AMK day

Question 1

women 19 week preg and son has chicken pox what is the management

Answer 1

give varicella zoster immunoglobulins

Question 2

congenital VZV in (dorsal ganglia fro shingles) tetragonal effects in 1st trimester from this what are symptoms

Answer 2

microcephaly, limb hypoplasia, eye defects and low birth weight

Question 3

diagnosis fo VZV

Answer 3

check maternal blood for VZV antibodies

Question 4

management fo VZV

Answer 4

non pregnant - VZV ig prophylaxis

under 20 week peg VZV ig
over 20 weeks with - oral acyclovir

Question 5

congenital toxoplasmosis - cat shits - toxoplasmosis Gondi amniocentesis needed and treament is

Answer 5

triple therapy
after 18 weeks
pyimethanmne, sulfadiazine and folinic acid

Question 6

congenital rubella - greatest risk in first trimester - deafness and cataracts and congenital distress - need to do USS and rubella IgM antibodies

mangemtn

Answer 6

don’t give MMR in pregnancy - receive vaccine 28 days prior to conception or post natal

Question 7

congenital CMV - microcephaly and hearing loss and visual imapriemtn
seizures and jaundice
USS and ventrculomegaly
treatment Is what

Answer 7

IV ganciclovir

similar to toxoplasmosis

Question 8

over 24 weeks classified as birth

placenta preavia of myometrium - invaded more than half what finding on USS

Answer 8

placenta increta - penetration into myometrium
accreta- attachment to myometrium
procreate - penetrating past it and reaching uterine serosa

Question 9

adherent placenta RF

Answer 9

previous c section
previous placenta pavia
multigravida and increased maternal age

doppler USS diagnose s

Question 10

which of the following defines a major primary post part haemorrhage

Answer 10

blood loss over 500ml 24hr following delivery

Question 11

secondary PPH

Answer 11

24hr to 12 weeks post delivery

Question 12

cause of PPH

Answer 12

tone- uterine atony - plates of placenta a
trauma
tissue - retained products of conception
thrombin

Question 13

tretemtn pPH

Answer 13

ABCDE , clotting etc
uterine massage and IV oxytocin
IM carboprost

Question 14

previous gestational diabetes via oral glucose tolerance test -what is most appropriate approach to screen of gestational diabetes in the future preg

Answer 14

OGTT immediately after booking and at 24-28weeks

macrosmic baby and BMI more than 30 - other risk factors just a OGTT at 24-28 weeks
oGTT-5678 - more than 5.6 gestational diabetes , glucose at 2 hours more than 7.8 have diabetes

Question 15

treatment for gestational

Answer 15

fasting glucose if under 7 diet and exercise for 1-2 weeks
over 7 - insulin with metformin or not
over 6 - macrosmai - insulin and metformin

Question 16

preexisting diabetes

Answer 16

stop diabetic meds - start on 5mg of folic acid
weiht loss
retionpathy screening once pregnant and delivery between 37-38 weeks

Question 17

gestational HTN has be more than what week pregnant

Answer 17

20 weeks

Question 18

chronic HTN - high blood pressure before pregnancy or before gestation or before 20 weeks

treamtent

Answer 18

labetalol - avoid is asthma
nifedipine
methyldopa

Question 19

pre eclampsia

Answer 19

geasttioanl HTN and proteinuria
headache and visual distrrnace and visual disturbance
epigastric pain

Question 20

treatment of pre-eclampsia

Answer 20

labetaolo and IV magnesium sulphate

Question 21

for eclampsia with seizures treatment is

Answer 21

IV magnesium sulphate

calciumglucoante -

Question 22

HELLP syndrome

treatment

Answer 22

haemolysis, elevated liver enzymes, low platelets

onyl manegmt ndelviery baby - 3rd trimester

Question 23

acute fatty liver of pregnancy - raised LAT, ALP and AST and WBC

Answer 23

rapid accumulation of fat in liver cells happens in 3rd trimester
headache and raised sugar levels
obstetric emeegrnecy

cholestasisi of pregnancy
reduced outflow of bile acids and build up of bile acid - pyritise
jaundice and purity sand pale beast stools
gamma GT raised in cholestasis of pregnancy
treat wth uro

Question 24

treatment fro induction

Answer 24

membrane sweep
vaginal prostoglandin
blazon
artificial rupture and oxytocin

complication of induction is uterine hypesitmualtion - more problems

Question 25

bishop score

Answer 25

fro induction of aboru

8 or More fine
less than 8 stimulate cervix

Question 26

uterine hyperstimualtion - by medication

Answer 26

lots of contraction seen on ctg causing distress 
contraction fro more than 2 mins 
or more than 5 every 10 
lead to hypoxia and acids s
emergency c section and uterine rupture 

treatment is remove cause of hyeprstimulte so pessary 
give tocolysis( delay labour)  and terbutaline

Question 27

is prolapse of cord what do you do( vaginal introits)

Answer 27

ask mother to go on all fours

can cause vasal spasm if push umbilical cord back in

Question 28

rf for cord prolapse

Answer 28

abnormal lie after 37weeks gestation

if past introsisus - keep cord moist and warm and with minimal handling

tocolytics - reduce contractions and bfs time for c-section