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WCF Flashcards

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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
Whooping cough management
Abx if presenting in first 3 weeks Off school until 5 days abx and good hygiene Supportive care
26
Glandular fever complications
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
27
Glandular fever patient advice
Rest Avoid alcohol Avoid contact sports Avoid kissing / sharing cups etc
28
Who should have acyclovir with chicken pox?
children presenting within 24 hours, neonates, adolescents, pregnant women, immunocompromised individuals and adults or children with a chronic health condition Immunocompromised contacts
29
Roseola infantum symptoms
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
30
Roseola infantum treatment
Supportive
31
Age of Kawasaki disease
Under 5
32
De Quervain's tenosynovitis symptoms
pain on the radial side of the wrist tenderness over the radial styloid process abduction of the thumb against resistance is painful
33
De Quervain's tenosynovitis management
analgesia steroid injection immobilisation with a thumb splint (spica) may be effective surgical treatment is sometimes required
34
Impetigo management
Topical abx first line Oral abx if severe Stay off school until lesions crusted or 48hrs abx
35
ITP advice
avoiding contact sports, injections and NSAIDs and advice on management of nosebleeds and seeking help after injuries that may cause internal bleeding.
36
Severe ITP treatment
with steroids, IVIG, or blood or platelet transfusion (short term cure)
37
Wilms tumour management
Management is nephrectomy surgery. Adjuvant chemotherapy or radiotherapy may be indicated
38
What is minor APH?
<50mls
39
What is major APH?
50-1000mls
40
What is severe APH?
>1000mls or shock
41
What is minor PPH?
500-1000mls
42
What is major PPH?
1000-2000mls
43
What is severe PPH?
>2000mls
44
Investigation of secondary PPH
High vaginal swab for infection | USS for retained products
45
Pre-eclampsia investigations
``` BP Urinalysis and protein: creatinine ratio Bloods (look for HELLP syndrome) USS at diagnosis CTG at diagnosis ```
46
Pre-eclampsia monitoring
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
Medication given to reduce chance of seizures during birth in pre-eclampsia
Mg sulphate (in labour and 24 hours after birth)
48
Drug that can be used to reduce contractions in premature labour to delay it and allow time for steroids for the baby's lungs
Nifedipine
49
What is given to mothers in labour with preterm baby
``` Steroids (for lungs) Mg sulphate (for neuroprotection) ```
50
Pre-labour rupture of membranes investigation
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
Advice to women after premature rupture of membranes
Avoid sex | Prophylactic erythromycin
52
Management of premature rupture of membranes under 34 weeks
Aim to increase gestation to 34 weeks | Steroids and Mg sulphate
53
Management of premature rupture of membranes over 34 weeks
Induction of labour. Steroids if under 36 weeks
54
Additional monitoring in gestational diabetes
Additional growth scans at 28, 32 and 36 weeks
55
When should delivery be planned in gestational diabetes?
37-38 weeks if medication controlled. By 41 weeks if diet controlled
56
Monitoring after delivery in mothers with gestational diabetes
OGTT at 6-12 weeks after birth then yearly
57
Additional monitoring in multiple pregnancy
Additional growth scans form 20 weeks (2-weekly if one placenta, 4-weekly if 2 placentas) and FBC at 20 and 28 weeks
58
Management of monoamniotic twins
C-section 32-34 weeks
59
Management of diamniotic twins
Vaginal / C-section 36-38 weeks
60
Vulval cancer main investigation
Punch biopsy
61
Lichen sclerosus main investigation
Punch biopsy
62
What other conditions are lichen sclerosus associated with?
Autoimmune (may screen for these)
63
Lichen sclerosus treatment
Education and advice e.g. avoid scratching Steroids (long course topical or injected) Second line is other immunosuppressants Surgery on complications
64
Lichen sclerosus follow-up
Yearly follow up to assess for malignancy
65
Menorrhagia treatment
``` Education and iron if anaemic IUS first line TXA or mefenamic acid second line COCP Long acting progestogens Treat underlying cause ```
66
Medication to induce ovulation
Clomifene
67
First line investigation in endometriosis
TV USS
68
Endometriosis treatment
NSAIDS / paracetamol first line Hormonal contraception second line Laparoscopy and ablation third line
69
What is rectocele?
when the rectum prolapses into the posterior vagina
70
What is cystocele?
when the bladder prolapses into the anterior vagina
71
Chlamydia treatment
single dose of azithromycin or 7 days of doxycycline
72
Chlamydia repeat testing
Repeat in 3-6 months if under 25
73
Gonorrhoea repeat testing
Repeat for everyone
74
Syphilis treatment
Penicillin | Dose depends on stage e.g. if primary 1 dose IM. If tertiary 1 dose IM for 3 weeks. If neuro IV
75
Treatment prior to penicillin in syphilis
3 days steroids if tertiary as high risk of Jarisch-Herzheimer reaction
76
BV treatment
None if asymptomatic | Metronidazole (single high dose or 7 days lower dose or topical)
77
Trichomoniasis symptoms
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
Trichomoniasis treatment
Metronidazole (single IM dose or 7 days oral)
79
When to abstain from sex in herpes
Prodrome or infection
80
Genital herpes complications
bacterial superinfection, infection of other body areas, autonomic neuropathy (can lead to urine retention), meningitis, encephalitis, pneumonia, oesophagitis and hepatitis
81
Genital thrush investigation
None needed for diagnosis May do whiff tests / pH to exclude differentials STI screen recommended HbA1c if recurrent
82
Genital thrush treatment
Uncomplicated - clotrimazole cream or pessary | Complicated - oral fluclonazole

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