w/c 04/03 Flashcards
what is an absolute contraindication to ECV?
antepartum haemorrhage in past 7 days
whats is capgras vs cotards delusion
capgras= close people/self have been replaced by clones (cap=captured=captured and replaced)
cotards= rotting inside
what antiepileptic is best during pregnancy?
lamotrigine
what does herpes simplex virus present as?
painful vesicular lesions around the vagina
how is HSV infection in pregnancy managed?
oral aciclovir
c section if infection within 6 weeks of delivery to avoid transmission to baby
how often are blood tests needed in severe pre eclampsia?
3 times a week
how is hand foot and mouth disease managed?
supportive
ensure fluid intake and paracetamol if needed
what criteria is used to assess for septic arthritis?
kocher
how does threadworm present?
vulval/genital/anal itching worse at night with no abnormalities on examination
how is threadworm managed?
oral mebenazole
hygiene measures for house
for how long after birth should the COCP be avoided?
6 weeks
also if the women is breastfeeding
how long after birth should insertion of an IUS be avoided?
6 weeks
when can lactational amenorrhoea be used as contraception?
complete amenorrhoea
fully breastfeeding
for 6 weeks after giving birth
when does ovarian cyst rupture pain start?
usually during physical activity eg sexual intercourse or sports
what is likely diagnosis if bHCG continues to rise after management for a molar prganancy?
choriocarcinoma
what abx are given for PID?
oral doxy
oral metronidazole
IM ceftriaxone
what ix confirms diagnosis of hirschsprungs disease?
rectal biopsy
how do you differentiate OCD and obsessive compulsive personality disorder?
OCD= not pleasurable
obsessive compulsive personality disorder= patient derives pleasure from their actions and are happy to do them
what organisms commonly cause impetigo?
staph aureus
strep pyogenes
what are complications of orbital cellulitis?
blindness
meningitis
sepsis
what is alpha synuclein associated with?
Parkinsons and lewy bosy dementia
found in substantia nigra
what is seen on histopathology in alzheimers?
beta amyloid plaques
neurofibrillary triangles made of tau protien
at what age should a child have hand preference? why might it be concerning if this is abnormal
2 years
before this can indicate cerebral palsy
what is the most accurate ix for bacterial sepsis?
procalcitonin
how do you identify fibroids on examination?
firm, irregular, enlarged uterus
how does nisseria meningitides stain on gram stain?
gram negative diplococci
how does listeria stain on gram stain?
gram positive rods
what are some rf for ovarian cancer?
HRT >5yrs
increasing age
endometriosis
how is metastatic ovarian cancer mx?
surgery aiming to remove macroscopic disease, then chemotherapy
radiotherapy is not commonly used, usually after surgery and chemo if the cancer comes back
what is normal foetal head position in labour?
occiput anterior
what happens in normal labour after delivery of the foetal head?
external rotation of the foetus
shoulder is in antero posterior position
anterior shoulder can be delivered
whats the success rate of ECV?
around 50%
whats an absolute indication to VBAC?
classic c section scar (vertical)
when is booking appt, dating and anomaly scan performed?
booking= 6-8 weeks
dating= 10-13+6 weeks
anomaly= 18-20 +6 weeks
whats is the aim of the dating scan?
to date the pregnancy
to rule out multiple pregnancy
how do you differentiate bartholins cyst vs abscess?
cyst= mass palpable, not painful, no systemic illness
abscess= mass palpable, painful, systematic illness
how is the squat test performed?
patient is asked to stand up from a squatting position without using their hands
what is first line abx for acute tonsilitis?
phenoxymethylpenicillin
if allergic= macrolide
if a patient declines voluntary admission, what section of the MHA is used to detain them while awaiting assessment?
2
if a patient accepts voluntary admission, what section of the MHA is used to detain them while awaiting assessment?
section 5(2)
whats the diff between section 5(2) and 2
2= for non voluntary admissions, lasts up to 28 days
5(2)= for voluntary admissions while awaiting assessment, lasts 72 hrs
what enzyme does CF affect? what does this result in
lipase
steatorrhoea and vit A/D/E/K deficiency
what are sx of ovarain hyperstimulation syndrome?
abdo discomfort
weight gain
N+V
fluid retention
what are consequences of oligohydramnios?
fetal lung hypoplasia
fetal clubbed feet
fetal congenital hip dysplasia
how would dx recognise oligohydramnios?
exam= prominent fetal parts, low SFH
US= low amniotic fluid index
how is oligohydramnios managed?
monitoring and referral
maternal fluid resus
amniotic saline infusion
delivery if foetal distress
when should instrumental delivery be abandoned? what should be performed after?
after 3 unsuccessful pulls
convert to a lower segment c section
what are some indications for elective c section?
previous c section
multiple pregnancy
placenta praevia
vasa praevia
uncontrolled HIV
what are complications of c section
surgery risks: infection, bleeding, pain, damage to surrounding structures
to mum: PPH, VTE, future= repeat c section, placenta praevia, uterine rupture
to baby= transient tachyponoea of newborn, aspiration pneumonia, lacerations during delivery
what are trisomy 21, 18 and 13
21= downs
18= edwards
13= pataus
what are features of edwards and patuas syndrome at birth
edwards= ‘ocker-bottom’ feet, low birthweight, prominent occiput, small mouth and chin, shortened sternum and flexed overlapping fingers
pataus= microcephaly, micropthalmia, polydactyly, low set ears and congenital heart disease
what complication should you think of when assessing for PID?
fits hugh curtis syndrome= perihepatitis (inflammation of liver capsule and peritoneum)
when is membrane sweep for IOL offered?
between 41-42 weeks GA
what syndrome arises due to oligohydramnios? describe it?
potter syndrome
flattened nose, recessed chin, low-set ears (fetal squashing), and the presence of respiratory distress due to pulmonary hypoplasia
assoc with renal angenesis
what is venlaflaxine? what monitoring does it require?
SNRI (3rd line antidepressant/ anxiety medication)
requires BP monitoring as it causes hypertension
contraindicated in uncontrolled htn
what is the difference between panic disorder and acute stress reaction?
panic disorder= not related to one thing/comes on randomly
acute stress reaction= clear trigger, <1month of sx
whats the moa of sodium valproate?
blocks voltage gated na channels to supress neuronal firing
also inhibits CYP hepatic enzymes
what are side effects of valproate and how do you rememeber them?
VALPROATE:
Vomiting
Alopecia
Liver toxicity
Pancreatitis/Pancytopenia
Retention of fats (ie. weight gain)
Oedema
Anorexia
Tremor
Enzyme inhibition
what does cervical motion tenderness indicate?
PID
