Module 4 Women's Health

Question 1

What is a Braxton-Hicks contraction?

Answer 1

Irregular uterine contraction, not associated with labour

Question 2

Name for stretch marks

Answer 2

Straie Gravidarum

Question 3

Name for morning sickness

Answer 3

Hyperemesis gravidarum

Question 4

Hyperemesis Gravidarum treatment and complications

Answer 4

Pyridoxine or metoclopramide
Psychotherapy

Anaemia, hyponatraemia, kidney failure
PTSD
VTE
PE
Depression
Lower infant birth weight
Premature labour

Question 5

Pre-eclampsia cause

Answer 5

Abnormal formation of blood vessels in the placenta - leading to inflammatory reaction

Question 6

Pre-eclampsia definition

Answer 6

20 weeks, new onset, 140/90 HTN, Proteinuria, resolves after pregnancy

Question 7

Name of milk precursor

Answer 7

Colostrum

Question 8

What is Chadwick’s sign

Answer 8

vaginal/cervical cyanosis

Question 9

Hegar’s sign

Answer 9

Palpable softening of the Cervical Isthmus

Question 10

What is the white vaginal discharge of pregnancy called?

Answer 10

Leukorrhea

Question 11

How to calculate due date?

Answer 11

Naegele’s rule:

LMP +7 days
-3 months
+1 year

Question 12

maternal nutrition

Answer 12

30 mg iron a day

0.4-0.8 mg folic acid a day

Question 13

Normal weight gain in first trimester

Answer 13

5%

Question 14

How many additional calories needed by mother

Answer 14

300 calories extra per day

Question 15

Comparison between GHTN, Pre-eclampsia and chronic hypertension…

Answer 15

GHTM is >140/90 after 20 weeks

Pre-eclampsia is >140/90, after 20 weeks with proteinuria

Chronic HTN is >140/90before pregnancy, before 20 weeks oand after 12 weeks

Question 16

What is peripartum cardiomyopathy

Answer 16

Peripartum cardiomyopathy is a weakness of the heart muscle that by definition begins sometime during the final month of pregnancy through about five months after delivery, without any other known cause. Most commonly, it occurs right after delivery. It is a rare condition that can carry mild or severe symptoms

Question 17

Fundus measuring principles

Answer 17

Should be measured if over 20 weeks

At 20 weeks should reach umbilicus
in 16-36 weeks, length should match age in weeks

If 4 cm too long consider twin pregnancy, polyhydramnios, large fetus, uterine myoma

If 4cm too short, consider oligohydrosis, missed abortion, IUGR, fetal anomaly

Question 18

GP system

Answer 18

TPAL  
Term deliveries
Preterm deliveries
Abortions
Living children
Ga,Pbcde

Question 19

Normal folic acid dose

Answer 19

400 micrograms

Question 20

Who should have 5mg folic acid

Answer 20

Women with diabetes

Higher doses also needed for high BMI patients, patients on anti-epileptics, women with previous neural defect pregnancies

A prescription is needed

Question 21

Most common nutrient deficiency in pregnancy?

How is it identified?

Answer 21

Iron

Look at FBC, MCV

Ferritin drops in pregnancy anyway

There is physiological anaemia due to increased blood volume anyway.

Question 22

When is pre-eclampsia more common?

Answer 22

Primigravid, older patients, multiple pregnancy

Question 23

Is prednisolone safe in breast feeding?

Answer 23

Yes after 1st trimester

Question 24

Steroid given for fetus

Answer 24

Dexamethasone is given as metabolised by placenta

Question 25

Risk factors of obstetric cholestasis

Answer 25

Fetal size
Obesity
Multiple pregnancy

Manage anxiety, increased risk of still birth

Treat with ursodeoxycholic acid

Question 26

obstetric cholestasis sign

Answer 26

Itching with no rash

Question 27

Commonest cause of pregnancy related maternal mortality in the uk

Answer 27

Sepsis

Indirect cause - CVD

Question 28

Principles of HIV management in pregnancy

Answer 28

Screening
No breast feeding
if low viral load, vaginal birth can happen, if not then c-section

Question 29

Anti-emetics to use in hyperemesis

Answer 29

Cyclozine
hydrocortisone
Metoclopramide

Question 30

Risks of diabetes in pregnancy

Answer 30

3/4 x risk increase for fetal abnormalities

Question 31

When to worry about maternal heart murmur

Answer 31

Overseas patients

Diastolic murmur - RH overload