hard stuff

Question 1

When is continuous CTG indicated?

Answer 1

contractions last longer than 2 minutes
more than 5 in 10 minutes
presence of meconium
maternal pyrexia
suspected chorioamniotis
abnormal pain
fresh vaginal bleed
blood stained liquor
maternal pulse >120
severe htn >160
htn >140

Question 2

what is the volume of amniotic fluid that is consistent with polyhydramnios

Answer 2

> 2-3L of amniotic fluid

Question 3

respiratory changes that are physiological to pregnancy?

Answer 3

increased minute ventilation
increased respiratory workload
feeling of breathlessness

increase in tidal volume

Question 4

how is uterine hyperstimulation syndrome assessed?

Answer 4

6 contractions in 10 minutes
<60s between contractions

Question 5

Variable decelerations occur secondary

Answer 5

to compression of the umbilical cord, initially leading to occlusion of the umbilical vein, leading to an acceleration, followed by occlusion of the umbilical artery, leading to a deep deceleration

Question 6

14 weeks pregnant
pain, distress
per vaginum bleed
lower abdo cramp pain

tender suprapubic rgeion
signs of infection

elevated high temp
high heart rate
low bp
normal oxygen saturations

Answer 6

1) A-E
2) call for senior help

Question 7

how is breastfeeding recommended?

Answer 7

6 months exclusive
continue for more than 2 years

Question 8

When is LNG-IUS not recommended in menorrhagia?

Answer 8

if uterine cavity is distorted
large fibroids

Question 9

can carbamazepine and OCP be given together?

what can?

Answer 9

no
enzyme inducer

progesterone implant
mirena

Question 10

who should be screened fro thyroid disease at pregnancy?

Answer 10

T1DM
first degree relative
autoimmune conditions

Question 11

sacrospinous fixation

Answer 11

suture top of vaginal vault to sacrospinous ligament
> complications include damage to sciatic nerve and pudendal vessel

Question 12

complications of sacrospinous fixation?

Answer 12

sciatic nerve
pudendal vessel

Question 13

secondary prevention

Answer 13

cervical cancer screening
enable early detection and prompt effective intervention to correct departures from state of health

Question 14

when is methyldopa contraindicated in htn in pregnancy?

Answer 14

if previous hx of depression

Question 15

Ovarian torsion
how does it present

how to investigate?

Answer 15

acutely unwell
sudden onset
rly painful

radiates to back or thigh

USS - abnormal ovarian blood flow and the presence of free fluid

Question 16

how to manage ruptured ovarian cyst causing haemodynamic instability

Answer 16

A-E

emergency laporatomy

Question 16

which cancers metastatise to para aortic lymph nodes?

Answer 16

ovarian and endometrial

Question 17

which cancer mets to pelvic lymph node?

Answer 17

pelvic lymph node