ABC Flashcards
USS measurement most sensitive indicator of IUGR
AC
US in 3rd trimester detects 85% IUGR using AC
Best way to investigate a cardiac problem in rpreg lady
ECHO
155 cm tall, 155 kg, which statement is true
- LSCS necessary
- Size of baby dependent on weight gain in preg
- Epidural contraindicated
-Size of baby dependent on weight gain in preg
Best way to monitor fluid balance/dehydration post haemorrhage
Urine output
Pushing for 1.75 hours, Mx if there is no progress?
Station =2, caput ++
Wrigley’s: fetal scalp visible, without separating labia (outlet) + OA/OP or R/L OA/OP
Neville: leading point of skull 0 to +2(midcavity) or rotation <45 deg from OA
Kiellands used in OT, mid cavity or asynclitism
Multigravid, pushing for 1 h, presenting part above spines
LSCS
Preg lady exposed to rubella igG titre 1:8
order rubella igM- check for acute infection
genital herpes at k38
wait for SOOL and then reassess
if recurrent then vaginal birth isnt contraindicated, if primary then LSCS
HIV postive preg lady
which is true
A: tx with antiretroviral will decrease the likelihood of the baby developing HIV
B. Mx of preg should be no diff to any other preg
C: Breastfeeding should be encouraged
D: Vag delivery and LSCS have the same outcome for baby contracting HIV
ANS: A
D true if woman in on tx and viral load is <50 copies/ml
Mx of woman in labour with temp 37.6, ROM 4 hours, GBS neg
a. IV broad spectrum abx
b. IV penicillin
c. oral amoxi
d. screening samples
e. observe
E
a. IV broad spectrum abx
b. IV penicillin
c. oral amoxi
d. screening samples
e. observe
Q. Mx of woman in labour with temp 37, ROM for 16 hours and GBS pos
B
a. IV broad spectrum abx
b. IV penicillin
c. oral amoxi
d. screening samples
e. observe
Q: woman in labour, temp of 38, GBS pos, fetal tachy
A
Woman presents with 3 cm solid, mobile breast lump- present 3 months
Fibroadenoma
Best way to diagnose early endometriosis
GOld standard is laproscopy and histology
12 year old with 6 months painless, irreg periods MC cause Cervical polyp adenomyosis Anovulatory DUB Endometrial carcinoma
Anovulatory DUB
Oxytocin, which is true:
- antidiuretic properties at therapeutic levels
- effective as ergo for PPH
- affects all smooth muscles
-antidiuretic properties at therapeutic levels
4 y F, enuresis, on examination labial fusion, Mx
- topical oestrogen cream
- surgical division
- observe
- abx
oestrogen cream only if freq UTI or post micturation dribbling
Ix for azoospermia
- seminal fructose
- karyotype
- serum testo
- FSH
FSH: raised then spermatogenic failure or non obstructive azoospermia so need donor sperm
if normal FSH- obstructive azoospermia then can try epididymal aspiration together with IVF and ICSI
About NT
- able to detect 80% downs
- required TVS
- High PPV - positive predictive value
- best performed at k15
CFTS 90% sensitive for Downs’s (NT along has 75% sensitivity for Downs)
24 y F G1P0, k34- acute abdo pain_ tender ut
Most liekly
placenta abruptio
not ut rupture, abortion, appendicitis
OCP for epilepsy
ethinyloestradiol 50 mcg
not progesterone only pill
forceps vs ventouse
1. most likely to cause maternal trauma + PPH
- used in non fully diated cx
- safely used when presenting part above spines
- forceps
- neither
- neither
multigravid at k32, strong contractions, breech. shoulder born, head stuck. Most likely cause
incomplete cervical dilatation
if term brrech then extension of head
Alchohol advice
- safest to avoid alcohol compeltely
- safe to have a standard drink each week
- safe to have 2/ week
- safe to have 2/ day for 5/7
- safe to have alcohol in discrete episodes upto 10 SD a day, but only once a month and after 1st trimester
Ans 5
Binge drinking more harmful to fetus even if overall alcohol is lower than more regular drinking patterms
peak blood alcohol is more imp with regard to risk of fetal damage
Contraception- wanting OCP
PV: 5 cm palpable mass, cystic mass
- Laparotomy
- Repeat PV in 3 months
- give OCP and repeat PV in 1 month
- USS and drainage of cyst
- Nothing
give OCP and repeat PV in 1 months
In premenopausal women Ca125 is not needed in simple ovarian cyst by US
Should do LDH, AFP and HCG in women under 40 to exclude germ cell tumour
HIV in preg
LSCS may reduce vertical transmission
-Preg may advance HIV disease
-Breastfeeding should be encouraged
LSCS may reduce vertical transmission when viral load is high
induce precipitate labour suddenly develops tachycardia, SOB, afebrile
Cause AFE pulm oedema pneumonia PPH
AFE : RF include precipitate labour
which contracption increases risk of ectopic
OCP prog only pill diaphragm condom none
E:
? if preg occurs with prog only pill or mirena then the preg is more likely to be ectopic but the overall risk is lower
52 y F, one year post last period, has hot flushes and atrophic vaginitis
Mx
HRT combined-oestrogen and MPA
