w/c 11/03

Question 1

what is the kleihauer test

Answer 1

measures the circulating level of rh d antigen in maternal blood to see how much anti D IG is needed to be given

Question 2

whats the most common cause of paediatric nephrotic syndrome?

Answer 2

minimal change disease

Question 3

what ix are done for minimal change disease?

Answer 3

urine dipstick
kidney biopsy

Question 4

how is minimal change disease mx?

Answer 4

corticocteroids
fluid restriction
low salt/protein diet

Question 5

how do you differentiate FSGS and minimal change disease?

Answer 5

FSGS doesnt respond well to steroids

Question 6

what is sudden foetal bradycardia without pain suggestive of?

Answer 6

cord prolapse

Question 7

what test is done to check a woman has ovulated? when is it done?

Answer 7

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)

Question 8

how is overactive bladder syndrome mx?

Answer 8

1st line= bladder retraining, diary, lifestyle measures
2nd line= oxybutynin

Question 9

what is lithium toxicity associated with?

Answer 9

dehydration due to gastroenteritis
diarrhoea

Question 10

how do you differentiate simple febrile seizure from complex

Answer 10

simple= 1 seizure over the course of 1 febrile illness
complex= more than one seizure over the space of 24 hrs

Question 11

which HPV is associated with biggest risk of cervical cancer?

Answer 11

16
18

Question 12

whats 1st line mx for postpartum depression?

Answer 12

CBT

Question 13

whats the difference between 3a/3b/3c tears?

Answer 13

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

Question 14

whats the status of the internal anal sphincter in a 3a/3b/3c tear?

Answer 14

3a and 3b= internal anal sphincter in tact
3c= internal anal sphincter torn

Question 15

what organism causes hand foot and mouth disease?

Answer 15

coxsackie virus a16

Question 16

what side effect of clozapine is important to investigate and how is this done?

Answer 16

agranulocytosis
ix with FBC

Question 17

what condition does rupture of membranes followed by bleeding in pregnancy suggest?

Answer 17

vasa praevia

Question 18

when do you operate on a fibroid?

Answer 18

if its symptomatic and greater than 3 cm

Question 19

what is fregoli delusion?

Answer 19

a patient believes everyone they meet is the same person under different disguises

Question 20

why is folic acid taken during pregnancy

Answer 20

to prevent neural tube defects

Question 21

what imaging is used for pyloric stenosis?

Answer 21

US abdo

Question 22

what are first line benzos with route of admission in paediatric status?

Answer 22

buccal midazolam OR rectal diazepam

Question 23

describe the typical course of physiological jaundice

Answer 23

appears at day 2-4
bilirubin raised but not massively
resolves in 1-2 weeks

Question 24

what does of anti D is given to women when one injection is administered? at what GA

Answer 24

1500IU
28 weeks GA

Question 25

can you have vaginal delivery in placenta praevia?

Answer 25

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

Question 26

what are signs of paediatric resp distress?

Answer 26

nasal flaring use of accessory muscles subcostal and intercostal recessions raised RR tracheal tug abnormal airway noises

Question 27

how do you differentiate preseptal and orbital cellulitis?

Answer 27

preseptal= no optical sx orbital= optical sx

Question 28

how does CMV infection during pregnancy manifest in the foetus?

Answer 28

LBW microcephaly jaundice seizures petechial rash

Question 29

hows does foetal alcohol syndrome present?

Answer 29

microcephaly short palpable fissures hypoplastic upper lip absent philtrum reduced IQ cardiac abnormalities

Question 30

how does maternal cigarette use affect the pregnancy?

Answer 30

IUGR still birth miscarriage placental abruption

Question 31

how does toxoplasmosis infection during pregnancy manifest in the foetus?

Answer 31

neuro conditions= cerebral palsy, epilepsy, hydrocephalus learning disability visual impairment hearing loss

Question 32

how does rubella infection during pregnancy manifest in the foetus?

Answer 32

cataracts microcephaly LBW blueberry rash

Question 33

how can you differentiate germ cell from epithelial cell ovarian tumors?

Answer 33

germ cell= younger patients, AFP and bHCG rasied epithelial cell= older patients, AFP and bHCG normal

Question 34

what is androgen insensitivity syndrome?

Answer 34

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

Question 35

what is congenital adrenal hyperplasia?

Answer 35

usually presents at birth with severe sx- metabolic imbalance and ambiguous genetalia later in life= primary amenorrhoea, facial hair, acne

Question 36

how can you differentiate androgen insensitivity syndrome and congenital adrenal hyperplasia?

Answer 36

androgen insensitivity= no female genetalia, presents later in life congenital adrenal hyperplasia= presents sooner, male characteristics, ambiguous genetalia

Question 37

what complications are pregnanct women with diabetes more at risk of?

Answer 37

microvascular nephropathy causing pre eclampsia is the most common reason for pre term delivery

Question 38

whats another name for pre septal cellulitis

Answer 38

peri orbital cellulitis

Question 39

what enzyme is deficient in congenital adrenal hyperplasia?

Answer 39

21 alpha hydroxylase

Question 40

what electrolyte abnormalities do you get in congenital adrenal hyperplasia and why

Answer 40

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

Question 41

what class of medications are used for alzheimers disease?

Answer 41

cholinesterase inhibitors

Question 42

what generation antipsychotics cause hyperprolactinaemia?

Answer 42

first

Question 43

what medication switch can be done to reduce hyperprolactinaemia from antipsychotics?

Answer 43

aripripazole antipsychotic that has lowest risk of hyperprolactinaemia