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Round Up Email March 2025

In this month's Round Up highlights include haemorrhoids in pregnancy update, and updated faecal incontinence section and description of the NICE approved therapy for house dust related allergic rhinitis, SQ HDM SLIT-tablets.

Question 1
Congenital varicella syndrome – Is the risk of development of congenital varicella syndrome higher if maternal chickenpox is acquired in the first or second trimester? Is limb hypoplasia a characteristic feature of this condition?: Congenital varicella syndrome
With respect to congenital varicella syndrome, which statement is false?
- the risk of development of congenital varicella syndrome higher if maternal chickenpox is acquired in the first than if chickenpox is acquired in the third trimester
- characteristic features of foetal varicella syndrome include segmental areas of skin loss or scarring; limb hypoplasia and/or paresis; reduced birth weight
- microcephaly is characteristic of congenital varicella syndrome
Question 2
Faecal incontinence – this section has been updated on GPnotebook.: Incontinence of faeces
With respect to faecal incontinence, which statement is false?
- red flag features of faecal incontinence include nocturnal episodes
- red flag features associated with faecal incontinence include unintentional weight loss of more than 10% within three months
- red flag features associated with faecal incontinence include macrocytic anaemia
Question 3
Haemorrhoids in pregnancy – what are the suggested treatment options for haemorrhoids occurring during pregnancy? Generally, do haemorrhoids occur in most pregnancies? : Haemorrhoids in pregnancy
With respect to haemorrhoids in pregnancy, which statement is false?
- women are predisposed to developing haemorrhoids during pregnancy particularly after the second trimester
- non-pharmacological management includes avoidance of constipation by eating a healthy balanced diet including adequate dietary fibre and drinking plenty of water
- has been estimated that 25% to 35% of pregnant women are affected by this condition
Question 4
Postoperative analgesia – this section of GPnotebook has been updated. : Postoperative analgesia
With respect to postoperative analgesia, which statement is false?
- persistent post-operative opioid use (PPOU) is defined as continued opioid use beyond 30 days from the day of operation
- respiratory depression is also a well-known side effect of opioids, especially if taken in excess or in combination with other sedating medicines (for example benzodiazepines), pregabalin or gabapentin) which can lead to coma and potentially death
- it is not recommended to use transdermal patches for the treatment of post-operative pain
Question 5
Bartholin’s cyst – this section of GPnotebook has been updated. : Bartholin's cyst
With respect to a Bartholin's cyst, which statement is false?
- typically presents as a unilateral swelling on the posterolateral aspect of the introitus
- usually, the cyst is about 2 cm in diameter but may reach up to 8 cm
- if secondary infection occurs to produce a Bartholin's abscess, then the most common pathogen is pseudomonas
Question 6
SQ-HDM SLIT for treating allergic rhinitis and allergic asthma caused by house dust mites – this section of GPnotebook describes this option for treatment for house dust mite related allergic rhinitis. : SQ-HDM SLIT for treating allergic rhinitis and allergic asthma caused by house dust mites
With respect to SQ-HDM SLIT for treating allergic rhinitis associated with house dust mite, which statement is false?
- house dust mite induced allergic rhinitis is usually characterised by persistent symptoms, which are most pronounced during autumn and winter periods
- onset of clinical effects with AIT (allergen immunotherapy) is usually observed approximately 2-3 weeks after initiation
- NICE committee commented that "..is more uncertainty about the clinical effectiveness of 12 SQ-HDM SLIT for allergic asthma than for allergic rhinitis.."

Round Up Email March 2025

Question 1

Question 2

Question 3

Question 4

Question 5

Question 6