Medical problems

Question 1

What 2 antiemetics are useful in pregnancy?

Answer 1

Cyclizine and Metoclopramide.

Question 2

What do you give to reduce chance of pre-eclampsia?

Answer 2

75mg aspirin from week 12

Question 3

When is pregnancy induced hypertension?

Answer 3

After week 20.

Question 4

Main cause of death in pre-eclampsia?

Answer 4

Pulmonary oedema.

Question 5

In pre-eclampsia, what labour drug should never be used?

Answer 5

Ergometrine. (Due to raised BP)

Question 6

If previous gestational diabetes, what do u do?

Answer 6

Do a 2hr OGTT at booking then at 24-28 weeks.

Question 7

WHat is the limit for 2 hour OGTT?

Answer 7

8.5mmmol.

Question 8

Is thyroxine okay in pregnancy?

Answer 8

Yeas

Question 9

If someone has antiphospholipid syndrome or past VTEs, what do u do?

Answer 9

Aspirin from conece[room and then LMWH from week 6 to delivery.

Question 10

What can NSAIDs do?

Answer 10

They can prematurely close the ductus arteiorus.

Question 11

What can ACEI cause?

Answer 11

Renal hypoplasia.

Question 12

Diagnostic criteria for gestational hypertension?

Answer 12

DBO > 110 on any occasion.

BP > 140/90 twice

Increase of >30/15 since booking

Question 13

Symptoms of pre-eclampsia?

Answer 13

Dizziness, 
Headaches
Visual disturbance 
RUQ or epigastic pain. 
Rapidly progressiong oedema (face and ankles)

Question 14

Management of Eclampsia?

Answer 14

Magnesium Sulphaye.

Question 15

What rheum condition gets better with pregnancy?

Answer 15

RA

Question 16

What rheum condition flares during pregnancy?

Answer 16

SLE

Question 17

What do the bloods show in cholestasis of pregnancy?

Answer 17

Mildly increased ALT/AST and increased bilirubin.

Question 18

Management of itch in cholestasis?

Answer 18

Ursodeoxycholic acid.

Question 19

What is acute fatty liver of pregnancy?

Answer 19

AFP is an emergency with fat deposition in loibver and usually around weeek 30.

Question 20

What is the management of pyelonephritis in pregnancy?

Answer 20

Co-amoxilcav.

Question 21

What is the side effect of SSRI in pregnancy?

Answer 21

May cause pulmonary hypertension if used after 20 weeks.

Question 22

Baby Blues

Answer 22

3-10 days following delivery, very common and seen in 50% of women.

Tearful anxious etc.

Reassure

Question 23

Post natal depression.

Answer 23

Onset 2-6 weeks.

Resolution weeks to months but some up to a year.

Similar to baby blues but ore obvious depressive signs.

Question 24

Puerperal psycho is?

Answer 24

psych emergency due to maternal sucicid.
T

Occurs within 2 weeks of delivery

Risks are bipolar, previous episode, first degree FH.

Management = admit to mom and baby unit.

Question 25

Alcohol misuse risks in pregnancy?

Answer 25

Low IQ
Hearing proble,s
Heart and kidney malformations.
Facial dysmorphism.

Question 26

Presentation of vasa praevia

Answer 26

Painless bleeeding following rupture of membranes.

CTG shows fetal distesss.

IF Dx following ROM, Emergency section.

Question 27

Bloody show:

Answer 27

Loss of cervical mucus plug that develops during pregnancy.

Light vaginal bleeding, nothing else.

Question 28

Uterine rupture presentation?

Answer 28

Rare complication of fdelivery.

Most commonly seen in obstructed labour in women who has had previous section.

Typical = peritonism, vag bleed and fetal distress with loss of engagement

Management = emergency sectio