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w/c 12/02 Flashcards

1
Q

what organism usually causes bronchiolitis?

A

RSV

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2
Q

what is bronchiolitis obliterans?

A

a complication of bronchiolitis popcorn lung- terminal bronchiolar dilation, areas of air trapping seen on CT

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3
Q

what causative organism usually causes bronchiolitis obliterans?

A

adenovirus

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4
Q

what is raised immune tripsinogen on heel prick suggestive of?

A

cystic fibrosis

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5
Q

what is raised phenylalanine on heel prick suggestive of?

A

phenylketonuria

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6
Q

when is the heel prick test done?

A

5-8 days old

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7
Q

how does congenital hypothyroidism present?

A

macroglossia
floppy baby/hypotonia
abdo distention/ constipation
umbilical distention

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8
Q

whats the inheritance pattern of duchennes muscular dystrophy?

A

x linked recessive

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9
Q

what is phrens sign?

A

does elevation of the testes relieve pain?
negative= no (seen in testicular torsion)
positive= yes (seen in epididymitis)

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10
Q

what organism commonly causes early onset sepsis?

A

group B strep

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11
Q

why is IgA done with anti TTG?

A

lack of IgA leads to false negative

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12
Q

medical management for TOP is recommended for what GA?

A

10-23+6 weeks

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13
Q

what types of drugs are mifepristone and misoprostol? how do they work

A

mifeprostone= progesterone receptor antagonist, degrades endometrium, ripens cervix, opens os etc
misoprostol- prostaglandin analogue, causes smooth muscle contraction to expel uterine contents

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14
Q

describe medical mx of TOP

A

give oral mifeprostone
give vaginal misoprostol 36-48 hrs after

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15
Q

what medications are given in antiphospholipid syndrome to prevent miscarriage? when are they started and how do they work

A

LMWH= start when foetal heartbeat detectable
low dose aspirin= start when pregnancy confirmed on urinalysis
they both prevent thrombosis

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16
Q

what tests are done in the combined screening test

A

nuchal translucency
PAPP-A
free bHCG

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17
Q

what is seen in the combined screening test in downs syndrome?

A

high nuchal translucency and b-HCG
low PAPP-A

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18
Q

what nerve block is performed using local for instrumental delivery?

A

pudendal

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19
Q

how often do people with HIV need cervical screening?

A

every year

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20
Q

what is given to babies when mum has hep B?

A

HBV IgG and HBV vaccination within 24 hrs of delivery

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21
Q

what age does perthes disease occur in?

A

4-8 yrs

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22
Q

what are some RF for paediatric sepsis?

A

break in skin (cut/burn)
immunosupression (diabetes/splenectomy/cancer treatment etc)
surgery in past 6 weeks
indwelling catheter

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23
Q

what is oesophageal atresia?

A

when the oesophagus ends blindly, failing to connect to the stomach

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24
Q

what are the 4 main domains of developmental milestones?

A

gross motor
fine motor
social
hearing and vision

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25
what is rhesus status of mum and baby in haemolytic disease of the newborn?
mum= rhesus negative baby= rhesus positive
26
how would you explain sepsis to someone?
a condition wherein the immune systems response to an infection leads to the compromise of many organs in the body, it is serious and can be lifethreatening
27
what ix are done in paediatric sepsis?
bedside: obs, urine dip, urine mc/s, lumbar puncture, swabs, BG bloods: FBC, UEs, LFTs, culture, lactate VBG/ABG, CRP, clotting screen imaging: CXR, AXR
28
how is sepsis in a child managed?
immediate hospital admission administer broad spec IV abx escalate to senior paediatrician for review within 1 hr, prepare for escalation to ITU/HDU administer fluid bolus and maintenance fluids, high flow oxygen if needed
29
what is seen on bloods in women with turners syndrome?
high FSH
30
what drug is given in secondary nocturesis when conservative measures fail? at what age can it be given?
desmopressin can be given to children above 7
31
what medication is given while awaiting surgery in babies with duct dependant lesions? whats the moa
prostaglandin E it prevents the duct from closing
32
what medication should not be given while awaiting surgery in babies with duct dependant lesions? whats the moa
NSAIDs COX inhibitors will cause the lesion to close
33
how is transient synovitis mx?
rest and analgesia
34
what type of abx are given in whopping cough? give examples
a macrolide clarithromycin azithromycin
35
what is seen on electron microscopy in minimal change disease?
diffuse effacement of foot processes on podocytes
36
what is meckels diverticulum and how does it present?
a congenital GI condition where there are remnants of the embryonic vitello-duct can present with painless rectal bleeding, abdo pain etc and if obstructed more severe sx
37
what ix are done for meckels diverticulum?
CT 99mTC scan
38
how is meckels diverticulum managed?
NG decompression surgical resection
39
how is bilirubin measured in babies with jaundice first?
transcutaneous
40
what are the other names for slapped cheek syndrome?
erythema infectiosum fifth disease
41
what age is premature ovarian insufficiency diagnosed in?
under 40
42
what does a positive coombs test in a newborn baby confirm?
immune mediated haemolytic anaemia (rhesus disease)
43
what medication regime is adopted in pregnant women with hypothyroidism?
increase levothyroxine by 25mcg daily even if the patient is euthyroid
44
whats the most common type of vulval cancer?
squamous cell carcinoma
45
in cervical ectropion what type of cell extends to where?
ectopic columnar epithelium extends from the endocervix to the ectocervix
46
what HRT is recommend for perimenopausal vs most menopausal women? say how they differ
perimenopausal: monthly cyclical HRT where oestrogen is given always and progestogen last 10-14 days, induces a withdrawal bleed in final phase postmenopausal: continuous combined HRT where oestrogen and progestogen are taken daily to mimic the effects of physiological menopause
47
how do you differentiate pre eclampsia from pregnancy associated htn?
pre eclampsia= proteinuria present, >140 systolic and/or >90 diastolic
48
list RF of ectopic pregnancy
endometriosis PID smoking IVF previous ectopic age over 35
49
whats the biggest risk with IOL for a healthy women who hasnt gone into labour on time?
failure of induction and c section required
50
what is given in paracetamol overdose
n acetylcystine
51
what is significant paracetamol overdose?
>75mg/kg
52
how is delirium managed
de escalation techniques IM haloperidol
53
how long does section 5(2) last?
72 hrs
54
what are common side effects of SSRI in first 2 weeks?
GI disturbance agitation increased anxiety
55
whats the difference between schizoid vs schizotypal personality disorder?
schizoid= detachment from social relationships and emotional withdrawal schizotypal= magical/strange beliefs
56
what are class a personality disorders?
paranoid schizoid schizotypal
57
what blood test is done for biliary atresia and what is seen?
serum total and conjugated bilirubin both are high
58
what organism commonly causes croup?
parainfluenza
59
what are hyperinflated lungs and fluid level in a newborn characteristic of?
transient tachypnoea of the newborn
60
what conditions are those with downs syndrome at risk of developing?
ALL Alzheimers
61
what differetiates oligoarticular vs polyarticular juvenile idiopathi arthritis?
oligo= four or fewer joints poly= more than four
62
how is oligoarticular polyarticular juvenile idiopathic arthritis managed?
intraarticular steroids
63
what is seen on xray in someone with ewings sarcoma?
lamellated (onion skin) periosteal reaction
64
what is seen on mri in someone with ewings sarcoma?
a large mass with evidence of necrosis
65
what is seen on histology in someone with ewings sarcoma
small round cells with clear cytoplasm on haematoxylin and eosin staining
66
what are the 2 common causes of not passing meconium
cystic fibrosis hirschsprungs disease
67
what rf ellicit OGGT in pregnancy?
BMI >30 previous macrosomic baby previous gestational diabetes 1st degree relative with diabetes ethnic origin
68
when is OGTT in pregnancy done?
26-28 weeks
69
what folic acid supplementation is recommended for pregnant women? include doses and times
400 mcg folic acid daily until 12th week
70
what is the high dose for folic acid supplementation in pregnant women?
5mg
71
what is seen in the baby when there is maternal alcohol consumption
congential heart defects (VSDs) abnormal face: thin lips, smooth philtrum, small jaw
72
how uterine atony addressed in PPH?
IV oxytocin Bimanual uterine compression
73
what is erbs palsy, whats it associated with and how is it managed?
palsy of the arm: flaccid upper arm, extended lower arm rotated towards body and hand in waiters tip position associated with shoulder dystocia- damage to brachial plexus usually resolves in 12 months
74
what bloods would you do in someone with alcohol withdrawal?
TFTs FBC ESR CRP B12 folate UEs LFTs BG and Hba1c
75
what is first line treatment for acute mania?
antipsychotics (those with mood stabilising properties are used and include olanzipine, haloperidol, risperidone, quetiapine)
76
what electrolyte abnormality may be seen in someone after a panic attack? why?
hypocalcaemia hyperventilation causes alkalosis with promotes calcium binding to albumin
77
how does osteosarcoma in a child usually present?
localised pain for several months not associated with trauma or injury, sometimes palpable lump
78
whats the most common primary malignant bone tumor in kids and adolescents?
osteosarcoma
79
what depth are compressions done in paediatric basic life support?
1/3rd chest depth
80
how do you differentiate transient synovitis and septic arthritis?
joint aspirate- septic arthritis will grow bacteria and transient synovitis wont
81
how does tetralogy of fallot present?
tet spells- episodic syanosis left lower sternal edge murmur
82
how does transposition of the great arteries present?
constant cyanosis appears hours after birth prominent right venticular heave single second heart sound
83
where does fluid accumulate in a hydrocele?
tunica vaginalis
84
when is surgery for a hydrocele required?
if persistent beyond the age of 2
85
how long is folic acid taken for?
before conception through to 12 weeks
86
what are indications for high dose folic acid?
partner with NTD previous pregnancy with NTD coeliac disease diabetes thalassaemia trait obese
87
what microbio tests are done at booking appt?
HIV Hep B spyhillis
88
how long should you take iron for if you are anemic?
3 months even if levels are normal
89
what do you need to screen for when someone presents with suspected pre eclampsia
HELPP syndrome
90
how is hyperemesis gravidarum managed?
electrolyte and fluid replacement anti histamine first line (cyclizine or prochlorperazine) then anti emetics (ondansetron/metacloperamide) thiamine and folic acid supplementation to prevent wernickes enceph TED stockings to reduce risk of thrombosis due to pregnancy, dehydration and immobilisation
91
how is primary ovarian insufficiency diagnosed?
menopausal sx 2 elevated FSH 4-6 weeks apart
92
when is the booking appt done?
8-10 weeks
93
what cancers does PCOS increase the risk of?
endometrial and ovarian
94
when are anti D rhesus injections given?
one injection 28-30 weeks 2 injections one at 28 weeks and one at 34 weeks
95

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