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Obg > Dvt Obg > Flashcards

Dvt Obg Flashcards

1
Q

Doubling time of hcg in iup

A

48 hrs

Less than that ectopic

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2
Q

Viability

A

Msd more than or equalt o 25
Crl>=7mm
No embtyonal sac- blighted ovum

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3
Q

Lamba sign indicate

A

Dichorionic twins seen at 10-14 wks

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4
Q

Mc cause of increased nuchal translucemcy

A

Aneuploidy>cvs anomali>twintwin transfusion syn

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5
Q

If there is increased nt next step

A

Chorionic villous sampling
In bw 11-13
If done less than 9 weeks leads ro limb defects

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6
Q

Snow storm appearance marker of

A

Complete Molar pregnancy(46xx monospermic no fetus complete hydropoc chemge)

Partiql mole missed abortion dispermic
69 xxy fetus present

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7
Q

Idela time to look cervical length

A

18-24

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8
Q

Short cervix means

A

Less than 2.5 cm-cervical insufficiency

High risk for preterm labour

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9
Q

H/o short cervix preterm labour then xd

A

Do cerclage

If no history jo cerclage

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10
Q

Most comkon congenital anomaly in general

A

Cvs>ntd
Dose of folloc acid 4mg if there is prev history
Other wise 0.4 mg

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11
Q

Polyhydramnios in case of
Single deep pocket >=8 poly
<= 2 oligo

A

NTD/GIT
Oligo renal
Parvo virus hydrops plus poly
Placentomegalya- syphilis

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12
Q

Placent previa in preveious cs ption suspect

A

Morbidly adherent placenta(usg doppler and mri)

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13
Q

Best marker for diagnosis of ntd

A

Amniotic fluid acetylcholine eaterase

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14
Q

Lung maturqtion markers in amniocentesis

A

L/S ratio

Phosphatydyl glycerol_more reliable done in diabetic pregnancy

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15
Q

Usg in 3 rd trimester for fetal monitoring

A

1 Biometry- fetal growth(2-4 weeksly)
2 Biophysical profile-breathing gross kovmnts tone amniotic fluid nst)-<4 immediate delivery
3 umbilical artery doppler(absent end diastolic flow termination of p->=34 wks/cs
Reverse edf -termina preg >= 32 wks/cs)
4 MCA doppler- for feral anemia (pav > 1.5-anemiaa,<0.8 polycythemis

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16
Q

Fetal anemia sen in

A

Rh -
Parvo virus
Hydrops(pcv less than 15% hb < 5)
Polyhydramnios

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17
Q

Twin anemia polycythemis syndrome seen in(TAPS)

A

Monochorionic diamniotic - superficial a- v anastomoses

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18
Q

Oligo in 3 rd trimester cause

A

0IUGR/uteroplqcental insuff/prom

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19
Q

Polyhydramnios in 3 rd trimester

A

Diabetes

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20
Q

Ecv done at

A 
>=36 wks 
Relative contraindications 
Previous cs
Iugr
Macrosomia
Preeclampsia
Absolute ci
Muriple preruptured membr
Placenta previa
Active lqboucontacted pelvis
Uterine or fetal anomaloe
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21
Q

Best test to look for prom

A 
Per speculum exam
Others
Ph> 4.5(pregnabo<4.5)
Oligo onusg
Ferning pattern on microscopy
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22
Q

Retroplacenta clot indiactes

A

Placenta abruption

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23
Q

Hormone which maintains corpus luteum of pregnancy

A

Hcg

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24
Q

Hcg morphologicaly and functionally similar to

A

LH(beta subunit)

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25
Q

Dual test include

A

Hcg high+PAPP A low(at 11-13 weeks)

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26
Q

Quadrotest include

A 
Done at 15-22 wks
AFP
Inhibin A 
UE 3
HCG
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27
Q

Afp increased in

A

Ntd and git defects

Low in aneuplody,gestatitrophoplqztic da diabetes

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28
Q

In case of increased or decreased AFP next step

A

Usg

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29
Q

Proclatic seen highest in

A

Pregnancy

Estrogen stimulates)

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30
Q

Sheehan synd

A

Severe pph/failure to lactate

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31
Q

Y no laction during pregnancy

A

Estrogen inhibit action of prolactin on breast

32
Q

Thyroid storm highest in

A

Molar pregnancy during suction evacuation

33
Q

Source of progesterone

M

A

Maternal LDL

34
Q

Estrogen aource

A

Fetal DHEAS

Main E3

35
Q

Gonadotropin levels during pregnancy

A

Lh fsh very low

Inhition by estr and proges

36
Q

Placemta functioning assessd by whch hormone

A

Human placental lactogen/humanchorionic somatomammotropin - hisghest level 36 wks
Responsible for insulin resistance GDM

37
Q

Ace inhibitors causes

A

Renal dysfemesis oligohydramnios iugr

38
Q

Lithium causes

A

Ebsteins anomaly

39
Q

Fetal alcohol syndrome triad

A

Growth restrictions
Microcephqly
Cranio facial abnormality

40
Q

Diagnostic radiation in preg

A

<5 rads no fetal adverse effects

41
Q

Warfarin embryopathy occurs at a dose of

A

> 5 mg per day
6-12 wks- change to LMWH
At 12 wks-change to warfarin
At 36 wks-change to lmwh

42
Q

Mifipristone and misoproatol in pregnancy cause

A

Moebius syndrome

6 and 7 nerve miso> mifi)

43
Q

Abortion types

A 
Missed abortion
Os closed
 ut< Pog
Cardiqc activity - nil
Threatened
Os closed
Ut=pog
Cardiac activity present
Inevitable 
Os open
Ut= pog
Incomplete os open
Ut< pog
Prdts expelked
44
Q

Mtp done upto

A

24 weeks(rape/incest/gca)
Upto 20 -1 registers mp
20-24- 2 RMP
> 24 nedical bor

45
Q

Medical mtp

A 
Op upto 7 wks
200 mifi+ 409 miso
In pt 7-9 wk
200 mifi+ 800 miso
7-12 (s/e or mva)
12-24 d and e or medical
46
Q

Recurrent pregnancy loss most common cause

A

APLA
Antibodies-LAC/ACA
Abortion thrombosis ptl can happen
Treatment in pregnancy- LMWH+ Aspirin (lmwh only if h/o abortion or thrombosis)

47
Q

Common uterine anomaly for reccrnt abortion

A

Septate uterus

48
Q

Diagnositic criteria for gtn

A

Hcg
4 values plateau
3 values rise
After > 6 months of evacuation incrased hcg

49
Q

Treatment of gtn

A 
Low risk-(stage 1,2/3,who<6) -Methotrexate,actinomycin d
High risk(stage 4,2/3,who >=7)-mutiagent=EMACO,EMAEP
50
Q

DOC for prevntion and mx of pph

A

Oxytocin

51
Q

Half life of oxytocin

A

3 minutes

52
Q

Synthetic analogue of oxytocin

A

Carbetocin(40 minute half life)

53
Q

Next step in impending eclampsia

A

Mgso4

54
Q

Frst sign of toxicity of mg

A

Loss of pattelllar reflex( 10 meq)
Therapeutic level 4-7 meq
Antidote for mgso4 -10ml of 10% ca gliconate

55
Q

Carboprost

A 
Pgf2 alpha
Other names-dinoprost/hemabate)
Dose- 0.25 mg im (max dose in a day 2 mg)
Ci- asthma
Not used for induction at term
Not  used for AmTsl
Imp s/e diarrhea
56
Q

Misoprost

A

Pge1 alpha/only prostaglandin available in tablet
Myp/iol/pph
Safe in asthmatics
S/e hyper therimua

57
Q

Doc antihypertensive in pre

A

Labetalol

58
Q

Safest antihypertensive

A

Methyl dopa

59
Q

Acute hypertension doc

A

Iv labetalol
2 nd line- iv hydralazine
Donot use mwthyl dooa in acute htn

60
Q

Ci antihypertensives

A

Ace inhibitors
Beta blockesrs
Diuretics
ARBs

61
Q

Preferes sterold for lumg maturation

A

Dexamethaaone(6 mg 4 doses 12 hrs apart)
Betamethasone(12 mg 2 doaes24 hrs apart )
Bothbim

62
Q

Steriods contraindicated in

A

Chorioamnionitis
Cord prolapse
Eclampsia
Impending eclapmsia

63
Q

Diagnostic criteria for HELP synd(pain in the epigastrium or rght upper quadrant pain)

A 
Tennessce criteria
Hemolysis 
Smear shows schistocytesb
Bilirubin > 1.2
Low serum haptoglobin or high ldh
Severe anemia
Elevated liver enzyme(ast/ alt more than twice
Low playelet count
64
Q 
Liver enzymes 5-10 times elevated
Elevated ammonia
Decerease glucose
Fibrinogen decreased
Decreased paltrletsprolonged pt/ptt
Decreased antithrombin
A

Acute fattyliver diseas(AFLD)

65
Q

Risk factors for AFLP

A 
Mutifetal preg
History of aflp
Male sex
Htn
Primigravida
66
Q

Pruritis(cardinal symptoms)nausea vomiting poor apetite

A

Obstetric cholestasis
Dx- elevated bile acids ( conjugated)
Mx- ursodeoxychokic acid and termination at 37 weeks(more dangerus to fetus cause-rds,iud,mas)

67
Q

Most common hepatitis in preg

A

Hep b

68
Q

Most common acutete hepatitis

A

Hep e

69
Q

Peripartum cardiomyopathy

A

M/c within 1 week of delivery
Risk factor- twins preeclampsia advance age
No underlying heart disese present with heart failure

70
Q

Etilogical hormone in peripartum cardiomyopathy

A

Prolactin

71
Q

Postpartum patient with immediate shock

A 
Uterine inversion
Neurogenic shock
Fundis not felt -hemorrhage(cause of death)
Mannual repositioning
Stop oxytocidont remove placenta
72
Q

Postpartum patiemt with unexplained shock

A

Amniotic fluid embolism

Breathlessnecarfoo vascular collapse prebet as dic

73
Q

Postpartum pt with fever dd

A

1 endometritis - h/o cs prom chorioamniotis iv antibiotic
C/f uterine temderness foul smelling discharge
2)septic pelvic thrombophlebitis
Fever not reponding to antibiotic
Continue antibiotic and add coagulation
Ct or mri -cord like ovarian vein-rt vwin involved more dute to valveless
3) mastitis
Firm red tender
Staph auteus
Tx- complete emptying cold compresses antibiotics

74
Q

Episiotomy

A

Grade 2 perineal tear
Mediolateral
Does not extend to anal sphincter muscles cut- bulbospongiosus transverse perinela,levator ani(pubicoxxugeous)
Dehiscene early repair 2-3 wks

75
Q

Perineal tears

A

Grade 3 sphincters
4 rectal mucosa- immediate repair with in 24 hra
Pt comes > 24 hrs at 2-3 wks

76
Q

Most common cause of pph

A

Atony

77
Q

AMTSL

A

Uteritonic
Deluyaer clamping
Controled cord traction
Intermittent tone assessment

Obg (2 decks)

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