exam mix Flashcards
(269 cards)
1
Q
RF for GDM
A
Family history Obesity Black ethnicityPrevious GDMPrevious macrosomic baby
2
Q
Screening for GDM
A
Glycosuria Fasting plasma glucose 5.6 OGTT at 2h 7.8
3
Q
GDM plasma glucose >7 management
A
Insulin
4
Q
GDM plasma glucose <7 management
A
- Diet exercise (2 weeks)2. Metformin 3. Add insulin
5
Q
GDM risks
A
MacrosomiaNeonatal hypoglycaemia Traumatic birth Perinatal death
6
Q
Chronic hypertension in pregnancy
A
HTN <20 weeks
7
Q
Gestational hypertension
A
> 20weeks hypertension| NO proteinuria
8
Q
Pre-Eclampsia
A
HTN >20 weeksPROTEINURIA Resolves 6 weeks post partum
9
Q
Urine dipstick proteinuria
A
PCR >30| ACR > 8
10
Q
Pre eclampsia risk factors
A
>40 yo Obesity Multiple pregnancy 1st pregnancyPrevious pre eclampsia
11
Q
Pre eclampsia complications
A
Placental abruption Eclampsia HELLPFoetal growth restriction
12
Q
Pre eclampsia medications
A
LabetalolNifedipineMethyldopa
13
Q
Seizure prevention in pre eclampsia
A
IV magnesium sulphate
14
Q
VTE Management
A
LMWH (enoxaparin)At least 3 monthsAt least 6 weeks post partumAt least until end of pregnancy
15
Q
Which VTE drugs to avoid in pregnancy?
A
Warfarin DOACs (rivaroxaban, apixaban)
16
Q
Obstetric cholestasis
A
No rashItchingAbnormal LFT (raised ALP)
17
Q
Complication of obstetric cholestasis
A
Preterm birth (check weekly LFT)
18
Q
Obstetric cholestasis management
A
Weekly LFT| Urodeoxycholic acid
19
Q
Acute fatty liver of pregnancy symptoms
A
N & VAbdominal painJaundice-always 3rd trimester-
20
Q
HELLP
A
Haemolysis (LDH)Elevated Liver (ALT AST) Low Platelet
21
Q
Placenta praevia management
A
If bleed: Admit Steroids 24-36th weekDelivery (C section)
22
Q
Placental abruption symptoms
A
Severe abdominal painVaginal bleedingTense rigid abdomen
23
Q
Risk factors for placental abruption
A
HypertensionSmokingCocaineMultiple pregnancy
24
Q
Placental abruption management
A
Delivery
25
Placenta praevia - where does placenta attach?
Deep into myometrium
26
1* post partum haemorrhage causes
```4 TsToneTraumaThrombinTissue (retained)```
27
Preventing PPH routine
Prophylactic uterotonics 1st IM Oxytocin2nd IM Syntometrine (if high risk)+ Tranexamic acid
28
IM Syntometrine contraindications
HTN
29
Major PPH management
```Bimanual compression IV oxytocin 5UIV/IM ergometrine 0.5mgOxytocin infusionIM Carboprost 0.25mgSublingual Misoprostol 800ugSurgical / Balloon tamponade```
30
First stage of labour rate
1cm - 2h
31
2nd stage of labour length
Nulliparous: 3hMultiparous: 2h
32
Membrane sweep
Trying detach the membranes from inner cervix - 40+ weeks
33
Induction of labour
```Membrane sweep24h later: prostaglandin pessaryProstaglandin gel/tablet Artificial rupture of membranesSyntocinon```
34
1st stage latent dilatation rate
0-3cm /6h
35
1st stage active length
3-10cm| 1cm/hr
36
Antibodies in haemolytic disease of a newborn
IgG
37
Sensitising events treatment
1st term: 250 u anti-D immunoglobulin2nd: 250 u in 72h of event + Kleihauer test 3rd: 500 u in 72h + Kleihauer test
38
Kleihauer test
Quantifies how much foetal blood is in maternal circulation
39
Hyperemesis gravidarum
>5% weight lossElectolyte disturbance Dehydration PUQE sforę
40
Antiemetics in pregnancy
1) cyclizine, prochlorperazine, promethazine, chlorprimazine| 2) metoclopramide, domperidone, ondasetron
41
Ectopic - expectant management
No pain< 35mmNo heartbeat hCG < 1000
42
Ectopic - Medical management
PAIN< 35mmhCG < 1500 No heart beatIM METHOTREXATE
43
Ectopic - surgical management
PAIN> 35 mmhCG > 5000 Salpingectomy / salpingotomy
44
Threatened miscarriage
HeartbeatPain, bleedingOs closed
45
Inevitable miscarriage
No heartbeatPain, bleedingOs Open
46
Incomplete miscarriage
Retained products of conceptionPain, bleedingOs Open
47
Complete miscarriage
Empty uterus| Closed Os
48
Missed miscarriage
No heartbeat| Asymptomatic
49
Miscarriage Medical management
Vag misoprostol Pain relief Antiemetic
50
Surgical management of miscarriage
Manual vacuum aspirationSurgical management
51
Antiphospholytic syndrome triad
Recurrent miscarriage ThrombocytopeniaVTE
52
Antiphospholipid syndrome screen
Lupus anticoagulant| Anticardioliptin antibodies
53
Medical TOP
Mifepristone Misoprostol+ >22 feticide
54
Surgical TOP <14 w
Vacuum aspiration
55
Surgical TOP 14-24 weeks
Dilation and Evacuation
56
Complete mole
Sperm + empty egg = 46XX
57
Partial mole
2x sperm + egg = 69 XXY
58
Depot - characteristics
Weight gain Slow return to fertility Every 12-14 weeks
59
COCP
Prevents ovulation Makes period lighter Quickly reversible
60
POP
Thickens mucus Irregular period Small window for taking
61
Hormonal coil
Lasts 3-5 y Thins endometrium Lighter, less painful period
62
Copper coil
Work immediately Makes period more heavy5-10 y Sterile inflammation
63
Implant
Prevents ovulation 3 years Irregular period
64
Patch
Weekly 3 weeks, 1 week offSkin sensitivity Similar to COCP
65
Kallman syndrome
- hypogonadotrophic hypogonadism| - reduced or absent sense of smell (anosmia)
66
PCOS
PCOS on USS >12 cysts in 1 ovaryHyperandrogenism Anovulation
67
Estrogen only
-> endometrial cancer
68
HRT
VTESTROKEBREAST CANCER
69
Clomiphene
Stimulates egg release in PCOS to improve fertility| metformin also improves fertility
70
Diagnosis of premature ovarian insufficiency
2x FSH >30| 4-6 weeks apart
71
Ovarian cancer symptoms
Bloating Constipation Urination trouble PM
72
Ovarian cancer diagnosis
CA 125
73
Endometrial cancer diagnosis
TVUSS >4mm suspiciousHysteroscopy biopsy Mx: high dose progesterone
74
Cervical cancer symptoms
Postcoital bleeding| Intermestrual bleeding
75
Cervical cancer diagnosis
HPV 16/18| Check for CIN Cervical Intraepithelial Neoplasia
76
HPV -
Routine screening in 3 years
77
HPV +| Normal CIN
Re test in 1 year
78
HPV +| Abnormal
Invite for colposcopy
79
PID treatment
IM Ceftriaxone STAT 500mgPO Docycycline 100mg BD 14dPO Metronidazole 400mg BD 14d
80
PID management in penicillin allergy
PO Ofloxacin + Metronidazole 14d
81
Urge incontinence management
1) bladder retraining 6w2) oxybutynin, tolterodine3) mirabegron (b3 agonist)4. SNS, botox, PTNS
82
Stress incontinence management
1. Pelvic floor exercise 3 mth| 2. Duloxetine SNRI
83
Syphilis in pregnancy
FGR| Mx IM Benzathine Penicillin
84
VZV in pregnancy
Neonatal varicella - cutaneous scarring, FGR, Limb hypoplasia
85
#NAME?
Cytology Abnormal: colposcopyNormal: 12mth test
86
If +HPV and cytology normal at 12 month follow up
Repeat in 12months
87
If +HPV and cytology abnormal at 12 month follow up
Colposcopy
88
Inadequate sample cytology
1x return in 3 mth| 2x colposcopy
89
<20 w pregnant exposure to VZV
Check varicella antibodies| If negative, IVIG in 10 days
90
<20 w pregnant with VZV
Aciclovir
91
>20 weeks pregnant with VZV
Acyclovir within 24h of rash
92
>20 weeks pregnant with VZV exposure
If not immune: give VZIG or acyclovir 7-14 days post exposure
93
HSV in pregnancy
1-2nd term: acyclovir from 36w3rd term: acyclovir until delivery1st ever episode in 3rd term: C Section
94
HIV in pregnancy
Check viral load 2-4 weeksAnd at 36w Vaginal if <50 at 36w
95
C section in HIV pregnancy
```IV zidovudine (+ART to everyone as usual) Avoid breastfeeding```
96
Hep B in pregnancy
Vax + HBIG in 12h| Vax at 1 month, 6 months
97
Core symptoms of depression
Low moodAnhedonia (usual things don’t bring happiness)Lack of energy- for at least 2 weeks
98
Beck’s triad
HopelessWorthlessHelpless
99
High risk of suicide
```Anticipation actsPreventing discoveryCareful planningSuicide noteViolent method```
100
GAD Mx
GAD must be >6mthHigh dose SSRIBenzodiazepines
101
OCD management
Exposure and Response PreventionOr SSRI or after 12 weeks, Clomipramine, or alt SSRI
102
Schizophrenia triad
Auditory hallucinationsAbnormal thoughtsDelusions
103
Auditory hallucinations
Thought echo3rd person voice Running commentary
104
Abnormal thoughts
Thought insertion / withdrawal / broadcasting
105
Delusions
False fixed belief held despite evidence
106
Paranoid schizophrenia
Delusions and hallucinations
107
Hebephrenic schizophrenia
Disorganised mood, inappropriate, childlish
108
Catatonic schizophrenia
Psychomotor disturbance| Stupor, rigidity, flexibility
109
Simple schizophrenia
Only negative symptoms: social withdrawal, blunted affect
110
Typical antipsychotics SEs
Acute dystopia Tardive dyskinesiaAkathisiaParkinsonism
111
Typical antipsychotics examples
Haloperidol| Chlorpromazine
112
Treatment resistant schizophrenia
2 drugs failure At least 6 weeks At least 1 atypical
113
Treatment resistant schizophrenia drug & SEs
Clozapine| __AGRANULOCYTOSIS
114
Personality disorder treatments
Dialectical behavioural therapy| SSRI, antipsychotic
115
Capacity assessment
Understand / retain / weigh/ communicate
116
Section 135
Police enters premises with social worker warrant, move to a płace of safety for 72h
117
Section 136
Police removes from public space, no warrant, 24h
118
Section 2
Assessment and treatment 28days Can’t be renewed2 drs (GP, AMHP) and social worker
119
Section 3
Treatment order 6m 2 doctorsSocial worker needs relative approval (can disagree)
120
Section 4
Assessment in emergency72h1 AMPH
121
Section 5.2
Detention of inpatient for 72h| By doctor
122
section 5.4
Detention of inpatient by nurse for 6h
123
HAD
Hospital anxiety and depression
124
PHQ9
Patient health questionnaire (screening, diagnosing, severity of depression)
125
Social anxiety disorder
Fear of being critisized and judged
126
Agoraphobia
Fear of being unable to return to safe place
127
GAD
Symptoms for 6 mth
128
OCD
Exposure and response prevention
129
Positive symptoms (schizophrenia)
DelusionsHallucinationsDisorganised speechCatatonic behaviour
130
Negative symptoms
Blunted affectAlogia - can’t speakAnhedonia - no enjoymentAvolition - lack of motivation
131
Persecutory delusion
Persistent false belief that you are about to be harmed
132
Paranoid delusions
Fear and anxiety and can’t tell what is real and what is not
133
Delusions of reference
Unrelated external world events have significance in patient
134
Type 1 bipolar
Mania + depression
135
Type 2 bipolar
Hypomania + depression
136
Cyclothymic disorder
Hypomanic + depressive most of the time for 2 years
137
Binge eating
>1x week for 3 months| No purging
138
Bulimia
>1x a week for 3 months binge eating with purging
139
SCOFF for eating disorders
```S - make yourself sick C - lost control over eatingO - lost 1 stone in 3 monthsF - believe you are fat? F - food dominates life?```
140
Alcohol units
Litres x %
141
Alcohol withdrawal
Early - agitation sweating nauseaLate 24-48h confusion diarrhoea Seizures peak at 36h48h-72h delirium
142
Wernicke - triad and Mx
Nystagmus/ophthalmolegia, ataxic gait, confusion| Mx Thiamine
143
Korsakov syndrome
Wernickes triad + amnesia, confabulation
144
Paranoid personality disorder
Sensitive to criticism| Suspicion and conspiracy
145
Schizotypical personality disorder
Magical thinking| Odd speech
146
Schizoid personality disorder
Lack of emotionLack of interest in othersNo relationships and friends
147
Antisocial personality disorder
Going against social norms and law| Lying/fighting/ running naked
148
Borderline personality disorder
Unstable relationships Self harmMood swingsSwitching from ideal to devalued
149
Histrionic personality disorder
Needs attention ShallowDramatisingSexually inappropriate
150
Narcissistic personality disorder
Grandiose self importance Takes advantage of others ArrogantNeed for attention
151
Avoidant personality disorder
Fear of criticism or embarrassment| Social isolation but wanting acceptance
152
Dependent personality disorder
Needs to be cared forOther need to take control of their livesDesperate need for relationships
153
Obsessive compulsive personality disorder
Vs OCD- OCPD seek pleasure in tasks Perfectionist Occupied by rules and rituals
154
Serotonin syndrome
Too much serotonin Fever, HYPER reflexes, myoclonus, DILATED PUPILS- HOURS -
155
Neuroleptic malignant syndrome
#NAME?
156
Septal haematoma mx and risk
Incise and drain in 24h-> saddle shaped deformity
157
BPPV| Examination and Mx
Episodic <30s on head movementDix-Hallpike manoeuvreEpley manouvre
158
Otitis externa
Accitic acid| Fusidic acid
159
Otitis media
Amoxicillin
160
Cystic hygroma
Posterior triangle<2 yoFluctunant
161
Branchial cyst
Anterior triangle Young people & childrenFluctuant Radiating
162
Most common thyroid cancer
Papillary - orphan cells, lymphatic spreadFollicular - >50yo, haematologyMedullary - calcitonin, Men 2a/ 2b
163
Laryngeal cancer
SCCHPV 16, 18Abnormal voice, sore throat, ulceration and cancer
164
Chalezion
Painless eyelid cyst of meibomian gland
165
Hordeolum
Infected cyst of meibomian gland PAINFUL Tx chloramphenicol
166
Blepharitis
Mild bacterial eyelid margin, erythematous and crusty eyelid margins, uncomfortable Tx warm compress, chloramphenicol
167
Viral conjunctivitis cause
Adenovirus
168
Bacterial conjunctivitis
Staph aureus
169
Bacterial keratitis
Staph aureus
170
Viral keratosis
HSVrf: immunosuppressiveDendritic ulcer on fluorescent stain
171
Acanthamoeba
Contact lensesRing infiltrateDisproportional pain
172
Diabetic retinopathy
Gradual vision loss| Micro aneurysm, hard exudate, blot haemorrhage, cotton wool spots
173
Ectopic pregnancy risk
Previous ectopic PID assisted conception Previous pelvic surgery
174
DCML
Ascending| Fine touch, propritocention
175
Nephritic syndrome
```Increased PCR IgA NephropathyPost Strep GlomerulonephritisHaemolytic Ureamic SyndromeHenoch-Schonlein PurpuraSLE```
176
Nephrotic syndrome
Proteinuria, hypoalbuminaemia, oedemaMinimal Change DiseaseFSGSMembranous Glomerulonephritis
177
Tetralogy of fallot
Pulmonary stenosisVSDoverriding aortaRight ventricular hypertrophy
178
Onset of cyanosis in bebos
In days: TGA| in months: TOF
179
TGA Xray
Egg on a string
180
TOF Xray
Boot shaped heart
181
ASD
Ejection systolic murmur| Left sternal edge
182
VSD
Pansystolic murmur| Left sternal edge
183
AVSD
pulmonary hypertension| Down syndrome
184
PDA
machinery murmur below left clavicle| Indamethasin/ Nsaid
185
Anaphylaxis
IM adrenaline 1:10005 min later IM adrenaline 1:1000Adrenaline infusion
186
DKA and dehydration pH
pH > 7.1 = 5% loss| pH < 7.1 = 10% loss
187
Total fluid deficit volume
%deficit x weight x 10 Over 48h
188
Maintenance fluids paediatrics
0-10kg 100mL/kg10-20kg 50mL/kg>20kg 20mL/kg
189
Status epilepticus
IV lorazepam /rectal diazepam, buccal midazolam 10min IV lorazepamPhenytoin infusionGA
190
Generalised seizure mx
Sodium valproate| Lamotrigine
191
Focal seizure mx
Lamotrigine
192
Absence seizure
Ethosuximide
193
ADHD Mx
MethylphenidateLisdexamphetamine-> may impair growth (hight weight ecg)
194
Pyloric stenosis treatment
Ramstedt pylorymyotomy
195
Constipation paeds
Movicol (draw water into intestine)Senna (stimulant laxative, intestine contractions) If impaction: Movicol on 2 week escalation dose + Senna
196
Bulk forming laxative
Fybrogel
197
Osmotic laxative - draws water to intestine
Movicol| Lactulose
198
Stool softener
Glycerol| Docusate
199
Stimulant laxative - augment contractions
Senna| Bisacodyl
200
Intussuception
red currant jelly stoolSausage shaped massDx USS, AXRMx Rectal air insuflation, surgery
201
Jaundice 24h - 14d
Breast milkBruising / traumatic birth RBC breakdown
202
Jaundice <24h
Rhesus incompatibilityABO incompatibilityG6DP deficiencyPyruvate Kinase deficiency
203
Jaundice >14d
Biliary atresiaCongenital hypothyroidismNeonatal hepatitis
204
Transcutaneous bilirubin
Jaundice >24h| Born >35w
205
Serum bilirubin
Jaundice <24h| Born <35w
206
Hearing tests
Otoacoustic test| Adutiroty brainstem response test
207
Meningitis in HIV
Cryptococcus neoformans- india ink stain
208
HIV diarrhoea
Cryptosporidium
209
Fever followed by maculopapular rash
Roseola infantum| HHV6
210
Itchy red papular lesions between toes and fingers
Scabies| Sarcoptes scabies
211
Bilateral malar erythrema
Slapped cheek syndrome / fifth disease| Parvovirus B19
212
Widespread erythrema and tenderness, desquamation
Scalded skin syndrome| Staphylococcus
213
Painful lesions on hands, foot, month
Coxsackie virus
214
Erythrematous pustules with yellow crust
Impetigo| Staph aureus
215
Blueberry muffin rush
Rubella
216
Cancer that metastasises to bone
```BLT Kocher PickleBreastLungThyroidKidneyProstate```
217
Homonymous hemianopia - congruous defect
Optic radiation or occipital cortex
218
Homonymous hemianopia - incongruous defect
Optic tract
219
Homonymous hemianopia - macula sparing
Occiptial cortex
220
PPROM sign
Pooling of water in posterior vault| Do FIBRONECTIN test
221
Praeder Willi
```Eating everything OverweightShort statureHypotoniaDelay```
222
Eosinophilic granulomatosis with polyangitis
AsthmaBilateral nasal polypsNasal obstruction
223
Painless red eye in autoimmune conditions
Episcleritis
224
Painful red eye in ankylosing spondylitis
Anterior uveitis
225
Ewing sarcoma
MRI large mass with necrosis| Small blue round cells on E&H
226
Frontal lobe seizure
Jacksonian movement
227
Limited systemic sclerosis ab
Anti centromere
228
Doffuse systemic sclerosis ab
Anti scl 70
229
Brocas area
EXPRESSIVE
230
Wernickes area
Receptive
231
Turner syndrome Heart problem
1st Bicuspid valve| 2nd is coarctation of aorta
232
Hearing tests in newborn
Evoked otoacoustic emission| Automated auditory brainstem resoinse
233
NEC
Ceftriaxone and Vancomycin
234
Neonatal jaundice bilirubin check
Serum bilirubin in jaundice >24h and born <35 weeksTranscutaneous bilirubin in jaundice >24h and >35 weeks
235
Bebo sepsis abx and cause
Benzyloenicillin + gentamycin<72h leisteria monocytogenes, GBS>72h staphylococcus epidermis
236
Neonatal meningitis tx
Penicillin + cegtriaxone/cefotaxime
237
GBS
Mother; benzylpenicillin| Bebo: benzylpenicillin + gentamycin/ceftriaxone
238
Hep B treatment
Tenifovir
239
Threadworms tx
Mebendazole
240
Drug for induction of ovulation
Clomiphene
241
When is anaemia checked in pregnancy?
Booking and 28w
242
Hb levels in pregnancy
1st 1102nd 105 3rd 100
243
Ovarian cancer risk factors
many ovulationsEarly menarcheLate menopauseNullparity
244
Endometrial cancer
```Many ovulations ObesityEarly menarcheLate menopauseNullparity```
245
DCML
ascending| Fine touch and proprioception
246
Corticospinal
Descending| Motor
247
Spinothalamic
Ascending| Pain and temperature
248
TIA onset <1w
Refer same day| 300mg aspirin
249
TIA onset >1w
1 week wait referral| 300mg aspirin
250
TIA pharmacotherapy
300 mg aspirin for 14 days| 75mg aspirin + clopidogrel + statin later
251
Bell’s palsy
HSV1
252
Ramsey Hunt Syndrome
HZV
253
Post seizure management
2ww Neurology6m No driving & DVLA notification if idiopathic12 m if diagnosis or abnormality
254
Focal seizure
Carbamazepine| Lamotrigine
255
Generalised seizure
Sodium valproate| Lamotrigine
256
Absence seizure
Ethosuxamide
257
Subarachnoid haemorrhage
Berry aneurysm
258
Extradural haemorrhage
Trauma to pterion| Convex not crossing sutures
259
Subdural haemorrhage
ConcaveCrossing suturesBridging veins
260
Syphilis
```Painless ulcers1* chancre2* condylomata lata 3* gummatous lesions Tx IM benzylphenicillin```
261
Genital herpes
Flu-like symptoms dysuria fever PAINFUL ulcersHSV 1 oralHSV 2 genitalMx: Acyclovir
262
Genital warts HPV strain
6,11
263
Genital warts tx
Multiple - topical podophyllum| Single - cryotherapy
264
HPV cancer
16, 18, 33 - cervical cancer
265
Alzheimer mx
Mild-Moderate: donezepil, gantamine, rivastigmine| Severe: memantine
266
Dobezepil SE
Do not give in bradycardia| Causes insomnia and weight gain
267
SLE Derm involvement
Oral ulcers
268
Glioblastoma multiformae
Young personSpace occupying lesionCrosses midline
269
Prosthesis septic arthritis
Staph epidermidis
