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Qbanks > w/c 15/04 > Flashcards

w/c 15/04 Flashcards

1
Q

what surgery is done for paediatric malrotation?

A

ladds procedure

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2
Q

what are 2 missed pills rules for COCP depending on the stage of the cycle?

A

week 1= emergency contraception
week 2= no action needed in 7 previous days taken correctly
week 3= back to back packs no break

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3
Q

what are nasal polyps and recurrent chest infections in a child indicative of?

A

CF

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4
Q

what is russells sign?

A

knuckles on the back of the hand seen in bulimia due to forced vomitting

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5
Q

whats the difference between gastroschisis and omphalocele?

A

gastroschisis= lateral to umbilicus, not covered by peritoneum
omphalocele= involves the umbilicus itself, covered by peritoneum

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6
Q

what is plagiocephaly?

A

skull deformity
unilateral occiput flattening
ipsilateral ear pushed forward
enourage sleep on back to reduce risk of SID

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7
Q

what are rules for POP when on abx?

A

no change

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8
Q

what is tardive dyskinesia and how does it usually present?

A

involuntary repetitive movements
usually regarding ear and mouth

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9
Q

when is oral rotavirus given?

A

2 months and 3 months

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10
Q

what does methotrexate use in pregnancy cause in the child?

A

cleft palate
anencephaly
hydrocephalus
skull defects

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11
Q

what is naegeles rule?

A

add one year and 7 days to LMP minus 3 months

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12
Q

what steroids are used for lichen sclerosus

A

potent topical eg dermovate

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13
Q

whats is the most common cause of neonatal early vs late onset sepsis? how do you differentiate early and late?

A

early= listeria- first 72 hrs of life
late= staph aureus- after 72 hrs life

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14
Q

how is acute fatty liver of pregnancy mx?

A

supportive care until delivery is possible

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15
Q

when is menarche expected to start?

A

in someone that has secondary sexual characteristics= 16yrs

in someone that does not have secondary sexual characteristics= 14 yrs

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16
Q

what are features of pataus syndrome

A

microcephaly
cleft lip
polydactyly
cardiac defects

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17
Q

what score on mmse indicates dementia?

A

> 24/30

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18
Q

what is krukenberg tumor and how is it identified?

A

gastric carcinoma that has metastasised to the ovaries

histologically signet ring cells are seen

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19
Q

what is affected in MCAD?

A

fatty acid oxidation

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20
Q

what is affected in porphyria?

A

haem synthesis

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21
Q

what is affected in G6PD deficiency?

A

haemolysis (in stress)

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22
Q

what is affected in PKU?

A

amino acid metabolism

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23
Q

what is affected in lesch nyhan syndrome?

A

uric acid metabolism

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24
Q

when are compressions started in an unresponsive neonate?

A

give 5 inflation breaths
check for response
give 5 more
check for response
ventilate for 30 secs
check HR
if <60bpm start compressions

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25
Q

how do you remember what capgras syndrome is?

A

cap=captured= loved ones have been replaced

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26
Q

what is pica?

A

urge to eat non food items eg soil

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27
Q

what is pica in a child indicative of?

A

iron deficiency anaemia

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28
Q

whats a common cause of iron deficiency anaemia in children?

A

excessive ingestion of cows milk- its low in iron

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29
Q

what ethnicity are fibroids more common in?

A

afro caribbeans

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30
Q

what are the compressive sx of fibroids

A

compression of bladder= increased urination
compression of rectum= constipation
compression of veins= pedal oedema

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31
Q

what are rules regarding cocp and smoking?

A

if over 35 and currently smoking/ smoking in past year are UKMEC3

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32
Q

what are rules regarding breast cancer in relatives and cocp?

A

not a contraindication
only if the patient themself has or had breast cancer

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33
Q

when is agranulocytosis on clozapine most common and how is it monitored for in this period?

A

most common in first 6-12 weeks
monitor every week for the first 6 months

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34
Q

how is acute heroin withdrawal managed?

A

first line symptomatic mx
loperamide if diarrhoea is most concerning
lofexidine for physical sx

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35
Q

how is parity linked to risk of cervical cancer?

A

increased parity increases risk

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36
Q

what is continuous dribbling after prolonged labour and poor obstetric care indicative of? how is it ix

A

vesicovaginal fistula
urinary dye studies

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37
Q

whats first line for menorrhagia?

A

mirena IUS

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38
Q

whats the typical age for croup?

A

6-12 months

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39
Q

what are some indications for ECT?

A

catatonia
severe depression
prolonged or severe mania

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40
Q

what are hypertension and multiple ovarian cysts in pregnancy indicative of?

A

molar pregnancy
high beta HCG causes growth of follicles

41
Q

what can cause raised ca125

A

ovarian cancer
endometriosis- chocolate cysts on ovaries

42
Q

what inheritance pattern is polycystic kidney disease in neonates?

A

autosomal recessive

43
Q

what IQ levels are normal/mild/moderate/severe disability

A

70= normal range
50-70= mild disability
35-49= moderate disability
20-35= severe disability

44
Q

when is US renal tract done in paediatrics?

A

all kids with atypical UTI

45
Q

how is vesicoureteral reflux mx?

A

often improves with time so surgical intervention is not necessarily needed

46
Q

in testicular torsion do you do bilateral or unilateral orchidopexy?

A

bilateral

47
Q

where is a mass in intussecption most commonly found?

A

right upper quadrant

48
Q

what 2 ix confirm diagnosis of hirschsprungs?

A

air enema
rectal biopsy

49
Q

what part of the nervous system is affected in hirschsprungs disease?

A

parasympathetic

50
Q

how can you differentiate viral vs bacterial gastroenteritis?

A

viral= non bloody diarrhoea

51
Q

what complication of gastroenteritis do you need to consider in children?

A

HUS

52
Q

whats the triad for HUS?

A

MAHA
renal failure
thrombocytopenia

53
Q

what ix is done for pyloric stenosis?

A

abdominal US

54
Q

what is gauchers disease?

A

a lysosomal storage disorder where there in abnormal fat deposition in organs- especially the liver and spleen

55
Q

on auscultation how do you differentiate VSD and ASD?

A

VSD= lower left sternal edge, normal 1st and 2nd heart sounds

ASD= upper left sternal edge, radiate to back, fixed splitting of second heart sound

56
Q

what is considered prolonged second stage of labour?

A

> 1hr multip
2hrs primip

add one hr if on epidural analgesia

57
Q

when is oxytocin given in labour?

A

1st stage= if supoptimal progess
2nd stage= if irregular contractions

58
Q

what is done if there is prolonged labour and the women is fully dilated?

A

instrumental delivery

59
Q

what is gold standard ix for endometrial cancer?

A

hysteroscopy and biopsy
not first line is TVUS but this is gold standard

60
Q

what are rules regarding mania/hypomania in bipolar 1 vs 2

A

1= mania needed, identify by not being able to do usual daily activities
2= hypomania and depressive episodes, identify by being able to do usual daily activities

61
Q

what ecg feature is seen in refeeding syndrome and due to what electrolyte abnormality?

A

prominent u waves due to hypokalemia

62
Q

what are sx of amniotic fluid embolism?

A

shortness of breath
chest pain
hypotension
high resp rate
tachycardia
hypotension
hypoxia

63
Q

what will obs in amniotic fluid embolism be?

A

all obs high apart from BP which is low
temp may be normal

64
Q

what scoring system is used for tonsilitis?

A

centor

65
Q

what is in the centor scoring system?

A

tonsilar exudate
anterior cervical lymphadenopathy
fever over 38 degrees
absence of cough

66
Q

how do you immediately know how to manage an ectopic (when deciding between medical and surgical)?

A

presence of any symptoms= surgical mx

this includes any abdominal pain

67
Q

what drug is VZV mx with in pregnancy?

A

> 20 weeks GA= oral aciclovir
<20 weeks GA= consider oral aciclovir
note: VZV IG is no longer used

68
Q

how long do these different contraceptive methods take to work if someone isnt on the first day of their cycle:
IUS
COCP
IUD
POP
implant
injection

A

IUS- 7 days
COCP- 7 days
IUD- immediate
POP- 2 days
implant- 7 days
injection- 7 days

69
Q

describe mcroberts manoeuvre

A

supine, both legs full flexed and abducted

70
Q

what is the SSRI of choice in someone with unstable angina and previous MI?

A

sertraline

71
Q

what part of the sternum are chest compressions started in for children?

A

lower half of sternum

72
Q

what is conservative advice for bedwetting?

A

toileting before bed
reduced liquid consumption before bed
star chart for dry nights

73
Q

what are risk factors for endometrial cancer?

A

menopausal
obesity
nulliparity
PCOS
diabetes
tamoxifen or unopposed estrogen

74
Q

whats first line mx for severe PMS?

A

SSRI

75
Q

what does boot shaped heart signify?

A

tet of fallot

76
Q

what mechanism is responsible for the development of tetralogy of fallot?

A

anterosuperior displacement of the infundibular septum

77
Q

what should be mx if a child comes in having self harmed?

A

admission and urgent CAHMS assessment

78
Q

how is a patient who had a LLETZ managed in terms of cervical screening?

A

test to see if HPV negative in 6 months

If positive refer back to colposcopy without further tests

if negative recall in 3 years
if negative in 3 years go back to routine screening (this could be every 3 or 5 yrs depending on age)

79
Q

what age does bronchiolitis present?

A

<18 months

80
Q

whats the incidence of baby blues?

A

50-75%

81
Q

what does loss of internal rotation in flexion of a leg in paeds MSK signify?

A

SUFE

82
Q

what are missed pill rules for COCP missing only one pill?

A

take missed pill asap and no further action needed

83
Q

how is screening for DDH for breech babies carried out?

A

all breech babies should have US pelvis at 6 weeks

84
Q

what heart defects is turners syndrome associated with?

A

aortic stenosis
bicuspid aortic valve
aortic coarctation

85
Q

what are blood glucose targets for someone with gestational diabetes?

A

fasting= <5.3
post prandial= <6.4

86
Q

what are high risk vs moderate risk factors for pre eclampsia

A

high:
CKD
previous htn disease in pregnancy
autoimmune condition
diabetes 1 or 2

moderate:
age over 40
first pregnancy
BMI >35
multiple pregnancy
fhx pre eclampsia
pregnancy interval >10 yrs

87
Q

what does abdo x ray in hirschsprungs disease show?

A

dilated loops of bowel with a fluid level

88
Q

what needs to be given to all children after they have an asthma attack?

A

steroids for 3-5 days

89
Q

in fitz hugh curtis what happens to the liver capsule and what is this called?

A

inflammation
called glissons capsule

90
Q

what type of murmur are innocent murmurs in children?

A

ejection

91
Q

what are the 2 main innocent murmurs in children? describe how they sound

A

stills murmur- low pitched sound heard at lower sternal edge
venous hums- continuous blowing under the clavicles

92
Q

whats medical therapy for PTSD

A

venlaflaxine or SSRI

93
Q

what GA do you treat maternal chickenpox?

A

> 20 weeks GA

94
Q

what age do children start to parallel play?

A

2 years

95
Q

at what GA can you manage someone expectantly for PV bleeding?

A

<6 weeks
note: they must have no pain

96
Q

when do you treat household for threadworm?

A

always

97
Q

what ix is done for NEC?

A

abdo x ray

98
Q
A

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