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Obstetrics And Gynaecology > Extra > Flashcards

Extra Flashcards

1
Q

What are the Hb value in the different trimesters of pregnancy that define anaemia?

A

1st = less than 100g/l
2nd = less than 105 g/l
3rd = less than 100 g/l

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2
Q

How long should iron tablets be given after iron deficiency is corrected?

A

3 months to allow iron stores to be replenished

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3
Q

What are risk factors for placenta praevia?

A

Prev placenta praevia, prev C section, endometrium damage and multiple pregnancies

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4
Q

What are clinical features of placenta praevia?

A

Shock in proportion to visible loss, painless, uterus not tender, lie and presentation may be abnormal,

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5
Q

Would you do a digital vaginal examination before an ultrasound in someone with suspected placenta praevia?

A

No as this could provoke a severe haemorrhage

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6
Q

What are the four grading of placenta praevia?

A

1- placenta reaches lower segment but not internal os
2- placenta reached internal os but does not cover it
3-covers internal os but not when dilated
4- placenta completely cover internal os

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7
Q

In gestational diabetes, if the glucose targets are not met with diet changes or 1-2 weeks of metformin, what should be done?

A

Insulin should be added

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8
Q

What are risk factors for gestational diabetes?

A

BMI>30, previous macrosomia babies, prev gestational diabetes, first degree FHx, ethnicity (south Asian, black Carribean, middle eastern)

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9
Q

What are the diagnostic thresholds for gestational diabetes? (Hint= 5678)

A

Fasting blood glucose >5.6
2-hour blood glucose >7.8

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10
Q

What is a galactocoele and how is it differentiated from an abscess?

A

Galactocoele is cystic lesion lesion in the breast caused by a build up of breast milk from an occluded lactiferous duct.
Galactocoeles are painless and have no local or systemic signs of infection

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11
Q

What does of folic acid are some with BMI over 30 adviced to take?

A

High dose 5 mg daily

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12
Q

What is placenta accreta?

A

The attachment of the placenta to the myometrium due to a defective decidua basalis

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13
Q

What is the main risk associated with placenta accreta?

A

Postpartum haemorrhage

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14
Q

What are the 3 different types of placenta accreta? How do they differ?

A

Accreta- attach to myometrium
Increased- invade into myometrium
Percreta- invade through the perimetrium

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15
Q

When do women who are rhesus negative have routine anti-D injections?

A

28 and 34 weeks gestation

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16
Q

After how many weeks would you refer a pregnant woman if they had still not felt any fetal movements?

A

24 weeks

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17
Q

What combination of results would indicate increased risk of downs from the combined test?

A

Thickened nuchal translucency, increased beta-HCG, decreased PAPP-A

18
Q

What examination can be done to confirm premature prelabour rupture of membranes?

A

Sterile speculum examination- looking for pooling of amniotic fluid in posterior vaginal vault

19
Q

If PPROMS is suspected but no pooling is seen on speculum examination, what investigation can be done?

A

Test the fluid for placental alpha microglobulin-1 protein (PAMG-1) or insulin like growth factor binding protein-1

20
Q

What is the management of a patient with PPROMs?

A

Admission
Regular obs to check if chorioamnionitis developing
Oral erythromycin for 10 days
Corticosteroids for baby resp
Delivery considered after 34 weeks gestation

21
Q

What screening tool can be used to assess postnatal depression?

A

Edinburgh scale

22
Q

Increases and decreases in AFP during pregancy are associated with what pathologies in the baby?

A

Raised= neural tube defects
Decreased= downs

23
Q

What further manoeuvre can help the effectiveness of Roberts manouevre in shoulder dystocia?

A

Suprapubic pressure

24
Q

What is the definitive treatment for obstetric cholestasis?

A

Ursodeoxycholic acid

25
Q

Delivery should not be offered to pregnant women with pre-eclampsia unless which conditions are met?

A

Severe maternal hypertension that is refractory to treatment
Maternal or fetal indications develop as specified in consultants plan

26
Q

What antibiotic is used for GBS prophylaxis?

A

Benzylpenicillin

27
Q

What are some clinical features of placental abruption?

A

Shock out of proportion to visible blood loss, constant pain, tender and tense uterus, fetal heart absent/distressed

28
Q

How are pregnant women over 20 weeks that develop chicken pox treated if they present within 24 hours of rash onset?

A

Oral aciclovir

29
Q

What is first line treatment for magnesium sulphate induced respiratory depression?

A

Calcium gluconate

30
Q

What are some potential consequences of pre-eclampsia?

A

Eclampsia and other neuro symptoms
Intrauterine growth retardation, prematurity, liver involvement, haemorrhage (placental abruption, intracerebral, intraabdominal), cardiac failure

31
Q

In the quadruple test for down screening what results would predict an increased risk?

A

AFP and oestriol decreased
B-HCG and inhibin A increased

32
Q

What are the SSRIs of choice in breast feeding women?

A

Sertraline and paroxetine

33
Q

Is aspirin okay to continue during breastfeeding?

A

No aspirin must be avoided in breastfeeding

34
Q

If a pregnant woman is found to be group b strep positive what can be done to reduce risk to baby?

A

Intrapartum IV benzylpenicillin

35
Q

How long should methotrexate be stopped for before conception? Do men need to stop taking methotrexate?

A

Both men and women should stop taking methotrexate for 6 months before conception

36
Q

A score of what on the Edinburgh postnatal depression scale suggested a depressive illness?

A

Over 13

37
Q

When should women with any risk factor other than previous gestational diabetes be tested with OGTT?

A

24-28 weeks

38
Q

What prophylaxis should be offered to pregnant women who had a previous baby develop GBS infection after being born?

A

IV benzylpenicillin for the mother during labour

39
Q

what are risk factors for placental abruption?

A

multiparity, increased maternal age, maternal trauma, pre-eclampsia

40
Q

what are some concerning features of lochia that would require further investigation?

A

volume increases, starts to smell bad, doesnt stop (usually lasts around 2weeks)

41
Q

what are the risk factors for placental abruption (ABRUPTION mneumonic)?

A

A- abruption previously
B- blood pressure (high)
R- rupture of membranes
U- uterine injury
P- polyhydramnios
T- twins/multiple pregnancy
I- infection
O- older age
N- narcotic use

42
Q
A

Obstetrics And Gynaecology (8 decks)

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