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w/c 18/03 Flashcards

1
Q

what infection does eating unpasteurised diary in pregnancy increase risk of?

A

listeria

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2
Q

what abx is associated with increased QT interval?

A

macrolides (clarithro/azithro)

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3
Q

what is 1st line treatment for pre menstrual syndrome?

A

COCP

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4
Q

what part of the brain is associate with fight or flight/ anxiety?

A

amygdala

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5
Q

what are causes of prolonged APTT and how can you differentiate them?

A

von willebrand disease
heamophilia a

haemophilia a= unlikely in a female

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6
Q

how do you diagnose von willebrand disease?

A

von willebrand antigen testing and factor assay
factor VIII activity
will also have a prolonged APTT

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7
Q

how can you differentiate primary and secondary dysmenorrhoea?

A

primary= pain starts as period starts
secondary= pain starts before peroid

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8
Q

what is charles bonnet syndrome?

A

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.

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9
Q

whats the most serious complication of parvovirus b19 infection?

A

aplastic crisis

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10
Q

when would you give donepazil vs memantine in alzheimers?

A

donepezil= mild/moderate disease
memantine= severe disease

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11
Q

what abx are given in PID and what do they cover for?

A

gonorrhoea= IM ceftriaxone
chlamydia= oral doxycycline
anerobes= oral metronidazole

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12
Q

what ix is done to confirm malrotation?

A

upper gi contrast study
corkscrew appearance is seen

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13
Q

what are differentials for bilious vomitting in a baby and how do you tell them apart?

A

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

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14
Q

what pathological process occurs in autoimmune encephalitis?

A

demyelination

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15
Q

whats the most common cause of secondary PPH?

A

endometritis

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16
Q

what is secondary PPH?

A

PPH starting 24hrs after delivery

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17
Q

what does dyskinetic cerebral palsy present as?

A

athetoid movements and oro motor problems

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18
Q

what are the areas damaged and symptoms for spastic, dyskinetic and ataxic cerebral palsy

A

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

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19
Q

what are causes of cerebral palsy

A

antenatal= congenital infection
intra partum= birth asphyxiation, hypoxic brain injury
post partum= meningitis, head trauma

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20
Q

how can you differentiate candida, BV and trichomonas ?

A

BV= thin grey discharge, fishy smelling
candida= curd like discharge, pain during sex, itch
trichomonas= green frothy discharge, discomfort during sex, strawberry cervix

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21
Q

if someone has been treated for CIN 1/2/3 when is follow up done?

A

6 months

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22
Q

whats a key rf for neonatal hypoglycaemia

A

preterm birth

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23
Q

when would you do an urgent vs routine referral to community psych?

A

routine= mild symptoms
urgent= risk of harming themselves or others

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24
Q

when can POP be started after birth?

A

immediately

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25
what type of onset for schizophrenia is considered high risk?
gradual
26
what are adverse effects of atypical antipsychotics?
weight gain hyperprolactinaemia agranulocytosis on clozapine increased risk of stroke and VTE in the elderly
27
list some atypical antipsychotics
olanzipine clozapine aripriprazole quitiapine risperidone
28
what does the rash in hand foot and mouth disease look like?
small red bumps that might develop to blisters
29
how is uterine hyperstimulation managed?
tocolytics
30
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
31
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
32
after what GA is a neonatal still birth defined?
24 weeks
33
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
34
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
35
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
36
what hormone can bHCG mimick? what does this result in
TSH hyperthyroidism like sx
37
when do you consider HELPP syndrome?
any pregnant women presenting with new onset GI pain until proven otherwise
38
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
39
what is the diagnosis before ptsd can be diagnosed at 1 month?
acute stress reaction
40
what ages do smear tests occur and at what frequency?
25-49= every 3 years 50+= every 5 yrs
41
how do you do age adjustments for premature babies
current age in weeks - (no of weeks before 40GA they were born)
42
whats the normal age for a child to have a responsive smile
6-8 weeks
43
if a cervical smear is inadequate when can a second sample be taken?
in 3 months
44
what are benefits of mirtazipine as an antidepressant?
sedative- good for insomnia increased appetite- good if lost appetite
45
what abx is given in preterm labour and why?
benzylpenicillin covers against group b strep
46
what is a normal period for baby blues?
10 days post natally- usually resolves after this
47
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)
48
what sign is pathognomic of NEC?
pnuematosis intestinalis- gas in the gut wall
49
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
50
what is conversion disorder?
neurological sx without an underlying neurological cause, linked to stress
51
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
52
list the common age groups for croup bronchiolitis laryngomalacia epiglottitis
croup= 6 months- 3yrs bronchiolitis= 3-6 months laryngomalacia= neonates epiglottitis= 2-4 yrs
53
what are causes of stridor in children?
epiglottitis croup inhaled foreign body laryngomalacia
54
go through the mx of PPH due to uterine atony
uterine massage and catheterisation IV oxytocin IM carboprost intrauterine carboprost rectal misoprostol ballon tamponade
55
what does a-e for PPH include?
2 wide bore cannula commence warm crystalloid fluid lie woman flat cross match and group and save
56
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
57
what is seen on bloods in PCOS?
high LH:FSH slightly high testosterone low SHBG
58
what dose of mag sulfate is given in eclampsia?
4g IV
59
what metabolic imbalance do panic attacks cause?
respiratory alkalosis
60
what bolus fluids are given to a child with DKA?
10ml/kg of 0.9% NaCl
61
whats the triad for wernickes encephalopathy?
ataxic gait opthalmoplegia confusion
62
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
63
how is asymptomatic neonatal hypoglycaemia mx?
encourage regular feeds and monitor BG
64
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
65
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
66
what is 1st line medical mx for hyperemesis in pregnancy?
antihistamine eg cyclizine or promethazine
67
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
68
what insulin is given in gestational diabetes?
short acting NOT long acting
69
when are bow legs normal in a child?
until 4yrs of age
70
by what age should a child speak in short 3-5 word sentences?
2.5-3yrs
71
by what age should a child have a vocab of 12-18 months?
12-18 months
72
by what age should a child respond to their name?
9-12 months
73

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