Medical Obstetrics

Question 1

When in pregnancy does pre-eclampsia first occur?

Answer 1

20 weeks onwards
- Treatment after 34/40: delivery

Question 2

Most common cause of ACS in pregnancy?

Answer 2

Sudden coronary artery dissection (SCAD)

Question 3

Which hepatitis B anti-viral is able to be used in pregnancy, and when?

Answer 3

Tenofovir fumarate
- If viral load 100K (10^5)

F for foetus

Question 4

Rash in pregnant woman?

Answer 4

Polymorphic eruption of pregnancy (PEP) typically begins with intensely pruritic papules arising within striae distensae late in the third trimester of a first pregnancy

Question 5

How to distinguish lupus nephritis vs. pre-eclampsia?

Answer 5

sFlt/PIGF ratio
• >38 is pre-eclampsia
• Deranged LFTs and raised urate in pre-eclampsia

SLE nephritis
- Haematuria/active sediment
- Low complement
- Increased DsDNA

Question 6

Treatment hyperthyroidism in pregnancy

Answer 6

Dx 1st trimester - PTU
Dx after 1st trimester - carbimazole

Question 7

Sudden onset of SOB, hypotension/cardiovascular collapse, and coagulopathy during acute peripartum period makes you think?

Answer 7

Amniotic fluid embolus

TTE findings: right ventricle dilatation, hypokinesis, and overload, tricuspid regurgitation, and right atrial enlargement. Early cardiac thrombi may be detected in the enlarged right ventricle or right atrium. Highly associated with this syndrome is the bowing of the intraventricular septum into the left ventricle, creating left ventricular obstruction and systolic dysfunction

Question 8

Anti-HTN for urgent control of BP in pregnancy?

Answer 8

IV labetalol
IV hydralazine
IR nifedipine