w/c 26/02

Question 1

what are some causes of macrocephaly

Answer 1

meningitis
traumatic brain injury
haemorrhage

Question 2

whats gold standard emergency contraception?

Answer 2

IUD

Question 3

whats the difference between IUD and IUS

Answer 3

IUS= mirena/hormonal coil
IUD= copper coil (not hormonal)

Question 4

out of IUD and IUS which is hormonal?

Answer 4

IUS

Question 5

in the first stage of labour what is an appropriate rate and duration for contractions

Answer 5

rate= 3-5/10 mins
duration= 30-60 seconds

Question 6

what do you need to monitor in molar pregnancy and why?

Answer 6

bHCG
to ensure all contents are expelled as retained products will increase risk of developing choriocarcinoma

Question 7

and what time should women with gestational diabetes deliver?

Answer 7

no later than 40+6 weeks

Question 8

what class of medications will cause the ductus arteriosus to close vs stay open? give examples of both

Answer 8

close= prostaglandin inhibitor eg indomethacin
stay open= prostaglandin E1 eg alprostadil

Question 9

how is pain in endometriosis managed?

Answer 9

COCP or POP

Question 10

what organism commonly causes bartholins cyst?

Answer 10

e coli

Question 11

what is seen on x ray in rickets?

Answer 11

widened epiphyseal plates

Question 12

what acronym is used for remembering innocent murmurs?

Answer 12

6 S:
short
soft
systolic
S1 normal
S2 normal
standing/sitting

Question 13

what is fitz hugh curtis syndrome and how does it present?

Answer 13

a complication of PID
adhesions form due to inflammation of the liver capsule
upper right quadrant pain, shoulder tip pain, previously untreated STI

Question 14

what are sx of vulval cancer?

Answer 14

mass, pruritus, bleeding, burning

Question 15

where are vulval cancers commonly found?

Answer 15

labia majora

Question 16

what are rf for vulval cancer?

Answer 16

HPV
chronic inflammation eg lichen sclerosus

Question 17

what is first line contraception for a women with menorrhagia but no pathology?

Answer 17

doesnt want to get pregnant= IUS
wants to get pregnant= mefanamic/tranexamic acid

Question 18

when are abx given in GBS infection?

Answer 18

intrapartum

Question 19

what does parvovirus b19 infection during pregnancy cause?

Answer 19

hydrops fetalis

Question 20

how does parvovirus b19 infection present?

Answer 20

bright red rash across cheeks, reticular rash across body

Question 21

whats an advantage of dermal hrt compared to tablets?

Answer 21

no increased risk of VTE

Question 22

what score is used for IOL? what does it look at

Answer 22

bishop score
looks at the cervix

Question 23

what bishop score indicates labour is unlikely to occur without induction?

Answer 23

5

Question 24

what are the 5 components of the bishop score?

Answer 24

cervix:
position
consistency
effacement
dilation
station

Question 25

how many presentations of tonsilitis are needed for tonsillectomy in: a single year over 2 years over 3 yrs

Answer 25

single yr= 7 over 2 years= 5 per year over 3 years= 3 per year

Question 26

when should a child be admitted for anaphylaxis and why?

Answer 26

always admit for at least 6 hrs anaphylaxis can occur as a biphasic reaction with the second phase in 4-6 hrs

Question 27

whats the difference between CIN grade 1 vs 2 vs 3

Answer 27

1= affects lower 1/3 of epithelium or less 2= affects between 1/3 and 2/3 of epithelium 3= affects more than 2/3 of epithelium

Question 28

what is the biggest rf for rectocele?

Answer 28

straining due to constipation

Question 29

what do you always prescribe with opiates and why

Answer 29

laxative for constipation

Question 30

what infection is most likely to cause a paediatric febrile seizure and why?

Answer 30

roseola infantum the fever is fast rising

Question 31

what condition in paeds is HHV 6 infection associated with?

Answer 31

roseola infantum

Question 32

when does transient tachypnoea of the newborn present?

Answer 32

2hrs-72hrs then resolves

Question 33

what is first line medication for delirium tremens?

Answer 33

oral lorazepam

Question 34

what nerves are affected in erbs palsy?

Answer 34

C5-C6

Question 35

what imaging is used for pyloric stenosis?

Answer 35

abdo US

Question 36

what electrolyte and pH abnormality is seen in pyloric stenosis?

Answer 36

metabolic hypochloraemic hypokalemic alkalosis

Question 37

what is used to mx meningitis caused by nisseria?

Answer 37

IV ceftriaxone

Question 38

what is first line mx in PCOS?

Answer 38

weight loss

Question 39

when does the 3rd stage of labour start and end?

Answer 39

start= after delivery of foetus end= expulsion of placenta and membranes

Question 40

what does cottage cheese discharge indicate?

Answer 40

vulvovaginal candidiasis

Question 41

how is vulvovaginal candidiasis treated?

Answer 41

clotrimazole cream or pessary

Question 42

at what GA should twins be delivered by c section?

Answer 42

37 weeks

Question 43

what ECG change is seen most commonly in anorexia nervosa?

Answer 43

prolonged QT interval

Question 44

what feature of tetralogy of fallot determines the severity?

Answer 44

pulmonary stenosis

Question 45

what clinical findings will coarctation of the aorta cause?

Answer 45

weak femoral pulses mid systolic murmur heard best in between scapulae

Question 46

what murmur is associated with turners syndrome?

Answer 46

mid systolic murmur heard best in between scapulae

Question 47

what abx are used to mx meningitis in hospital?

Answer 47

penicillin or 3rd gen cephalosporin specifics depend on local guidelines

Question 48

what 2 things are applied to the cervix during colposcopy?

Answer 48

acetic acid iodine

Question 49

how might a symptomatic imperforate hymen present?

Answer 49

a young girl who hasn't menstrauted yet (but is having her first period) worsening abdo pain, bloating blue bulging membrane seen overlying the vagina

Question 50

when do you admit a child with croup?

Answer 50

any sign of respiratory distress

Question 51

whats the moa of naloxone?

Answer 51

opiod receptor antagonist

Question 52

how do you differentiate schizoaffective disorder from mania with psychosis?

Answer 52

schizoaffective= needs periods of depression as well as mania, features of schizophrenia and affective changes without qualifying for a diagnosis of both of those

Question 53

how do you differentiate delusional perception from thought insertion?

Answer 53

thought insertion= thoughts are inserted directly into the mind ie telepathically delusional perception= thoughts come from incorrect perceptions of physical things eg newspapers/ radio

Question 54

what bloods do you need to check before starting someone on lithium and why?

Answer 54

TFTs lithium somehow inhibits thyroid hormone causing hypothyroidism

Question 55

what 2 cancers need to be assessed for in PMB and how?

Answer 55

endometrial= TVUS cervical= colposcopy

Question 56

what test should a pre menopausal women with PV bleeding have?

Answer 56

chlamydia

Question 57

what type of bacteria is bordetella pertussis?

Answer 57

gram negative cocobacillus

Question 58

whats the aetiology behind antiphospholipid syndrome causing recurrent miscarriage?

Answer 58

the antibodies= hypercoagulable state insufficient placental development due to thrombi in placental vessels

Question 59

when might it be ok if a child isnt walking by 18 months?

Answer 59

if they bottom shuffle

Question 60

what abx are used to treat PID?

Answer 60

third gen cephalosporin eg doxy of ceftraixone with or without metronidazole

Question 61

what is a missed miscarriage?

Answer 61

when the foetus is dead but in utero (not expelled) often asymptomatic