12 hrs and no longer than 72hrs
what is the usual dose of levonelle one?
1.5mg - double to 3mg if taken a enzyme inducer in past 4 weeks
at what point would you need to conduct a feticide?
after 21 weeks and 6 days
when would you need to repeat mifipristone?
if abortion hasnt occured at 12-24 weeks - give mifipistone 3 hours after last misoprostol
what is arthrotec?
NSAID diclofenac and misoroprostal - gastroprotectant
what are isotretinoin prescriptions limited to for women of child bearing potentional?
30 days - as can cause miscarriages and each px is only valid for 7 days
2nd line treatment for dysmenorrheoa involves contraception which is contraindicated when?
obesity, high BP and significant family hx of VTE
what are frequent causative agents of secondary dysmenorrheao?
chlamydia and gonorrhoea
what 3 categories is the aetiology of menorrhagia divided into?
(1) pelvic pathology (2) dysfunctional uterine bleeding (3) systemic diseases e.g. hypothyroidism
treatment options for menorrhagia?
NSAIDs, Levonogesteral releasing intrauterine system, COC, oral norethisterone
when should tranexamic acid be stopped when treating menorrhagia?
if no benefits after 3 cycles
why does endometriosis not occur before or after menarche?
the condition is dependant upon oestrogen stimulation
when is menopause diagnosed?
after 12 months of amenorrhoea
treatment for chlamydia?
doxycycline 100mg BD for 7 days OR azithromycin 1g stat then 500mg for 2 days orally
symptoms of pubic lice
black powder in underwear, blue spots on skin
treatment for syphillis less than 2 years
1 penicillin injection into buttocks OR oral A/B for 10-14 days
treatment for vasomotor symptoms ONLY of menopause
tibolone
what is tertazoospermia?
abnormal shaped sperm - cause of infertility
how can ED cause infertility?
inability to maintain an erection, retrograde ejaculation, premature ejaculation
what lifestyle factor is associated with reduced semen quality?
smoking
how does progesterone affect women in pregnancy?
reduces gut motility and gastric emptying - causing constipation
what happens to EGFR from week 6 of pregnancy?
increases - increased elimination of renally excreted drugs such as lithium
what does movement of drugs across placenta depend on?
lipid solubility, molecular weight, degree of ionisation and polarity of drugs
what is thiopental?
used in caesarean - can cause apnaoe in the baby very lipid soluble so crosses placenta
when is it considered the most susceptible time for teratogen sensitivity?
organogenesis
what week gestation is considered the earliest number of which 10% of live babies survive?
23 weeks
what is respiratory distress syndrome also known as?
hyaline membrane disease
who is severely affected by respiratory distress syndrome?
babies born less than 32 weeks, or smaller premature babies
what is cytomegalovirus usually treated with?
IV ganciclovir and oral valganciclovir
what is zidovudine?
usually given to babies to prevent vertical transmission of HIV from mother to baby for 4 weeks
first line treatment for seizure
phenobarbital - 2 loading doses before trying phenytoin (40mg/kg)
when is complete maturation of GFR in babies?
6-8 months
which children have an increased elimination of furosemide?
children with nephrotic syndrome
which children have a high plasma clearance of antibiotics such as penicillin/aminoglycosides?
children with cystic fibrosis
how long does irritability last in colic?
more than 3 hours a day for more 3 days per week for 3 weeks
when does colic resolve by?
improves at 3-4 month of age (resolves by 6 months)
when does GORD in children usually resolve by?
1 years
treatment for GORD in breastfed children
1-2 week trial of alginate therapy mixed with water and given after each feed
what condition is a sea-like barking cough seen in?
croup - usually self-limiting
what is aprostadil?
2nd line treatment for ED - PGE1
which nerves release NO?
nitrergic nerves going into smooth muscle activating guanylyl cylase increasing cAMP and releasing protein kinase G - which causes vasodilation and penile erection
when does sildenafil peak?
30-120 mins - so take 1 hr before sexual intercourse
what age is sildenafil indicated for?
> 18 years
what condition makes sildenafil ineffective?
hypogonadism
what is alprostadil available in the UK as?
intracavernous injection (caverject) and intraurethral application (MUSE) and topical cream (vitaros)
What is given to preterm babies at risk of respiratory distress syndrome to prevent it?
antenatal steroids (betamethasone) and post natal surfactant administration
what role does caffeine play in apnoea?
stimulant - reduces apnoea in short term and improves long term outcome
prognosis of GORD?
usually begin before the age of 8 weeks and resolve before 1 year of age
prevalence in GORD vs COLIC?
gord - 40%
colic - 20%
what are non-hormonal treatment options in menopause?
venlaflaxine and gabapentin and clonidine - vasomotor symptoms
bisphosphonates and teriparatide - post menopausal osteoporosis
what is the max duration for GNRH analogues?
6 months - after this can significantly reduce BMD
what is buserelin and example of?
GnRH analogue
how do oral COCs increase risk of VTE?
undergo first pass metabolism - causing antithrombin deficiency increasing risk of VTE
how can menopause increase your risk of high BP and CVD?
oestrogen decreases VLDLs and LDLs and increases HDLs decreasing CVD risk and oestrogen increases NO availability regulating endothelin dependant vasodilation which is impaired in menopause
what hormonal change signifies menopause?
persistent decrease in oestrogen and increase in FH and LH
what increases severity of primary dysmenorrhoea?
young age at menarche, extended duration of menstrual flow (lighter), severity decreases as you have children
what are causative agents of secondary dysmenorrhoea?
chlamydia and gonorrhoea
what are underlying systemic causes of menorrhagia?
hypothyroidism, coagulation disorders, kidney or liver diseases
