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w/c 1/04 Flashcards

1
Q

describe bHCG levels at 24 and 48hrs in someone with a intrauterine pregnancy vs ectopic

A

intrauterine= double or more increase
ectopic= increase but slowly

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2
Q

what is mum given before ECV?

A

anti D if rhesus positive
tocolytics
analgesia

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3
Q

what are ENT manifestations of downs syndrome?

A

flattened nasal bridge
small and low set ears
hearing issues
ear infections

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4
Q

what type of bilirubin is raised in physiological jaundince and why?

A

unconjugated
1. there is high red cell turnover
2. the immature liver can’t conjugate bilirubin quick enough

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5
Q

how is parity calculated?

A

delivery of a viable or non viable foetus
twins are counted as 1
+1= miscarriage or TOP

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6
Q

what cancer does tamoxifen increase risk of?

A

endometrial

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7
Q

within what time do category 1 and 2 c sections need to be performed?

A

1= 30 mins
2= 75 mins

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8
Q

what are indications for category 1 c section?

A

placental abruption
cord prolapse
uterine rupture
persistent foetal bradycardia
foetal hypoxia

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9
Q

what are rf for surfactant lung disease?

A

maternal diabetes
male sex
c section
second born of premature twins

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10
Q

what cardiac pathology is most associated with duchennes muscular dystrophy?

A

dilated cardiomyopathy

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11
Q

whats nexplanon?

A

contraceptive progesterone implant

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12
Q

whats the main adverse effect of the progesterone implant?

A

irregular bleeding

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13
Q

what is done when developmental dysplasia of the hip is suspected?

A

barlow/ortolani normal= hip US within 4-6 weeks
barlow ortolani abnormal= hip US within 2 weeks

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14
Q

describe how barlow and ortolani tests are performed?

A

barlow= adduct hip and place downward pressure to see if the hip will dislocate (you can feel the femoral head)

ortolani= abduct hip to see if it relocates (clunk will be heard if positive)

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15
Q

what is the most important treatment for viral encephalitis?

A

IV aciclovir

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16
Q

how does viral encephalitis present?

A

confusion
seizures
altered behaviour
all preceded with viral sx

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17
Q

what organisms might cause viral encephalitis?

A

HSV1
HSV2
japanese encephalitis
CMV
EBV

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18
Q

how is vulval cancer mx?

A

vulvectomy and inguinal node resection
if invasion <1mm or stage 1a and no lymph nodes involved, lymph node resection can be avoided

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19
Q

whats the most common hallucination in schizpophrenia?

A

auditory

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20
Q

how do you differentiate tracheooesophageal fistula and pyloric stenosis

A

in pyloric stenosis the vomited milk will be curdled as it will have passed through the stomach, in tracheoesophageal fistula it wont be

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21
Q

what makes a UTI in a child atypical?

A

seriously ill
problems with urine flow
septicaemia
high creatinine
mass on bladder
infection with non -coli organisms
failure to respond to treatment within 48 hrs

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22
Q

what are ix are done in children with a UTI and at what age/ times?

A

if under 6 months
USS during active infection
4-6 months after DMSA and MCUG

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23
Q

how is cellulitis for c section scars mx?

A

oral flucloxacillin first line
oral erythromycin if allergic

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24
Q

what male/female cells secrete androgens?

A

leydig

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25
Q

how do you differentiate turners syndrome and androgen insensitivity syndrome? what are their karyotypes

A

androgen insensitivity= 46 XY, breast development, normal height, primary amenorrhoea, no uterus

turners syndrome= 45 XO, primary amenorrhoea, lack of secondary sexual characteristics

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26
Q

what therapies are used to mx OCD?

A

exposure response therapy
cognitive behavioural therapy

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27
Q

when is OGTT done if a women has had previous gestational diabetes?

A

asap
eg after booking visit

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28
Q

what rf for gestational diabetes will warrant an OGTT?

A

BMI >30
previous macrosomic baby
1st degree relative with diabetes
ethnicity

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29
Q

what are the red flags in the paediatric traffic light system regarding colour, activity, respiratory, circulation and other

A

colour= pale/mottled/ashen
activity= doesn’t wake or can’t stay awake, weak/high pitched cry
respiratory= resp rate over 60
circulation= reduced skin turgor
other= under 3 months and temp >38, neurological deficit, meningism signs (non blanching rash/neck stiffness), status epilepticus/focal seizures, bulging fontanelle

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30
Q

what does apgar stand for?

A

appearance
pulse
grimace
activity
resp rate

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31
Q

what is 0/1/2 for appearance on apgar?

A

0= blue all over
1= peripheral cyanosis
2= pink

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32
Q

what is 0/1/2 for pulse on apgar?

A

0= absent
1= <100 bpm
2= >100 bpm

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33
Q

what is 0/1/2 for grimace on apgar?

A

0= absent
1= grimace
2= cries on stimulation/ sneezes/coughs

34
Q

what is 0/1/2 for activity on apgar?

A

0=floppy
1= flexion of limbs
2= normal movement

35
Q

what is 0/1/2 for respiration on apgar?

A

0=no cry
1= weak irregular cry
2= strong cry

36
Q

what does adding progestogens to HRT increase risk of?

A

breast cancer

37
Q

what are rf for transient tachypnoea of the newborn?

A

c section
male
birth asphyxia
gestational diabetes

38
Q

what is high foetal fibronectin indicative of?

A

potential early labour
levels can indicate if its within 1/2 weeks but not definitive

39
Q

what do you need to do in mums with gestational diabetes when steroids are given?

A

monitor blood glucose closely as steroids can cause hyperglycaemia

40
Q

what are rules regarding IUS/IUD insertion after birth?

A

insert within 48hrs of birth or wait 4 weeks

41
Q

how is postpartum thyrotoxicosis mx?

A

propanolol alone
thyroxine later when they enter hypothyroid phase

42
Q

what is cyclical oral progestogen?

A

a form of HRT NOT contraception (contraception is continuous progestogen)

43
Q

what abx are used for whooping cough

A

macrolide (azithromycin/clarithromycin)

44
Q

when there is prolonged rom what infections might mum have?

A

choriamnionitis
intrauterine infection

45
Q

what vitamin do you need to replace in hyperemesis gravidarum when mum is dehydrated?

A

thiamine

46
Q

what ix confirms PID?

A

endocervical swab

47
Q

how does transposition of the great arteries present?

A

cyanosis at birth or within 24hrs of birth
loud S2

48
Q

how can you differentiate placenta praevia and vasa praevia in a pregnancy woman with PV bleeding?

A

placenta= placenta on US <2cm from os
vasa= placenta on US >2cm from os

49
Q

what is chandelier sign?

A

severe pain on palpation of the anterior cervix while applying pressure to the fundus of the uterus

associated with PID

50
Q

what does of adrenaline is given to children in anaphylaxis?

A

<6yrs old= 150 ug 1:1000
6-12 yrs= 300 ug 1:1000

51
Q

whats the difference between early onset and late onset GBS infection

A

early= within 48 hrs of delivery
late= after one week, usually presents as meningitis and has a better mortality

52
Q

in sheehans syndrome where does necrosis occur?

A

anterior pituitary

53
Q

if a women is still hypertensive after delivery how is she monitored?

A

every other day in the community until targets are met

54
Q

where is foreign body aspiration likely to cause a blockage?

A

right main bronchus

55
Q

what skin change is associated with PCOS?

A

acanthosis nigricans- hyperpigmentation and skin thickening

56
Q

what can cause cord prolapse during labour?

A

polyhydramnios

57
Q
A
57
Q

what is used to calculate expected delivery date and how does it work?

A

naegeles rule
add 9 months to LMP plus 7 days

58
Q

when can you give an epidural in labour?

A

once active labour starts

59
Q

what do nabothian cysts look like and where are they found?

A

amber/yellow mucous containing cysts
found on the cervical os where the epithelium transitions

60
Q

how are nabothian cysts mx?

A

can leave them as they are normal but they should be swabbed

61
Q

how is proteinuria quantified in pre eclampsia? what is considered significant

A

urine protein:creatinine
>30 mg/mmol

62
Q

when should membrane sweep be offered for IOL?

A

40 weeks nullip
41 weeks parous

63
Q

how does the pearl index for contraception work?

A

tells you how many women per 100 would get pregnant on the contraception in one year

64
Q

what cardiac issue does VSD increase the risk of?

A

endocarditis

65
Q

what will be in the question stem for meckels diverticulum?

A

GI bleed- rectal bleeding
patient is haemodynamically unstable
between 1-2 yrs old
right lower quadrant pain (similar to appendicitis)

66
Q

how is meckels diverticulum ix and mx?

A

ix= 99 technetium scan
mx= surgical removal if symptomtatic

67
Q

what is a diverticula?

A

a small bulging pouch in the small intestine

68
Q

why are NSAIDs contraindicated in chickenpox?

A

they increase the risk of necrotising fascitis

69
Q

what rate are chest compressions performed in paediatric bls?

A

100-120 bpm

70
Q

what abx are given in pprom?

A

10 days erythromycin

71
Q

what are early signs of hyperemesis gravidarum?

A

ketonuria
weight loss >5%

72
Q

what are some causes of second trimester miscarriage?

A

SLE
antiphospholipid syndrome
bicornuate or septate uterus

73
Q

whats type of rash is nappy rash?

A

irritant dermatitis

74
Q

what is done when semen analysis is abnormal?

A

repeat in 3 months

75
Q

explain ebsteins anomaly

A

when due to maternal lithium use during pregnancy, there is a heart defect in the baby wherein the tricuspid valve is low set, meaning the right atrium is big and the ventricle is small= atrialisation of the right ventricle

76
Q

how can you recognise growing pains?

A

bilateral
affects legs and shins mainly
never present at start of the day
no limitation on activity
systemically well
no findings on examination

77
Q

how is SUFE mx?

A

internal fixation

78
Q

what blood test is done for POI and why?

A

FSH
2 high FSH 4-6 weeks apart are diagnostic

79
Q
A

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