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Progress Tests > Pulsenotes finals > Flashcards

Pulsenotes finals Flashcards

1
Q

Management of ruptured ectopic

A

Emergency surgery

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2
Q

Management of ectopic pregnancy with severe symptoms

A

Surgery

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3
Q

Management of ectopic with very high bHCG

A

Surgery

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4
Q

Management of ectopic with low hCG

A

Expectant management

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5
Q

Management of ectopic with intermediate hCG

A

Medical management

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6
Q

Management of ectopic with high hCG (not very high)

A

Medical or surgical

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7
Q

Definition of missed miscarriage

A

Non viable pregnancy but no miscarriage symptoms

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8
Q

Definition of threatened miscarriage

A

Viable pregnancy with PV bleeding

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9
Q

Definition of inevitable miscarriage

A

Non viable pregnancy with PV bleeding and open os

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10
Q

Definition of incomplete miscarriage

A

Os is open but foetus not fully expelled

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11
Q

Definition of complete misscarriage

A

Os is closed and foetus expelled

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12
Q

Follow-up after expectant misscarriage

A

Pregnancy test after 3 weeks

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13
Q

Follow-up after medical misscarriage

A

Pregnancy test after 3 weeks

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14
Q

Options for surgical miscarriage

A

Local or general anaesthetic

Manual vacuum aspiration or open surgery (general anaesthetic)

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15
Q

Risk factors for ovarian torsion

A

Young female

Enlarged ovaries e.g. PCOS or cysts

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16
Q

What does a ruptured endometrioma look like?

A

Chocolate coloured fluid seen

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17
Q

Complications of endometriosis

A

Adhesions
Endometrioma
Reduced fertility
Cysts

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18
Q

Gold standard for endometriosis diagnosis

A

laparoscopy

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19
Q

Investigation of endometriosis

A

USS
MRI
Laparotomy

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20
Q

Medical management of endometriosis

A

Analgesia

GnRH agonists

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21
Q

Indications for surgery in endometriosis

A

Failed medical management

Surgery indicated for fertility

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22
Q

High-risk factors for pre-eclampsia

A 
Previous pre-eclampsia
Current HTN
Autoimmune disease
Diabetes
CKD
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23
Q

Medication given for pre-eclampsia prophylaxis

A

Aspirin

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24
Q

Signs and symptoms of pre-eclampsia

A 
Proteinuria
HTN
Persistent headache
Vision changes
Confusion
Abdo pain
Oedema
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25
Q

Management of pre-eclampsia if over 37 weeks

A

Induction of labour

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26
Q

When to admit patients with pre-eclampsia

A

BP over 160\110

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27
Q

First line medication in pre-eclampsia

A

Labetolol

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28
Q

Second line medication in per-eclampsia

A

Nifedipine or methyl-dopa

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29
Q

Investigations in pre-eclampsia

A 
BP
Urinalysis
Bloods
Foetal heart beat
USS
CTG monitoring of foetus
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30
Q

What is vasa praevia?

A

Vessels cover the cervical os

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31
Q

What meds should be given prior to anticipated pre-term labour?

A

Steroids or magnesium sulfate (helps with foetal lung maturation)

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32
Q

Management of minor antepartum haemorrhage

A

Admit and observe for 24 hours

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33
Q

Causes of post-partum haemorrhage

A 
Uterine atony (most common cause of bleeding in the 12 hours after birth
Retention of tissue (most common cause of delayed post-partum haemorrhage)
Trauma
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34
Q

Management of post partum haemorrhage where uterus isn’t contracted (feels soft)

A

Massage
Synthetic oxytocin
If ongoing, balloon / packing
If still ongoing, surgery

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35
Q

Causative organism of bacterial vaginosis

A

Gardnerella vaginalis

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36
Q

Diagnosis of bacterial vaginosis

A 
3 out of:
Typical discharge (thin grey)
Clue cells
Positive whiff test
Low vaginal pH
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37
Q

Microscopic finding in bacterial vagonosis

A

Clue cells

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38
Q

Treatment of bacterial vagonosis

A

Abx (metronidazole)

Advice on reducing risk

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39
Q

Risk factors for bacterial vaginosis

A

Young females
Change sexual partner
Excessive hygiene

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40
Q

Common symptoms in secondary syphylis

A

General e.g. fever/ headache
Dermatological (dense red-brown rash on trunk, palms and soles)
GI symptoms e.g. hepatitis
Neurological symptoms

41
Q

Most common form of tertiary syphilis

A

Cardiovascular (often affects aorta e.g. aortitis)

42
Q

Treatment of syphilis

A

Single dose of IM penicillin

43
Q

What is the Jarisch-Herxheimer reaction?

A

Acute febrile illness within a day of syphilis treatment. Usually self-resolves within a day

44
Q

Treatment of chlamydia

A

Single dose azithromycin or seven days doxycycline

45
Q

Who should be followed-up after chlamydia treatment?

A

Under 25s should have re-testing in 3-6 months due to high rate or reinfection

46
Q

Treatment of gonorrhoea

A

Single dose of IM ceftriaxone

47
Q

Age affected by bronchiolitis

A

Under 2 (usually under 1)

48
Q

Symptoms of bronchiolitis

A

Cough
Cold-like symptoms
Signs of resp distress
Reduced feeding and wet nappies

49
Q

How to differentiate croup and bronchiolitis

A

Croup tends to have barking cough

50
Q

Symptoms of croup

A

Barking cough
Cold-like symptoms
Signs of resp distress
Reduced feeding and wet nappies

51
Q

What is biliary atresia?

A

Biliary tree not fully formed leads to obstructive jaundice in a newborn

52
Q

Imaging in suspected ovarian cancer (no mass)

A

Urgent abdo and pelvic USS

53
Q

Sites of dissemination of gonorrhoea

A

Joints
Skin
Brain
Heart

54
Q

Management of pyloric stenosis

A

NG tube
IV access, bloods, fluids
Surgery

55
Q

Acute management manic episode

A

Antipsychotic

Consider a benzodiazepine

56
Q

Section 2

A

Patient detained for assessment and treatment for 28 days

57
Q

Platelet count in Henloch-Schonlein purpura

A

Normal

58
Q

Section 5(2)

A

Doctor detained person for 72 hours for assessment

59
Q

Management of neuroleptic malignant syndrome

A

Stop precipitating drug
Cooling and fever control
Symptom relief e.g. manage agitation

60
Q

Symptom of conjunctivitis

A

Red eye
Discharge
Vision intact

61
Q

What suggests viral conjunctivitis?

A

Bilateral

62
Q

What symptom suggests allergic conjunctivitis?

A

Itchy

63
Q

What symptoms suggest anterior uveitis?

A 
Pain
Red eye
Gradual loss of vision
Irregular pupil
Association with inflammatory diseases
64
Q

Symptoms of angle closure glaucoma

A 
Acute painful red eye
unilateral Headache
Nausea and vomiting
Visual loss
Halo around lights
65
Q

Symptoms of open angle glaucoma

A

Often asymptomatic and picked up routinely

May have gradual vision loss

66
Q

Signs in angle closure glaucoma

A

Fixed mid dilated pupil that isn’t reactive
Hazy pupil
Red eye

67
Q

What is idiopathic cholestasis of pregnancy?

A

Liver disease of pregnancy (typically 2nd and 3rd trimester) causing pruritis and bile accumulation

68
Q

Good standard for diagnosis of angle closure glaucoma

A

Gonioscopy (looks disentangle closure)

69
Q

Medication to reduce intraocular pressure

A

IV acetazolamide

70
Q

Treatment to cure closed angle glaucoma

A

Laser iridotomy (creates hole in iris for fluid to drain)

71
Q

Surgical options in glaucoma

A

Cataract surgery

Iridectomy

72
Q

What does a cherry red spot indicate?

A

Retinal artery occlusion

73
Q

Symptoms of retinal artery occlusion

A

Vision loss
Cherry red spot on retina
Pale retina

74
Q

Retinal vein occlusion on ophthalmoscopy

A

Retinal haemorrhage and exudate

75
Q

Retinal vein occlusion symptoms

A

Acute painless vision loss

76
Q

Ophthalmoscopy in GCA

A

Pale and oedematous optic disc

77
Q

Treatment of GCA with vision loss

A

IV steroids for 3 days

Then oral steroids as normal in GCA

78
Q

Management of bronchiolitis

A

Mostly supportive

If severe, feeding / hydration support or respiratory support

79
Q

Imaging in suspected ovarian cancer (no mass)

A

Urgent abdo and pelvic USS

80
Q

Sites of dissemination of gonorrhoea

A

Joints
Skin
Brain
Heart

81
Q

How to differentiate reactive and septic arthritis

A

Reactive will have sterile joint aspiration

82
Q

What is Henloch-Schonelein purpura?

A

Vasculitic rash following viral illness

83
Q

Main differentials in new onset petichial or purpuric rash in children

A

Immune thrombocytopenic purpura
Henloch-Schonlein purpura
Infection
Cancer

84
Q

Platelet count in Henloch-Schonlein purpura

A

Normal

85
Q

Symptoms of neuroleptic malignant syndrome

A 
On anti-psychotic
Altered mental status and agitation
Rigidity
Fevers
Autonomic dysfunction
AKI
86
Q

Management of neuroleptic malignant syndrome

A

Stop precipitating drug
Cooling and fever control
Symptom relief e.g. manage agitation

87
Q

When does neuroleptic malignant syndrome occur?

A

Any time but usually first 2 weeks of taking drug

88
Q

Key investigation in neuroleptic malignant syndrome

A

Raised CK

89
Q

What is retinitis pigmentosa?

A

Inherited vision disorders due to loss of photoreceptor function

90
Q

Symptoms of retinitis pigmentosa

A

Progressive night vision loss and progressive peripheral vision loss

91
Q

Ophthalmoscopy in retinitis pigmentosa

A

Pigmented around edge of retina

92
Q

Treatment of proliferative diabetic retinopathy

A

Panretinal photocoagulation

93
Q

Investigation in patient with thickened endothelium and suspected endometrial cnacer

A

Papelle biopsy

94
Q

What is idiopathic cholestasis of pregnancy?

A

Liver disease of pregnancy (typically 2nd and 3rd trimester) causing pruritis and bile accumulation

95
Q

What organism causes lymphogranuloma venereum

A

Chlamydia trachomatis

96
Q

Symptoms of lymphogranuloma venereum

A

Painless ulcers
Lymphadenopathy
Proctitis if rectal

97
Q

Symptoms of antidepressant withdrawal syndrome

A

Nausea, headache, dizziness, fatigue within a week of stopping SSRI

98
Q

Prognosis of antidepressant withdrawal syndrome

A

Typically mild and resolves within 1-2 weeks

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