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YEAR 4 > Prep 3 > Flashcards

Prep 3 Flashcards

1
Q

What is GH normally supressed to after OGTT?

A

<2

in acromegaly no suppression

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2
Q

exclamation mark hair

A

allopecia areata

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3
Q

single crease on nose

A

chronic rubbing

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4
Q

white spots on soft palate and ear pain

A

ramsey hunt

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5
Q

PE in pregnancy

A

LMWH

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6
Q

CURB 65

A 
confusion
urea >7
RR >30
BP <90 or <60
65 years
0-2 amox 5days
3-5 IV co-amox + PO doxy 7days
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7
Q

endocarditis IVOST

A

always requires IV no oral switch

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8
Q

addisons

A

primary adrenal insufficiency

AI destruction most common cause

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9
Q

normal endometrial thickness

A

<4mm

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10
Q

risk factors for endometrial cancer

A 
nulliparous
diabetic
early menarche, last menopause
unoposed oestrogen
tamoxifen (although antagonistic to breast tissue can be agonistic at other sites)
PCOS
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11
Q

what is tamoxifen and hat is it used for

A

selective oestrogen receptor modulator

oestrogen receptor positive breast ca (typically continues for 5 years post surgery)

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12
Q

colposcopy shows ulcerated lesion with discharge

A

LLETZ

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13
Q

what are the main types of shock

A 
Septic
Haemorrhagic
Neurogenic
Cardiogenic
Anaphylactic
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14
Q

diagnosing sepsis

A

sews > 4 or infection likely

SIRS >2

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15
Q

SIRS

A 
RR > 20 
change in mental state
temperature <36 >38
known/suspected neutropenia
HR >90
WCC <4 >12
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16
Q

assessing organ dysfunction in sepsis

A

systolic BP <90 or <40 below norm or MAP <65
urine output <30 for 24 hrs
lactate <4
newly altered mental state
new need for O2
serum creatinine >150
unexplained coagulopathy/thrombocytopenia

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17
Q

SEPSIS 6 management

A

take blood cultures, lactate and urine output

give O2, fluids and abx

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18
Q

pathophysiology of drowning

A

conscious breath hold until hypercapnia triggers breathing reflex
fluid aspiration or into stomach if laryngospasm
cerebral anoxia (hypoxemia and acidosis)
irrevesible cerebral damage

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19
Q

What happens with inhalation of fresh water

A

hypervolemia, hyponatatremia, hpyerkalemia (fresh water is hypotonic and hyponatremic so causes osmotic diffusion of water into blood and sodium into alveoli)

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20
Q

motorcycle accident, airway clear and breathing ok but weak radial pulse what kind of shock

A

haemorrhagic

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21
Q

fluid administration followed by rapid deterioration

A

stop fluids

IV furosemide

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22
Q

dose of adrenaline in anaphylaxis

A

0.5ml 1g:1000ml IM (1mg:1ml)

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23
Q

dose of adrenaline in cardiac arrest

A

1ml 1:1000 IV

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24
Q

what does a 100% solution mean

A

1gram of drug for 1ml of vol

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25
how many mg in a g
1000
26
how many mcg in a mg
1000
27
What does a 1% solution mean
1g in 100ml
28
bradycardia with adverse features (shock, syncope, myocardial ischamia, hf)
atropine 500mcg IV
29
hepatoxic drugs
paracetamol and NSAIDs
30
SABA + ICS step up
SABA + beclamethasone and falmeterol combo inhaler
31
Centor criteri
cough absent exudate nodes temperature >38
32
why does trimethorpim not work in upper UTI
doesnt penetrate renal parenchyma
33
why do antibiotics not help ulcer on foot
needs drainage, abcess walled off from the drug and bacteria live on
34
too painful to examination rectum
examin under anaestheesia
35
blood on toilet paper and pain
anal fissure
36
ankylosing spondylitis and then blood diarrhoea for 2 weeks
UC
37
cruise down river nile and then watery diarrhea 6 weeks later
urine or stool microscopy for eggs
38
what phase is the primary oocyte arrested in until puberty
prophase 1 (continues meiosis each month)
39
function of theca layer
produces oestrogen precursors
40
function of granular layer
forms oestrogen from precursors
41
lichen sclerosis versus lichen simplex
sclerosis: white patch and thin parchment skin of the skin (post menopausal women, atrophy and inflammatory reaction) simplex: white patch and thick leatherly skin (hyperplasia due to chronic scratching)
42
carcinoma vs sarcoma
carcinoma is malignancy of epithelium | sarcoma is malignancy of tisssues with mesenchymal origin (bone and soft tissue)
43
transexamic acid
antifibronylitic
44
mefanamic acid
antiprostaglandin
45
menorrhagia
IUS/COCP | tranexamic acid
46
Irregular periods
COCP
47
Painful periods
Mefanamic acid
48
lynch syndrome
increased risk of colon, endometrial and ovarian
49
PE in pregnancy
LMWH
50
hyperthyroid in pregnancy
propylthiouracil (not carbimazole)
51
PCOS diagnosis
clinical or biochemical signs of hyperandrogenism oligo/amenorrhoeic cysts on USS
52
investigation for endometriosis
laproscopy
53
management of endometriosis
NSAIDs/paracetamol COCP or progesterones (depo) GnRH analogues (inhibit oestrogen production)
54
key feature of endometriosis
dysmenorrhea (pain)
55
women at high risk of developing pre-eclampsia
aspirin 75mg from week 12 till birth (HTN in previous pregnancy, DM, CKD, SLE, antiphospholipid syndrome)
56
what drug can be given for the active management of 3rd stage of labour after delivery of anterior shoulder to reduce risk of postpartum haemorhage
syntocinon (synthetic oxytocin) | stimulates contraction of the uterus
57
mechanism of ergometrine and its uses
constricts vascular smooth muscle of uterus | can be used in active 3rd stage of labour
58
Who carry's out low risk antenatal care
community mid wife
59
Who provides breast feeding support
midwife
60
who conducts vaginal breech delivery
obstetrician
61
who repairs 3rd degree tears
obstetrician
62
who resuscitates a pre-term infant
paediatrician
63
main causes of post coital bleeding
``` idiopathic cervical ectropion (33%) cervical or endometrial polyps cervicitis secondary to infections cervical cancer trauma ```
64
normal delivery
midwife
65
abnormal smear
unsatisfactory - repeat in 3 months if >3 then refer borderline/LG - repeat in 1 year HG dyskaroysis moderate - refer 4 weeks HG dyskarosis severe - refer suspsion of cancer immediate refer 2 weeks
66
PPH definitions
moderate 500-1500 severe >1500 primary (within 24hrs) secondary (after 24 hrs)
67
management of PPH
``` massage 5units iv syntocinon 500mcg iv ergometrine IM carboprost (synthetic prostaglandin) all attempt to contract uterus ```
68
bitemporal haemianopia and infertility
pituitary adenoma (most likely prolactinoma)
69
breast feeding and oral contraceptive (contraception is needed from day 21 unless exclusively breast feeding till 6 months)
POP (COCP CI as can reduce breast mil production)
70
organism in BV
gardnerella vaginalis
71
tibolone
continuous HRT only suitable after 1 year post menopausal
72
investigation for chlamydia
NAAT and PCR (endocervical swab/first pass urine)
73
Nulliparous woman, diabetic: known endometrial biopsy thickening:
endometrial cancer
74
Woman with previous breast cancer taking tamoxifen for 5 years
endometrial hyperplasia
75
severe dyskariosis
colposcopy in 4 weeks
76
mild dyskarosis
repeat smear in 6 months
77
who does amniocentesis
obstetrician
78
who repairs 2nd degree tears
midwife (can repair 1 & 2 degree episiotomies (obstetrician for 3rd and 4th)
79
postnatal baby check
gp at 6 weeks
80
44 year old para 0+0 woman is currently at 16 weeks gestation. She wishes to know for certain whether or not her child has trisomy 21
amniocentesis chromosomal analysis
81
36 year old para 2+0 woman is currently at 28 weeks gestation. Her BMI is 45. The symphyseal fundal height is 34cm and there is clinical evidence of polyhydramnios. What investigation?
OGTT

YEAR 4 (27 decks)

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