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How long do you have to wait after C-section before you can get pregnant again and why?

1 year because you have to wait for the womb to heal


How to manage a C-section scar

Massage it after shower to avoid fibrosis of the scar and it being pulled inwards - to get a thin and white scar


Insertion of IUD after birth

Can't insert IUD before 3 months after birth because womb is not back to its normal size and it will be expulsed


Risk factors for late miscarriage x3

Scars on uterus
Previous late miscarriages
Fibroma or mass in uterus


Where is affected with hydra-adenitis?

Groin, armpits, between buttocks, labia, below breasts, on buttocks


What happens with hydra-adenitis?

Abscesses, swelling, pain and boils


Treatment of hydra-adenitis?

Infliximab treatment, 4-weekly infusions


What vitamin are all babies given and why?

All babies are given vitamin K because they don't have vitamin K stores
Therefore give any child with prolonged clotting extra vitamin K, check 6 hours later and liver should have had time to synthesise vitamin K


What sort of milk do children with chronic liver disease get?

Milk with MCT's (medium chain triglycerides) in it because they are water soluble therefore more easily absorbable


What is galactosemia?

Rare genetic disorder that affects an individuals ability to metabolise galactose leading to toxic levels of galactose-1-phosphate


Symptoms of galactosemia?

Galactosemia leads to hepatomegaly, cirrhosis, renal failure, cataracts, vomiting, seizure, hypoglycaemia, lethargy, brain damage and ovarian failure


Management of galactosemia

Stop breast milk to cure


Why is EBV bad in immunosuppressed patients and what happens pathologically?

Because T cells are low when immunosuppressed therefore get EBV B cells and these colonially expand because there are no T cells stopping them - therefore get lymphadenopathy from B cell proliferation


What is Sandifer syndrome?

Syndrome of gastro-oesophageal reflux and neurological symptoms


Symptoms of Sandifer syndrome?

Spasmodic torticolis and dystonia and gastro symptoms


Treatment of Sandifer syndrome

Treatment of associated underlying disease eg. GORD or hiatus hernia


What do you worry about with seizures in a child

Neurological problem - eg. neuro migrational disorder etc. always do MRI
Infection - eg.meningitis
Cardiac - look for cardiac SVT - floppy, sweaty and pale
Metabolic - check glucose, lactate, ammonia, amino acids, u&e's, cardinitine


What do you query if child is not moving arm in first few months

Surgical trauma eg. clavicle fracture most common


When are febrile convulsions seen?

5/6 months to 5/6 years


Characteristics for febrile convulsions x5

Temperature just needs to be high
Need to normalise after seizure
Duration 1 then complex febrile seizures)


Risk of having a second febrile seizure if you have a first

30% risk of another seizure


How do you do neonatal MRI

Feed and wrap or General Anaesthesia


What do you give for status epilepticus in children

Diazepam is not given
Lorazepam if access or rectal


Another name for metopic synostosis and what is it?

Trigonocephaly - premature fusing of the metopic suture causing a triangular shape to the forehead


What does valproate to do lamotrigine?

Valproate increases lamotrigine half-life
All enzyme inducers do this to lamotrigine


What effect can topiramate have on kidney

(Treatment for tonic clonic)
It can cause renal stones


What type of pain do you get with Gall Stones?

Colicky (coming and going) RUQ pain and jaundice


What is Gilberts syndrome

GAL 1 enzyme dysfunction - high bilirubin in blood - can cause jaundice


What is given after splenectomy

Lifelong penicillin because risk of being immunocompromised and risk of pneumococcus infection


Type of wheeze in foreign body obstruction

Unilateral, sudden onset and also red in the face