EFA Session Flashcards by Lottie Barot

what is the chance of a woman being haemophilia carrier if her father has it?

100%

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inheritance pattern of haemophilia

X linked recessive

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chance of carrier of haemophillia if healthy dad and mother is carrier

50% girls are carriers

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chance of son having haemophilia if healthy dad and mother is carrier

50% boys have it

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x linked recessive diseases

red green colour blindness
DMD
becker MD
haemophillia A / B
a-gammaglobulinaemia
ichythyosis

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what structure is palpated to allow correct placement of pudendal nerve block

ishial spine

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what else are ishial spines used to assess

engagement of head
pudendal nerve block placement

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why shouldn’t ibuprofen be given to pregnant women

it will close the ductus arteriosus

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woman comes in with high BP, proteinuria, epigastric pain, blurred vision and brisk reflexes. what medication should be given immediately?

MgSO4

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what is loading dose of mgso4

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what is infusion dose of mgso4

1g/hr for 24hrs

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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

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what supplement can reduce recurrent risk of anencephaly

folic acid

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when should folic acid be started

3 months pre conception

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when should folic acid be stopped

after 1st trimester

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low and high dose folic acid

low = 400ug
high = 5mg

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iranian woman at ANC at 14/40
Hb normal
MCV low
ferritin normal
Dx?

beta thalasaaemia trait
(microcytosis)

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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)

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what is the commonest inherited abnormality of RBCs

G6PD def

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nuchal translucency scan assesses the quantity of which fluid at the nape of the foetal neck?

lymph

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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