O&G

Question 1

What fluids are given in hyperemesis gravidarum?

Answer 1

IV saline + KCl + cyclizine

Question 2

What drugs are used in hyperemesis gravidarum?

Answer 2

Anti-histamine = promethazine
Anti-emetic = cyclizine, ondasetron, metoclopramide

Question 3

Which position are pregnant women put in during distress?

Answer 3

Left lateral position - prevents uterine compression of IVC

Question 4

How do you calculate Parity?

Answer 4

Number of viable pregnancies over 24w - e.g. stillbirth still counts

Question 5

What does Parity 1+1 mean?

Answer 5

1 pregnancy before 24w

1 miscarriage before 24w

Question 6

What dates are anti-D given?

Answer 6

28 and 34 weeks to Rh-ve mothers

Question 7

Which analgesia is used in LS C-section?

Answer 7

Spinal anaesthesia

Question 8

What are the 4 grades of C-section?

Answer 8

1 - emergency
2 - urgent
3 - scheduled
4 - elective

Question 9

What are 2 risks of breech?

Answer 9

Cord prolapse

DDH

Question 10

How do you do induction of labour?

Answer 10

1. Membrane Sweep to stimulate natural prostaglandins
2. PGE-2 gel
3. Amniotomy + oxytocin

Question 11

What are the 3 treatments for shoulder dystocia?

Answer 11

1. McRoberts
2. Episiotomy + rotational manoeuvre
3. Hands and Knees Position

Question 12

For which patients is prophylaxis for pre-eclampsia given?

Answer 12

75mg Aspirin from 12w

1 high risk: CKD, DM, previous HTN in pregnancy, HTN normally, autoimmune (APS, SLE)

2 medium risk: obesity, 10 year gap, multiple pregnancy, over 40, nuliparity

Question 13

When do obstetric cholestasis / acute fatty liver of pregnancy present?

Answer 13

3rd trimester, after 30 weeks

Question 14

What are LFTs in obstetric cholestasis / acute fatty liver of pregnancy?

Answer 14

Obstetric cholestasis - high ALP, high GGT

Acute fatty liver - high ALT

Question 15

What is a common feature of HEELP urine?

Answer 15

Coca Cola Urine

Question 16

How long is LMWH given in pregnancy?

Answer 16

High risk (e.g. APS, hyperemesis, previous VTE) - start until 6 weeks post partum

Medium risk - 28 weeks to 6 weeks post partum

Low risk - 10 days post partum

Question 17

Ix for APS

Answer 17

Cardiolipin Ab

Question 18

Level of platelets in APS

Answer 18

Low platelets (Thrombocytopaenia)

Question 19

What should be given to epileptic patients from 36w?

Answer 19

Vitamin K

Question 20

What is given if there is a seizure during pregnancy?

Answer 20

Benzos

Question 21

What is the difference between PROM and PPROM?

Answer 21

PROM is rupture with absence of uterine contractions, after 37 weeks.
PPROM is rupture with absence of uterine contractions, before 37 weeks

Question 22

What is Mx of PPROM?

Answer 22

(If before 34w)
48h - keep in hospital, erythromycin + steroids + dexamethasone
Discharge if no spontaneous labour

Question 23

What is Mx of PROM?

Answer 23

(After 37w)
24h - wait for spontaneous labour
Induce if not

Question 24

3 common causes of premature birth?

Answer 24

Bacterial vaginosis
IUGR
Gestational diabetes

Question 25

Describe threatened miscarriage

Answer 25

Bleeding No pain Cervical os closed

Question 26

Describe what is unique about inevitable miscarriage

Answer 26

Only one with cervical os OPEN

Question 27

Describe completed miscarriage

Answer 27

Bleeding

Question 28

Complications of Oligohydramnios and Polyhydramnios

Answer 28

``` Oligo = pulmonary hypoplasia + clubbed feet (Potter) Poly = cord prolapse + PROM ```

Question 29

In which situations are anti-Ab given apart from sensitising events?

Answer 29

ALL Rh-ve women at 28w and 34w

Question 30

Reasons for maternal IV benpen during birth for GBS prophylaxis

Answer 30

GBS in previous pregnancy GBS detected earlier Fever during labour Premature

Question 31

Reasons for fetal IV benpen after birth

Answer 31

High risk: - Chorioamnionitis - PROM - Premature

Question 32

Complications of Multiple Pregnancy

Answer 32

Hyperemesis (more BHCG) Pre-eclampsia PROM DM

Question 33

How do you Mx 'small for gestational age'

Answer 33

USS every 2w | If normal uterine artery doppler, no Mx

Question 34

How do you Mx IUGR

Answer 34

If at term, deliver

Question 35

Cause of IUGR

Answer 35

Pre-eclampsia Placental abruption Cocaine, smoking Maternal age > 40

Question 36

2 main organisms of maternal sepsis

Answer 36

Group A Strep E.coli GBS causes NEONATAL sepsis, not maternal!