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Jason's MD3 Women's > Antenatal Care > Flashcards

Antenatal Care Flashcards

1
Q

Routine

A

Routine screening

Mx of current probs

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2
Q

3 routine test you must do in pre preg Counselling?

A

Rubella
Varicella
Pap smear

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3
Q

Further assessment prepreg optimization?

A

DM - oral hypoglycaemia to insulin
Epilepsy - Poly to Mono therapy
Anticoagulation: switched from warfarin to LMW Heparin

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4
Q

DM woman how to change Rx prepreg?

A

Change from oral hypo glycaemics to INSULIN

Metformin ok

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5
Q

Prognostic advice for prepreg for renal failure?

A

Renal failure: creatinine >0.3: pulmonary HT (Mortality 50%)

Treat with surrogacy.

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6
Q

Counselling for prepreg?

A

Pharma: folate(500ug 3/12 before or 5mg) : avoid teratogens
Behavioural: Freq and timing:alcohol, smoking

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7
Q

Freq and timing to conceive?

A

Intercourse 48hrly or daily in the week before ovulation

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8
Q

Alcohol

A

Avoid Worse than cannabis, Heroin

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9
Q

6 steps in first antenatal visit

A 
Confirm preg
Gestational age
Screening for probs
Mx of any probs
General advice (OSCE station)
Booking (planning model of care)
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10
Q

Pregnancy tests? Which is best?

A

Serum: hCG 100% (DO THIS.)G
Urinary hCG: cross reacts with LH
Lots of false positives and false negatives

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11
Q

Gestational Age? Best?

A

Ultrasounds 6-12 weeks: Crown rump length. +/-3 days

12-20wks: biparietal diameter. +/- 7 days

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12
Q

Naegle’s rule breaks down when?

A

If cycle longer/shorter than 28 days

Not realizable if unrealizable cycle or recently stopped OCP

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13
Q

FHx Social Hx? prepreg?

A

Alcohol, smoking, illicit, marital, occupation

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14
Q

What does gynaecological exam involve?

A

External inspection
Speculum
Bimanual

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15
Q

TEsts at Antenatal visits?

A 
Haematologic: Anaemia: Thal Minor!
Blood bank
Microbiology (rubella, varicella, syphilis, HepB,C, HIV
Cytology: pap
Biochem:
Imaging: U/S
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16
Q

Why check MCV?

A

Thal Minor

Anaemia

17
Q

If preg woman is not immune to varicella?

A

Hyperimmune ZiG. IVIG

18
Q

HIV in preg?

A

No breastfeeding, C-section, antiretrovirals

19
Q

Biochem in first antenatal visit?

A

Trisomy 21 screen

20
Q

Worst epilepsy drug in preg?

A

Valproate

21
Q

General advice in first antenatal visit?

A 
Diet - 
Mineral vitamin supplementation
Exercise
Smoking
Alcohol
Sex
Working
Meds
22
Q

Diet first antenatal?

A

Nutrition,
Listeria - Chicken
Avoid salads, soft serve ice cream

23
Q

Why chicken get more likely food poisoning

A

Cause it’s frozen, doesn’t get cooked thoroughly

24
Q

first antenatal mineral vitamin supplementation?

A

Iron, calcium, Vit D
Folate?
Iodine?

25
Q

20% of population has this thrombophilia? How to avoid?

A

Hyperhomocysteinaemia

continue folate and multi it’s

26
Q

Exercise first antenatal advice?

A

Moderate not heavy

27
Q

Heavy alcohol use is defined?

A

More than 2 SD per day

28
Q

Working? first antenatal advice?

A

34 weeks, or earlier if increased BP

29
Q

Meds first antenatal advice?

A

Penicillin.amoxyl
Paracetomol: PRN not regular
Maxalon

30
Q

2 important conditions first antenatal visit?

A

Preeclampsia

Placental insufficiency

31
Q

Mx in antenatal

A

General well being
Fetal movements >20 weeks
Oedema (preeclampsia, not ankle, look at fingers)

32
Q

Women must have what EVERY visit?

A

Dipstick to check for protein

33
Q

28 weeks

A

FBE
OGTT
Rh anti-D PRN

34
Q

36 weeks tests?

A

FBE is low at 28weeks
GBS: penicillin or erythromycin
Anti-D PRN again

35
Q

Mother who wants to deliver 2nd vaginally after C-section?

A

1/200 risk of death

36
Q

If after 39 weeks gestation, risk of probs?

A

1/400 of perinatal death

37
Q

PAPP-A should be what level?

A

Not below 0.42 MoM

Jason's MD3 Women's (58 decks)

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