w/c 03/06

Question 1

how to give clomiphene to a woman

Answer 1

if regular cycles= start on day 2 of period and take for 5 days

if irregular cycles= progesterone for 10 days to induce withdrawal bleed then start on day 2 of period and take for 5 days

Question 2

white staining after acetic acid on colposcopy indicates what

Answer 2

abnormal nuclear: protein ratio within cells

Question 3

for a diagnosis of gestational hypertension how many times does BP measured need to be high and how far apart

Answer 3

twice
4 hrs apart

Question 4

short cervix during pregnancy is defined as

Answer 4

<25mm at 16-24weeks GA

Question 5

prophylaxis for short cervix

Answer 5

cervical cerclage or vaginal progesterone

Question 6

macrocephaly with short arms and feet

Answer 6

achondroplasia

Question 7

movicol full name

Answer 7

polyethylene glycol

Question 8

mumps school exclusion

Answer 8

5 days from onset of parotitis

Question 9

features of candida infection in nappy rash

Answer 9

widespread
demarcated scaly border
satellite lesions

Question 10

how to manage nappy rash with candida infection

Answer 10

avoid barrier protection
clotrimazole cream

Question 11

2 differentials for kidney injury following viral illness and how to differenitate them

Answer 11

post strep glomerulonephritis- presents weeks after illness
iga nephropathy- presents days after illness

Question 12

best way to diagnose asthma

Answer 12

FEV1

Question 13

FVC in asthma

Answer 13

normal

Question 14

anti phospholipid syndrome medications

Answer 14

low dose aspirin
low dose molecular weight heparin

Question 15

how does the IUS act as a contraceptive

Answer 15

thickens cervical mucus plug
thinning of endometrial lining
reduces sperm survival

Question 16

which contraceptives inhibit ovulation

Answer 16

ones that contain oestrogen and progesterone

if only progesterone ovulation is not completely inhibited

Question 17

surgical management of endometriosis

Answer 17

laparoscopic ablation and adhesiolysis

follow this with hormonal treatment IF NOT desiring fertility

hormonal treatment will prolong the effects of the surgery

Question 18

if there is dyskaryosis on cervical smear do you do urgent or non urgent colposcopy

Answer 18

non urgent

Question 19

cyclical HRT is preferred over combined when

Answer 19

women are peri menopausal

Question 20

if someone has endometrial hyperplasia with no atypia how do you mx them

Answer 20

IUS- continuous progesterone to thin the lining
surveillance-TVUS and biopsy every 6 months

Question 21

PMS management

Answer 21

1st= symptom diary for 2 cycles
mild= lifestyle advice
moderate/interfering with life= COCP first line, if doesnt work then refer for CBT
severe= SSRI

Question 22

best COCP for PMS mx

Answer 22

yasmin, used continuously instead of cyclically

Question 23

lifestyle advice for PMS

Answer 23

small, carbohydrate rich meals frequently
reduce stress
regular exercise
good sleep
reduce smoking and alcohol

Question 24

when should you not give oxybutynin and what do you give instead

Answer 24

to elderly frail women as it increases risk of falls

give mirabegron instead

Question 25

oxybutynin moa

Answer 25

anti muscarinic

Question 26

mirabegron moa

Answer 26

beta 3 agonist

Question 27

what happens to platelet count in normal physiological pregnancy

Answer 27

decreases

Question 28

CTG in vasa praevia

Answer 28

foetal bradycardia sinusoidal pattern

Question 29

mastitis causative organism

Answer 29

staphylococcus aureus

Question 30

what is tinea capitis

Answer 30

a ringworm infection on the scalp that can cause scarring alopecia

Question 31

systemic onset juvenile arthritis presentation

Answer 31

girl aged 1-10 salmon pink rash arthritis uveitis fever weight loss myalgia reduced appetite

Question 32

what is stills disease

Answer 32

systemic onset juvenile arthritis

Question 33

when is cleft lip vs cleft palate repaired

Answer 33

cleft lip= first 3 months of life cleft palate= 6-12 months

Question 34

dyskinetic cerebral palsy is damage to what area

Answer 34

basal ganglia

Question 35

which cerebral palsy has all the movement symptoms eg athetoid movements, chorea, dystonia

Answer 35

dyskinetic

Question 36

types of cerebral palsy

Answer 36

ataxic dyskinetic hemiplegic diplegic quadriplegic

Question 37

most common malignant bone tumor in children

Answer 37

osteosarcoma

Question 38

ewing sarcoma vs osteosarcoma sign on x ray

Answer 38

ewing= onion skin osteosarcoma= codmans triangle

Question 39

what sound do you hear in bronchiolitis

Answer 39

wheeze

Question 40

causes of stridor

Answer 40

laryngomalacia croup epiglottitis

Question 41

whats the best imaging for malrotation?

Answer 41

GI ultrasound with contrast

Question 42

how often is chest physiotherapy done for crohns

Answer 42

twice daily

Question 43

activated charcoal vs n acetylcycsteine in paracetamol overdose when

Answer 43

activated charcoal if presenting in first hr of ingestion n acetylcysteine immediately if staggered overdose, if single measure levels after 4 hrs and then decide if needed

Question 44

persistent grief disorder time frame

Answer 44

over 6 months

Question 45

prolonged complex bereavement disorder time frame and sx

Answer 45

over 12 months person wants to die to be with the loved one

Question 46

how to differentiate variant vs sporadic CJD

Answer 46

variant= psychiatric sx first then neuro sporadic CJD= neuro sx first then psychiatric

Question 47

what is a staggered overdose defined as

Answer 47

taken over more than one hour

Question 48

fregoli vs capgras delusion

Answer 48

fregoli= different people are one person just in different forms/disguise capgras= a love one has been CAPtured and replaced by an imposter

Question 49

lithium monitoring after starting someone on lithium

Answer 49

lithium levels weekly until stable then 3 months TFTs and renal function every 6 months

Question 50

ebsteins anomaly affects what valve

Answer 50

tricuspid

Question 51

how long is the washout period when switching antidepressants

Answer 51

4-7 days

Question 52

which valves have 2 leaflets and which have 3

Answer 52

only the bicuspid has 2 (left side of heart)

Question 53

when is the anomaly scan offered

Answer 53

18-20 weeks GA

Question 54

what protein:creatinine ratio indicates pre eclampsia

Answer 54

>30mg/mmol

Question 55

what extra screening for anaemia is done in a twin pregnancy

Answer 55

screen at booking, 20 weeks and 28 weeks

Question 56

at what age do children play with other children

Answer 56

4 yrs

Question 57

what is prehns sign and what is it used to differentiate

Answer 57

reduced pain on elevation of the scrotum positive in epididymitis negative in testicular torsion