w/c 29/04 Flashcards
how does memory loss in alzheimers present specifically?
trouble with short term memory but long term memory intact
what haemorrhage is likely to occur in a newborn due to birth trauma
intraventricular ie subdural and subarachnoid
what should you rule out when suspecting incontinence and how?
UTI and DM
with urinalysis
whats normal vaginal pH?
4.0-4.5
what BG should a neonate be treated even if asymptomatic?
<1mmol/L -this is classified as very low blood glucose
start on IV 10% dextrose
what on bishop score scores 2
effacement= 60-70%
consistency= soft
dilation= 3-4cm
position= anterior
station=0
what usually happens to Hb and platelets in physiological pregnancy?
decrease
often dilutional
what usually happens to urine in physiological pregnancy?
increased protein loss
increased serum urea and creatinine
what LFT is most raised in biliary atresia?
GGT
what type of bilirubin is raised in biliary atresia?
conjugated
what abx is given for BV
oral metronidazole
what abx is given for trichomonas
oral metronidazole
what type of bacteria is gonorrhoea
gram neg diplococcus
what is done next if foetal heartbeat cant be found with handheld doppler
US
what are the rules for late changing of the patch?
at end of week 1 or 2= if under 48 hrs change immediately and no further action, if over 48 hrs barrier contraception for 7 days and emergency contraception if had sex
at end of week 3= remove and apply new patch as normal
at end of week 4 late patch application= barrier contraception for 7 days then as normal
how do you differentiate between infantile spasms and colic?
infantile spasms= child is distressed between spasms
colic= child is distressed during spasms
what are causes of post coital bleeding?
cervical ectropion
cervical polyps
cervical neoplasia
vaginal atrophy
how do you remember difference between gastroschisis and omphalocele
omphalocele= sealed in peritoneal sac
what genetic condition is associated with large head but small limbs
achondroplasia
what causes achondroplasia
activation of FGFR3 (fibroblast growth receptor 3)
in alcoholic dependance when are antidepressants considered?
after a month of sobriety
what therapy is first line for alcohol dependance?
group
what is karyoptype 46XY
androgen insensitivity syndrome
whats true incontinence
incontinence all the time associated with a fistula between the ureter and vagina
whats functional incontinence
incontinence associated with not being able to get to the toilet in time due to physical barriers/environment
what are the 2 causes of urge incontinence
detrusor activity dysfunction
overactive bladder
what age does the MCA apply for
over 16
if under 16 use gillick competence to assess capacity
how many principles are there in the MCA
5
when in the cycle does oestrogen peak
before ovulation
how long can you wait for the placenta to be delivered?
1 hr
what is placenta attached to in accreta/increta/percreta?
accreta= attached to myoterium
increta= invades into myometrium
percreta= invades through perimetrium
how many hrs after UPSI is ellaone and levonrgesteral effective?
ellaone= 120 hrs
levonorgesteral= 72 hrs
what congenital disorder is associated with development of ASD
fragile X
whats the genetic abnormality in fragile x?
trinucleotide repeat on x chromosome
what is a contraindication for lung transplant in those with cystic fibrosis?
chronic infection with bukholderia
when do you refer someone for TVUS for intermittent bleeding on a new contraception?
persists more than 3 months
what is AFP in downs syndrome?
low
how does omphalocele affect AFP
causes high AFP
what age does cervical smear routine screening change from every 3 years to every 5 years
50
how is a formula fed baby with suspected cows milk protein intolerance mx
trial extensively hydrolysed formula
what are top differentials in a child with abdo distention and bilious vomitting
malrotation
volvulus
child with unilateral undescended testes review and surgery when
review 6-8 weeks
review 3 months
if undescended at 3 months, surgery at 6 months
child with bilateral undescended testes review and surgery when
review and surgery within 24 hrs
how long do copper IUDs last
5 or 10 yrs
how is coarctation of the aorta mx
balloon angioplasty with or without stenting
can be treated surgically
test done for gonorrhoea
NAAT
apart from stepwise deterioration how can you identify vascular dementia
early gait disturbance, urinary incontinence, changes in concentration/mood
high risk RF for pre eclampsia
previous pre eclampsia
hypertensive disease
diabetes
autoimmune conditions eg SLE, antiphospholipid syndrome
trichomonas abx
metronidazole 400-500mg BD 7 days
when is aciclovir given for herpes in pregnancy
during in infection
from 36 weeks onwards
what medication for ovulation induction is most assoc with ovarian hyperstimulation syndrome?
gonadotrophin therapy
what features in a child are associated with perthes disease
hyperactvity
short stature
boy aged 5-12
abx for mycoplasma pneumonia in children
macrolide
erythromycin/clarithromycin
what do tocolytics do
reduce uterine contractions
what murmur does anaemia cause
soft systolic
medical conditions that increase the risk of endometrial cancer
diabetes
PCOS
HNPCC/lynch syndrome
how long does capput succedaneum take to heal
few days
abx for pertussis
azithro or clarithro if cough onset within past 21 days
women with diabetes should give birth no later than
40+6 weeks
women with diabetes should be induced at
37-38+6 weeks
risk factors for pavlik harness splinting in DDH
avascular necrosis and femoral nerve palsy
shaken baby syndrome triad
retinopathy
subdural haemorrhage
encephalopathy
rules for when you need contrception if you are menopausal
1 year after cessation of menses if over 50
2 yrs after cessation of menses if under 50
side effects of HRT
nausea
breast tenderness
fluid retention and weight gain
adverse effects of HRT
increased risk of breast cancer (RR 1.26/5)
increased risk of endometrial cancer (not if progesterone is given continuously)
increased risk of VTE (not with transdermal patch)
increased risk of IHD if >10 yrs post menopause
increased risk of stroke
meckels diverticulum age
2
intussecption age
under 9 months
where is atopic eczema usually present in an infant
face and trunk
what ssri is used post MI
sertaline
what are the gonads
ovaries and testes
what conditions come under gonadal dysgenesis
turners syndrome
how to identify toddlers diarrhoea
contains undigested food
what sign on examination is specifically associated with pre eclampsia
brisk tendon reflexes
pregnancy test positive after TOP for how long
4 weeks
below what hb is iron supplementation needed in pregnancy
<110
TVUS findings diagnostic of misscarriage
CRL >7mm
no foetal heartbeat
when can hcg be detected
8 days after fertilisation
what secretes hcg
syncitiotrophoblasts
what is cerazette (deogesterel)
POP
how can you differentiate cows milk protein intolerance from GORD
cows milk protein intolerance with have changes to stool and rashes
