30.5.2013(obstetrics,skin) 22 Flashcards Preview

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Flashcards in 30.5.2013(obstetrics,skin) 22 Deck (92)
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0
Q

Time between delivery of umbilicus to delivery of mouth in breech is

A

5-10 min

1
Q

Timing of episiotomy in breech

A

When breech is climbing the perineum

2
Q

Methods of delivery of after coming head

A

Marshall burns
Piper forceps
Mauriceau smellie veit

3
Q

Delivery of extended leg in frank breech

A

Pinnard manoeuvre -popliteal pressure

4
Q

Delivery of breech with extended arms

A

Lovset manoeuvre

5
Q

Reverse mauriceau smellie veit

A

Prague manoeuvre

6
Q

Screening of Gestational diabetes is done at

A

24-28wks

7
Q

Amount of glucose used in glucose challenge test

A

50grams

8
Q

Oral hypoglycaemic without fetal side effects

A

Glyburide

9
Q

Triple drug ART for pregnant women

A

CD4 count< 350 or

Stage 3 and stage 4

10
Q

Most common cardiac complication of gestational diabetes

A

1.VSD

TGA

11
Q

Most specific complication of gestational diabetes

A

Caudal agenesis

12
Q

Most common complication of gestational diabetes

A

CVS

13
Q

During pregnancy HIV transmission occurs mostly during

A

Labor

14
Q

Drug supplied by NACO for preventing HIV transmission to foetus

A

Nevirapine

15
Q

Factors increasing vertical transmission

A
Disease factors:
Maternal viral load
Advanced maternal disease
Seroconversion in pregnancy
Low CD4 count
Obstetric factors:
 Vaginal delivery
  Preterm delivery
 Coexistent STD
 Prolonged rupture of membranes
 Chorioamnionitis
 Low birth weight
Antepartum invasive procedures
Postpartum invasive procedures
16
Q

HIV testing in pregnant women

A

Opt out approach

17
Q

Prevention of vertical transmission

A

Caesarian section

ART

18
Q

Women with infertility.
B/L cornual block on HSG
Next step

A

Confirmation by hysteroscopy and laparoscopy

19
Q

False positive proximal tubal occlusion on HSG

A

Tubal spasm
Amorphous debris
Minimal adhesions
Extensive fibrosis or debris

20
Q

Management in HIV positive mother with no prior ART

A

Single dose nevirapine to mother at onset of labor

Single dose to infant within 72 hours after birth

21
Q

elective CS in HIV

A

All HIV positive women with RNA load> 1000 copies/ml

22
Q

Timing of elective CS in HIV positive women

A

38 wks to lessen chances of premature rupture of membranes

23
Q

Rx of HIV positive pregnant women who don’t meet ART criteria

A
Antepartum zidovudine at 14-34 wks
100mg 5 times a day
IV zidovudine during labor
2mg/kg orally is given to neonate every 6 hours for 6 weeks
Commencing at 8-12hrs after birth
24
Q

Early cord clamping is done in

A

HIV positive mothers

25
Q

Postpartum hemorrhage in HIV positive women

A

Ergometrine is avoided,interaction with Protease and reverse transcriptase inhibitors to cause severe vasoconstriction

Give oxytocin and prostaglandin

26
Q

Disposal of HIV positive placenta

A

10% sodium hypochlorite bleach for 20min

27
Q

Vaccines contraindicated in neonates born to HIV positive women

A

OPV

BCG

28
Q

Surgery is effective in which type of tubal occlusion

A

Distal tubal occlusion

29
Q

Distal tubal occlusion

Sx done

A

Fimbrioplasty

Neosalpingostomy

30
Q

Treatment of choice in prenatal congenital adrenal hyperplasia

A

Dexamethasone

31
Q

Prenatal steroid Rx for neonatal congenital adrenal hyperplasia should start at

A

At the time of first missed menstrual period

32
Q

Type of inhibin more commonly elevated

A

InhibinB

33
Q

Inhibin levels elevated in post menopausal women cause

A

Granulosa cell tumor

Mucinous cystadenocarcinoma

34
Q

CK20 is associated with

A

Adenocarcinoma

35
Q

CK 7 is associated with

A

Ovarian tumor

36
Q

HRT in postmenopausal women is not given for

A

Prevention of CAD

37
Q

Indications of HRT

A

Vaginal dryness
Hot flushes
Prevention of osteoporosis

38
Q

Risk of HRT

A

CAD
stroke
VTE
breast cancer

39
Q

Benefits of HRT

A

Osteoporosis
Ovarian and endometrial cancer
Colorectal cancer
Cognitive function and dementia

40
Q

Prevention of postmenopausal osteoporosis

A

Raloxifen
Bisphosphanates

For Rx only bisphosphonates are used

41
Q

Tumor markers in dysgerminoma

A
Placental alkaline phosphatase
LDH
Rarely
Alpha fetoprotein
hCG
42
Q

Tumor markers positive in embryonal carcinoma

A

AFP

hCG

43
Q

Benign conditions associated with increased CA125

A
Pregnancy
PID
endometriosis
Uterine fibroid
About 1% of normal females
44
Q

Malignant conditions

A
Endometrial Ca
Ca pancreas 
Ca colon
Ca cervix
Ca Fallopian tube
Breast ca
Lung ca
Ovarian epithelial ca
45
Q

Contraindications for forceps

A

Above +2 station

Rotation is more than 45 degrees

46
Q

Presentations for which forceps delivery is applicable

A

Vertex
Face where chin is anterior
After coming head in breach

47
Q

Prerequisites for forceps delivery

A
Delivery must be mechanically feasible
Presentation must be suitable
Head should be engaged and less than 1/5th palpable per abdomen
Cervix must be fully dilated 
Bladder and rectum must be empty
Uterine contractions should be present
Membranes should have ruptured
48
Q

Most common age of atopic dermatitis

A

5-7 yrs

49
Q

Areas affected in infantile atopic dermatitis

A

Face

Extensor aspect

50
Q

Diff between Infantile atopic dermatitis and scabies

A

Palms and soles are involved in scabies

51
Q

Antigen in paraneoplastic Pemphigus

A

Desmoplakin

52
Q

Factors deposited in Pemphigus vulgaris and Bullous pemphigoid

A

IgG

C3

53
Q

Linear BM deposits

A

Bullous pemphigoid
Epidermolysis bullosa acquisita
Bullous SLE

54
Q

Network pattern in IF

A

P.vulgaris
IgA Pemphigus
Paraneoplastic Pemphigus

55
Q

Antigen in epidermolysis Bullous acquisita and Bullous SLE

A

Collagen 7

56
Q

Granular deposit along BM

A

SLE

57
Q

Granular papillary tip deposits along BM

A

Dermatitis herpetiformis

58
Q

Ovoid bodies with ragged fibrin band along BM

A

Lichen planus

59
Q

Peri vascular and basement membrane deposits

A

Porphyria

60
Q

Globular deposits in tip of papillary dermis

A

Amyloid

61
Q

Fibrin deposition is seen in which Bullous lesions

A

Porphyria

Lichen planus

62
Q

Indications of steroids in psoriasis

A

Impetigo herpetiformis

63
Q

Impetigo herpetiformis is associated with

A

Pregnancy

64
Q

Impetigo herpetiformis

A

Pustular psoriasis of pregnancy

65
Q

Sites not involved in impetigo herpetiformis

A

Face
Hands
Feet

66
Q

Topical therapy for psoriasis

A
Emollients
TOPICAL steroids
VitD analogues calcipotriene,calcitriol
Tar
Tazarotene
Calcineurin inhibitors (tacrolimus,pimecrolimus)
Uv light
67
Q

Systemic Rx of psoriasis

A
Methotrexate 
Retinoids
Calcineurin inhibitors
Hydroxy urea
Azathioprine
Paclitaxel
Ethanercept
Infliximab
68
Q

Rx of psoriatic arthritis

A

mild-NSAID

severe-methotrexate

69
Q

Rx of inverse psoriasis

A

Topical steroids alone

Don’t use high potency steroids

70
Q

Rx of guttate psoriasis

A

Streptococcal infection should be treated first

Later uv light

71
Q

Hypoxia on EEG

A

Early hypoxia- excitatory
Late hypoxia- depression

Hypercapnia shows similar changes

72
Q

Effect of hypocarbia on EEG

A

Slowing

73
Q

Monophasic EEG depression seen with which anaesthetic agent

A

Opioid

74
Q

Monophasic EEG excitation is seen with which anaesthetic agent

A

N2O

Ketamine

75
Q

Somatic passivity is a feature of

A

Paranoid schizophrenia

76
Q
Associated with panic disorders are all except
Serotonin
GABA
CCK
glutamate
A

Glutamate

77
Q

Amygdala and panic attacks

A

Reduced activity of Amygdala

78
Q

Panic disorder reduction in size of which brain structure

A

Right Anterior cingulate cortex

79
Q

Neurotransmitters associated with panic disorders

A
Noradrenaline
Endogenous opioids
Serotonin
GABA
CCK
Orexin
80
Q

Panicogens

A
CCK
Yohimbine
Beta carboline
Co2
Sodium bicarbonate
Sodium lactate
Caffeine
162
Q

Type D personalities are at increased risk for

A

CAD

163
Q

Bipolar 1 disorder

A

Atleast one episode of mania

164
Q

Type 2 bipolar disorder

A

Atleast one episode of hypomania and one episode of depression

165
Q

Unipolar mania

A

Type VI

166
Q

Hypomania or mania precipitated by antidepressant drugs

A

Type IV

167
Q

Depressed pts with family history of bipolar illness

A

Type V

168
Q

Cyclothymic disorder

A

Type III

169
Q

Functional somatic disorders

A

Somitization
Chronic fatigue syndrome
IBS

Fibromyalgia is not included

170
Q

Substance elevated in CSF of pts with fibromyalgia

A

Substance P

171
Q

cis atracurium is preferred over atracurium

A

No histamine release,less laudanosine

4times more potent

Longer duration of action

172
Q

Laudanosine causes

A

Seizures
Hypotension
Bradycardia