Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP > Maternal medicine > Flashcards

Maternal medicine Flashcards

1
Q

Thyrotoxicosis in preg

A

Increase fetal loss, maternal HFx, prematurity

Graves

Mx:
Use PTU - 1st tri
Carbimazole 2nd

Dont use block and replace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypothyroidism

A

Thyroxine safe
Breastfeeding safe on thyroxine

MEasure TSH every triester then 6-8 wks post-partum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DB in preg - RFs

A 
prev GDM
prev macrosomia 
Obesity BMI>30
!st degree relative
High risk origin

If prev GDM –> OGTT as soon as possible then 24-28 weeks.
any other RF –> 24-28wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DB in preg diagnosis

A

Fasting 5.6

2hr - 7.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

GDM Mx

A

new diagnosis - joint endo ANC

Fasting BGL <7 –> Diet and Ex –> Fx of targets @ 2/52 –> +metformin

FBGL>7 –> Insulin

FBG 6-6.9 + Hydraminos/macrosomia –> insulin

glibencamide only if fx with metformin and refuase insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pre-existing DB

A

WL if BMI>27

Stop all oral hypoglycaemics –> insulin + metformin

Folic acid 5mg (conception –> 12 weeks)\

Aspirin 75mg (12 wks –> birth)

detailed anomaly scan @ 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BGL targets

A

fasting - 5.3

1hr - 7.8

2hr - 6.4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

BP normal physiology

A

Falls during 1st trimester –> 20-24 wks

Returns to normal term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

pre-existing HTN - pregnancy

A

up to 20 weeks gestation

> 140/90

no proteinuria/oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PIH

A

> 20wks

140/90

Proteinuria/oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pre-eclampsia

A

PIH + Proteinuria (0.3g/24hr)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HTN in preg definition

A

> 140/90

Or increase of >30/15 between booking readings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

High risk of HTN - pregnancy

A

HTN - prev pregnancy
CKD
AI - SLE/antiphospholipid
DB1 & 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antiphospholipid syndrome in pregnancy

A

Thrombosis

Presence of Lupus anticoagulant or anti-cardiolipin ab ( vs Cardiolipin component of cell wall)

Diagnosis:
- 2 tests (12weeks apart)
&

1 of:

  • Thrombosus
  • => 3 miscarriages
  • pre-eclampsia +/or FGR < 34 weeks
  • Fetal loss >10 wks
  • Placental abruption

Complications:

  • Recurrent miscarriage
  • IUGR
  • Still Birth
  • VTE
  • Premature
  • Pre-eclampsia

MX:

  • ASPIRIN as soon as confirmed preg
  • once fetal heart confirmed - LMWH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Post-partum thyroiditis

A

A.I.

assoc w/ thyroid anti-perocidase Ab

Histology:

  • Focal diffuse
  • lymphocytic infiltratio
  • follicular destruction
  • hyperplasia

3 Stages:

1) thyrotoxicosis - 1-3/12
2) Hypothyroid 3-8/12
3) Normal thyroid fn - 1yr post partum

LT surveillance as increase risk permanent hyothyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HTN in pregnancy Mx

A

High risk groups:

  • Prev HTN w/preg
  • CKD
  • A.I.
  • DB1+2

Aspirin 75mg (12wks to birth)

Labetolol/methldopa/nifedipine

17
Q

Pre-eclampsia - complications

A

predisposes:

  • eclampsia
  • fetal risk - premature/IUGR
  • haemorrhage - Placental abruption/intrauterine/intracerberal
  • cardiac fx
  • multi-organ fx
18
Q

pre-eclampsia - risk factors

A

High risk:

  • prev htn - w/preg
  • CKD
  • Antiphospholipid/SLE
  • DB1 & 2

Low Risk:

  • 1st preg >40yrs
  • Gap between preganncy - 10yrs
  • BMI >35
  • FHx
  • multiple preg
19
Q

Sev pre-eclampsia

A 
BP >170/110 + proteinuria 
Proteinuria ++/+++
Headache
visual change/papilloedema 
Epigastric pain 
hyperreflexia 
low platelets <100
20
Q

Pre -eclampsia mx

A

Labetolo - 1st line

Nifedipine/hydralazine second

21
Q

pre-eclampsia indications for delivery

A 
refractory severe HTN
LFx/RFx
Low platelets 
neuro 
Fetal CTG/fetal compromise
22
Q

pre-eclampsia - Maternal complications

A 
Low platelets
hypovol
DIC
Renal impairment + uric acid 
AST/ALT
23
Q

Intrahepatic cholestasis

A

most common cause of jaundice

seen in 3rd trimester

Ft

  • pruritus
  • high bili
  • no rash

Mx:

  • UDA
  • Wkly LFTs
  • Deliver @37wks
24
Q

Acute fatty liver

A

Rare

  • Increaseed ALT >500

Ft

  • Abdo pain
  • N/V
  • Headache
  • Jaundice
  • sev –> preclampsia

Assoc. w. HELLP:
- heamolysis, educated liver enzymes, low platelets

25
Q

Eclampsia

A

Convulsions occuring w/ pre-eclampsia in absence

Mx:

  • MgSO4- - used to prevetnt or x
  • 4g IV –> infusion 1g/hr
Montor:
UO
Reflexes
RR
O2 sats

MgSO4 –> RR Depression –> CA GLUCONATE
Fluid restrict

26
Q

Pregnancy DVT/PE

A

PReg hypercoaguable state –> Esp 3rd trimester

Aetiology:

  • increased F7/8/10
  • reduced protein S
  • Venous stasis

Mx - Warfarin CI –> LMWH

27
Q

Thrombophillia in Preg

A

Main disease:

  • homocystinuria
  • Antithrmbin deficiency
  • Protein C/S deficiency
  • Antiphospholiid syndrome
  • prothrombin gene variant
  • factor V leiden
28
Q

RF og thrombophilia - THROMBOSIS

A 
trauma 
HRT/hypercoaguable 
Recreational drugs 
Obesity/Obstetric 
Malignancy 
Birth control - OCP 
Old age 
Surgery 
immobile 
serious ill/sepsis
29
Q

Investigation of VTE in preg

A

US Doppler

CXR
ABG
ECG
V/Q - 1st line for PE unlesss lung pathoogy –> CTPA

30
Q

Air travel in preg

A

Long haul flight - >4hr - Stockings

if have a RF –> LMWH on day off and days after

31
Q

Post-partum thromboprophylaxis

A

Encourage early mobilisation

=> 2 RF - LMWH - 1/52

=>3 RF –> LMWH + Stockings

BMI>40 + Vag deliver –> 1/52 LMWH

BMI >40 + Csec –> 6/52 LMWH

If antenatal LMWH –> cont for 6/52 post-partum

MRCP (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions