w/c 1/04 Flashcards by Aaska Banthiya

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

intrauterine= double or more increase
ectopic= increase but slowly

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what is mum given before ECV?

anti D if rhesus positive
tocolytics
analgesia

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what are ENT manifestations of downs syndrome?

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

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

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

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how is parity calculated?

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

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what cancer does tamoxifen increase risk of?

endometrial

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

1= 30 mins
2= 75 mins

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what are indications for category 1 c section?

placental abruption
cord prolapse
uterine rupture
persistent foetal bradycardia
foetal hypoxia

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what are rf for surfactant lung disease?

maternal diabetes
male sex
c section
second born of premature twins

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what cardiac pathology is most associated with duchennes muscular dystrophy?

dilated cardiomyopathy

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whats nexplanon?

contraceptive progesterone implant

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whats the main adverse effect of the progesterone implant?

irregular bleeding

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

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

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describe how barlow and ortolani tests are performed?

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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what is the most important treatment for viral encephalitis?

IV aciclovir

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how does viral encephalitis present?

confusion
seizures
altered behaviour
all preceded with viral sx

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what organisms might cause viral encephalitis?

HSV1
HSV2
japanese encephalitis
CMV
EBV

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how is vulval cancer mx?

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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whats the most common hallucination in schizpophrenia?

auditory

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how do you differentiate tracheooesophageal fistula and pyloric stenosis

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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what makes a UTI in a child atypical?

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

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

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how is cellulitis for c section scars mx?

oral flucloxacillin first line
oral erythromycin if allergic

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what male/female cells secrete androgens?

leydig

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

androgen insensitivity= 46 XY, breast development, normal height, primary amenorrhoea, no uterus turners syndrome= 45 XO, primary amenorrhoea, lack of secondary sexual characteristics

what therapies are used to mx OCD?

exposure response therapy cognitive behavioural therapy

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

asap eg after booking visit

what rf for gestational diabetes will warrant an OGTT?

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

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

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

what does apgar stand for?

appearance pulse grimace activity resp rate

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

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

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

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

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

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

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

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

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

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

what does adding progestogens to HRT increase risk of?

breast cancer

what are rf for transient tachypnoea of the newborn?

c section male birth asphyxia gestational diabetes

what is high foetal fibronectin indicative of?

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

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

monitor blood glucose closely as steroids can cause hyperglycaemia

what are rules regarding IUS/IUD insertion after birth?

insert within 48hrs of birth or wait 4 weeks

how is postpartum thyrotoxicosis mx?

propanolol alone thyroxine later when they enter hypothyroid phase

what is cyclical oral progestogen?

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

what abx are used for whooping cough

macrolide (azithromycin/clarithromycin)

when there is prolonged rom what infections might mum have?

choriamnionitis intrauterine infection

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

thiamine

what ix confirms PID?

endocervical swab

how does transposition of the great arteries present?

cyanosis at birth or within 24hrs of birth loud S2

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

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

what is chandelier sign?

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

what does of adrenaline is given to children in anaphylaxis?

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

whats the difference between early onset and late onset GBS infection

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

in sheehans syndrome where does necrosis occur?

anterior pituitary

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

every other day in the community until targets are met

where is foreign body aspiration likely to cause a blockage?

right main bronchus

what skin change is associated with PCOS?

acanthosis nigricans- hyperpigmentation and skin thickening

what can cause cord prolapse during labour?

polyhydramnios

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

naegeles rule add 9 months to LMP plus 7 days

when can you give an epidural in labour?

once active labour starts

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

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

how are nabothian cysts mx?

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

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

urine protein:creatinine >30 mg/mmol

when should membrane sweep be offered for IOL?

40 weeks nullip 41 weeks parous

how does the pearl index for contraception work?

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

what cardiac issue does VSD increase the risk of?

endocarditis

what will be in the question stem for meckels diverticulum?

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

how is meckels diverticulum ix and mx?

ix= 99 technetium scan mx= surgical removal if symptomtatic

what is a diverticula?

a small bulging pouch in the small intestine

why are NSAIDs contraindicated in chickenpox?

they increase the risk of necrotising fascitis

what rate are chest compressions performed in paediatric bls?

100-120 bpm

what abx are given in pprom?

10 days erythromycin

what are early signs of hyperemesis gravidarum?

ketonuria weight loss >5%

what are some causes of second trimester miscarriage?

SLE antiphospholipid syndrome bicornuate or septate uterus

whats type of rash is nappy rash?

irritant dermatitis

what is done when semen analysis is abnormal?

repeat in 3 months

explain ebsteins anomaly

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

how can you recognise growing pains?

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

how is SUFE mx?

internal fixation

what blood test is done for POI and why?

FSH 2 high FSH 4-6 weeks apart are diagnostic