w/c 06/05

Question 1

rf for cord prolapse

Answer 1

multiparity
prematurity
polyhydramnios
twin pregnancy
abnormal lie

Question 2

mx cord prolapse

Answer 2

call for senior help
place woman on all 4s
push presenting part upwards manually
cat 1 c section
can give tocolytics
if cord outside keep it warm and hydrated

Question 3

what age are antidiarrhoeals used for gastroenteritis in children

Answer 3

over 5

Question 4

most common cause of pulmonary hypoplasia

Answer 4

congenital diaphragmatic hernia

Question 5

paediatric BLS where to check for pulses

Answer 5

brachial and carotid

Question 6

webbed neck
short stature
pectus excavatum
pulmonary stenosis

Answer 6

noonan syndrome

Question 7

medication to relieve itching in chickenpox

Answer 7

calamine lotion

Question 8

ketonuria/weight loss on antiemetics in DKA

Answer 8

admit

Question 9

premenopausal, large and boggy uterus, menorrhagia, dysmenorrhoea

Answer 9

adenomyosis

Question 10

incomplete vs complete hyatidiform mole on US

Answer 10

incomplete= foetal parts present
complete= no foetal parts, snowstorm appearance

Question 11

oxybutynin not given in urge incontinence when and what is given instead

Answer 11

to old people
mirabegron

Question 12

follicles on US for PCOS diagnosis

Answer 12

12 follicles in one ovary size 2-9mm

Question 13

if someone is HPV positive and cytology is inadequate what do you do

Answer 13

repeat smear in 3 months

Question 14

what age does atopic dermatitis present

Answer 14

under 2 years

Question 15

chlordiazepoxide moa

Answer 15

benzodiazepine
enhances GABA to reduce alcohol withdrawl sx

Question 16

findings in anorexia (bloods, clinical etc)

Answer 16

most things low
Gs and Cs high: glucose, GH, glands salivary, cortisol, cholesterol, carotinaemia

Question 17

antipsychotics side effects

Answer 17

akithisia= restlessness

tardive dyskinesia= involuntary movements usually orofacial muscles

acute dystonia= sustained contraction of muscles

parkinsonism= bradykinesia, resting tremor, postural instability, rigidity

Question 17

maternal labetalol use increases risk of what in foetus

Answer 17

neonatal hypoglycaemia

Question 18

duloxetine class of medication

Answer 18

SNRI

Question 19

GAD first line SSRI doesnt work, next step in mx

Answer 19

another SSRI or SNRI

Question 20

most common ovarian cancer

Answer 20

serous epithelial cell carcinoma

Question 21

common complication of rubella

Answer 21

arthritis of small joints

Question 22

common complication of mumps

Answer 22

orchitis
deafness

Question 23

SSRI discontinuation syndrome sx

Answer 23

diarrhoea
vomitting
GI upset

Question 24

eczema what is used after topical steroids fail

Answer 24

wet wraps

Question 25

mental state in puerperal psychosis vs postpartum depression/baby blues

Answer 25

change will be acute not gradual

Question 26

when should dysmenorrhoea be referred to gynae

Answer 26

when it is secondary (precedes the period and develops later in life)

Question 27

primary vs secondary dysmenorrhoea

Answer 27

primary= presents 1-2yrs after menarche, pain starts just before or with period, less concerning mx with NSAIDs 1st line and OCP 2nd line secondary= presents years after menarche, pain precedes period often by days, mx by referring all to gynaecology

Question 28

causes of secondary dysmenorrhoea

Answer 28

endometriosis adenomyosis PID fibroids IUDs

Question 29

why is COCP not used for the forst 21 days postpartum

Answer 29

risk of clots

Question 30

medication for acute dystonia after benzo

Answer 30

procyclidine

Question 31

baby looses >10% birthweight in first week of life mx

Answer 31

refer to breastfeeding clinic

Question 32

candida discharge pH

Answer 32

<4.5

Question 33

PHQ-9 score indicating severe depression

Answer 33

>15

Question 34

first line mx for non pregnant women with thrush

Answer 34

oral fluconazole

Question 35

mag sulf in pre eclampsia when

Answer 35

for 24 hrs after delivery or for 24 hrs after last seizure stops

Question 36

in the first trimester, second trimester and postpartum iron supplementation is needed when Hb is

Answer 36

1st trimester <110 2nd trimester <105 postpatrum <100

Question 37

what type of oxybutynin is given for urge incontinence

Answer 37

immediate release

Question 38

BCG vaccination given to which babies in UK

Answer 38

born in area with high TB family hx of TB from high risk region/country for TB

Question 39

what medication can be given for vasomotor sx of menopause if someone doesnt want HRT

Answer 39

SSRI

Question 40

DM in pregnancy targets

Answer 40

fasting <5.3 1hr post prandial <7.8 2 hrs post prandial <6.4

Question 41

NEC diagnostic ix

Answer 41

abdo x ray

Question 42

whats the most common cause of cardiac arrest in children

Answer 42

respiratory ie hypoxia from 4hs and ts

Question 43

pavlik harness vs spica

Answer 43

harness if under 6 months spica if over 6 months

Question 44

duodenal atresia causes what type of vomiting

Answer 44

bilious

Question 45

advice for transgender males with a uterus regarding contraception

Answer 45

dont use oestrogen containing contraceptives as they can affect testosterone therapy

Question 46

ssris for breastfeeding women

Answer 46

sertraline or paroxetine

Question 47

if someone has the mirena and wants HRT what do you give them

Answer 47

just oestrogen the mirena acts as the progesterone component of HRT for 10 yrs

Question 48

what is microgynon

Answer 48

COCP

Question 49

how long after birth till you can take COCP

Answer 49

21 days

Question 50

normal pco2 in asthma attack

Answer 50

life threatening

Question 51

spuravalvular aortic stenosis congenital condition

Answer 51

williams syndrome

Question 52

whats seen on echo in ebsteins anomaly

Answer 52

tricuspid valve leaflets attached to right ventricle or septum

Question 53

POP missed for over 12 hrs with UPSI

Answer 53

take emergency contraception

Question 54

dyskinetic cerebral palsy areas of brain affected

Answer 54

basal gangla and substantia nigra

Question 55

outline active management of the third stage of labour

Answer 55

ureterotonic drugs given (oxytocin) delayed cord clamping (over 1 min after birth but less than 5) controlled cord traction after evidence of placental separation

Question 56

TOF components

Answer 56

VSD right ventricular hypertrophy pulmonary stenosis (right ventricular tract outflow obstruction) overriding aorta

Question 57

hep B screening in pregnancy is offered to

Answer 57

everyone

Question 58

breastfeeding in hep B

Answer 58

safe

Question 59

referral for someone presenting with mania

Answer 59

urgently to secondary care

Question 60

rubella presentation

Answer 60

fever coryza cervical adenopathy erythematous macropapular rash starting on hands and neck and spreads down body

Question 61

complete breech is the same as

Answer 61

flexed breech

Question 62

frank breech is the same as

Answer 62

extended breech

Question 63

naegeles rule

Answer 63

add 9 months and 7 days to day of LMP if cycle is not 28 days add the no over days over 21 the cycle is to the end result

Question 64

when are abx given for mastitis

Answer 64

if 12-24hrs of conservative measures dont improve sx

Question 65

what is tangentiality

Answer 65

wandering from a topic and not returning to it eg when asked a question they dont answer it and talk about something else

Question 66

diagnostic test of DMD

Answer 66

genetic analysis

Question 67

what is a compulsion

Answer 67

a senseless action done to relieve the anxiety of a compulsion this doesnt have to be a physical action, it can be repeating a phrase/thinking something

Question 68

when is the heel prick test performed

Answer 68

between the 5th and 9th day of life

Question 69

when would a child have little to no head lag when being pulled to sit

Answer 69

3 months

Question 70

previous gestational diabetes what screening is offered

Answer 70

OGTT immediately alongside OGTT at 24-28 weeks

Question 71

screening tool for postnatal depression

Answer 71

edinburgh scale

Question 72

how many hrs after last drink would a patient have seizures vs delirium tremens

Answer 72

seizures= 36 hrs delirium tremens= 72 hrs

Question 73

SSRIs for breastfeeding

Answer 73

sertraline or paroxetine

Question 74

difference between pregnancy induced hypertension and pre existing hypertension

Answer 74

pre existing= before 20 weeks GA there is no pregnancy related hypertension

Question 75

how to differentiate mania and hypomania

Answer 75

true mania will affect functioning eg work true mania may have psychotic features