w/c 18/03 Flashcards
what infection does eating unpasteurised diary in pregnancy increase risk of?
listeria
what abx is associated with increased QT interval?
macrolides (clarithro/azithro)
what is 1st line treatment for pre menstrual syndrome?
COCP
what part of the brain is associate with fight or flight/ anxiety?
amygdala
what are causes of prolonged APTT and how can you differentiate them?
von willebrand disease
heamophilia a
haemophilia a= unlikely in a female
how do you diagnose von willebrand disease?
von willebrand antigen testing and factor assay
factor VIII activity
will also have a prolonged APTT
how can you differentiate primary and secondary dysmenorrhoea?
primary= pain starts as period starts
secondary= pain starts before peroid
what is charles bonnet syndrome?
an organic brain syndrome of the elderly associated with visual field defects. Cortical input from other areas closely involved with the occipital lobe is hypothesised to fill in for a visual deficit, producing a hallucinogenic effect.
whats the most serious complication of parvovirus b19 infection?
aplastic crisis
when would you give donepazil vs memantine in alzheimers?
donepezil= mild/moderate disease
memantine= severe disease
what abx are given in PID and what do they cover for?
gonorrhoea= IM ceftriaxone
chlamydia= oral doxycycline
anerobes= oral metronidazole
what ix is done to confirm malrotation?
upper gi contrast study
corkscrew appearance is seen
what are differentials for bilious vomitting in a baby and how do you tell them apart?
malrotation= in first day of life/ v early, corkscrew sign on upper gi contrast study
duodenal atresia= double bubble sign on imaging
intestinal obstruction= pain with distention, constipation, absent bowel sounds
what pathological process occurs in autoimmune encephalitis?
demyelination
whats the most common cause of secondary PPH?
endometritis
what is secondary PPH?
PPH starting 24hrs after delivery
what does dyskinetic cerebral palsy present as?
athetoid movements and oro motor problems
what are the areas damaged and symptoms for spastic, dyskinetic and ataxic cerebral palsy
spastic
damaged= upper motor neurones
sx= hemiplegia, diplegia
dyskinetic
damaged= basal ganglia and substantia nigra
sx= athetoid movements and oro motor problems
ataxic
damaged= cerebellum
sx= co ordination, gait problems
what are causes of cerebral palsy
antenatal= congenital infection
intra partum= birth asphyxiation, hypoxic brain injury
post partum= meningitis, head trauma
how can you differentiate candida, BV and trichomonas ?
BV= thin grey discharge, fishy smelling
candida= curd like discharge, pain during sex, itch
trichomonas= green frothy discharge, discomfort during sex, strawberry cervix
if someone has been treated for CIN 1/2/3 when is follow up done?
6 months
whats a key rf for neonatal hypoglycaemia
preterm birth
when would you do an urgent vs routine referral to community psych?
routine= mild symptoms
urgent= risk of harming themselves or others
when can POP be started after birth?
immediately
what type of onset for schizophrenia is considered high risk?
gradual
what are adverse effects of atypical antipsychotics?
weight gain
hyperprolactinaemia
agranulocytosis on clozapine
increased risk of stroke and VTE in the elderly
list some atypical antipsychotics
olanzipine
clozapine
aripriprazole
quitiapine
risperidone
what does the rash in hand foot and mouth disease look like?
small red bumps that might develop to blisters
how is uterine hyperstimulation managed?
tocolytics
what is prader willi syndrome?
inherited by genomic imprinting
sx= hyptonia, global developmental delay, poor feeding in infancy then hyperphagia leading to obesity in childhood
what advice do you give regarding when children are no longer infectious when they have:
scarlett fever
measles
slapped cheek syndrome
chickenpox
scarlett fever= 24hrs after first dose of abx
measles= 4 days after rash resolves
slapped cheek= once rash appears
chickenpox= once rash crusts over
after what GA is a neonatal still birth defined?
24 weeks
describe screening pathway when someone has high risk HPV but normal cytology on a smear
follow up in 12 months
if normal on second smear, follow up at 24 months
if normal at 24 months, return to routine follow up
if still have high risk HPV at 24 months refer to colposcopy despite normal cytology
what is a branchial cyst, how do you identify it and manage it
common paediatric cyst
found anterior to sternocleidomastoid, doesnt move on swallowing, doesnt transilluminate, anechoic, slow growing
can excise or manage conservatively
what is a complete hyaditiform mole?
when a sperm fertilises an empty ovum so all the genetic material is paternal
presents with hyperemesis, lack of foetal tissue on US etc
what hormone can bHCG mimick? what does this result in
TSH
hyperthyroidism like sx
when do you consider HELPP syndrome?
any pregnant women presenting with new onset GI pain until proven otherwise
what is the quadruple test used for, what is tested for and what levels constitute a high risk
screening for downs syndrome between 15-20 weeks GA
tests for
papp-A-low
AFP-low
unconjugated osetriol-low
bHCG-high
inhibin A-high
what is the diagnosis before ptsd can be diagnosed at 1 month?
acute stress reaction
what ages do smear tests occur and at what frequency?
25-49= every 3 years
50+= every 5 yrs
how do you do age adjustments for premature babies
current age in weeks - (no of weeks before 40GA they were born)
whats the normal age for a child to have a responsive smile
6-8 weeks
if a cervical smear is inadequate when can a second sample be taken?
in 3 months
what are benefits of mirtazipine as an antidepressant?
sedative- good for insomnia
increased appetite- good if lost appetite
what abx is given in preterm labour and why?
benzylpenicillin
covers against group b strep
what is a normal period for baby blues?
10 days post natally- usually resolves after this
how will biliary atresia present?
prolonged neonatal jaundice with high unconjugated bilirubin
RUQ and LUQ mass will be palpated in 3-4th week of life (liver and spleen)
what sign is pathognomic of NEC?
pnuematosis intestinalis- gas in the gut wall
whats the most common cause of menorrhagia? how do you identify it
dysfunctional uterine bleeding- more likely if in the question there has always been menorrhagia and there is no indication of fibroids eg bimanual
what is conversion disorder?
neurological sx without an underlying neurological cause, linked to stress
how does schizoid personality disorder present? how do you differentiate it from EUPD
lack of interest in having relationships with other people- this may present as negative attitudes to others but in EUPD relationships swing between idealisation and devaluation and the patient will usually have mood swings
list the common age groups for
croup
bronchiolitis
laryngomalacia
epiglottitis
croup= 6 months- 3yrs
bronchiolitis= 3-6 months
laryngomalacia= neonates
epiglottitis= 2-4 yrs
what are causes of stridor in children?
epiglottitis
croup
inhaled foreign body
laryngomalacia
go through the mx of PPH due to uterine atony
uterine massage and catheterisation
IV oxytocin
IM carboprost
intrauterine carboprost
rectal misoprostol
ballon tamponade
what does a-e for PPH include?
2 wide bore cannula
commence warm crystalloid fluid
lie woman flat
cross match and group and save
how are lithium levels monitored?
a week after starting or a dose change, then weekly until they stabilise
12 hrs after a dose is given
once stabilised every 3 months
TFTs and renal function every 6 months
what is seen on bloods in PCOS?
high LH:FSH
slightly high testosterone
low SHBG
what dose of mag sulfate is given in eclampsia?
4g IV
what metabolic imbalance do panic attacks cause?
respiratory alkalosis
what bolus fluids are given to a child with DKA?
10ml/kg of 0.9% NaCl
whats the triad for wernickes encephalopathy?
ataxic gait
opthalmoplegia
confusion
how can you differentiate hypomania from mania
mania will usually have delusions or hallucinations
hypomania will have less severe sx like reduced need for sleep
how is asymptomatic neonatal hypoglycaemia mx?
encourage regular feeds and monitor BG
what are the rules for missing 1 day of the COCP?
take the missing pill today even if it means taking 2 pills in a day
what are the rules for missing 2 or more pills of the COCP?
week 1 of cycle/withdrawal bleed period= use emergency contraception
week 2 of cycle= once 7 days of pill are taken consecutively no barrier protection needs to be used
week 3 of cycle= finish current pack of pills and take next pack immediately without withdrawal bleed period
what is 1st line medical mx for hyperemesis in pregnancy?
antihistamine eg cyclizine or promethazine
how is gestational diabetes mx?
FG <7 at diagnosis= 2 weeks trial of lifestyle measures, if sugar not controlled start metformin, if still not controlled add insulin
FG >7 at diagnosis= start insuline immediately
what insulin is given in gestational diabetes?
short acting NOT long acting
when are bow legs normal in a child?
until 4yrs of age
by what age should a child speak in short 3-5 word sentences?
2.5-3yrs
by what age should a child have a vocab of 12-18 months?
12-18 months
by what age should a child respond to their name?
9-12 months
