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713 Flashcards

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1
Q

HbA1c >= X at booking for diagnosis of T2DM

A

50

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2
Q

HbA1c X-Y to get referred for 24-28 week OGTT

A

41-49

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3
Q

OGTT fasting and 2 hour BSL measurement for GDM diagnosis

A

Fasting >= 5.5
2 hour post >= 9

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4
Q

Polycose BSL measurement for diagnosis of GDM

A

11.1

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5
Q

Polycose range for OGTT

A

7.8-11.0

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6
Q

GDM BSL targets
Fasting
1 hour post
2 hour post

A

5
7.4
6.7

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7
Q

Neonatal hypoglycaemia

A

<= 2.6

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8
Q

How often should you express milk?

A

within 6 hours of delivery, then 8 times within 24 hours

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9
Q

what percentage of stillbirths >34/40 are SGA?

A

40%

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10
Q

BMI > X needs growth scans and not SFH in pregnancy

A

35

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11
Q

EFW < Xth, and AC <Yth diagnose SGA

A

10th, 5th

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12
Q

SGA diagnosed on USS - should have what doppler?

A

Umbilical artery doppler

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13
Q

When do you start to measure SFH?

A

26-28 weeks

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14
Q

When measuring SFH, what are the indications for a growth scan?

A

<10th or >30% change

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15
Q

Delivery time for SGA with abnormal dopplers

A

38 weeks

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16
Q

Delivery time for SGA with normal dopplers

A

39 weeks

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17
Q

First BSL measurement on SGA baby in first X-Y hours of life

A

1-2

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18
Q

When can you stop BSL measurements on SGA baby?

A

Once 3 consecutive normal range

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19
Q

What is the BSL monitoring schedule for SGA baby?

A

1-2 hours of life
Then prefeed

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20
Q

Placenta praevia delivery

A

36-37 weeks

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21
Q

Timing of delivery for accreta

A

35-36+6

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22
Q

Normal amount of fetal movements per 2 hours

A

10

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23
Q

when do MCDA twins split

A

Day 4-8

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24
Q

when do MCMA twins split

A

day 8-12

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25
Q

DCMA twins

A

Do not split, >12, conjoined

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26
Q

How much does aspirin reduce the risk of PET?

A

15-20%

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27
Q

If your risk of PET is >X%, then you should take aspirin

A

10%

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28
Q

Severity of bile salts > X for severe obstetric cholestasis

A

Bile salts > 40 = severe
bile salts > 100 = very severe

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29
Q

Four T’s of PPH

A

Tone
Tears
Tissue
Thrombin

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30
Q

Antidote to Mg toxicity

A

10ml 10% Ca gluconate or 10ml 10% Ca chloride

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31
Q

BP aim in emergency management of HTN in pregnancy

A

<160/100

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32
Q

MgSO4 dose

A

4g loading dose, then infusion at 1g/hr

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33
Q

How long do you continue MgSO4 post delivery?

A

24 hours

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34
Q

IOL time for PPROM

A

37/40

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35
Q

Management of term PROM

A

expectant management for 24H versus IOL - if GBS, then recommend IOL

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36
Q

can offer ECV from X/40

A

36/40

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37
Q

Delivery for DCDA

A

37-38

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38
Q

growth scan timing for DCDA twins

A

4 weeks from 24/40 if normal growth

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39
Q

definition of labour

A

regular, painful uterine contractions with progressive cervical effacement and dilatation

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40
Q

Risk of uterine rupture with VBAC

A

1 in 200

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41
Q

chance of successful VBAC

A

70%

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42
Q

First stage of labour

A

onset of contractions to full dilatation

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43
Q

delay in first stage

A

<2cm in 4 hours

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44
Q

How long should second stage take in first time mom

A

3 hours

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45
Q

how long should second stage take in multip

A

2 hours

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46
Q

is passive decent included in the total time

A

yes

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47
Q

3x P’s of second stage

A

passenger
passage
power

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48
Q

neonatal sats screening, need sats >

A

95 %

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49
Q

target coooling temp for neonate

A

33.5 degrees

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50
Q

guthrie card is done at X hours of life

A

48

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51
Q

if guthrie is abnormal, first line is to…

A

repeat guthrie

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52
Q

in general, milk comes in day X after birth

A

3

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53
Q

risk of hepatitis transmission if baby isnt given prophylaxis

A

90%

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54
Q

when can baby be given hepatitis B vaccine

A

6 weeks

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55
Q

How long do you treat a baby with oral thrush for

A

7/7

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56
Q

likelihood of CS for the second twin

A

5%

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57
Q

4x Ts of reversible cardiac arrest

A

Thrombosis
Tamponade
Tension PTX
Toxin

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58
Q

4x Hs of reversible cardiac arrest

A

hypo/hyperthermia
Hypo/hyperkalaemia
hypoxia
hypovolaemia

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59
Q

additional causes of cardiac arrest in maternal cardiac arrest

A

eclampsia
ICH

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60
Q

angle of L lateral tilt

A

15-30 degrees

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61
Q

numbers of weeks gestation that displacement of the uterus should be used from in maternal arrest

A

20/40

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62
Q

if no response to maternal collapse within X mins, then should proceed for PCMS

A

4 mins

63
Q

ideally within how many mins of collapse should PMCS be undertaken

A

5 mins

64
Q

how long should you wait to give clexane after spinal or removal of epidural catheter

A

4 hours

65
Q

at what gestation do you measure the cervical length in women who have had a previous PTB

A

16-24 weeks

66
Q

what is the cervical length to consider cerclage or PV progesterone

A

25mm

67
Q

when should you start PV progesterone

A

16 to 24 weeks

68
Q

how long should you cont PV progesterone until

A

until 34 weeks

69
Q

do not offer emergency clerclage to:

A

PV bleeding
infection
contractions

70
Q

gestations to consider emergency cerclage

A

16-27+6 with dilated cervix and intact membranes

71
Q

what percentage of women experience postnatal depression in the first year after childbirth

A

15%

72
Q

greatest risk factor for postnatal depression

A

anxiety or depression in the antenatal perdio

73
Q

what percentage of women are affected by baby blues

A

70-80%

74
Q

what day does baby blues peak and when should it resolve by

A

peaks day 3-5, resolves day 10-14

75
Q

Incidence of puerperal psychosis

A

2 per 1000 births

76
Q

score >= X on EPDS suggests possible depression

A

10

77
Q

antidepressants compatible with breastfeeding

A

paroxetine
citalopram
fluoxetine

78
Q

what is the triad of hyperemesis

A

weight loss
dehydration
electrolyte disturbance

79
Q

what % of PPH are from tone

A

70%

80
Q

what percentage of PPH are from tear

A

20%

81
Q

what percantage of PPH are due to tissue

A

10%

82
Q

what percentage of PPH are due to thrombin

A

1%

83
Q

what percentage of people have a caesrean birth

A

25-30%

84
Q

wound infections, UTI and endometritis occur in X% of CS births

A

8%

85
Q

risk of uterine rupture with 1x prev CS

A

8 in 1000

86
Q

risk of uterine rupture with 2x prev CS

A

16 in 1000

87
Q

risk of uterine rupture with 2x prev CS

A

16 in 1000

88
Q

rate of major congenital malformation in baseline community

A

2-3%

89
Q

rate of major congenital malformation in women taking antiepileptic drugs

A

4-7%

90
Q

antiepileptic drug with the greatest risk of congential malformation

A

sodium valproate

91
Q

best antiepileptic for women of child bearing age

A

levetiracetam
lamotrigine

92
Q

what percentage of women with epilepsy experience an increase in seizure frequency

A

33%

93
Q

40F with twins, what is teh risk of T21 at term

A

1 in 50

94
Q

what is often the first sign of uterine rupture

A

abnormal CTG

95
Q

PDA murmur

A

pansystolic over precordium and posteriorly over L scapula

96
Q

what % of cases of shoulder dystocia will have erbs palsy

A

5%

97
Q

what % of cardiac output enters the pulmonary circulation in term infants

A

<10%

98
Q

neonatal resus chest:breaths

A

3:1

99
Q

pre-existing hypothyroidism, increase thyroxine dose X% ?

A

30%

100
Q

TSH range trimester 1

A

0.1-2.5

101
Q

TSH range trimester 2

A

0.2-3

102
Q

TSH range trimester 3

A

0.3-3

103
Q

what % of breastfeeding women will get mastitis

A

18%

104
Q

what is the most common organism with mastitis

A

S aureus

105
Q

how many times should a baby feed in a day

A

8-12

106
Q

what percentage of women with breech vaginal birth need CS

A

40%

107
Q

at what gestations presenting with APH should women be given steroids

A

24-34+6

108
Q

optimal gestation for cyst surgery

A

14-16 weeks

109
Q

BSL management for hypo <2.6-1.2

A

buccal dex gel 40% 0.5mg/kg and breastfeed, recheck 30 mins

110
Q

BSL management for <1.2

A

NICU

111
Q

most common organisms in early onset neonatal sepsis

A

GBS
E coli
Listeria

112
Q

first line investigations for baby with >10% weight loss

A

BSL
Bilirubin

113
Q

treatment for early onset neonatal sepsis

A

amox and gent

114
Q

ductus closure normally occurs day X - Y of life

A

3-5

115
Q

pH < X on gas would be an indication for therapeutic cooling

A

7

116
Q

what hormone drives lactation during pregnancy

A

progesterone

117
Q

suckling reflex causes the release of

A

oxytocin

118
Q

what do you treat a baby with oral thrush with, and for how long?

A

Nylstat 7/7 OD

119
Q

anticoagulants that are safe in breastfeeding

A

Heparins
Warfarin

120
Q

HIE has to be identified < X hours of life to initiate therapeutic cooling

A

6 hours

121
Q

Once there is X L lost in PPH, the recommendation is replacement with blood products

A

1.5L

122
Q

IV Synto infusion prescription and rate

A

40IU In 1000mL NaCl at 250ml/hr

123
Q

most sensitive time for radiation exposure to the fetus

A

10-17 weeks

124
Q

what is the difference between TTTS and twin anaemia polycythaemia sequence?

A

both are from vascular anastamoses in the placenta, but TTTS results in discrepancy in amniotic fluid volume, and TAPS results in differences in fetal Hb with normal amniotic fluid

125
Q

what percentage of women experience depression in pregnancy

A

18%

126
Q

what percentage of women with a psychiatric illness experience deterioriation in pregnnacy

A

50%

127
Q

nitrofurantoin should be avoided from

A

36 weeks onwards

128
Q

trimethoprim should be avoided

A

in the first trimester

129
Q

what percentage of successful ECV will return to breech

A

1 in 35

130
Q

what is the risk of major complication in ecv (cord prolapse, fetal distress, placenta abruption)

A

1 in 200

131
Q

what is the rate of minor complications for ecv (minor APH, CTG change for <3 mins, ROM)

A

4%

132
Q

what percentage of ECV attempts are successful?

A

50% (40% in nullip, 60% in multip)

133
Q

if an ECV is successful, what is the likelihood of vaginal birth

A

70%

134
Q

for a diagnosis of postpartum depression, symptoms must be present for

A

2 weeks

135
Q

what is the most common cause of hemolytic disease of the fetus and newborn?

A

ABO incompatibility

136
Q

why do only 1% of neonates develop clinically significant ABO incompatibility hemolysis, despite 15-25% being incompatible with their mother?

A

due to IgM not crossing the placenta

137
Q

conjugated hyperbili =

A

> 20%

138
Q

maternal mortality is X times greater in twin pregnancy

A

2.5

139
Q

fetal mortality is X times greater in twin pregnancty

A

4.5

140
Q

growth scan timing in MCDA or MCMA twins

A

fornightly from 16 weeksq

141
Q

MCMA twin delivery

A

32 weeks due to concern re cord entanglement

142
Q

MCDA twin delivery

A

36-37

143
Q

DCDA twin delivery

A

37-38

144
Q

recommended mode of delivery for MCMA twins

A

CS due to risk of cord entanglement

145
Q

recommended mode of delivery for MCDA twins

A

deepends on the presentation. if teh leading twin is cephalic, recommend attempting vaginal birth

146
Q

recommended mode of delivery for DCDA twins

A

depends on the presentation, if the leading twin is cephalic, recommend trying for vaginal birth

147
Q

timing for aspirin use in pregnancy

A

16 weeks until 36 weeks

148
Q

what % of MC twins will develop TTTS?

A

10-15%

149
Q

when does TTTS most commonly occur?

A

16-26 weeks

150
Q

EFW discordance in monochorionic pregnancies for risk of sGR

A

20%

151
Q

TTTS presenting before X weeks should be treated by fetoscopic laser ablation rather than amnioreduction or septostomy

A

26

152
Q

delivery of monochorionic twins treated with laser ablation should be delivered X - Y

A

34 to 36+6

153
Q

IOL timing for obstetric cholestasis with bile salts >40

A

38 weeks

154
Q

IOL timing with obstetric cholestasis < 40

A

40 weeks

O&G Diploma (5 decks)

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