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9 Flashcards

1
Q

what does naltrexone do

A

opiod antagonist-prevents euphoria in former addicts to prevent relapse

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2
Q

what is the treatment for opiod detoxification

A

a2 adrenergic agonists eg LOFEXIDINE

or can use opiod subsititue therapies-OST eg methadone or Buprenorphine

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3
Q

what is buprenorphine

A

synthetic partial agonist at u-opiod receptors

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4
Q

what does HCS do

A

produced form week 5 of pregnancy
GH like effects
decrease insulin sensitivity in mother-more glucose for fetus
involved in breast development

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5
Q

what are the side effects of carbamazepine

A

SIADH, leucopenia, ataxia, blurred vision, drowsiness, diplopia and can cause agranulocytosis

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6
Q

what are the side effects of carbamazepine in pregnancy

A

Neural tube defects, facial dysmorphism, cardiac anomalies, fingernail hypoplasia, VIT K DEFICIENCY

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7
Q

what is Uhthoff’s phenomenon

A

worsening of vision following increase in body temperature in MS

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8
Q

what is Lhermitte’s phenomene

A

paraesthesia in limbs on neck flexion

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9
Q

if get nausea with parkinsons medication what should you use to treat

A

DOMPERIDONE

nb metoclopramide can worsen PD, cyclizine and prochlo

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10
Q

what is mefenamic acid

A

NSAID-avoid in pregnanacy

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11
Q

in antipsychotics why do you get sedation

A

secondary to the blockage of histamine

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12
Q

what are accelerations in CTG

A

abrupt increase in BHR for >15bpm for >15s

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13
Q

how can you treat hypersalivation caused by clozapine

A

HYOSCINE

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14
Q

what is treatment for mastitis

A

flucloxacillin

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15
Q

what is breast thrush treatment

A

miconazole

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16
Q

if long term treatment with carbamazepine, phenytoin, sodium valproate what vitamin supplementation is needed

A

vitamin D

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17
Q

can you breast feed if on AEDs

A

yes and should be encouraged to help with withdrawl if they were continued in pregnancy

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18
Q

why do you need to stay in hospital for 24 hours if history of epilepsy

A

greatest risk of seizures in first 24 hours

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19
Q

diagnosis of gestational diabetes

A

fasting >5.6mmol 2hr random or after 75g oral glucose tolerance test >7.8

20
Q

can you use NSAIDs in pregnancy

A

no they should be avoided as thought to be a link with miscarriage, paracetamol should be used instead

21
Q

what is Charcot Marie-Tooth syndrome

A

type of hereditary sensorimotor peripheral neuropathy
no UMN signs
can present with LMN in all limbs and decrease sensation
high stepping gait, wasting of lower legs and high arches

22
Q

which TCA antidepressants are most dangerous in overdose

A

amitryptylline and dosulepin

23
Q

most sedative TCas

A

amitrypylline, clomipramine and dosulepin

24
Q

what is the denticulate made of

A

arachnoid and pia tissue

25
Q

what are the types of longitudinal artery

A

1 anterior and 2 posterior

26
Q

what is todds paralysis

A

prolonged weakness after a seizure

27
Q

what is a conus lesion

A

presents as cauda equine-do MRI

28
Q

what is lateral medullary syndrome

A

stoke in posterior inferior cerebellar artery

29
Q

what is another name for lateral medullary syndrome

A

Wallenbergs syndrome

30
Q

what does lateral medullary stroke cause

A

ipsilateral ataxia, nystagmus, dysphagia, facial numbness, CN palsy eg horners
contralateral limb sensory loss

31
Q

what are the 4 types of MS

A

relapsing remitting, primary progressive, secondary progressive, progressive relapsing

32
Q

what is a weber stroke

A

ipsilateral III palsy

contralateral weakness

33
Q

what is great anterior segmental artery also known as

A

ADAMKIEWICZ

this reinforces circulation to inferior 2/3 of spinal cord found on LEFT in many individuals

34
Q

what does tectospinal tract do

A

input mostly to cervical segments

thought to mediate reflex head and neck movments due to visual stimuli

35
Q

what does reticulospinal tract do

A

reticular formation forms central core of brainstem
many nuclei and receives input from virtually all parts of CNS
influences voluntary movement

36
Q

what are the risk factors for endometrial cancer

A

early menarche, late menopause, nulliparity, obesity, tamoxifen, PCOS, unopposed oestrogen, diabetes mellitus

37
Q

the COCP has protective effects to which cancers

A

endometrial and ovarian

38
Q

COCP increases risk of

A

breast and cervical cancer

39
Q

what investigation is to be done if there is suspicion of ovarian cancer

A

blood test for CA125 and If this is above 25 urgent ultrasound of abdomen and pelvis

40
Q

treatment for endometrial cancer

A

for localised disease-total abdominal hysterectomy with bilateral salpingo-oophrectomy
patients with high risk disease may also have post operative radio
progestogen therapy sometime used in frail elderly women who are not suitable for surgery

41
Q

whats the first line investigation for ?endometrial cancer

A

transvaginal ultrasound <4mm is a good negative prognostic indicator but if >4mm then do hysteroscopy with endometrial biopsy

42
Q

how does lactation prevent against pregnancy

A

sucking reduces release of gonadotrophins which suppress ovulation and as sucking reduces ovulation returns

43
Q

how effective is lactational amenorrhoea

A

if all 3 criteria fulfilled 98%

44
Q

what are criteria for lactational amenorrhoea

A

less than 6 months postpartum
amenorrhoeic-no vaginal bleeding after 56 days postpartum
fully breast feeding day-at least 4 hrly and 6 hrly night feeds

45
Q

what is decorticate posturing

A 
damage to one or both of the corticospinal tracts 
plantar flexion
extension knees 
internally rotated legs 
flexion elbow, adduction shoulder
46
Q

what is decerebrate posturing

A

damage to the upper brainstem-midbrain/pons
arms adducted and extended
wrists pronated and fingers flexed
legs stiffly extended with plantar flexion of feet

47
Q

side effects for carbamazepine

A

SIADH, leucopenia, ataxia, blurred vision, drowsiness, diplopia agranulocytosis

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