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July > 4.7.2013(OG-infections,Anemia,drugs,gynaec disorders)57 > Flashcards

4.7.2013(OG-infections,Anemia,drugs,gynaec disorders)57 Flashcards

0
Q

Transmission of Hep A to neonate

A

Focal contamination during delivery

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1
Q

Hepatitis B is highly transmissible during

A

3rd trimester(90%)

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2
Q

Risk of transmission of hepatitis B based on maternal serology

A

HbeAg+ - 90%
Ab to HbeAg+ - 25%
HbeAg and anti-HbeAg both absent - 10%

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3
Q

Routes of transmission of hepB to child

A

Vertical transmission

Breast feeding

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4
Q

Breast feeding and hepatitis B

A

Not contraindicated

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5
Q

Commonest cause of endemic viral hepatitis in Asia

A

Hepatitis E

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6
Q

Cause of fulminant hepatitis in pregnant women

A

Hep E

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7
Q

Infections in different trimesters

A 
Syphilis after 20wks
Rubella rare after 20wks
HSV and hepatitis during delivery
CMV any time during pregnancy 
Toxoplasmosis in third trimester
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8
Q

Why syphilis is transmitted only after 20wks?

A

It can be transmitted only after disappearance of langhans layer(cytotrophoblast) in villi

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9
Q

A women with previous h/o toxoplasma infection now becomes pregnant.what is the risk of infection to her child?

A

Nil

One time infection with toxoplasma provides lifelong immunity

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10
Q

Triad of toxoplasmosis

A

Hydrocephalus
Chorioretinitis
Intracranial calcification

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11
Q

Rx of toxoplasmosis in pregnant women

A

Spiramycin for 3 weeks followed by 2 weeks interval

Fetal infection confirmed- 3 weeks Spiramycin followed by 3 wks pyrimethamine sulfonamide(avoid during 1st trimester)

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12
Q

Maximum risk of HIV transmission.

Intrapartum or peripartum?

A

Peripartum

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13
Q

Mode of delivery in HIV infection

A

Vaginal delivery if viral load less than 1000/ml

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14
Q

Contraindication of methergin in HIV positive women

A

Drug interaction with protease inhibitors and RT inhibitors to cause severe vasoconstriction

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15
Q

Disposal of HIV positive placenta

A

10% sodium hypochlorite treatment

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16
Q

Time of Ab testing for HIV in children born to HIV positive women

A

1
6wks
12wks
18months

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17
Q

In twin pregnancy who is at a higher risk of HIV infection

A

First born twin

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18
Q

High risk of HIV transmission in pregnancy

A

P24 antigenemia

CD4 count less than 700/uL

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19
Q

Rx of pneumocystis carinii

A

Co trimoxazole

Pentamidine

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20
Q

Most common manifestation of CRS

A

Deafness

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21
Q

Pregnant women with primary rubella infection in first or second trimester.Rx?

A

MTP

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22
Q

Pregnancy should be avoided how many months after rubella vaccine

A

1 month

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23
Q

Commonest cause of fetal and perinatal infection

A

CMV

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24
Q

Infection with least risk of transmission during delivery

A

Toxoplasmosis

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25
Q

Congenital infection with minimal teratogenic risk

A

HIV

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26
Q

Indication for C/S section in which infections

A

HIV

HSV

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27
Q

Infections that can affect newborn and foetus

A 
Chicken pox
HEpatitis
AIDS
MALARIA
parvovirus 
Syphilis
Toxoplasmosis
others
Rubella
CMV
HSV

CHAMPS TORCH

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28
Q

Types of varicella infections in foetus and neonates

A 
Varicella embryopathy(before 20wks of gestation)
Congenital varicella (20wks to term)
Neonatal varicella(near term or after delivery)
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29
Q

Cause of death in adult varicella

A

Pneumonia

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30
Q

Rx of pulmonary TB in pregnancy

A

Oral INH and rifampicin for 9months(ethambutol for 1st two months)
Ethambutol is given if INH resistance

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31
Q

Baby born to TB+ mom

A

prophylactic INH for 3 months

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32
Q

Breast feeding in TB positive mother

A

Not contraindicated

Pyridoxine should be given to infants of mother taking isoniazid

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33
Q

TB in pregnancy flares up during

A

Peurperium

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34
Q

Earliest sign of early congenital syphilis

A

Snuffles

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35
Q

Early congenital syphilis

A 
Snuffles
Meningeal  irritation
Lacrimation
Arthralgia
Hepatosplenomegaly 
Lymphadenopathy
Rash
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36
Q

Late congenital syphilis

A 
Presents after 2 years 
Interstitial keratitis
Clutton joint
8th nerve deafness 
Saddle nose
Hutchinson teeth
Mulberry molars
Saber shin
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37
Q

Effect of listeriosis on foetus

A

Disseminated Granulomatous lesion with microabscess

Still birth

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38
Q

Maternal complications due to listeria infection

A 
Preterm labor
Meconium stained liquor
Chorioamnionitis 
Abortions
Placental microabscess
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39
Q

Commonest bacterial infection seen in pregnancy

A

urinary tract infection

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40
Q

Risk factor for urinary tract infection in pregnancy

A

Papillary necrosis
Sickle cell Anemia
Analgesics

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41
Q

Asymptomatic bacteriuria

A

Count of same bacterial species more than 10 to the power 5 in midstream clean catch sample on two occasions without symptoms of urinary tract infection

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42
Q

Most common cause of UTI and pyelonephritis

A

E.coli

43
Q

Maternal complications of asymptomatic bacteriuria

A 
PREECLAMPSIA
ANEMIA
Acute pyelonephritis
Chronic renal lesions 
Premature labor
44
Q

Placental parasitisation is seen in which malaria

A

Falciparum

45
Q

Rx of malaria in preganancy

A 
Vivax
  Chloroquine
  Quinine(chloroquine resistant)
Falciparum
  Artemisin
46
Q

Rx of UTI in pregnancy

A

Ampicillin
Clavamox
Nitrofurantoin
Cephalexin/cephalosporin

47
Q

DOC of choice for typhoid in pregnancy

A

Ceftriaxone

48
Q

Parity and asymptomatic bacteriuria

A

Increases with increasing parity

49
Q

Severity of Anemia

A

Mild 10-11
Moderate 7-10
Severe 4-7
Severe Anemia less than 4

50
Q

Spectrum of iron deficiency

A

Stage of negative iron balance
Iron deficient erythropoiesis
Iron deficiency Anemia

51
Q

Factors abnormal in negative iron balance

A

Low ferritin
Increased TIBC
low marrow iron stores

52
Q

Diff btw iron deficient erythropoiesis and iron deficiency anemia

A

RBC morphology abnormal in fe deficiency anemia

53
Q

Commonest Anemia in tropics

A

Dimorphic Anemia

Bone marrow is predominantly megaloblastic

54
Q

Type of nutritional Anemia that is rare

A

Isolated B12 deficiency

55
Q

Fetal Fe requirement

A

300mg

56
Q

With oral iron therapy rise in Hb can be seen in

A

3wks

57
Q

Calculation of total iron requirement

A
  1. 4* weight in kg* Hb deficit
  2. 3weight in poundsHb deficit
  3. 3weight in kghb deficit+500/1000
58
Q

Rate of Hb increase with iron treatment

A

1gm/week

59
Q

Amount of iron required for maternal RBC expansion

A

500mg

60
Q

Iron requirement in pregnancy

A

2.5mg/day upto 20wks
5.5mg/day 20-32wks
6-8mg/day 32 weeks onwards

61
Q

Treatment dose of iron

A

180 mg(3 feso4 tablets are given)

62
Q

Response to iron therapy

A

Increased reticulocyte count within 5-10 days of therapy

63
Q

1 feso4 tablet has ____mg of elemental iron

A

100mg tablet has 60mg of elemental iron

64
Q

Max dose of iron that can be given IV at a time

A

2500mg

65
Q

Complications of Anemia during pregnancy

A

PREECLAMPSIA
Heart failure
Preterm labor
Infection

66
Q

Absolute indication for blood transfusion in Anemia

A

Severe Anemia more than 36wks of gestational age

67
Q

Iron formulation that is given IV

A 
Iron dextran 
Iron sucrose(no need of test dose)
68
Q

Vasopressor of choice in obstetrics

A

Ephedrine

Pure alpha 1 agonists are contraindicated as they cause utero placental insufficiency

69
Q

Anti rheumatic drugs to be avoided in pregnancy

A

MTX
mycophenolate mofetil

Azathioprine can be given

70
Q

Classes of drugs according to safety profile in pregnancy

A

Class A no risk
Class B risk not proved in controlled animal or human studies
Class C risk only in animals
Class D given based on risk benefit ratio
Class X contraindicated

71
Q

Lupus in pregnancy

A

Improves in 1/3
Unchanged in 1/3
Worsens in 1/3

72
Q

Neonatal lupus

A

Lupus dermatitis
Thrombocytopenia
Hepatic involvement
Congenital heart block

73
Q

Contraception in lupus pts

A

Progestin only pills

Barrier method

74
Q

Drug used for Chemoprophylaxis against malaria in pregnancy

A

Mefloquine

75
Q

Treatment withdrawal in pregnant pts with epilepsy can be tried if

A

The pt was seizure free for 5 yrs

76
Q

Anti epileptic drugs absolutely contraindicated in pregnancy

A

Valproate

Trimethadone

77
Q

Drug of choice in epilepsy

A

Phenobarbitone

78
Q

Doc in status epileptics in pregnancy

A

Diazepam

79
Q

Teratogenic effects caused by cocaine

A 
Cutis aplasia
Microcephaly
Porencephaly
Subependymal and Periventricular cysts
Cerebral infarction
Periventricular leukomalacia 
Illeal atresia
Cardiac anomalies 
GU abnormalities
Limb reduction defects
80
Q

Teratogenic effects of warfarin

A

Contradi syndrome

Chondrodysplasia punctata

81
Q

Calcium supplementation is needed for which drug therapy

A 
HEPARIN
Steroids
anticonvulsants
Alcohol
Thyroxine
GnRH
Li
Cyclosporine
Aluminium
Aromatase inhibitors
82
Q

Fetal warfarin syndrome

A 
Chondrodysplasia punctata
Epiphyseal stippling
Nasal hypoplasia
Optic atrophy
Microcephaly
83
Q

Fetal valproate syndrome

A

Brachycephaly
Shallow orbits
Overlapping long fingers
Hyper convex nails

84
Q

Teratogenic effects caused by isotretinoin$

A 
Cleft palate
NTD
microcephaly
ASD
Deafness
Blindness
85
Q

Maximum sensitivity to teratogens is seen btw

A

3-8wks

86
Q

Teratogenic effects of methimazole

A

Aplasia cutis
Esophageal atresia
Chonal atresia

87
Q

Effect of maternal smoking on foetus

A

ADHD in later life

88
Q

Most common ovarian tumor in pregnancy

A

Benign cystic teratoma

89
Q

Most common tumor to undergo torsion in pregnancy is

A

Dermoid cyst

90
Q

Most common time of occurrence of torsion of pregnancy

A

8-10wks

91
Q

Management of ovarian cysts

A 
Symptomatic - immediate laparotomy irrespective of gestational age
Asymptomatic 
 Sx done in second trimester
 Before 36 wks- immediate laparotomy
 After 36wks- withhold till delivery
92
Q

Ovarian cyst diagnosed during peurperium,Rx $

A

Immediate laparotomy

93
Q

Why asymptomatic ovarian cysts are not removed during first trimester?

A

Removal of corpus luteal cyst may be detrimental to pregnancy

94
Q

Tumors which increase in size during pregnancy

A

Neurofibroma
Meningioma
Angioma
Pitutary adenoma

95
Q

Other name for red degeneration of fibroid

A

Carneous degeneration

96
Q

Characteristic of red degeneration of fibroid

A

Fishy odor

Salmon pink in appearance

97
Q

Rx of bacterial vaginosis in pregnancy

A

Metronidazole after 1st trimester

Clindamycin can also be given

98
Q

Retroverted uterus causing urinary retention occurs at

A

12-16 weeks

99
Q

Complications of retroverted gravid uterus

A 
Abortion
Rupture uterus
Anterior sacculation of uterus
Malpresentation
Non engagement of head
100
Q

Commonest genital malignancy in pregnancy

A

Cervical cancer

101
Q

Rx of varices in pregnancy(vulva,rectum,lower leg)

A

Conservative

Disappear following delivery

102
Q

Rx of Retroverted gravid uterus

A

Prone position

Manual correction and insertion of hodge smith pessary

103
Q

Management of cervical cancer in pregnancy

A

CIN(1,2,3) Ca in situ follow up with repeat smear and pt is allowed to deliver vaginally
IA1- conisation in second trimester followed by C section
1A2- C section after pulmonary maturity is reached and modified radical hysterectomy and pelvic lymphadenectomy

104
Q

Programmes adopting syndromic approach to STD

A

STD CONTROL programme

Family health awareness programme$

July (7 decks)

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