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Qbanks > w/c 26/05 > Flashcards

w/c 26/05 Flashcards

1
Q

what does giving vit K to babies prevent

A

haemorrhagic disease of the newborn

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2
Q

whats foetal hyantoin syndrome

A

syndrome due to maternal anti epileptic use (ones which are teratogenic)

manifests as IUGR, microcephaly, cleft lip/palate, intellectual disability, hypoplastic fingernails and distal limb deformity

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3
Q

how many principles in the mca

A

5

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4
Q

adjustment disorder definition

A

clear stress
presents within 3 months of stress
sx last <6 months

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5
Q

what type of neonatal jaundice does hypothyroidism cause

A

unconjugated

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6
Q

NSAIDs in breastfeeding

A

yes

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7
Q

roseola infantum rash

A

appears after fever/coryza
starts on trunk and spreads to limbs

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8
Q

what do krukenberg tumors contain histologically

A

signet ring cells

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9
Q

when does vomitting in pyloric stenosis usually start

A

3/4th week of life

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10
Q

duodenal atresia is associated with

A

downs syndrome

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11
Q

describe the respiratory physiological changes in pregnancy

A

increased tidal volume
increased minute ventilation

this causes breathlessness

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12
Q

how long after vaginal PGE2 is the cervix reassessed

what is done if theres no improvement

A

6 hrs

if bishop score is still under 6 give PEG2 again

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13
Q

meckels diverticulum rule of 2s

A

2% of population
2cm from ileocaecal valve
2 inches long
2 types of hypertrophic mucosa (gastric or pancreatic)

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14
Q

how might meckels diverticula present

A

usually asymptomatic
may mimic appendicitis

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15
Q

what methods of contraception increase risk of ectopic pregnancy

A

POP
IUD

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16
Q

when is interpersonal therapy used

A

when there is one clear trigger that can be the focus of therapy

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17
Q

atypical antipsychotic starting dose

A

10mg

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18
Q

what antihypertensives can contribute to/exacerbate depression

A

beta blockers

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19
Q

what class of medication is venlaflaxine

A

SNRI

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20
Q

what class of medication is paroxetine

A

SSRI

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21
Q

what class of medication is dosulepin

A

tricyclic

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22
Q

in a second episode of depression how long should you continue antidepressants after remission

A

2 years

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23
Q

multiple episodes of mania are considered to be a diagnosis of

A

bipolar affective disorder

NOT recurrent mania

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24
Q

whats the likelihood of someone with a manic episode experiencing depression

A

90%

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25
Q

3 main effects of lithium use

A

hypothyroidism
nephrotoxcity
hyperparathyroidism

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26
Q

psychological therapy in mania

A

is not offered in acute phase, not really effective for mania

effective for concordance with medication and future depressive episodes

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27
Q

max time period of benzo use in anxiety

A

2-4 weeks

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28
Q

how should someone be weaned off benzos after long term use

A

reduce 1/8th dose every fortnight

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29
Q

what benzo has the shortest half life

A

lorazepam

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30
Q

which benzo will give the worst withdrawal sx and why

A

lorazepam because it has the shortest half life- switch to diazepam (longer half life) then wean off

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31
Q

do all adult patients who self harm need to be seen by a psychiatrist or mental health nurse before discharge?

A

no

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32
Q

use of what psychiatric medication in the first trimester is associated with cleft lip

A

benzodiazipines

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33
Q

how should women be routinely screened for depression postpartum

A

ask about anhedonia and low mood
if they say yes to either, use the edinburgh postnatal depression scale

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34
Q

knights move thinking synonym

A

loosening of associations

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35
Q

what is the treatment plan for early psychosis

A

start low, go slow

ie low dose antipsychotics

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36
Q

what are the rules around testing for huntingtons

A

can only be done after genetic counselling, so not by gp

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37
Q

huntingtons chance of passing down?

A

50%

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38
Q

environmental risk factors for alzheimers

A

smoking
head injury

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39
Q

in those with dementia how many have alzheimers

A

60-70%

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40
Q

memantine class of drug

A

NMDA (glutamate) receptor partial agonist

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41
Q

acetylcholinesterase inhibitors

A

donepazil
rivastigmine
galantamine

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42
Q

how many people recover from anorexia nervosa in 20 years

A

50%

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43
Q

main difference between anorexia nervosa and bullimia

A

anorexia= weight low
bullimia= wight normal

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44
Q

what is section 48

A

for transfer of an unsentenced prisoner to hospital for detention there

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45
Q

what is section 49

A

a restriction order

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46
Q

who can apply a section 49

A

ministry of justice

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47
Q

IQ for mild, moderate, severe and profound disability

A

mild= 50-69
moderate= 35-49
severe= 20-34
profound= under 20

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48
Q

how long does a section 5(4) last

A

6 hrs

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49
Q

what is diagnostic overshadowing

A

when a persons symptoms are assumed to be relating to their learning disability

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50
Q

why are atypical antipsychotics preferred over typical

A

less extra pyramidal side effects

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51
Q

atypical antipsychotics cause more x side effects than typicals

A

metabolic

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52
Q

antipsychotics main moa

A

dopamine antagonists

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53
Q

what things do you check before starting lithium

A

patient mental state
pulse/BP
FBC
TFTs
UEs
calcium

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54
Q

what is required before a patient can be detained under section 2?

A

assessment by 2 doctors

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55
Q

how do atypical antipsychotics cause weight gain?

A

increased appetite

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56
Q

venlaflaxine class of drug

A

SNRI

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57
Q

driving and dementia

A

patient should be asked to inform the DVLA (even if they can still drive)
explore accidents etc with them and the family

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58
Q

screening for before someone is put on an acetylcholiensterase inhibitor

A

peptic ulcer disease/dyspepsia
LFTs
ECG
cardiac hx
asthma

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59
Q

activated charcoal is given when

A

when a patient presents within an hour of taking an overdose

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60
Q

when should bloods be done in paracetamol overdose

A

4 hours after ingestion as this is when levels peak

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61
Q

when do paracetamol levels peak after overdose

A

4 hours

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62
Q

whats used in the acute treatment of mania

A

atypical antipsychotic
consider adding lithium or valproate

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63
Q

what should you not prescribe in bipolar affective disorder

A

antidepressant

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64
Q

which is the only antidepressant licensed for use in bipolar affective disorder

A

fluoxetine

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65
Q

one unit of alcohol is

A

the amount of alcohol an adult can metabolise in an hr, 10ml or 8g of pure ethanol

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66
Q

what neurotransmitter does alcohol enhance and what effect does this produce

A

GABA-A
causes reduced anxiety

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67
Q

what neurotransmitter does alcohol inhibit and what effect does this produce

A

NMDA
causes amnesia

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68
Q

harmful drinking vs dependant drinking

A

dependant= has withdrawal sx

harmful= non dependant drinking that continues despite harm

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69
Q

alchohol withdrawal time

A

4-12 hrs after last drink

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70
Q

whats the most common infection in IVDU

A

hep C

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71
Q

benzo OD reversal

A

flumazenil

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72
Q

opiate OD reversal

A

naloxone

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73
Q

when can you start buprenorphrine

A

when withdrawal symptoms start (dont give before this)

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74
Q

does opiate analgesia need to be avoided in IVDU

A

no

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75
Q

what is given acutely in delirium tremens

A

benzodiazepine

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76
Q

what medications reduce seizure threshold when giving ECT

A

antipsychotics
antidepressants

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77
Q

first rank sx of schizophrenia

A

auditory hallucinations (3rd person where people are speaking about pt is most common)

passivity

thought interference

delusional perception

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78
Q

learning disability vs difficulty

A

difficulty= challenges in one aspect of learning

disability= overall intellectual function is impacted

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79
Q

how to differentiate dilutional anaemia of pregnancy from iron deficiency anaemia

A

dilutional= normal MCV
IDA= microcytic

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80
Q

why are foreign inhaled bodies more likely to be in the right main bronchus than the left

A

the angle the right bronchus makes with the carina is less severe

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81
Q

indications for CT head within an hour in a child

A

do CT within an hour if more than 1 of:
- 3 episodes of vomiting
- amnesia for over 5 mins
- LOC over 5 mins
- abnormal drowsiness
- dangerous mechanism of injury

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82
Q

what to do if a child doesn’t qualify for CT head within an hour

A

observe them for 4 hrs if they have 1 of
- 3 episodes of vomiting
- amnesia for over 5 mins
- LOC over 5 mins
- abnormal drowsiness
- dangerous mechanism of injury

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83
Q

exudative ascites definition

A

> 30 g/L protein

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84
Q

exudative ascites causes

A

malignancy
abdominal TB
pancreatitis

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85
Q

transudate ascites definition

A

protein <30g/L

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86
Q

transudate ascites causes

A

cardiac failure
hypoalbunaemia
liver cirrhosis
myoexedma
renal failure

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87
Q

what ovarian mass is associated with meigs syndrome

A

ovarian fibroma

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88
Q

most common histological subtype of ovarian cancer

A

cystadenocarcinoma

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89
Q

corpus luteum produces what

A

prgesterone

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90
Q

what cyst is most likely to tort and why

A

dermoid
heavy in weight due to hair, teeth etc
usually have a long peduncle so twist anticlockwise

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91
Q

most common presentation of chlamydia

A

asymptomatic

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92
Q

abx for chlamydia in pregnant women

A

azithromycin

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93
Q

after CIN 1 diagnosis how often is follow up done

A

yearly

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94
Q

what diagnostic test should you not perform on an ovarian mass and why not

A

biopsy
it will disseminate the disease, remove the mass as a whole

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95
Q

how is bartholins cyst managed

A

marsupialisation

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96
Q

what class of medications are tranexamic acid and mefanamic acid

A

antifibrinolyitcs

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97
Q

in what patient group should you not discuss mirena IUS/IUD

A

patients who arent sexually active

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98
Q

what class of analgesics should be avoided in pregnancy

A

NSAIDs

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99
Q

NSAID use in pregnancy affects

A

renal agenesis
teratogenic in 1st trimester

100
Q

surgical TOP preferred at what GA

A

> 14 weeks

101
Q

missed miscarriage what do you see on TVUS

A

gestational sac small for dates
no foetal heartbeat

102
Q

VSD presentation

A

6 weeks of age
failure to thrive
systolic murmur at lower left sternal edge

103
Q

VSD close spontaneously in what age

A

<1
>2 unlikely to close

104
Q

patients with VSD at higher risk of what infection

A

infective endocarditis

105
Q

medications for neuroleptic malignant syndrome

A

dantrolene
bromocriptine

106
Q

how quickly does acute dystonia present

A

can present in a few hrs

107
Q

how is imperforate hymen managed

A

incise the membrane

108
Q

mid urethreal tape repair is for

A

stress incontinence

109
Q

sacrcospinous fixation is done for

A

vaginal vault prolapse

110
Q

urethral bulking agent is for

A

stress incontinence

111
Q

burch colposuspension is for

A

stress incontinence

112
Q

sacrocolpexy is for

A

prolapse repair

113
Q

what class of medication is used for urge incontinence

A

parasympathomimetics

114
Q

LMWH dose during pregnancy

A

BD 1mg/kg

115
Q

stop LMWH injections in pregnancy if

A

feel like going into labour
24hrs before an elective procedure

116
Q

spinal/epidural analgesia can only be given how long after last LMWH injection

A

24hrs

117
Q

protamine sulfate reverses

A

unfractionated heparin

118
Q

continue anticoagulation in pregnancy for

A

at least 3 months total duration
for 6 weeks postpartum

119
Q

risks of evacuation of retained products of conception

A

bleeding
cervical trauma
infection
retained products of conception
uterine perforation
repeat evacuation of retained products needed

120
Q

pph order of steps

A

A-E
call for help
vaginal exam and remove placenta if present
uterine massage
administer syntocinon
inset wide bore cannulae
FBC, groupsave, x match
consider catheterisation

121
Q

what ix is important for pregnant women with suspected diabetes apart from glucose tests

A

obstetric US

122
Q

what does an US help with in suspected diabetes?

A

exclude congenital abnormality
establish foetal growth
assess for polyhydramnios

123
Q

what genetic condition is pyloric stenosis seen in

A

turners syndrome

124
Q

how to differentiate schizoaffective disorder and major depression with psychotic features

A

in schizoaffective there will be evidence of psychosis even when mood is normal

in depression with psychosis the psychosis will only occur during/around the low mood

125
Q

what is reaction formation

A

when a feeling/emotion is repressed by doing the exact opposite eg a homosexual man being outspokenly homophobic

126
Q

what is dissociation

A

when someones personality/identity is drastically changed to avoid a stressor eg a child being abused adopting an aggressive personality

127
Q

what is identification

A

when someone adopts the personality of someone who is more powerful eg a child who was abused becomes abusive as an adult

128
Q

what is splitting

A

when someone sees people/things as either completely good or completely bad

129
Q

what metabolic condition is associated with premature menopause

A

addisons disease

130
Q

surgical procedures of total vault prolapse

A

sacrocolpopexy and sacrospinous fixation

131
Q

what nerve may be damaged as a complication of sacrospinous fixation

A

sciatic

132
Q

what type of hallucinations do you get with cocaine use

A

auditory or tactile

133
Q

o2 sats above what allow salbutamol therapy to be stretched

A

92%

134
Q

pregnancy parvovirus b19 infection complication

A

foetal death

135
Q

when does most plasma volume expansion occur in pregnancy

A

2nd trimester

136
Q

mumps complications

A

epididymo orchitis
pancreatitis
meningitis

137
Q

what 2 methods are used for monitoring in uncomplicated labour

A

CTG
intermittent auscultation

138
Q

causes of early late and variable decelerations

A

early= head compression
late= foetal hypoxia
variable= cord compression

139
Q

normal foetal blood pH

A

> 7.25

140
Q

when is progesterone level not an important ix in infertility

A

when the woman has irregular/absent periods as you cant determine when she has ovulated

141
Q

FSH above what indicates poor ovarian reserve

A

15

142
Q

poor ovarian reserve conceiving options

A

donor egg IVF

143
Q

how does premature ovarian insufficiency affect thyroid

A

causes hypothyroid disease

144
Q

what route is oestrogen not available

A

IM

145
Q

risk of uterine scar rupture in VBAC

A

0.5%

146
Q

grade 3a/3b/3c tear

A

3a= <50% of external anal sphincter
3b=>50% of external anal sphincter
3c=involves internal anal sphincter

147
Q

what 3 things are women with 3/4th degree tears given on disharge

A

physiotherapy
laxatives
analgesia

148
Q

dont give ulipristal on what medication

A

enzyme inducing drugs

149
Q

incomplete miscarriage on ultrasound

A

there will be retained products of conception

150
Q

what oral contraceptive is associated with an increased risk of ectopic pregnancy

A

POP

151
Q

listeria prgenancy abx

A

ampicillin
erythromycin

152
Q

steroids in placenta praevia/low lying placenta given when

A

34-35+6 weeks

152
Q

what type of incident is given medication by wrong route vs wrong dose

A

wrong route= never event
wrong dose= serious incident

153
Q

complication of listeria

A

septic abortion or premature labour and severely infected baby

154
Q

mullerian agenesis is agenesis of

A

the uterus and top 2/3 of the vagina

155
Q

klinefelter karyotype

A

47 XXY

156
Q

HRT reduces risk of what cancer

A

colorectal

157
Q

low libido on HRT what is given

A

testosterone

158
Q

what nerve pain might you get in ovarian cyst torsion

A

medial thigh- obturator nerve

159
Q

rf for ovarian cyst torsion

A

dermoid cyst
polycystic kidneys
IVF (ovarian hyperstimulation)

160
Q

ca125 is useful when

A

post menopausal
due to low sensitivity its not useful in early cancers

161
Q

ca125 physiologically raised when

A

during menstruation, first trimester and post partum

162
Q

how does BMI affect severity of endometriosis

A

low BMI= more severe

163
Q

anaemia in pregnancy screened at

A

booking
28 weeks

164
Q

how does c section affect risk of PPH

A

increases

165
Q

in psych/paeds ACE stands for

A

adverse childhood experiences

166
Q

how is speech affected by autism

A

less words spoken for the age

167
Q

no social smile at what age is concerning

A

3 monthsq

168
Q

when to give combined HRT progesterone last 14 days of every month vs every 3 months

A

3 monthly if their periods are irregular
1 monthly if their periods are regular

169
Q

physiological changes in pregnancy are due to what hormone

A

progesterone

170
Q

how does cardiac output change in pregnancy and why

A

increases
due to increased stroke volume and heart rate

171
Q

increase in what makes pregnant women hypercoagulable

A

fibrinogen and factor 8

172
Q

how does blood pressure change in pregnancy

A

decreases in first trimester then starts to normalise by term

173
Q

how does FRC change in pregnancy

A

decreases so oxygen reserve is less

174
Q

how does minute ventilation change in pregnancy

A

increases due to increased oxygen demand and co2 production

175
Q

if a women is due for a smear during pregnancy it is delayed in

A

3 months post partum

176
Q

schizophrenia diagnostic criteria

A

1 out of: auditory hallucinations, thought interference, passivity, delusional perception

or 2 out of: any other hallucination, negative sx, speech disorder, catatonia

present for 1 month with a decline in function for 6 months

not occuring alongside substance misuse or affective episode

177
Q

whats the most common site of referred pain from the ovaries

A

periumbilical

178
Q

what is ulcer in the ileum associated with

A

meckels diverticulum

179
Q

meckels diverticulum presentation

A

usually asymptomatic
rectal bleeding
inflammation
signs of obstruction

180
Q

in korsakoffs syndrome what type of anemia do you get

A

anterograde

181
Q

what type of cells line the endometrium

A

columnar

182
Q

LH and FSH levels in PCOS

A

LH is high
FSH is normal (might be a bit high)

183
Q

dose of dexamethasone for croup

A

single dose 0.15mg/kg

184
Q

trichomonas vaginalis diagnosis

A

high vaginal swab
wet mount

185
Q

urethrocele is what

A

descent of front part of vagina which is attached to the urethra

186
Q

urethrocele causes what incontinence symptoms

A

stress

187
Q

sacrocolpoplexy is used in what prolapse

A

vaginal vault

188
Q

when is a lump on babies head concerning

A

when it crosses the suture lines

189
Q

how many hrs after peak LH does ovulation occur

A

12

190
Q

dsm v criteria for anorexia nervosa

A

intense fear of getting fat leading to reduced food intake
height/weight <85th percentile for their age

191
Q

ortolani test is to see if what has happened to the hip

A

posterior dislocation

192
Q

what does nitrofurantoin cause near term

A

haemolysis

193
Q

lichen sclerosus treatment after steroids

A

topical tacrolimus

194
Q

reviewing after starting ssri

A

weekly for a month after starting if under 30

195
Q

what is contraindicated when a women is on tamoxifen therapy

A

ssris

196
Q

what hormone do leydig vs sertoli cells respond to

A

leydig=LH
sertoli=FSH

197
Q

1st/2nd/3rd/4th degree prolapse

A

1st= descent of cervix and uterus but doesnt reach introitus
2nd= descent of cervix and uterus but reaches introitus
3rd= descent of cervix and uterus to outside the introitus
4th= cervix, uterus and vaginal wall outside introitus

198
Q

whats the pathology of henloch schonlein purpura

A

deposition of IgA complexes

199
Q

cin 1/2/3 mx

A

cin1= observation and follow up smear in 12 months
cin2/3=lletz

200
Q

if a mother contracts parovirus b19 how is foetal monitoring carried out

A

doppler ultrasound of middle meningeal artery fortnightly

201
Q

pathological baseline rate on ctg

A

<100
>180

202
Q

pathological variability on ctg

A

<5 for >50 mins
>25 for >25 mins

203
Q

pregnant women on LMWH for DVT stop when

A

24 hrs before delivery
then give for 6 more weeks postpartum

204
Q

what are the 2 different prolapses of the posterior vaginal wall and how do you differentiate them

A

rectocele= dre finger insertion will affect the prolapse
enterocele= dre finger insertion will not affect the prolapse

205
Q

what does enterocele involve

A

loops of the small bowel

206
Q

hypothyroidism in pregnancy increases risk of

A

pre eclampsia

207
Q

what is the ROM plus test used for and what is measured

A

to check if membranes have ruptured
looks for IGF-1

208
Q

miscarriages in the first trimester are usually due to

A

genetic abnormality

209
Q

miscarriages in antiphospholipid syndrome usually occur when

A

after first trimester

210
Q

fever pain score

A

used to determine risk of bacterial pharyngitis

<2= unlikely to be bacterial so no abx
2-3= maybe bacterial so deayed abx prescription
4-5= likely bacterial so start abx

211
Q

cxr for meconium aspiration vs RDS

A

meconium aspiration= patchy opacity
RDS= ground glass opacities and air bronchograms

212
Q

chondromalacia patellae presentation

A

pain at the knee
present more when walking up stairs or standing from a seated position

213
Q

osteogenesis imperfect is a mutation in

A

type 1 collagen

214
Q

features of osteogenesis imperfecta

A

repeated fractures
blue tinge to the eye

215
Q

gold standard imaging for cerebral palsy diagnosis

A

MRI head

216
Q

section 18 is for

A

forced return of a patient on leave from their section under section 17

217
Q

section 135 vs 136

A

135= from home
136= from public

218
Q

rapid plasma reagin in syphilis

A

positive

219
Q

first line mx for catatonia

A

benzodiazepine

220
Q

when might you give typical antipsychotics instead of atypical?

A

if someone has metabolic conditions like diabetes, hyperlipidaemia etc

atypicals have metabolic side effects

221
Q

haloperidol what type of antipsychotic

A

typical

222
Q

tricyclics have what side effects

A

anticholinergic:
blurred vision
dry mouth
constipation
tachycardia
delirium
urinary retention

223
Q

antidepressant for someone with a background of heart disease

A

SSRI- sertraline

224
Q

definition of antepartum haemorrhage

A

bleeding after 24 weeks

225
Q

what organism is most commonly involved in puerperal sepsis

A

group a streptococcus/streptococcus pyogenes

226
Q

dont do kleihauer test before what GA

A

20 weeks

227
Q

give anti d within

A

72 hrs of a sensitising event

228
Q

dose of anti d after a sensitising event before 20 weeks ga vs after

A

before 20 weeks= 250 IU
after 20 weeks= 500 IU (plus kleihauer test)

229
Q

nuchal translucency over what is considered elevated

A

9mm

230
Q

how is gestational age estimated at the first ultrasound

A

crown lump length
if its over 84 mm head circumference is used

231
Q

conclusive tests offered is high risk of downs syndrome

A

amniocentesis
chorionic villus sampling

232
Q

SFH low how do you mx

A

book appt to see midwife in 2 weeks
if still low refer for US to see foetal size

233
Q

women with previous gestational diabetes are offered what screening and when

A

OGTT at booking and 24-28 weeks
early self monitoring can also be used

234
Q

category 3 c sections require delivery within

A

24 hrs

235
Q

duchenne vs becker muscular dystrophy presentation/life expectation

A

duchenne- presents earlier, life expectancy 20 yrs
becker- presents later (5-25) yrs, life expectancy 40, its like a milder duchennes

236
Q

what rash is seen in children after a viral infection

A

pityriasis rosea

237
Q

describe pityriasis rosea

A

follows a viral infection
large oval macule
followed by widespread rash around torso

238
Q

what diet may be helpful in crohns

A

polymeric feeds

239
Q

tonic clonic seizures first line anti epileptic

A

sodium valproate

240
Q

wilms tumor presenation

A

firm non tender flank mass
haematuria
hypertension

241
Q

wilms tumor imaging

A

abdominal ultrasound

242
Q

shizophreniform disorder is

A

milder schizophrenia lasting 1-6 months

243
Q

what is used in a care home/hospital to restrict someone

A

deprivation of liberty safeguard

244
Q

what is used outside a care home/hospital to restrict someone

A

the court of protection

245
Q
A

Qbanks (19 decks)

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