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Progress Test > O&G > Flashcards

O&G Flashcards

1
Q

18 weeks ultrasound

A

Anatomy screen

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2
Q

18 weeks ultrasound

A

Anatomy screen

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3
Q

Normal fetal heart rate

A

110 to 160 bpm

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4
Q

Miscarriage definition

A

Loss of pregnancy before 20 weeks

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5
Q

BHCG pattern before 9 weeks

A

SHould double every 48 hours

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6
Q

BHCG after 9 weeks

A

Should plateau (hence not a good marker of fetal growth)

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7
Q

Causes of abnormally high BHCG

A
  • Incorrect dates
  • Molar pregnancy
  • Twins
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8
Q

Implantation bleed

A

Light

10 days into pregnancy

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9
Q

Causes of abnormally low BHCG

A

Wrong dates
miscarriage
ectopic
(repeat after 48 hours)

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10
Q

Fetal heart beat should be seen by what gestation

A

7 weeks

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11
Q

Differntial diagnosis for PV bleeding in pregnancy

A
  • Ectropion
  • Polyps
  • Infecton
  • Cancer
  • intercourse over last 24 hours
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12
Q

Investigations for early pregnancy bleeding

A

BHCG

USS

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13
Q

Threatened miscarriage Features

A 
mild PVB
no pain
Closed cx 
Normal BHCG
Normal USS
Reassure and RhD test
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14
Q

Missed miscarriage definition

A 
Mild to moderate PVB
variable pain
closed cx
low BHCG
Small or absent CRL
absent fHR
abnormal irregular gestation sac
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15
Q

Missed miscarriage management

A

Conservative
Medical: misoprostol loading dose
Surgical: D+C
RhD test

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16
Q

Incomplete miscarriage definition

A 
Heavy bleeding with PVB
Severe pain 
Open cx with clots and blood
Low BHCG
Blood, clots and placenta on USS
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17
Q

Incomplete miscarriage management

A 
ABCDs/resus
Surgical evacuation
Mesoprostol
remove tissue
RhD status
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18
Q

Complete miscarriage definition

A 
Heavy PVB which settles
Severe pain which settles
Open cx
Low BHCG
empty uterus
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19
Q

Complete miscarriage management

A

Reassurance

RhD

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20
Q

Ruptured Ectopic pregnancy presentation

A 
minimal PVB
Uncomfortable/peritonitic, agonising pain
Normal cervix
Low BHCG
Empty uterus, fluid in POD, adnexal mass
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21
Q

Unruptured ectopic presentation

A 
Mild PVB
unilateral adnexl pain
normal cx
low BHCG
empty uterus, adnexal mass
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22
Q

Ectopic management

A

ABCDs/ resus
Methotrexate and confrim BHCG decline
Salpingectomy
RhD

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23
Q

Molar pregnancy findings

A 
mild PVB
Pain
Closed cx
very high BHCG
honey comb or snow storm appearance of uterine cavity
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24
Q

Molar pregnancy management

A

Surgica;: suction and curretage
Follow up BHCG till 0
Histology to determine if complete or partial mole
Can fall pregnant only after 1 year

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25
Q

Anti D timing

A

After 72 hours

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26
Q

Ectopic risk factors

A

IUCD

Fallopian tube integrity impaired

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27
Q

Molar pregnancy definition

A

Proliferation of trophoblast from placenta

Increased risk of choriocarcinoma in complete mole

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28
Q

Molar pregnancy epidemiology

A

Asian population

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29
Q

Definition of term gestation

A

37 to 42.6 weeks

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30
Q

Very preterm definition

A

<32/40

31
Q

Extremely preterm definition

A

<28/40 weeks

32
Q

Low birth weight definition

A

<2.5 kg

33
Q

Very low birth weight definition

A

<1.5 kg

34
Q

Extremely low borth weight definition

A

<1 kg

35
Q

Causes of SGA

A 
(Maternal vascular disease)
Hypertension
Pre-eclampsia
Smoking
DM
Chromosomal or congenital abnormalities
TORCH infectiosn
36
Q

TORCH infections

A

Toxoplasmosis
Rubella
CMV
HSV

37
Q

Definition of LGA

A

> 90th centile

38
Q

Causes of LGA

A

Diabetes
Beckwith-wiedermann
Large parents
Hydrops fetalis

39
Q

Short term complications of IUGR

A

Respiratory distress

Hypoglycemia

40
Q

Causes of IUGR

A

Uteroplacental insufficiency
Congenital infection
Chromosomal/genetic disorders

41
Q

Causes of symmetrical IUGR

A

(early)
Infection
Genetic disorder

42
Q

Causes of asymmetrical IUGR

A

Uteroplacental insufficiency
maternal malnutrition
pre-eclampsia
diabetes

43
Q

Contraindications to breast feeding

A

Anticancer drugs

44
Q

Definition of menorrhagia

A

Woman describes bleeding as heavy

45
Q

Definition of dysmenorrhoea

A

Pain with periods

46
Q

Definition of oligoenorrhoea

A

3-9 cycles per year, irregular, unpredictable

47
Q

Definition of Amenorrhea

A

no perods for 3 weeks

48
Q

Definition of menopause

A

No periods for at least 1 year

49
Q

Jadelle

A

Implant goes in arm
Lasts 5 years
SIde effects are irregular bleeding

50
Q

Copper IUD

A

Lasts 10 years

Can make period longer and heavier

51
Q

Mirena

A

Lasts 5 years
Progesterone: thins endothelium, stops ovulation, thickens mucus
Some initial bleeding but then reduced
Side effects: bloating, breast tenderness

52
Q

Definition of Pre-eclampsia

A

New hypertension with multisystem effects

53
Q

Pre-eclampsia manifestation: placenta

A

Fetal growth restriction

54
Q

Pre-eclampsia manifestation: Kidney

A

proteinuria

Protein:Cr >30

55
Q

Pre-eclampsia manifestation: hematological

A

Low platelets
Heamolysis
DIC

56
Q

Pre-eclampsia manifestation: Liver

A

Elevated transaminases

57
Q

Pre-eclampsia manifestation: Neuro

A

Headaches, hyperreflexia(3 beats of clonus), visual changes

58
Q

Pre-eclampsia investigations

A 
Repeat BP
Urine: protein Cr ratio
FBC
Plt
Group and hold
Fetal USS
CTG
59
Q

Pre-eclampsia management

A

Delivery
Antihypertensives: Methyldopa, Labetalol, Nifedipine
MgSO4 for seizure prophylaxis

60
Q

BP management on pregnancy

A

NOT ACEI or diuretics

61
Q

HELLP definition

A

Haemolysis
Elevated liver enzymes
Low platelets

62
Q

HELLP management

A

Deliver

63
Q

Antenatal blood tests

A 
Hb
MCV
Plt
Blood group
MSU: UTI, bacteuria
STI 
HbA1c
USS: confirm dates
64
Q

Pregnancy recommendations

A

Folic acid till 14/40

Iodine throughout and during breast feeding

65
Q

Diabetes screening date

A

24 to 28 weeks

66
Q

Downs screening

A

MSS1 is a T1 blood tests

11-13/40 USS for nuchal transluscency

67
Q

Definition of antepartum haemorhage

A

> 20/40 till delivery

68
Q

Causes of Antepartum haemorhage

A

Upper: placental abruption, placenta praviea, fibroids
Lower: Cervical cancer, infection, ectropion, cervical polyps

69
Q

Placental abruption presentation

A 
PVB if revealed
Pain if concelaed
rigid tender uterus
blood stained liquor
fetal distress
70
Q

Placental abruption risk factors

A 
HTN
smoking
pre-eclampsia
age > 30
previous abruption
trauma
multiple pregnancies
cocaine use
Lupus anticoagulant
antiphospholipid syndrome
71
Q

Placenta praevia definition

A

Placenta implants into lower uterus

72
Q

Placeta praevia presentation

A

Painless bleeding (may be provoked by intercourse)
recurrent bleeds
soft non tender uterus

73
Q

Placenta praevia risk factors

A

previous c-section or uterine surgery
increase parity
multiple pregnancy
age

74
Q

Placenta praevia management

A

Monitor fetal growth and deliver by c section

Progress Test (7 decks)

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