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Thurs Flashcards

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1
Q

cluster headaches symptoms

A

unilateral headache

worse around eye

bloodshot eye

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2
Q

heavy bleeding during period treatment

menorragia

A

mirena coil

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3
Q

Temporal Lobe Epilepsy symptoms

A

Fumbling, picking, fidgeting

Chewing, lip smacking, swallowing

wide-eyed motionless stare which can last for 1-2 minutes

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4
Q

Multiple Sclerosis- what happens

A

degeneration of the insulating covers of nerve cells in the brain and spinal cord

demyelination and axonal loss.

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5
Q

Multiple sclerosis symptoms

A

patchy paraesthesia

Optic neuritis

Internuclear ophthalmoplegia

cerebellar ataxia

Spastic paraparesis

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6
Q

Optic neuritis

A

loss of central vision and painful eye movements

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7
Q

Internuclear ophthalmoplegia

A

lesion in the medial longitudinal fasciculus of the brainstem

blurry vision or diplopia or dizziness on lateral gaze

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8
Q

Spastic paraparesis

A

weakness and stiffness in the leg muscles

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9
Q

signs of MS

A

periventricular white matter lesions

Oligoclonal bands in the CSF

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10
Q

acute management of MS

A

1g of intravenous methylprednisolone every 24 hours for 3 days

plasma exchange

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11
Q

relapsing remitting multiple sclerosis management

A

First-line injectables - beta-interferon

oral dimethyl fumarate, teriflunomide

biologics

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12
Q

fatigue medication for MS

A

Modafinil

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13
Q

medication for bladder dysfunction in MS

A

Anticholinergics - Oxybutinin or Tolterodine

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14
Q

erectyle dysfunction medication in MS

A

Sildenafil

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15
Q

medication for tremor in MS

A

Clonazepam

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16
Q

signs of infection post chemo

what do you do?

A

refer to hospital

could be neutropenic sepsis

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17
Q

GAD management

A

sertraline

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18
Q

Shoulder dystocia

A

obstructed labour foetal anterior shoulder becomes lodged behind the maternal pubic symphysis

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19
Q

signs of shoulder dystocia

A

difficulty in delivering the foetal face or chin

retraction of the foetal head

failure of restitution

descent of the shoulders following head delivery

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20
Q

risk factors for shoulder dystocia

A

Maternal gestational diabetes/obesity

Macrosomia

Advanced maternal age

Maternal short stature or small pelvis

Post-dates pregnancy

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21
Q

management for shoulder dystocia

A

Do not apply fundal pressure as this may lead to uterine rupture

no maternal pushing as this may exacerbate shoulder impaction

McRoberts manoeuvre

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22
Q

McRoberts manoeuvre

A

Hyperflexion and abduction of the mother’s legs tightly to the abdomen

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23
Q

when do you do an episiotomy

A

cut when baby is in distress and needs to be born quickly

there is a need for forceps or vacuum delivery (ventouse)

there is a risk of a tear to the anus.

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24
Q

Left internuclear ophthalmoplegia

A

ipsilateral impairment of the adducting eye and nystagmus in the abducting eye

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25
Fibroadenomas arise from
arise from the breast lobule stroma
26
Breast cysts causes
overgrowth of glandular and connective tissue, leading to blocked breast ducts and subsequent fluid accumulation.
27
Intraductal papilloma
benign tumour of the breast ducts
28
Fibrocystic breast disease cause
due to an exaggerated hormonal response causing inflammation, fibrosis, cyst formation, or adenosis (lobules are enlarged, and there are more glands than usual. )
29
Mammary duct ectasia cause
inflammation and dilation of the large breast ducts.
30
indications for induction of labour
>41 weeks gestation Preterm prelabour rupture of membranes Intrauterine foetal death Abnormal CTG Maternal conditions such as pre-eclampsia, diabetes, cholestasis
31
when do you not do induction of labour
Placenta praevia vasa previa
32
management of labour induction
Membrane sweep Vaginal prostaglandins (PGE2) Amniotomy: Artificial rupture of membranes. Balloon catheter- dilate
33
Placenta praevia
placenta blocks uterus neck
34
Placenta praevia symptoms
painless bleeding after 24 weeks
35
vasa previa
foetal vessels are too near internal cervical os
36
symptoms of vasa previa
Painless vaginal bleeding Rupture of membranes Foetal bradycardia
37
management for vasa previa
c section arranged for 35-36 weeks or emergancy
38
Prelabour rupture of membranes
rupture of the amniotic membranes before the onset of labour after 37 weeks
39
Prelabour rupture of membranes symptoms
Foul-smelling or greenish amniotic fluid Maternal fever Reduced foetal movements
40
management of Prelabour rupture of membranes
lif no labour within 24 hours, induction of labour signs of infection, immediate induction and antibiotics
40
medications not in pregnancy
Chloramphenicol. Cipro and levofloxacin. Sulfonamides. Trimethoprim Codeine. Ibuprofen Warfarin LABA carbemazipine
41
medication for bipolar pregnant lady
Switch gradually to an antipsychotic from lithium
41
management for breech presentation
ECV (EXTERNAL CEPHALIC VERSION) turn the baby using their hands on the abdomen
42
HOWELL JOLLY BODIES
hyposplenism
43
Schistocytes
microangiopathic haemolytic anaemia haemolytic uraemic syndrome and thrombotic thrombocytopenia purpura) or disseminated intravascular coagulation (DIC).
44
Haemophilia A
X-linked recessive deficiency in clotting factor VIII
45
Haemophilia B
X linked recessive clotting factor 9 no
46
bloods in Haemophilia A
Clotting profile - APTT is elevated vWF antigen is normal Defective platelets
47
management of Haemophilia A
minor- desmopressin major- recombinant factor VIII or IX
48
Von Willebrand Disease
reduced quantity or function of von Willebrand factor (VWF)
49
what is the most common inherited bleeding disorder
VWD
50
clotting tests results of von willebrand disease
normal PT and TT, and prolonged APTT
51
Multiple myeloma
plasma cell dyscrasia by abnormal clonal proliferation of plasma cells
52
epidermiology of multiple myeloma
afro carabbean second most common haem malignancy men
53
multiple myeloma symptoms
CRAB HAI HyperCalcaemia renal anemia bone/back pain Hyperviscosity- visual, headache, thrombosis Amyloidosis- cardiac, neuropathy infefction
54
diagnostic investigations of multiple myeloma
Serum and/or urine electrophoresis IgG high Serum free light chain bone marrow- >10% plasma cells
55
treatment of hypercalcaemia
bisphosphonates
56
treatment of Hyperviscosity
plasmapheresis
57
treatment of MM under 70
Haematopoietic stem cell transplantation induction therapy - bortezomib/thalidomide/dexamethasone + Daratumumab
58
treatment of MM over 70 yo
melphalan, prednisolone and thalidomide
59
symphysis-fundal height after 16 weeks
same roughly as gestation week
60
oligohydramnios
not enough amniotic fluid
61
polyhydramnios
too much amniotic fluid
62
polyhydramnios symptoms
maternal discomfort, difficulty in palpating the foetus, and a larger uterus
63
causes of oligohydramnios
Fetal renal agenesis reduced fetal urine production and thus reduced amniotic fluid prostaglandin inhibitors and ACE-inhibitors. pre-eclampsia, maternal smoking and placental abruption.
64
Motor neuron disease
destroy motor neurons misfolding of the TDP-43 protein
65
genes related to MND
SOD1, FUS and C9ORF72 90% random 10% genetic
66
management of MND
Riluzole extends life by 3 months 5 years after diagnosis
67
asymptomatic bacteriuria in pregnancy
antibiotics
68
Sideroblastic anaemia
produces ringed sideroblasts - red blood cells with iron-loaded mitochondria.
69
Sideroblastic anaemia signs and symptoms
symptoms same as iron deficiency anemia but high serum ferritin, high iron levels and a microcytic anaemia
70
Sideroblastic anaemia treatment
Chelation therapy Vitamin B6 (pyridoxine) with X linked patients
71
diagnosis of gestational diabetes
oral glucose tolerance test at 24-28 weeks
72
nucleated red blood cells, immature neutrophils and tear drop poikilocytes on blood film spenomegaly
Primary myelofibrosis
73
grade 3 and 4 perineal tears management
repair in theatre and discharge with laxitives so no constipation
74
MS epidermiology
caucasian
75
umbilical cord prolapse
umbilical cord comes out during labour before baby
76
umbilical cord prolapse sign
sudden change in the fetal heart rate pattern
77
what drug stops uterine contractions
tocolytics, such as terbutaline
78
venthouse delivery
3 pulls only then lower section cesarian
79
normal pressure hydrocephalus symptoms
wet wacky wobbly - broad based shuffling gait (narrow in parkinsons)
80
treatment of normal pressure hydrocephalus
Ventriculo-peritoneal shunt
81
pain relief in labour
paracetamol Oral Codeine Phosphate and IV/IM Diamorphine epidural
82
most common cause of secondary postpartum haemorrhage
postpartum endometriosis

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