w/c 11/03 Flashcards
what is the kleihauer test
measures the circulating level of rh d antigen in maternal blood to see how much anti D IG is needed to be given
whats the most common cause of paediatric nephrotic syndrome?
minimal change disease
what ix are done for minimal change disease?
urine dipstick
kidney biopsy
how is minimal change disease mx?
corticocteroids
fluid restriction
low salt/protein diet
how do you differentiate FSGS and minimal change disease?
FSGS doesnt respond well to steroids
what is sudden foetal bradycardia without pain suggestive of?
cord prolapse
what test is done to check a woman has ovulated? when is it done?
mid luteal progesterone
measure 7 days before end of cycle (doesnt necessarily need to be day 21 as not all women have a 28 day cycle)
how is overactive bladder syndrome mx?
1st line= bladder retraining, diary, lifestyle measures
2nd line= oxybutynin
what is lithium toxicity associated with?
dehydration due to gastroenteritis
diarrhoea
how do you differentiate simple febrile seizure from complex
simple= 1 seizure over the course of 1 febrile illness
complex= more than one seizure over the space of 24 hrs
which HPV is associated with biggest risk of cervical cancer?
16
18
whats 1st line mx for postpartum depression?
CBT
whats the difference between 3a/3b/3c tears?
3a= less than 50% of the external anal sphincter is affected
3b= more than 50% of the external anal sphincter is affected
3c= external and internal sphincters have been torn
whats the status of the internal anal sphincter in a 3a/3b/3c tear?
3a and 3b= internal anal sphincter in tact
3c= internal anal sphincter torn
what organism causes hand foot and mouth disease?
coxsackie virus a16
what side effect of clozapine is important to investigate and how is this done?
agranulocytosis
ix with FBC
what condition does rupture of membranes followed by bleeding in pregnancy suggest?
vasa praevia
when do you operate on a fibroid?
if its symptomatic and greater than 3 cm
what is fregoli delusion?
a patient believes everyone they meet is the same person under different disguises
why is folic acid taken during pregnancy
to prevent neural tube defects
what imaging is used for pyloric stenosis?
US abdo
what are first line benzos with route of admission in paediatric status?
buccal midazolam OR rectal diazepam
describe the typical course of physiological jaundice
appears at day 2-4
bilirubin raised but not massively
resolves in 1-2 weeks
what does of anti D is given to women when one injection is administered? at what GA
1500IU
28 weeks GA
can you have vaginal delivery in placenta praevia?
no- risk of haemorrhage is high
if placenta is more than 20 mm from the cervical os a trial of labour can be offered
note: give corticosteroids if there is pre term bleeding incase of delivery
what are signs of paediatric resp distress?
nasal flaring
use of accessory muscles
subcostal and intercostal recessions
raised RR
tracheal tug
abnormal airway noises
how do you differentiate preseptal and orbital cellulitis?
preseptal= no optical sx
orbital= optical sx
how does CMV infection during pregnancy manifest in the foetus?
LBW
microcephaly
jaundice
seizures
petechial rash
hows does foetal alcohol syndrome present?
microcephaly
short palpable fissures
hypoplastic upper lip
absent philtrum
reduced IQ
cardiac abnormalities
how does maternal cigarette use affect the pregnancy?
IUGR
still birth
miscarriage
placental abruption
how does toxoplasmosis infection during pregnancy manifest in the foetus?
neuro conditions= cerebral palsy, epilepsy, hydrocephalus
learning disability
visual impairment
hearing loss
how does rubella infection during pregnancy manifest in the foetus?
cataracts
microcephaly
LBW
blueberry rash
how can you differentiate germ cell from epithelial cell ovarian tumors?
germ cell= younger patients, AFP and bHCG rasied
epithelial cell= older patients, AFP and bHCG normal
what is androgen insensitivity syndrome?
XY (male karyotype) than doesnt respond to androgens
manifests as a female looking patient with breast development but lack of female genetalia- may have a blind ended/short vagina
what is congenital adrenal hyperplasia?
usually presents at birth with severe sx- metabolic imbalance and ambiguous genetalia
later in life= primary amenorrhoea, facial hair, acne
how can you differentiate androgen insensitivity syndrome and congenital adrenal hyperplasia?
androgen insensitivity= no female genetalia, presents later in life
congenital adrenal hyperplasia= presents sooner, male characteristics, ambiguous genetalia
what complications are pregnanct women with diabetes more at risk of?
microvascular
nephropathy causing pre eclampsia is the most common reason for pre term delivery
whats another name for pre septal cellulitis
peri orbital cellulitis
what enzyme is deficient in congenital adrenal hyperplasia?
21 alpha hydroxylase
what electrolyte abnormalities do you get in congenital adrenal hyperplasia and why
hyponatraemia
hyperkalemia
this is known as a salt wasting crisis
due to lack of aldosterone (21 alpha hydroxylase deficiency), which is responsible for salt reabsorption and potassium secretion
what class of medications are used for alzheimers disease?
cholinesterase inhibitors
what generation antipsychotics cause hyperprolactinaemia?
first
what medication switch can be done to reduce hyperprolactinaemia from antipsychotics?
aripripazole
antipsychotic that has lowest risk of hyperprolactinaemia
