10/06 and 11/06 Flashcards
suspected aortic dissection invx
CT chest abdo pelvis
bishop score <= 6
vaginal prostaglandins or oral misoprostol
if prev section or higher risk of hyperstimulation -> mechanical methods eg balloon catheter
bishop score >6
amniotomy and IV oxytocin infusion
expectant mx of an ectopic
1) An unruptured embryo
2) <35mm in size
3) Have no heartbeat
4) Be asymptomatic
5) Have a B-hCG level of <1,000IU/L and declining
when can trial of diet and exercise be offered in GDM
fasting glucose <7
secondary dysmenorrhea mx
refer to gynae
which anticoagulants are contraindicated in preg
NOACs and warfarin -> switch to LMWH
what increases risk of ovarian cancer
more hormone exposure eg early menarche, late meno, nulliparity
RF for placental abruption
A for Abruption previously;
B for Blood pressure (i.e. hypertension or pre-eclampsia);
R for Ruptured membranes, either premature or prolonged;
U for Uterine injury (i.e. trauma to the abdomen);
P for Polyhydramnios;
T for Twins or multiple gestation;
I for Infection in the uterus, especially chorioamnionitis;
O for Older age (i.e. aged over 35 years old);
N for Narcotic use (i.e. cocaine and amphetamines, as well as smoking)
when can hormonal contraception be taken after emergency contraception
levonelle -> straight away
ullipristal -> 5 days (breast feeding also delayed 1 week)
delivery in intrahepatic cholestasis of labour
increased risk of stillbirth so IOL at 37-38 wks
when can IUS/IUD be inserted after birth
within 48 hours or after 4 weeks
chalmydia tx where compliance concern
azithromycin 1g orally single dose then 500mg orally for 2 days
pansytolic murmur
ventricular septal defect
mesenteric ischaemia tx
laparotomy
right sided heart failure
pulmonary stenosis = systolic murmur in 2nd intercostal space left sternal edge
JVP, ankle oedema and hepatomegaly
which statin cannot be prescribed with amlodipine
simvastatin
which statin is better/higher intensity
atorvastatin
what suggests idiopathic parkinsons
asymmetrical symptoms
what needs to be checked before starting azathiprine tx
TPMT activity
which analgesics cause hyperkalaemia
saids
mx of pyloric stenosis (olive shaped mass)
Ramstedt pyloromyotomy
mx of bronchiolitis
supportive
mx of croup
single dose oral dex or pred
plummer vinson syndrome
Plummers DIE: Dysphagia, Iron deficiency anemia, Esophageal webs
an arhythmia and signs of decompensation eg hypotension, heart failure
DC cardioversion
first line primary dysmenorrhea
NSAIDs eg mefanemic acid
charcots triad of ascending cholangitis
RUQ pain
jaundice
fever
Acute heart failure not responding to treatment
CPAP
flashers and floaters
vitreous detachment which can lead to retinal detachment
somatisation disorder
multiple physical SYMPTOMS present for at least 2 years
patient refuses to accept reassurance or negative test results
illness anxiety disorder (hypochondriasis)
persistent belief in the presence of an underlying serious DISEASE, e.g. cancer
patient again refuses to accept reassurance or negative test results
conversion disorder
typically involves loss of motor or sensory function
the patient doesn’t consciously feign the symptoms or seek material gain
dissociative disorder
dissociation is a process of ‘separating off’ certain memories from normal consciousness
in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor
facticious disorder
also known as Munchausen’s syndrome
the intentional production of physical or psychological symptoms
malingering
fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain
inguinal hernia in infants
urgent surgery as high risk of strangulation
Wernicke’s encephalopathy features
CAN OPEN
confusion
ataxia
nystagmus
ophthalmoplegia
peripheral neuropathy
symptomatic bradycardia, atropine fails
external pacing
why does raised ICP cause a third nerve palsy (down and out)
transtentorial or uncal herniation
surgery to defunction colon to protect anastomosis
loop ileostomy
