Flashcards in Pass Deck (29):
Normal collagen in the palmar fascia
Collagen in dupuytrens contracture?
What is erbs palsy? Which trunks are usually involved?
Paralysis of the arm caused by injuries to the brachial plexus
-particularly damage to C5 and C6 trunks
What is erbs palsy associated with?
Commonly associated with schoulder dystocia during difficult labour
Which nerve is involved in wrist drop and what injuries could cause it?
-Radial nerve palsy
-It can occur in patients with stab wounds in the chest and fractures of the humerus
Examination findings of Charcot Marie Tooth (hereditary sensorimotor polyneuropathy)?
Often have a strong family history
This tract connects the primary motor cortex with the alpha motor neurons in the ventral horn of the spinal cord
Lesions in the corticospinal tract cause UMN or LMN lesions?
(LMN lesions are lesions of the alpha motor neurones, not this tract)
Plexiform neuroma symtpoms?
Mononeuritis multiplex symptoms?
Vagus nerve palsy
Palatal weakness (this causes 'nasal speech')
Loss of reflex contraction of the palate in the gag reflex
Hoarseness of the voice (in a unilateral laryngeal lesion)
Bovine cough (with a bilateral recurrent nerve lesion)
The 4 T's that can cause PPH
Tissue (retained placenta)
Thrombin (coagulation abnormalities)
Most common cause of PPH?
Uterine atony (accounts for 90% of cases)
What defines a PPH?
Blood loss more than 500mls
Which vitamin can be teratogenic in high doses?
Key clinical feature of placenta praevia?
Painless (often bright red) bleeding after 24 weeks
Eclampsia seizure management
IV magnesium sulphate, 4g over 5-10 minutes
Followed by infusion of 1g/hour
Urine output, reflexes, respiratory rate and oxygen saturations should be monitored during treatment
Treatment should continue for at least 24 hours after last seizure or delivery
Other important aspects of treating severe pre-eclampsia include fluid restriction to avoid the potentially serious consequences of fluid overload
Why should you avoid cooked liver in pregnancy?
Contains high levels of vitamin A
Definition of puerperal pyrexia?
Temperature of >38 degrees C in the first 14 days following delivery
Most common cause of puerperal pyrexia?
Management of endometritis?
Patient should be referred to hospital for IV antibiotics (clindamycin and gentamicin) until afebrile for greater then 24 hours
Pleocytosis with "tumbling motility" on wet mounts
Diagnosis of listeria infection?
Diagnosis can ONLY be made from blood cultures
Treatment of listeria
Which UTI antibiotic should be avoided in the first trimester and why?
Trimethoprim (should be avoided as it is a folate antagonist)
When do you avoid nitrofurantoin in pregnancy and why?
Avoid close to term (due to risk of causing neonatal haemolysis)