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Isleans Mrcog Part 2 > Maternal Medicine > Flashcards

Maternal Medicine Flashcards

1
Q

How soon should methyldopa be stopped postpartum

A

2 days

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2
Q

What treatment reduces pruritis in OC

A

Ursodeoxychic acid

Chlorpheniramine provides sedation at night but has no significant impact on pruritis

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3
Q

At what viral load should a LSCS be considered if on HAART treatment

A

50-400

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4
Q

At what viral load should a LSCS be recommended if on HAART treatment

A

> 400

ELCS recommended at 38-39 weeks

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5
Q

In the U.K. What is the rate of HIV transmission if the mother is on HAART

A

0.7%

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6
Q

Regarding women on ART for HIV at what gestation should a decision on delivery be made

A

36 weeks

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7
Q

In HIV positive women not requiring treatment for themselves, when should cART be commenced

A

By 24/40

At 13/40 if baseline viral load >30,000

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8
Q

In HIV positive women not requiring treatment for themselves, when should zidovudine be commenced

A

Only if opting for ELCS between 38-39 weeks and baseline viral load <10,000

IV zidovudine to be given at delivery

Stop all medication after delivery

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9
Q

What is the management for HIV positive women with PPROM <34 weeks

A

If no chorioamnionitis

Steroids
Erythromycin
MDT discussion regarding delivery

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10
Q

incidence of idiopathic intracranial hypertension in women of childbearing age

A

0.9/100,000

Obese 19.3/100,000

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11
Q

Regarding asthma, what is recommended for maintaining control in labour

A

Systemic steroids

100mg hydrocortisone 6-8hourly during labour

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12
Q

What percentage of sickle patients have a painful crises in pregnancy

A

27-50%

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13
Q

What percentage of women have overt hypothyroidism in pregnancy

A

0.5%

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14
Q

What percentage of women have subclinical hypothyroidism in pregnancy

A

2.5%

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15
Q

A women with hypothyroidism is taking 75mcg at booking, what would you advise

A

Increase to 100mcg (increase by 25mcg)

Repeat LFT 4-6 weekly to maintain TSH <2.5

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16
Q

What medication should be avoided in the acute phase post MI

A

Nifedipine

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17
Q

What is the traid of wernickes

A deficiency of what causes it

A

Ophthalmoplegia, ataxia and confusion

Vitamin B1 - thiamine

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18
Q

What % of women are affected by hyperemesis gravidarum

A

<1%

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19
Q

What percentage of pregnancies are effected by round ligament pain

A

10-30%

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20
Q

How common is pyelonephritis in pregnancy

A

10-25 in 1000 pregnancies

21
Q

How common is acute appendicitis in pregnancy

A

1:800-1500

22
Q

What % of pregnant women are affected by OC

A

0.7%

23
Q

What is the recurrence risk for OC

A

> 90%

24
Q

What is the rate of fetal mortality within OC

A

1-4%

But now comparative to normal population due to treatment and delivery at 38 weeks

25
Q

What % of PET are affected by HELLP syndrome

A

5-20%

26
Q

What is the maternal mortality associated with HELLP

A

1%

27
Q

Regarding acute fatty liver of pregnancy

What deficiency should be screened for in the baby

What is the most common mutation

A

LCHAD deficiency

The most common mutation is E474Q

28
Q

Regarding acute fatty liver of pregnancy

A

25%

29
Q

What is the risk of VTE in pregnancy with antithrombin deficiency

A

30%

30
Q

What management should be given a woman IS HIV + untreated and arrives in labour

A

Nevirapine
IV zidovudine
Start triple ART

31
Q

What screening should be offered if a HIV woman presents >13+6

What would you warn her

A

Quad test

However increased risk of false positives due to higher hcg and aFP in HIV + population

32
Q

Regarding HIV positive patients

When should IV zidovudine be given

A

In labour with unknown viral load, viral load >1000

Prom with unknown viral load or viral load >1000

Viral load >1000 or zidovudine monotherapy admitted for ELCS

33
Q

What is the risk of HIV vertical transmission in utero if not on ARVs

A

25-30%

34
Q

What is the risk of HIV vertical transmission during breast feeding if not on ARVs

A

50-60%

35
Q

What are the cut off values for OGTT

Fasting and 2hr

A

> 5.6 fasting

>7.8 2 hour

36
Q

What is the fetal radiation exposure from a cxr

A

0.01msu

37
Q

What is the fetal radiation exposure from a CTPa

A

0.1 mGy

38
Q

What is the fetal radiation exposure from a V/Q scan

A

0.5mGy

39
Q

By how much is the risk of childhood cancer increased by for fetal exposure to 1 mGy

A

0.006%

Or 1:17,000

40
Q

What finding on echo indicates increased risk of pulmonary HTN

A

Tricuspid regurg jet velocity >2.5m/sec

41
Q

Women with pre existing diabetes should be advised against conception if their hba1c is over what level

A

10% 86mmol/mol

42
Q

What % of women will need metformin or insulin after a diagnosis of GDM

A

15-20%

Usually initiated if failure to meet by targets over 1-2 weeks

43
Q

What BM thresholds should prompt initiation of sliding scale in labour

How often should bms be checked

A

4-7 mmol/L

Hourly

44
Q

At what gestation should trab Ab be checked

A

20-24 weeks

45
Q

How long after radioidine therapy should a woman wait to conceive

A

4 months

46
Q

BM target ranges in pregnancy

Fasting
1hr post
2hr post

A

Fasting 5.3
1hr post 7.8
2hr post 6.4

47
Q

When should women with GDM be started on insulin +/- metformin immediately, without a trial of diet and exercise

A

fasting BM >7

Fasting 6-6.9 if macrosomia or polyhydramnios

48
Q

What is the fetal radiation exposure from a CT head

A

<0.005mGy

Isleans Mrcog Part 2 (26 decks)

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