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Year 4 MMS RPH > Antenatal > Flashcards

Antenatal Flashcards

Antenatal medicine

1
Q

When is it recommended for a female to take folic acid tablets?

A

When they start trying to conceive and for the first 12 weeks of pregnancy

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2
Q

Why is folic acid intake important for expectant mother’s?

A

It decreases the risk of neural tube defects such as spina bifida and cleft palate as well as helping to produce RBC

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3
Q

What is the normal dose recommended for folic acid?

A

400 micrograms daily

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4
Q

Which group of women is it recommended take 5mg of folic acid daily?

A

Previous pregnancy with NTD, family history of NTD, anti-eplieptic medication, diabetes, bowel disease, obesity

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5
Q

How many appointments will a nulliparous woman have for an uncomplicated pregnancy?

A

10

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6
Q

How many appointments will a parous woman have for an uncomplicated pregnancy?

A

7

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7
Q

Why should pregnant women avoid liver?

A

it contains high levels of vitamin A which could be teratogenic if intake above 700 micrograms

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8
Q

How much is the recommended supplement of vitamin D?

A

10 micrograms daily

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9
Q

Which groups of women is it vital to recommend vitamin D supplement?

A

Those with dark skin or with limited exposure to sunlight (housebound, skin covered for cultural reasons)

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10
Q

Which foods should pregnant women avoid to reduce the risk of listeriosis?

A

unpasteurised milk
camembert, brie and blue-veined cheeses
any type of pate
uncooked or underprepared ready meals

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11
Q

Which foods should pregnant women avoid to reduce the risk of salmonella?

A

raw or partially cooked eggs or meat especially poultry and mayonnaise

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12
Q

What are the recommendations regarding alcohol consumption during pregnancy?

A

No safe limit
Increased risk of miscarriage in the first trimester
Binge drinking (>5 drinks on one occasion) maybe harmful to unborn baby

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13
Q

How should a pregnant woman wear a three point seatbelt?

A

Above and below the bump, not over it

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14
Q

Which interventions appear to be effective in reducing symptoms of morning sickness?

A

ginger
P6 (wrist) acupressure
antihistamines

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15
Q

What is the normal range of haemoglobin levels for pregnant women?

A

110g/L at first contact

105g/L at 28 weeks

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16
Q

If the woman is identified as a carrier of a clinically significant haemoglobinopathy what is the recommendation?

A

The father should be offered counselling and appropriate screening without delay

17
Q

What are the four options to be discussed with the woman regarding the anomaly scan to enable an informed choice?

A

Reproductive choice
Parents to prepare
Managed birth at specialist centre
Intrauterine therapy

18
Q

What is included in a ‘combined test’?

A

nuchal translucency
beta-human chorionic gonadotrophin
pregnancy-associated plasma protein-A

19
Q

Which strain of hepatitis should be serologically screened for in pregnancy?

A

Hepatitis B

so that effective postnatal interventions can be offered to reduce the risk of mother to child transmission

20
Q

What are the five primary prevention measures to avoid toxoplasmosis infection for pregnant women?

A

Washing hands before handling food
Thoroughly washing all fruit and veg, including pre-prepared salads
Thoroughly cooking raw meats and ready meals
Wearing gardening gloves and thoroughly washing hands after handling soli
Avioding cat faeces in cat litter and soil

21
Q

Name 5 of the 9 risk factors for pre-eclampsia

A 
Aged 40 or above
Nulliparity
Pregnancy interval greater than 10 years
Family history
Previous history
BMI 30kg/m2 and above
Pre-existing vascular disease
Pre-existing renal disease
Multiple pregnancy
22
Q

What are the main 5 symptoms of pre-eclapsia?

A

Severe headache
Problems with vision (blurring or flashing lights)
Severe pain just below the ribs
Vomiting
Sudden swelling of the face, hands or feet

23
Q

Which age groups are at higher risk of having problems with the grow of their baby?

A

less than 18

more than 40

24
Q

What are the 3 main risks identified from the family origin questionnaire?

A

Diabetes
Haematological disorder such as Thalassaemia or Sickle Cell Disease
FGM

25
Q

What events in a previous pregnancy can impact a current one?

A

Prematurity
Fetal growth restriction
Antepartum haemorrhage
Gestational hypertension, pre-eclampsia, diabetes, thrombocytopenia
Assisted delivery, c section, forceps, ventouse
PPH
Previous stillbirth, late miscarriage or neonatal death
3rd or 4th degree tear

26
Q

Family history is associated with which risks in pregnancy?

A

First degree relative with diabetes increases risk of gestational diabetes
First degree relative with gestational hypertension or pre-eclampsia is at increased risk

27
Q

Why is social history so important during antenatal booking?

A

Women are most vulnerable when pregnant
Women who do not usually engage with services are in contact with medical or midwifery services.
It is an important time to identify domestic abuse, homelessness, addiction, or financial problems

28
Q

Which blood tests are taken at the booking appointment?

A 
Haemoglobin level
Platelets
Infections - HIV, syphilis, Hepatitis B
Blood group and antibody status
Sickle cell & thalassaemia if indicated by FOQ
29
Q

When is the dating ultrasound scan usually performed?

A

Between 8 to 14 weeks

30
Q

Which factors are considered to give a predicted risk of the baby having down syndrome?

A

Size of nuchal fold combined with blood test, maternal age and some other factors

31
Q

The quad test can be carried out between 14-20 weeks, what does it include?

A

Blood test for Alpha-fetoprotein, Inhibin A, Oestriol and Beta-HCG

32
Q

What are the diagnostic tests for T21?

A

Chorionic villous sampling

Amniocentesis

33
Q

When is the anomaly screening ultrasound scan usually performed?

A

Between 18-21 weeks

34
Q

What are the 6 risk factors for gestational diabetes?

A 
BMI>30
Ethnicity
First degree relative with DM
PCOS
Previous baby >4.5kg (9lb 15)
Previous gestational diabetes
35
Q

Under which circumstances is a baby’s blood tested at birth and why?

A

If the mother is Rh-ve, she is at risk of Rhesus disease if her baby is Rh+ve
Rhesus disease will affect future pregnancies unless prophylactice Anti-D is injected

36
Q 
Which of the following is diagnostic for gestational diabetes?
A - Fasting glucose >3.5
B - Fasting glucose >2.5
C - 2 hour glucose >6.0
D - 2 hour glucose >7.8
A

D

37
Q 
Which of the following is not a physiological change observed in early pregnancy?
A - Increased cardiac output
B - Reduction in blood pressure
C - Reduction in clotting factors
D - Increase in red cell volume
A

C

38
Q

How and when would you screen for gestational diabetes?

A

GTT between 26-28 weeks

Year 4 MMS RPH (7 decks)

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