w/c 08/04

Question 1

what is pco2 in a life threatening asthma attack? why?

Answer 1

normal
this indicates poor respiratory effort

Question 2

how is whooping cough mx?

Answer 2

admit if under 6 months
macrolide abx if within 21 days of onset

Question 3

when are patients reviewed after starting an SSRI?

Answer 3

in one week if under 25
in 2 weeks if over 25

Question 4

how is haemophilia a inherited?

Answer 4

x linked recessive

Question 5

what vaccines are routinely given to pregnant women? when are they given

Answer 5

pertussis- 16 to 32 weeks, note this is given again in pregnancy even if they have had it previously
influenza- anytime

Question 6

what does paediatric diarrhoea after gastroenteritis indicate?

Answer 6

lactose intolerance
transient intolerance is common in children after viral gastroenteritis, exclude lactose from diet and reintroduce gradually to mx

Question 7

whats in the quadruple test for downs and what suggests high likelihood

Answer 7

bHCG and inhibin A high
oestriol and AFP low

Question 8

what is given first line in alcohol withdrawal?

Answer 8

chlordiazepoxide

Question 9

whats done if there are late decelerations on CTG?

Answer 9

foetal blood sampling- if acidosis emergency c section

Question 10

what indicates septic arthritis on kochers criteria?

Answer 10

high temp
raised WCC
raised CRP
non weight bearing joint

Question 11

what exactly are diagnostic criteria for pre eclampsia

Answer 11

1. > 20 weeks GA
2. hypertension:
   2 readings taken 4-6 hrs apart with systolic >140 or diastolic >90 OR over increase of 30 SBP or 20 DPB from booking
3. proteinuria (dip at least +1)

Question 12

what ix do you do when you suspect henloch schonlein purpura and why?

Answer 12

urine dip
to assess kidney involvement

Question 13

whats the triad for henloch schonlein purpura?

Answer 13

purpura over legs/buttocks
arthralgia
abdo pain

Question 14

what scale can you use to assess stage of puberty?

Answer 14

tanner

Question 15

what organism causes scarlet fever?

Answer 15

streptococcus

Question 16

in babies, what is done to reduce secondary reperfusion injury?

Answer 16

cooling to 33-34 degrees

Question 17

what is a classical c section

Answer 17

c section with vertical scar

Question 18

whats the triad for shaken baby syndrome?

Answer 18

retinal haemorrhage
subdural haematoma
encephalopathy

Question 19

what is avoidant personality disorder?

Answer 19

avoiding relationships (friends/romantic), social inhibition, interpersonal inhibitions due to fear of rejection and negative evaluation

Question 20

what are caput succedaneum and cephalohaematoma?

Answer 20

caput succedaneum= present at birth, at vertex and crosses suture lines, resolves in days
cephalohaematoma= develops after birth, in parietal region, doesnt cross suture lines, resolves in months

both are mx conservatively

Question 21

interpret the bishop score

Answer 21

<5= IOL needed, spontaneous labour unlikely
8 or greater= spontaneous labour likely

Question 22

what are the ESPEs and how are they mx?

Answer 22

acute dystonia= sustained muscle contractions, mx with procyclidine
tardive dyskinesia= abnormal repetitive movements, mx with tetrabenazine
parkinsonism
akathisia= severe restlessness

Question 23

what GA is lack of fetal movements concerning?

Answer 23

24

Question 24

when can you put the progesteron implant in after birth?

Answer 24

immediately

Question 25

whats the most common risk of TOP

Answer 25

infection

Question 26

what are rules for going to school in hand foot mouth disease?

Answer 26

no exclusion needed

Question 27

when can you do cone biopsy for mx of cervical cancer?

Answer 27

stage 1a

Question 28

whats the difference between stage 1a and 1b cervical cancer?

Answer 28

1a= less than 7mm visible by micrsocpy 1b= more than 7mm visible by eye both confined to cervix cos stage 1

Question 29

what is the neonatal period?

Answer 29

0-28 days of life first 7 days= early 7-28= late

Question 30

when do you do kleihauer test?

Answer 30

any sensitising event after 20 weeks

Question 31

how long after starting ellaone can you start long term hormonal contraception?

Answer 31

5 days

Question 32

when is indomethacin given for PDA?

Answer 32

in the neonatal period can do echo before giving it

Question 33

whats the first step in PPH?

Answer 33

resus: 2 wide bore cannula group and save, cross match, FBC, clotting studies start IV fluids lay flat high flow oxygen

Question 34

what happens when during controlled cord traction a women starts to bleed and the uterus is not palpable in the abdomen?

Answer 34

uterine inversion

Question 35

how is uterine inversion managed?

Answer 35

push fundus of uterus back into the abdomen

Question 36

what are some contraindications for lumbar puncture?

Answer 36

meningococcal septicaemia- risk of coning raised ICP focal neurological deficit coagulation disorder cardiovascular instability

Question 37

what are the sx of hereditary haemochromatosis?

Answer 37

liver fibrosis diaebetes joint pains secondary amenorrhoea

Question 38

how can you differentiate ovarian torsion from ovarian cyst rupture and haemorrhage?

Answer 38

torsion will have whirlpool sign on US

Question 39

what is a high vaginal swab culture used for?

Answer 39

gonorrhoea (it can be cultures, chlamydia cannot)

Question 40

what is a NAAT vulvovaginal swab used for?

Answer 40

chlamydia or gonorrhoea

Question 41

what does a NAAT vulvovaginal swab look for?

Answer 41

bacterial DNA

Question 42

what is cervical motion tenderness and cervical excitation suggestive of?

Answer 42

PID

Question 43

what is a seizure after a child has been crying inconsolably indicative of?

Answer 43

breath holding spell they can be reassured and discharged

Question 44

how does hydrocephalus present?

Answer 44

enlarged head circumference sunsetting eyes bulging anterior fontanelle

Question 45

what are RF for hydrocephalus?

Answer 45

prematurity spina bifida meningitis

Question 46

how can you differentiate inhaled foreign body from asthma?

Answer 46

asthma ALWAYS has a wheeze

Question 47

how does the progesterone implant work?

Answer 47

inhibits ovulation

Question 48

how do you differentiate somatisation vs hypochondriasis?

Answer 48

somatisation= symptoms are present hypochondriasis= symptoms not present

Question 49

whats first line abx for UTI while breastfeeding?

Answer 49

thrimethorpim

Question 50

what is the test done if newborn otoacoustic emission test is abnormal?

Answer 50

auditory brainstem response test

Question 51

what can someone with migraines on an SSRI not take

Answer 51

triptans

Question 52

what do you need to monitor in someone on SNRI?

Answer 52

BP

Question 53

name an SNRI

Answer 53

venlaflaxine

Question 54

how is new onset confusion in someone starting an SSRI/ increasing their SSRI dose indicative of?

Answer 54

hyponatraemia check their UEs

Question 55

what ovarian pathology is associated with meigs syndrome?

Answer 55

fibroma

Question 56

whats the most common benign ovarian tumor in women under 25?

Answer 56

dermoid cyst

Question 57

how long after birth is contraception not needed in a women who isnt breastfeeding?

Answer 57

21 days

Question 58

what are rocker bottom feet associated with?

Answer 58

edwards syndrome

Question 59

where does gestational trophobastic disease metastasise to?

Answer 59

lungs

Question 60

what vol of amniotic fluid is considered plyhydramnios?

Answer 60

2-3 l

Question 61

what medication switch can be done if someone on antipsychotics has espes?

Answer 61

put them on olanzapine- lowest risk of espes

Question 62

whats chlorpromazine?

Answer 62

a typical antipsychotic

Question 63

what medication can you not give to someone with lewy body dementia?

Answer 63

first gen antipsychotics

Question 64

why does downs syndrome increase risk of alzheimers?

Answer 64

amyloid protein gene is on chr 21 and downs is trisomy 21

Question 65

what are rules regarding breast cancer and HRT?

Answer 65

past or active breast cancer is a contraindication even if they are in remission, HRT can accelerate recurrence

Question 66

whats the risk of transmission of HIV to baby if there is optimal treatment? outline what this treatment is

Answer 66

undetectable viral load on ART neonatal zidovudine avoiding breastfeeding risk of transmission is 2%

Question 67

how can you differentiate viral hepatitis in pregnancy from acute fatty liver?

Answer 67

viral hep= LFTs severely raised (>500) acute fatty liver= LFTs raised but not severely

Question 68

whats the moa of tranexamic acid?

Answer 68

antifibrinolytic

Question 69

describe acetic acid and iodine staining in colposcopy

Answer 69

acetic acid= abnormal cells take it up and appear white, normal cells stay pink iodine= stains normal cells so white cells from acetic acid appear more prominent note acetic acid is applied first then iodine

Question 70

whats a missed miscarriage?

Answer 70

os closed gestational sac in uterus no symptoms no heartbeat

Question 71

whats the hyperemesis gravidarum diagnosis triad?

Answer 71

5% weight loss dehydration electrolyte imbalance

Question 72

what is abx regime for PID?

Answer 72

IM ceftriaxone 1g for 14 days metronidazole 400mg orally twice daily doxycycline 100mg orally twice daily

Question 73

how long does section 3 last?

Answer 73

6 months

Question 74

describe the renewal rules for section 3

Answer 74

initial 6 months first renewal: 6 months second renewals and thereafter: 1 year at a time

Question 75

what fluid is commonly given in hyperemesis gravidarum?

Answer 75

IV saline with potassium

Question 76

what BP are pregnant women admitted?

Answer 76

>160/110

Question 77

what class of drugs is phenelzine?

Answer 77

MAOI

Question 78

what abx is given in children to cover for listeria?

Answer 78

IV amoxicillin

Question 79

what abx is given to all children for meningitis?

Answer 79

IV cefotaxime