Flashcards in Pad notes for First Two Rotations Deck (121)
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