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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
Infection with least risk of transmission during delivery
Toxoplasmosis
25
Congenital infection with minimal teratogenic risk
HIV
26
Indication for C/S section in which infections
HIV | HSV
27
Infections that can affect newborn and foetus
``` Chicken pox HEpatitis AIDS MALARIA parvovirus Syphilis Toxoplasmosis others Rubella CMV HSV ``` CHAMPS TORCH
28
Types of varicella infections in foetus and neonates
``` Varicella embryopathy(before 20wks of gestation) Congenital varicella (20wks to term) Neonatal varicella(near term or after delivery) ```
29
Cause of death in adult varicella
Pneumonia
30
Rx of pulmonary TB in pregnancy
Oral INH and rifampicin for 9months(ethambutol for 1st two months) Ethambutol is given if INH resistance
31
Baby born to TB+ mom
prophylactic INH for 3 months
32
Breast feeding in TB positive mother
Not contraindicated | Pyridoxine should be given to infants of mother taking isoniazid
33
TB in pregnancy flares up during
Peurperium
34
Earliest sign of early congenital syphilis
Snuffles
35
Early congenital syphilis
``` Snuffles Meningeal irritation Lacrimation Arthralgia Hepatosplenomegaly Lymphadenopathy Rash ```
36
Late congenital syphilis
``` Presents after 2 years Interstitial keratitis Clutton joint 8th nerve deafness Saddle nose Hutchinson teeth Mulberry molars Saber shin ```
37
Effect of listeriosis on foetus
Disseminated Granulomatous lesion with microabscess | Still birth
38
Maternal complications due to listeria infection
``` Preterm labor Meconium stained liquor Chorioamnionitis Abortions Placental microabscess ```
39
Commonest bacterial infection seen in pregnancy
urinary tract infection
40
Risk factor for urinary tract infection in pregnancy
Papillary necrosis Sickle cell Anemia Analgesics
41
Asymptomatic bacteriuria
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
42
Most common cause of UTI and pyelonephritis
E.coli
43
Maternal complications of asymptomatic bacteriuria
``` PREECLAMPSIA ANEMIA Acute pyelonephritis Chronic renal lesions Premature labor ```
44
Placental parasitisation is seen in which malaria
Falciparum
45
Rx of malaria in preganancy
``` Vivax Chloroquine Quinine(chloroquine resistant) Falciparum Artemisin ```
46
Rx of UTI in pregnancy
Ampicillin Clavamox Nitrofurantoin Cephalexin/cephalosporin
47
DOC of choice for typhoid in pregnancy
Ceftriaxone
48
Parity and asymptomatic bacteriuria
Increases with increasing parity
49
Severity of Anemia
Mild 10-11 Moderate 7-10 Severe 4-7 Severe Anemia less than 4
50
Spectrum of iron deficiency
Stage of negative iron balance Iron deficient erythropoiesis Iron deficiency Anemia
51
Factors abnormal in negative iron balance
Low ferritin Increased TIBC low marrow iron stores
52
Diff btw iron deficient erythropoiesis and iron deficiency anemia
RBC morphology abnormal in fe deficiency anemia
53
Commonest Anemia in tropics
Dimorphic Anemia | Bone marrow is predominantly megaloblastic
54
Type of nutritional Anemia that is rare
Isolated B12 deficiency
55
Fetal Fe requirement
300mg
56
With oral iron therapy rise in Hb can be seen in
3wks
57
Calculation of total iron requirement
4. 4* weight in kg* Hb deficit 0. 3*weight in pounds*Hb deficit 2. 3*weight in kg*hb deficit+500/1000
58
Rate of Hb increase with iron treatment
1gm/week
59
Amount of iron required for maternal RBC expansion
500mg
60
Iron requirement in pregnancy
2.5mg/day upto 20wks 5.5mg/day 20-32wks 6-8mg/day 32 weeks onwards
61
Treatment dose of iron
180 mg(3 feso4 tablets are given)
62
Response to iron therapy
Increased reticulocyte count within 5-10 days of therapy
63
1 feso4 tablet has ____mg of elemental iron
100mg tablet has 60mg of elemental iron
64
Max dose of iron that can be given IV at a time
2500mg
65
Complications of Anemia during pregnancy
PREECLAMPSIA Heart failure Preterm labor Infection
66
Absolute indication for blood transfusion in Anemia
Severe Anemia more than 36wks of gestational age
67
Iron formulation that is given IV
``` Iron dextran Iron sucrose(no need of test dose) ```
68
Vasopressor of choice in obstetrics
Ephedrine | Pure alpha 1 agonists are contraindicated as they cause utero placental insufficiency
69
Anti rheumatic drugs to be avoided in pregnancy
MTX mycophenolate mofetil Azathioprine can be given
70
Classes of drugs according to safety profile in pregnancy
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
Lupus in pregnancy
Improves in 1/3 Unchanged in 1/3 Worsens in 1/3
72
Neonatal lupus
Lupus dermatitis Thrombocytopenia Hepatic involvement Congenital heart block
73
Contraception in lupus pts
Progestin only pills | Barrier method
74
Drug used for Chemoprophylaxis against malaria in pregnancy
Mefloquine
75
Treatment withdrawal in pregnant pts with epilepsy can be tried if
The pt was seizure free for 5 yrs
76
Anti epileptic drugs absolutely contraindicated in pregnancy
Valproate | Trimethadone
77
Drug of choice in epilepsy
Phenobarbitone
78
Doc in status epileptics in pregnancy
Diazepam
79
Teratogenic effects caused by cocaine
``` Cutis aplasia Microcephaly Porencephaly Subependymal and Periventricular cysts Cerebral infarction Periventricular leukomalacia Illeal atresia Cardiac anomalies GU abnormalities Limb reduction defects ```
80
Teratogenic effects of warfarin
Contradi syndrome | Chondrodysplasia punctata
81
Calcium supplementation is needed for which drug therapy
``` HEPARIN Steroids anticonvulsants Alcohol Thyroxine GnRH Li Cyclosporine Aluminium Aromatase inhibitors ```
82
Fetal warfarin syndrome
``` Chondrodysplasia punctata Epiphyseal stippling Nasal hypoplasia Optic atrophy Microcephaly ```
83
Fetal valproate syndrome
Brachycephaly Shallow orbits Overlapping long fingers Hyper convex nails
84
Teratogenic effects caused by isotretinoin$
``` Cleft palate NTD microcephaly ASD Deafness Blindness ```
85
Maximum sensitivity to teratogens is seen btw
3-8wks
86
Teratogenic effects of methimazole
Aplasia cutis Esophageal atresia Chonal atresia
87
Effect of maternal smoking on foetus
ADHD in later life
88
Most common ovarian tumor in pregnancy
Benign cystic teratoma
89
Most common tumor to undergo torsion in pregnancy is
Dermoid cyst
90
Most common time of occurrence of torsion of pregnancy
8-10wks
91
Management of ovarian cysts
``` Symptomatic - immediate laparotomy irrespective of gestational age Asymptomatic Sx done in second trimester Before 36 wks- immediate laparotomy After 36wks- withhold till delivery ```
92
Ovarian cyst diagnosed during peurperium,Rx $
Immediate laparotomy
93
Why asymptomatic ovarian cysts are not removed during first trimester?
Removal of corpus luteal cyst may be detrimental to pregnancy
94
Tumors which increase in size during pregnancy
Neurofibroma Meningioma Angioma Pitutary adenoma
95
Other name for red degeneration of fibroid
Carneous degeneration
96
Characteristic of red degeneration of fibroid
Fishy odor | Salmon pink in appearance
97
Rx of bacterial vaginosis in pregnancy
Metronidazole after 1st trimester | Clindamycin can also be given
98
Retroverted uterus causing urinary retention occurs at
12-16 weeks
99
Complications of retroverted gravid uterus
``` Abortion Rupture uterus Anterior sacculation of uterus Malpresentation Non engagement of head ```
100
Commonest genital malignancy in pregnancy
Cervical cancer
101
Rx of varices in pregnancy(vulva,rectum,lower leg)
Conservative | Disappear following delivery
102
Rx of Retroverted gravid uterus
Prone position | Manual correction and insertion of hodge smith pessary
103
Management of cervical cancer in pregnancy
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
Programmes adopting syndromic approach to STD
STD CONTROL programme | Family health awareness programme$

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