11/6/22 Flashcards
Rash appeared as pink blotches which have since developed into well-defined target-shaped lesions. What is the most likely underlying diagnosis? mx?
Erythema multiforme - hypersenitivity reaction usually to viral infections (eg HSV)
Usually self-limiting
What is miliaria?
Sweat rash caused by
obstruction of the sweat ducts and is common in neonate - presents w clear blisters on head, neck and trunk
What are the indications for admission in bronchiolitis?
Apnoea
O2 sats <92% on air,
<50% of usual fluid intake
Persistent severe respiratory distress
Who is delayed puberty more common in and what is the main cause?
Mainly boys
Caused by hypogonadotrophic due to constitutional delay
Blood test results in:
Hypergonadotrophic hypogonadism
Hypogonadotrophic hypogonadism
Hypergonadotrophic hypogonadism = High FSH + LH
Hypogonadotrophic hypogonadism = Low FSH + LH
What is AIS caused by?
Androgen insensitivity syndrome is caused by end-organ resistance to
testosterone in which genotypically male children have a female phenotype
Influenza vaccine in children:
- Who should get it?
- Any precautions?
Offered to all primary school children, those w/ DM or asthma get it until 18
Check for egg allergy - if mild reaction (hives) administer in primary care, if more serious reaction consider risks of vaccine and if administered do in hospital
What is ‘onion skinning’?
‘Onion skinning’ is a periosteal reaction characterised by the formation of concentric layers of new bone and is suggestive of Ewing sarcoma
(2nd most common childhood malignant bone tumour, 1= osteosarcoma)
What can be found in urine quantification of Wilm’s tumour?
Raised catecholamine metabolite levels (such as homovanillic acid (HVA) and vanillylmandelic acid (VMA))
NB: Biopsy is required for definitive diagnosis + MIBG scan for mets
Mx of confirmed VTE in pregnancy? what to do in labour?
Treatment dose LMWH for remainder of pregnancy + 6w post-partum (minimum 3m total)
Stop all injections when they go into labour, if planned last dose should be at least 24h before
What effect does HRT have on the following? VTE CVD Breast cancer Endometrial cancer Colorectal cancer Ovarian cancer Gallbladder disease Osteoporosis T2DM
VTE - Increased (can use patch if this is an issue)
CVD - None
Breast cancer - Combined increases risk, opt for oestrogen
Endometrial cancer - Oestrogen only increases risk
Colorectal cancer - decreased risk
Ovarian cancer - Unknown
Gallbladder disease - increased risk but might involve other factors
Osteoporosis - decreased
T2DM - none
What do the following findings on CTG mean?
Baseline bradycardia Baseline tachycardia Reduced baseline variability Early deceleration Late deceleration Variable deceleration
Baseline bradycardia:
Cord prolapse, epidural / spinal anaesthesia, rapid foetal descent
Baseline tachycardia:
Maternal pyrexia, hypoxia, prematurity
Reduced baseline
variability:
Hypoxia, prematurity
Early deceleration:
Usually a benign feature caused by head compression during descent
Late deceleration: Foetal distress (e.g. asphyxia)
Variable deceleration:
Sometimes due to cord compression
What is the order of IoL sequence?
- Membrane sweep
- Vaginal PE2
- Mechanical induction (CRB - cervical ripening balloon) - reduces risk of UHSS
- ARM (Amniotomy)
- IV Syntocinon
Major PPH mx?
ABCDE approach (flat, 2x large bore cannulae, bloods, transfusion ASAP)
- IV/IM syntocinon or IM ergometrine or syntometrine (last 2 are contraindicated
in asthma and HTN) - IM carboprost (not in asthmatics)
- Intrauterine balloon tamponade i.e. Bakri balloon.
- Other surgical measures (e.g. iliac artery ligation, uterine artery embolization
IR, hysterectomy)
Why is marsupialisation preferred over incision+drainage in mx of bartholins cyst?
Reduces the risk of reforming the cyst as the pouch created allows any fluid to drain without reforming a cyst
