Brainscape's Knowledge GenomeTM

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


See full index

Phase 3a > O&G > Flashcards

O&G Flashcards

1
Q

Describe what happens to insulin in pregnancy

A

Release is increased
Resistance increases

Maternal insulin resistance

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

What Fetal compound antagonises maternal insulin

A

Fetal hPL

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

What is endovascular remodelling seen in the maternal uterus

A

spiral arteries Goes from low bore high resistance ->high bore low resistance

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

What can a mother do to optimise her foetus’s health?

A 
Not smoke.
Folic acid
Stop teratogenic meds
Don’t eat undercooked meats- listeria
Avoid oily fish - pollutants and mercury
Avoid liver - high vit A
Maternal rubella vaccination
Good control of preexisting med conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What medications are teratogenic

A 
Valporate 
Warfarin 
Retinoids
Trimethoprim 
ACEi
Methotrexate
Co amox
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

For what reasons might a woman need higher doses of folic acid?

A

Diabetes
Previous child/ relative with neural tube defects
On anticonvulsants

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

Up to what age is a neonate

A

Up to 28days

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

What is preterm

A

<37w

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

What is considered term

A

37-41w

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

What is considered low birthweight

A

<2500g

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

What weight is very low birthweight

A

<1500g

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

What weight is extremely low birth weight

A

<1000g

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

What is SGA?

A

Below 10th centile for gestation

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

What is large for gestational age?

A

> 90th centile for gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What risks do maternal obesity carry

A

Miscarriage
Gestational diabetes
Pregnancy induced hypertension

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

Benefits of neonatal screening

A

Reassurance when it’s fine
Counselling
Early termination
Interventions in utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the types of antenatal screening test?

A 
Standard= maternal serum screen, detailed USS
Advanced = chorionic villus sampling, fetal blood test, amniocentesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Benefits of glucocorticoids before preterm delivery

A

Matures lungs - less RDS

Less risk of IVH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How many hours do steroids need to be given before birth

A

At least 24hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When might a pregnant mother be given digoxin?

A

What the foetus is experiencing supraventricular tachyC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is screened for in a maternal antenatal blood test ?

A 
Blood group
HIV
Syphilis
HepB
Rubella
Neural tube defects- raised alphafetoprotein
Congenital abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complications of oligohydraminos

A

IUGR
Facial and limb deformities - potters syndrome
Pulmonary hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What information can be obtained in antenatal USS

A

Gestation of foetus
Growth of foetus
Anatomical abnormalities
Oligo/polyhydraminos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the Arnold chari malformation ?

A

Lemon shaped skull associated with spina bifida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Complications of preeclampsia to the foetus

A

Eclampsia-
Placental insufficiency
Growth restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Two causes of IUGR

A

Oligohydraminos

Placental insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Give the names of three drugs to treat OAB/urge incontinence

A

Oxybutanin
Tolterodine
Mirabegran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What investigations should you do for incontenence

A

Bladder diary
PV exam
Urine dip
Urodynamics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the medical treatment for stress incontinence

A

Duloxitine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Symptoms of cervical Ca

A

Purulent discharge
Post coital bleeding
IMB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

In what area is cervical Ca most likely to occur and what cells would you find here

A

In the transition zone

Endocervix and ectocervix meet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the classic symptom in ovarian CA

A

IBS symps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the red flag for endometrial Ca

A

PMB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the risk factors for endometrial Ca

A

Nulliparity
HRT
Tamoxifen
Obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most common gynae CA

A

Endometrial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What age spikes is cervical most common at

A

30s and 80s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

HPV risk factors

A

Early SI
Multiple partners
OCP
smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Risk factors for ovarian CA

A 
FHX
Brca1/2
Early menarche
Late menopause 
Nulliparity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What type of CA is endometrial CA

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What type of CA is ovarian CA

A

Epithelial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What type of ultrasound is suggested in investigating ovarian Ca

A

Pelvic USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the investigations you would do in endometrial Ca

A

Histeroscopy
TVuss
Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the treatment for stage 1 cervical Ca

A

Cone biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Which cells is the follicle does oestrogen come from

A

Granulosa cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which cells in the follicle does FSH act on

A

Granulosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What 3 hormones does the corpus luteum secrete ?

A

Oe
P
Inhibit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

The CL secretes inhibin what is the role of this

A

To suppress FSH as we don’t want another follicle growing yet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the role of FSH

A

To stimulate follicular growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the role of LH

A

Ovulation.

Maintain CL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Where is beta-HCG produced from and where does it act

A

Produced from and acts on the Corpus luteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the role of oestrogen in the menstrual cycle

A

Endometrial growth
At low concs suppress LH and FSH
At high concs cause LH surge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Which hormone is prominent in the first half of the menstrual cycle

A

Oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Which hormone is dominant in the second half of the menstrual cycle

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the role of progesterone

A

To maintain endometrial lining and promote secretory changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Where are LH and FSH secreted from

A

Ant pit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Where is the ovary would you find the follicles

A

In the cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How does the admin of exogenous progesterone act as contraception

A

It maintains the secondary endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How does the administration of exogenous oestrogen act as contraception

A

Steady low levels of oestrogen prevent ovulation through suppression of LH and FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the relationship between oestrogen and FSH

A

As oestrogen increases (from the follicle) FSH decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How does the fertilised egg prevent menstruation

A

It produces bhcg which acts on itself to keep producing progesterone which maintains endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What are the 3 WHO causes of anovulation

A

Hypogonadotrophic hypogonasim inc kallmanns and FHA

  1. PCOS
  2. primary ovarian insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are the 3 causes of hyperprolactineamia resulting in anovulation

A

Hypothyroidism
Androgen secreting Tumour
Psychotropic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What medication would you use for hyperprolactinaemia

A

Cabergoline (dopamine agonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What does prolactin inhibit the secretion of

A

GnRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What inhibits the secretion of prolactin

A

Dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Where might you get referee pain in ectopic pregnancy

A

Shoulder tip pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What finding might you see in TVUSS in ?ectopic

A

Excess fluid in peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are the presenting features of ectopic pregnancy

A

Abdo pain
Amennorhoea
+/- bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Where is the most likely location for an ectopic

A

Ampulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

RFs for ectopics

A 
Previous ectopic
PID
Gynae surgery
IUD
IVF
Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the management of someone presenting to hospital with ?ectopics

A

Check they are HD stable
Is the bHCG doubling every two days
Methotrexate
Salpingectomy / salpingotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What investigations should you do in ?PCOS

A

TVUSS
GTT
Bloods - testosterone, LH, FSH, Oe, prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the TVUSS result in PCOS

A

Enlarged ovary with 12+ follicles on it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

At how many weeks does a person with an ectopic usually present to medical services

A

6-8w

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Differentials for ectopic

A

Ovarian torsion
Appendicitis
Miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What might you differentials be for someone who is tender on bimanual examination

A

PID

Endometriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What might your differentials be for someone with cervical motion tenderness

A

Ectopic

PID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is a large uterus on palpation suggestive of?

A

Fibroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What investigations would you do in someone with chronic pelvic pain

A 
MSU
Swabs- HVS, ECS
Laparoscopy - endometriosis 
TVUSS-fibroids
MRI- adenomyosis 
Bloods- TFT, acute p reactants, LFT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Where are endometrial tissue deposits most commonly found

A

Uterosacral ligaments

Pouch of Douglas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is the proper name for the pouch of Douglas

A

Rectouterine pouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Treatment of endometriosis

A 
NSAIDs
Tranexamic acid
COCP 
GnRH analogues
Diathermy of lesions
Hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What are the two characteristic features of endometriosis

A

Sub fertility

Cyclical abdo pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is the typical age of a patient presenting with endometriosis

A

Young female
As oestrogen dependent
Presents when trying for a baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What are the three theoretical causes of endometriosis

A

Retrograde mestruation - most common cause
Metaplastic theory
Blood/lymphatic dissemination theory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Explain how GnRH analogues work in tx endometriosis

A

GnRH sits in R causing release of LH &FSH
When they are being released they cannot be synthesised
The longer the R is occupied for there is down regulation
Therefore initial worsening of symps before artificial menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What other treatment do you need to give with GnRH in endometriosis

A

HRT- add back therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Give 3 aims of treatment in endometriosis

A

To reduce pain
Stop progression of implants
Address sub fertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What two radiological investigations would you do in adenomyosis

A

TVUSS

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Palpation on a patient with adenomyosis would give you what finding

A

Tender uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is adenomyosis

A

Endometrial deposits within the myometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is the treatment for adenomyosis

A

Same as endometriosis but without ablation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What age group would you see adenomyosis in?

A

40ish (older premenopausal women)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Name two gynaecological pathologies that are oestrogen drive

A

Endometriosis

Fibroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What are the main complications of a fibroid

A

Sub fertility
Red degeneration
Tortion
Miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is a fibroid

A

A benign tumour of myometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are the main symps of fibroids

A

Depends on size and location
Sub fertility
Menorrhagia
Pressing on structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the first line treatment for symptom management with fibroids

A

LNG-IUS (marina )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What problems may arise with fibroids in pregnancy

A 
Miscarriage 
Premature delivery 
Malpresentation/ lie
Obstruct delivery 
PPH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is an ovarian cyst

A

Fluid filled pouch

101
Q

Complications of ovarian cysts

A

Rupture- commonly after intercourse
Haemorrhage
Tortion

102
Q

What are the three types of functional ovarian cyst

A
  • follicular - dominant follicle that fails to rupture
  • corpus luteal cyst- didn’t dissolve
  • theca lutein cysts - over stim of HCG in preg
103
Q

What are the commonest ovarian tumours in young women

A

Ovarian teratomas

104
Q

What are the two classes of ovarian cyst

A

Functional

neoplastic

105
Q

What are the features of a neoplastic ovarian cyst

A

Over 10cm and irregular boarders

106
Q

Management of ovarian cysts

A

W&w
NSAIDs
Oophrectomy

107
Q

What is pelvic congestion syndrome

A

Incompetent pelvic veins post pregnancy

108
Q

When is pelvic congestion syndrome worse ?

A

After intercourse

When have been standing up for a long time

109
Q

investigations for pelvic congestion syndrome

A

Tvuss

MRI venogram

110
Q

What is the treatment for pelvic congestion syndrome

A

Transcatheter vein embolism

111
Q 
Fever
Dyspareunia
Cervical motion tenderness 
Purulent discharge 
Points to what diagnosis
A

PID

112
Q

What investigations would you do ?PID

A 
Swabs - HV , EC
NAAT
Bloods - CRP
USS 4 complications
Laparoscopy as last resort
113
Q

Treatment for PID

A

IM ceftriaxone
100mg doxycycline
400mg metronidazole

114
Q

Complications of PID

A
  • Hydrosalpinx from adhesions
  • Abscesses from pus- tubo- ovarian abscess is life threatening if ruptures
  • Ectopic pregtd
  • sub fertility
  • fitz Hugh Curtis syndrome
115
Q

What is fitz Hugh Curtis syndrome

A

Inflammation from PID spreads to Glissons capsule around the liver = RUQ pain

116
Q

What complication of pregnancy might China mans shuffle indicate?

A

Obstetric chloestasis

117
Q

What type of anaemia In pregnancy would present as macrocytic megaloblastic?

A

Folate deficiency anaemia

118
Q

What type of anaemia In pregnancy would present as microcytic

A 
Fe deficient 
(TICS- Thalassaemia, chronic disease, sideroblastic)
119
Q

What happens to tidal volume in pregnancy

A

Decreases

120
Q

What happens to CO in pregnancy

A

Increases due to SV increasing

121
Q

What are considered high risk cardiac lesions in pregnancy

A

Aortic stenosis
Coarctation
Prosthetic valves
Cyanosis

122
Q

What are the maternal complications of diabetes in pregnancy

A

DKA
Hypoglycaemia- common
Progression of retinopathy
PreE

123
Q

Complications of maternal diabetes on the foetus

A 
Macrosomia 
Hyperinsulinaemia
Neonatal hypoglycaemia 
Still birth
Resp distress
124
Q

What diabetic medications can’t you use in pregnancy

A

Sulphonyl ureas

125
Q

What effect does pregnancy have on renal function

A

Increases GFR , 50% increase in renal blood flow

126
Q

What effects could CKD have on the pregnancy

A

PreE
Severe hypertension
Growth restrictions
Prem delivery/ still birth/ caesarean

127
Q

What is the risk to the foetus with a maternal seizure ?

A

Hypoxia

128
Q

How would you manage epilepsy in preg

A

High dose folic acid
Make sure antiepileptics aren’t teratogenic
Regular checkups
Delivery Plan

129
Q

What can you give for VTE in preg

A

LMWH

Not warfarin

130
Q

What investigations would you do in a pregnant woman who is SOB and has chest pain

A

CTPA

131
Q

How would you manage hydatidform mole (GTD)

A

ERPC+ serial bHCG

132
Q

What interventions can you give during the first stage of labour

A

Membrane sweep
Vaginal PG pessary
Synt

133
Q

What are the 6 stages of delivery

A 
Decent 
Engagement
Flexion
IR
Extension 
Restitution/ ER
Expulsion
134
Q

When does stage 2 of labour begin?

A

With full dilation and contractions every 2-5mins

135
Q

What is the maximum cervical dilation reached in the latent phase

A

4cm

136
Q

What fetal attitude do we want during labour

A

Suboccipital bregmatic

137
Q

What diameter is the pelvic cavity

A

10.5cm

138
Q

What is the diameter of the suboccipital bregmatic presentation

A

9.5cm

139
Q

The pelvic outlet is widest in what plane

A

Anteroposteriorly

140
Q

How much flexion do we want for a suboccipitalbregmatic presentation

A

Well flexed

141
Q

And extended head will give what presentation

A

Brow or face

142
Q

What is the biparietal diameter

A

9.5 cm

143
Q

What intervention will be required in cephalopelvic disproportion

A

C section

144
Q

What factors effect the passage (pelvic cavity)

A 
Nutrition- vit D, Ca, rickets, osteomalacia
Abnormal gait- pelvic distortion 
Trauma - fractures
Soft tissue abnormalities 
Spinal abnormalities
145
Q

Types of breech presentation + descriptions

A

Frank- buttocks presents with legs extended
Complete- legs are flexed so feet present next to buttocks
Footling- foot below buttocks

146
Q

Which is the most common breech presentation ?

A

Footling

147
Q

What are the causes of breech presentation

A 
Idiopathic
Placenta previa
Polyhydraminos
Prematurity
Pelvic abnormalities 
Grand multiparty
148
Q

Causes of foetal tachyC = >160

A

Hyperthyroidism
Hypoxia
Chorioamnitis
Anaemia

149
Q

Cause of foetal bradyC

A

Hypoxia

150
Q

What range to you want variability to be in

A

5-25 from baseline HR

151
Q

What is an acceptable baseline HR for a foetus

A

110-160

152
Q

What are the foetal signs of hyperthyroidism

A

Goitre

TachyC

153
Q

What are the neonatal signs of hyperthyroidism

A 
Irritable 
Diarrhoea
Wt loss
TachyC
Exophthalmos
154
Q

How does the foetus get hyperthyroidism from the mum

A

TSHR abs cross the placenta

155
Q

Treatment for neonatal hyperthyroidism

A

Carbimazole

156
Q

What is the classic risk factor for someone to have placenta accreta

A

Placenta previa and c section

157
Q

What should the birth plan for someone with placenta previa or placenta accreta look like

A

Consultant obstetrician and anaesthetist there
UTI bed available
Blood products on site
Consent re potential interventions I.e. hysterectomy

158
Q

What is considered a low birth weight?

A

<2.5kg

159
Q

What is considered a very low birthweight

A

Less than 1.5kg

160
Q

What is considered an extremely low birth weight

A

<1kg

161
Q

What complications might a macrosomic infant have

A

Transient hypoG secondary to hyperinsulinaemia
Birth trauma
RDS
Polycythemia

162
Q

What is the treatment for polycythemia in macrosomia

A

Tx- partial exchange transfusion.

163
Q

What is the most common congenital infection and what is the treatment ?

A

CMV

Gancyclovir

164
Q

What are the potential complications of CMV infection in a baby

A

Sensorineural hearing loss
Hepatosplenomegally
Cerebral palsy
Epilepsy

165
Q

What are the potential complications of rubella as a congenital infection

A

Deafness
Cataracts
CHD

166
Q

What are the potential complications of toxoplasmosis in the neonate

A

Retinopathy
Cerebral calcifications
Hydrocephalus

167
Q

Name a congenital infection that can cause hydrops

A

B19

168
Q

What two congenital infections should you not breast feed with

A

HepC

HIV

169
Q

What are the mock common pathogens to cause neonatal sepsis

A

GBS.
Listeria
E. coli

170
Q

What factors should indicate the need to treat for group B strep intrapartum

A

Prolonged rupture of membranes

Maternal fever

171
Q

What is the intrapartum treatment for GBS

A

Penicillin

172
Q

What does foetal distress mean?

A

Hypoxia (ph might be low)

173
Q

What should you never do in a bleeding pregnant woman

A

PV exam until placenta previa has been excluded

174
Q

What investigations would you want to do in placenta previa

A

FBC
Cross match
CTG
USS/ MRI

175
Q

Painless bleeding at ROM + severe foetal distress points to what diagnosis

A

Vasa previa

176
Q

What is vasa previa

A

Foetal blood vessels run in the membranes of the uterus in front of the presenting part

177
Q

Give 5 causes of prepartum/ antepartum haemorrhage

A 
Uterine rupture
 Vasa previa
Placenta previa
Placental abruption 
Gynae cause
178
Q

Continuously painful tender uterus +/- bleeding =?

A

Placental abruption

179
Q

What are the complications of placental abruption

A

Shock
Renal failure
DIC
PPH

180
Q

How would you manage placental abruption?

A

Assess mum - FBC, U&E, crosshatch, monitor urine output hourly if foetus stable
Resus with fluids as required
Assess foetus w/ CTG- deliver if distressed >37w
Transfuse

181
Q

What is an antepartum haemorrhage

A

Bleeding after 24w (>50ml)

182
Q

What should you do with a placental abruption with no foetal distress and <37w

A

Monitor

183
Q

What should you do in a placental abruption >37w with no foetal distress

A

IOL via aminotomy

184
Q

What should you do if there is placental abruption with foetal distress

A

Emergency Csection

185
Q

What investigations should you do for placenta accreta

A

MRI

186
Q

Complications after APH

A 
PPH
DIC
Renal failure 
Transfusion 
Premature labour and delivery 
Fetal morbidity and mortality
187
Q

When is C section indicated in herpes simplex

A

If primary attack is In 6w of delivery

188
Q

What is the treatment for a neonate exposed to HSV

A

Acyclovir

189
Q

What is the definition of primary PPH

A

Blood loss over >500ml w/in 24hours (1000ml if Csection)

190
Q

What is the most common cause of PPH

A

Uterine tone- fails to contract properly

191
Q

Why might the uterus fail to contract properly

A

It is atonic

There is retained placenta

192
Q

What is a major PPH

A

Blood loss over 1000ml

193
Q

When would you stop antenatal thromboprophylaxis

A

12 hours before delivery

194
Q

What are two risk factors for uterine atony

A

Prolonged labour

Overstretched uterus I.e. multiparity/ polyH

195
Q

What should be the management of PPH >1500ml

A

Activate MOH protocol
Fresh frozen plasma
Tranexamic acid +/-

196
Q

If uterine atony persists after oxytocin what should the next step be

A

Inject PGF2a into myometrium

+/- tranexamic acid

197
Q

Bleeding from placental bed with a well contracted uterus - what is the tx

A

Rusch balloon

198
Q

What are the surgical options to tx PPH

A

Brace suture
Uterine artery embolism
Hysterectomy

199
Q

What is the definition of secondary PPH

A

Excessive blood loss 24hrs-6w

200
Q

What is the first line tx In an atonic uterus

A

Bimanual compression

201
Q

How do you prevent /tx coagulopathy problems in PPH

A

Fresh frozen plasma

+/- cryoprecipitate

202
Q

Common causes of secondary PPH

A

Retained placenta
Infection
Endometriosis

203
Q

Management of secondary PPH

A

Swabs
Pelvic USS for retained placenta - surgical evaction of retained placenta (SERP)
Abx
Uterotonics = misoprostel, syntocin

204
Q

What is the normal weight range at delivery In kg

A

2.5-4.5kg

205
Q

What is the normal weight range at delivery in lbs

A

5.5-10lb

206
Q

How much does the average baby weigh

A

7.5lb = 3.5kg

207
Q

What are the complications of shoulder dystocia

A 
Brachial plexus damage
Foetal hypoxia- fits/ cerebral palsy
PPH
Tears
Psychological
208
Q

Management of shoulder dystocia

A

HELPERR

Call for help
Evaluate for episiotomy
Legs in mc Roberts position
Suprapubic pressure
Enter pelvis
Rotational manoeuvres 
Remove posterior arm
209
Q

Risk factors for cord prolapse

A 
Polyhydraminos 
Prematurity 
Long cord
Malpresentation
SROM
210
Q

Causes of sudden deceleration in fetal HR in labour

A

Vasa previa

Cord prolapse

211
Q

What is the management of cord prolapse

A

Fill bladder or push back inside / trendelenburgs position to elevate pressure until Csection

212
Q

Definition of severe preE

A 
140/90+ proteinuria
\+1 of:
“HELLP”
Headache
Elevated liver enzymes
Liver tenderness
Low platelets
Papilodema / visual changes
\+ clonus
213
Q

What is the cure for severe preE

A

Spont Delivery

/ IOL

214
Q

Treatment of severe PreE

A 
Manage bp- labetalol , nifedipine
If hyperreflexia- MgSO4
Correct any coag issues 
Monitor urine output 
Monitor foetal wellbeing
215
Q

How do you treat eclampsia in pre-E

A

MgSO4 4mg In 5mins+ IV 1g/hour

Restrict fluids and monitor urine output

216
Q

What is a differential for post partum depression

A

Post partum thyroiditis

217
Q

What is medication used for depressive illness in pregnancy

A

Fluoxetine (SSRI)

218
Q

When does puerperal psychosis normally occur

A

4 days post delivery

219
Q

What is the management of puerperal psychosis

A

Admission

Major tranquillisers

220
Q

When would placental location be highlighted

A

20w scan

221
Q

What should you start someone on with RFs for PreE

A

Aspirin 75mg day

222
Q

What are the High risk indications for starting low does aspirin

A 
PreE in a previous pregnancy
Preexisting hypertension
CKD
Diabetic
AI disease (SLE)
223
Q

What is the criteria for PrE

A

Bp over 140/90
+ proteinuria >0.3
Past 20w gestation

224
Q

What is the cut off gestation for early vs late preE?

A

34w

225
Q

What are the consequences for early Pre E

A

IUGR

226
Q

What can you give as protection from eclampsia

A

MgSO4

227
Q

Shay do you need to monitor for when giving MgSO4

A

Mg toxicity

4hourly reflexes,RR, BP, pulse

228
Q

What is the pathophysiology as to why PreE develops

A

Placental origin
Fails to turn to a low resistance system
Secrete proteins that cause vasoC
Kidneys retain NaCl

229
Q

What are the complications of PreE

A 
Still birth
IUGR 
Placental abruption
Eclampsia
DIC
AKI 
Liver problems - HELLP syndrome
Cerebral haemorrhage 
Pulmonary odema
230
Q

When do you need to be cautious about giving MgSO4

A

In renal failure as is excreted by the kidneys

231
Q

Management of mild preE

A

2x weekly FBC, U&E, LFT

232
Q

Management of moderate PreE

A

Start on labetalol/ nifedipine

Monitor bloods 3x weekly

233
Q

Management of Severe preE

A

Should be on labetalol
3x weekly bloods
5x daily bp

234
Q

Management of eclampsia

A
  1. ABCDE
  2. Lie in L lateral position
  3. MgSO4 stat
  4. MgSO4 IV
  5. Labetalol IV
  6. :fluid restriction, monitor output
  7. Deliver by Csection when mum is stable
235
Q

What colour discharge do you get in gonorrhoea

A

Yellow green

236
Q

What symptoms do you get In syphilis

A

Chancre
Neuro syphilis
Rash
Thoracic AA

237
Q

Treatment of chlymidia

A

Doxycycline 100mg 7d

Erythromycin in preg

238
Q

Tx of gonorrhoea

A

Ceftriaxone once 1G

239
Q

Tx of trichomonas vaginalis

A

Metranidazole

240
Q

Female findings in trichamonas vaginalis

A

Strawberry cervix

PH>4.5

241
Q

Investigations in chlamydia

A

First void urine In males
Swan females
NAAT

242
Q

Investigations in gonorrhoea

A

Swabs NAAT

243
Q

Investigations in syphilis

A

Bloods

Swab- motile spirochetes

244
Q

What sort of discharge would you have in trichamos vaginalis

A

Frothy

245
Q

Tx In syphilis

A

IM penicillin

246
Q

How long are you covered for contraceptionally post delivery

A

21d if not b feeding

6mnths if solely bfeeding

247
Q

How long after delivery can you start CHC

A

6w if not b feeding

6m if breastfeeding

248
Q

When can you start the POP/ implant / injectable post delivery

A

Any time

249
Q

When can you have a device/ system fitted post delivery

A

<48hours

>4w

Phase 3a (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions