EFA Session Flashcards
what is the chance of a woman being haemophilia carrier if her father has it?
100%
inheritance pattern of haemophilia
X linked recessive
chance of carrier of haemophillia if healthy dad and mother is carrier
50% girls are carriers
chance of son having haemophilia if healthy dad and mother is carrier
50% boys have it
x linked recessive diseases
red green colour blindness
DMD
becker MD
haemophillia A / B
a-gammaglobulinaemia
ichythyosis
what structure is palpated to allow correct placement of pudendal nerve block
ishial spine
what else are ishial spines used to assess
engagement of head
pudendal nerve block placement
why shouldn’t ibuprofen be given to pregnant women
it will close the ductus arteriosus
woman comes in with high BP, proteinuria, epigastric pain, blurred vision and brisk reflexes. what medication should be given immediately?
MgSO4
what is loading dose of mgso4
4g
what is infusion dose of mgso4
1g/hr for 24hrs
woman in labour for 12hrs. 4cm dilated on arrival, now 8cm. cephalic presentation, normal CTG. what is her current status:
- normal labour
- failure to progress 1st SOL
- failure to progress 2nd SOL
- failure to progress 3rd SOL
- malpresentation
failure to progress in 1st stage of labour
what supplement can reduce recurrent risk of anencephaly
folic acid
when should folic acid be started
3 months pre conception
when should folic acid be stopped
after 1st trimester
low and high dose folic acid
low = 400ug
high = 5mg
iranian woman at ANC at 14/40
Hb normal
MCV low
ferritin normal
Dx?
beta thalasaaemia trait
(microcytosis)
iranian woman at ANC at 14/40
Hb normal
MCV low
ferritin normal
why is this not G6PD def?
women are only carriers of the disease, so she can’t have G6PD (x linked)
what is the commonest inherited abnormality of RBCs
G6PD def
nuchal translucency scan assesses the quantity of which fluid at the nape of the foetal neck?
lymph
what does increased nuchal translucency indicate
dilated lymphatic channels –> non specific sign of more generalised foetal abnormality
what kind of test is nuchal translucency scan?
screening NOT diagnostic
risk factors for preterm labour
IDIOPATHIC
prev preterm birth
multiple preg
infection
underweight / obese
current smoking
foetal abnormality
GDM
placenta praevia
iatrogenic - LLETZ, early due to PET/praevia
36F at 36/40. BP 115/65, longitudinal cephalic lie. SFH 38cm. + proteinuria, nil ketones, blood, nitrites, leucocytes. Dx?
NORMAL pregnancy
Dx of PET
140/90 and ++proteinuria
protein creatinine ratio
normal SFH
gestational age +/- 2cm
endometrial biopsy shows:
straight tubular glands with mitotic figures in epithelium and stroma. consistent with proliferative phase.
which day of 28 day cycle is this?
8 to 12
which days is the proliferative days
4 to 14
32F wants contraception to improve irregular periods and reduce Sx of premenstrual tension. non smoker, normal BMI. best contraception?
COCP
which hormone improves irregular bleeding
oestrogen
which hormone helps premenstrual Sx
oestrogen
which cancer risk is increased with combined HRT
breast
other risks of HRT
endometrial cancer
VTE
stroke / MI
breast (combined HRT)
29F has intermittent vaginal bleeding after mirena coil inserted 6 weeks ago. Best Ix?
NONE - normal to bleed for up to 6 months after IUD
cyst contains dirty fluid and fat, together with hair shafts and greasy material. Histological Dx?
mature cystic teratoma
types of ovarian cyst
dermoid (teratoma)
functional (enlarged follicle)
endometrioma (blood in cyst)
benign cystadenoma (ovarian capsule)
PCOS
woman with 2 children and 2 terminations after COCP didnt work. DNAd 2x previously. Uterine fibroids in bulky uterus. May want more children in future. Contraceptive?
Progesterone implant
- long lasting, reversible
- doesnt need regular attendance
- fine with fibroids etc
which contraceptive method doesn’t work with fibroids
coil
72F with painful grade 3 uterine prolapse. PMH COPD, IHD. 3 SVDs. BMI 46. Best Mx?
vaginal pessary
72F with painful grade 3 uterine prolapse. PMH COPD, IHD. 3 SVDs. BMI 46. Why is repair / hysterectomy not appropriate?
Poor surgical candidate due to COPD, IHD
38F at 10/40. Haemodynamically stable. Suprapubic tenderness, uterus palpable in abdomen. Cervical os open. Dx?
inevitable miscarriage
when is inevitable miscarriage more likely
multiple preg eg IVF
38F at 10/40. Haemodynamically stable. Suprapubic tenderness, uterus palpable in abdomen. Cervical os open. what is the relevance of palpable uterus?
too big for dates - multiple preg suspected
can inevtiable miscarriages be stopped?
no - os is open
Sx of missed miscarriages
NONE usually
32F no periods for 6 months. Normal BMI. FSH high (30), LH high(20). Cofirmed 1 month later. Dx?
Premature ovarian failure
why are LH and FSH high in POI
no negative feedback from oestrogen so high
diagnostic level of FSH for POI
> 30 on 2 blood tests, taken 4-6 weeks apart
37F 10/40. xs vomitting. SFH consistent with 16 weeks. High BP and HR. Dx?
Molar pregnancy
what is complete mole
2 paternal genes
no maternal genes (empty ovum)
no foetus
what is partial mole
3 sets of genes - 1 maternal, 2 paternal
non viable foetus
