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Progress Tests > WCF > Flashcards

WCF Flashcards

1
Q

What medications can be given to a preterm baby promote PDA closure?

A

Ibuprofen or indomethacin

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2
Q

PDA management

A 
Ibuprofen or indomethacin if preterm to close the PDA.
If asymptomatic watch and wait until 1 year.
Surgical closure (open or endovascular) if symptomatic or not closed at 1 year.
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3
Q

Biliary atresia management

A

Kasai procedure at 45-60 days (uses some small bowel to join to liver)
Most children then need transplant

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4
Q

Necrotising enterocolitis symptoms

A

bilious vomiting, intolerance to feeds, a distended tender abdomen with absent bowel sound and blood in the stools

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5
Q

Necrotising enterocolitis management

A

Initial management is to stop oral feeds and give IV fluids, nutrition and antibiotics. An NG tube can drain gas from the abdomen. Often emergency surgery is needed to remove necrotic bowel.

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6
Q

Necrotising enterocolitis complications

A

Complications include perforation, peritonitis, strictures, sepsis or abscesses. Complications of surgery include stomas and short bowel syndrome

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7
Q

Congenital varicella syndrome symptoms

A

growth restriction, scars, microcephaly, learning difficulty, eye problems or limb defect

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8
Q

Congenital CMV symtpoms

A

growth restriction, vision and hearing loss, learning difficulty or microcephaly

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9
Q

Congenital rubella symptoms

A

cataracts, heart disease, hearing problems and learning disability

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10
Q

Congenital toxoplasmosis symptoms

A

hydrocephalus, intracranial calcification, and chorioretinitis

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11
Q

Congenital Zika symptoms

A

growth restriction and microcephaly

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12
Q

What is caput succedaneum?

A

fluid collects on the scalp due to prolonged pressure

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13
Q

What is cephalohaematoma?

A

blood between the skull and periosteum due to blood vessel damage

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14
Q

What causes Erb’s palsy?

A

Brachial plexus injury

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15
Q

Risk factor for facial nerve paralysis birth injury

A

Forceps

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16
Q

Risk factor for Erb’s palsy birth injury

A

Shoulder dystocia

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17
Q

Fractured clavicle birth injury investigation

A

X-ray or USS

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18
Q

Cephalohematoma prognosis

A

Usually heals within a few months

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19
Q

Cephalohematoma complications

A

Anaemia and jaundice (as blood is broken down)

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20
Q

facial nerve paralysis birth injury prognosis

A

Resolves in a few months

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21
Q

Erb’s palsy birth injury prognosis

A

Resolves in a few months

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22
Q

Mild croup treatment

A

Single dose oral dexamethasone then supportive care

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23
Q

Severe croup treatment

A

Nebulised adrenaline and supportive care

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24
Q

Epiglottitis causative organism

A

HiB

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25
Q

Whooping cough management

A

Abx if presenting in first 3 weeks
Off school until 5 days abx and good hygiene
Supportive care

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26
Q

Glandular fever complications

A

splenic damage (may cause hypochondriac pain and usually resolves in a few weeks), hepatic inflammation (may cause jaundice but usually resolves in a few weeks), post-viral fatigue and depression

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27
Q

Glandular fever patient advice

A

Rest
Avoid alcohol
Avoid contact sports
Avoid kissing / sharing cups etc

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28
Q

Who should have acyclovir with chicken pox?

A

children presenting within 24 hours, neonates, adolescents, pregnant women, immunocompromised individuals and adults or children with a chronic health condition
Immunocompromised contacts

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29
Q

Roseola infantum symptoms

A

sudden onset high fever for 3-5 days with flu-like symptoms. This usually settles as a non-itchy rash develops on the chest or abdomen and spreads to the arms, face and neck

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30
Q

Roseola infantum treatment

A

Supportive

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31
Q

Age of Kawasaki disease

A

Under 5

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32
Q

De Quervain’s tenosynovitis symptoms

A

pain on the radial side of the wrist
tenderness over the radial styloid process
abduction of the thumb against resistance is painful

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33
Q

De Quervain’s tenosynovitis management

A

analgesia
steroid injection
immobilisation with a thumb splint (spica) may be effective
surgical treatment is sometimes required

34
Q

Impetigo management

A

Topical abx first line
Oral abx if severe
Stay off school until lesions crusted or 48hrs abx

35
Q

ITP advice

A

avoiding contact sports, injections and NSAIDs and advice on management of nosebleeds and seeking help after injuries that may cause internal bleeding.

36
Q

Severe ITP treatment

A

with steroids, IVIG, or blood or platelet transfusion (short term cure)

37
Q

Wilms tumour management

A

Management is nephrectomy surgery. Adjuvant chemotherapy or radiotherapy may be indicated

38
Q

What is minor APH?

A

<50mls

39
Q

What is major APH?

A

50-1000mls

40
Q

What is severe APH?

A

> 1000mls or shock

41
Q

What is minor PPH?

A

500-1000mls

42
Q

What is major PPH?

A

1000-2000mls

43
Q

What is severe PPH?

A

> 2000mls

44
Q

Investigation of secondary PPH

A

High vaginal swab for infection

USS for retained products

45
Q

Pre-eclampsia investigations

A 
BP
Urinalysis and protein: creatinine ratio
Bloods (look for HELLP syndrome)
USS at diagnosis
CTG at diagnosis
46
Q

Pre-eclampsia monitoring

A

FBC, U&Es, LFTs twice per week if mild or moderate or three times per week if severe to monitor for organ damage. A USS should be done every other week

47
Q

Medication given to reduce chance of seizures during birth in pre-eclampsia

A

Mg sulphate (in labour and 24 hours after birth)

48
Q

Drug that can be used to reduce contractions in premature labour to delay it and allow time for steroids for the baby’s lungs

A

Nifedipine

49
Q

What is given to mothers in labour with preterm baby

A 
Steroids (for lungs)
Mg sulphate (for neuroprotection)
50
Q

Pre-labour rupture of membranes investigation

A

Often no investigation is needed for diagnosis. If diagnosis is unclear, USS may look for reduced amniotic fluid or vaginal fluid can be tested for insulin-like growth factor binding protein 1 (IGFBP1) or placental alpha-microglobulin-1 (PAMG1). A high vaginal swab for group B strep or other infection should be done

51
Q

Advice to women after premature rupture of membranes

A

Avoid sex

Prophylactic erythromycin

52
Q

Management of premature rupture of membranes under 34 weeks

A

Aim to increase gestation to 34 weeks

Steroids and Mg sulphate

53
Q

Management of premature rupture of membranes over 34 weeks

A

Induction of labour. Steroids if under 36 weeks

54
Q

Additional monitoring in gestational diabetes

A

Additional growth scans at 28, 32 and 36 weeks

55
Q

When should delivery be planned in gestational diabetes?

A

37-38 weeks if medication controlled. By 41 weeks if diet controlled

56
Q

Monitoring after delivery in mothers with gestational diabetes

A

OGTT at 6-12 weeks after birth then yearly

57
Q

Additional monitoring in multiple pregnancy

A

Additional growth scans form 20 weeks (2-weekly if one placenta, 4-weekly if 2 placentas) and FBC at 20 and 28 weeks

58
Q

Management of monoamniotic twins

A

C-section 32-34 weeks

59
Q

Management of diamniotic twins

A

Vaginal / C-section 36-38 weeks

60
Q

Vulval cancer main investigation

A

Punch biopsy

61
Q

Lichen sclerosus main investigation

A

Punch biopsy

62
Q

What other conditions are lichen sclerosus associated with?

A

Autoimmune (may screen for these)

63
Q

Lichen sclerosus treatment

A

Education and advice e.g. avoid scratching
Steroids (long course topical or injected)
Second line is other immunosuppressants
Surgery on complications

64
Q

Lichen sclerosus follow-up

A

Yearly follow up to assess for malignancy

65
Q

Menorrhagia treatment

A 
Education and iron if anaemic
IUS first line
TXA or mefenamic acid second line
COCP
Long acting progestogens
Treat underlying cause
66
Q

Medication to induce ovulation

A

Clomifene

67
Q

First line investigation in endometriosis

A

TV USS

68
Q

Endometriosis treatment

A

NSAIDS / paracetamol first line
Hormonal contraception second line
Laparoscopy and ablation third line

69
Q

What is rectocele?

A

when the rectum prolapses into the posterior vagina

70
Q

What is cystocele?

A

when the bladder prolapses into the anterior vagina

71
Q

Chlamydia treatment

A

single dose of azithromycin or 7 days of doxycycline

72
Q

Chlamydia repeat testing

A

Repeat in 3-6 months if under 25

73
Q

Gonorrhoea repeat testing

A

Repeat for everyone

74
Q

Syphilis treatment

A

Penicillin

Dose depends on stage e.g. if primary 1 dose IM. If tertiary 1 dose IM for 3 weeks. If neuro IV

75
Q

Treatment prior to penicillin in syphilis

A

3 days steroids if tertiary as high risk of Jarisch-Herzheimer reaction

76
Q

BV treatment

A

None if asymptomatic

Metronidazole (single high dose or 7 days lower dose or topical)

77
Q

Trichomoniasis symptoms

A

asymptomatic in up to 50% of patients
smelly frothy green/yellow discharge
Other symptoms in women include vulval itching and soreness and dysuria
Other symptoms in men include urethral discharge and irritation and dysuria

78
Q

Trichomoniasis treatment

A

Metronidazole (single IM dose or 7 days oral)

79
Q

When to abstain from sex in herpes

A

Prodrome or infection

80
Q

Genital herpes complications

A

bacterial superinfection, infection of other body areas, autonomic neuropathy (can lead to urine retention), meningitis, encephalitis, pneumonia, oesophagitis and hepatitis

81
Q

Genital thrush investigation

A

None needed for diagnosis
May do whiff tests / pH to exclude differentials
STI screen recommended
HbA1c if recurrent

82
Q

Genital thrush treatment

A

Uncomplicated - clotrimazole cream or pessary

Complicated - oral fluclonazole

Progress Tests (17 decks)

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