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MCCEE Questions > OBs / Gyn > Flashcards

OBs / Gyn Flashcards

1
Q

when to give Rogham

A
  • 28 wk GA
  • w.i 72 hour of birth of a Rh positive fetus
  • if Kiehauer Betke test positive
  • with invasive procedure CVS amniocentesis
  • ectopic procedure
  • miscarriage or therapeutic aborption
  • antepartum haemorrhage
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2
Q

Medications termination of pregnancy

A

<9 week - MTX and misoprostol

>12 weeks - prostaglandin (intra or extra amniotic ally or IM) or misoprostol

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3
Q

surgery to terminate pregnancy

A

< 12 weeks - Dilation and vacuum aspiration +/- curettage

> 12 weeks - dilation and evacuation , early induction of labour

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4
Q

DDX of decreased fetal movement

A 
DASH 
death 
amniotic fluid decreased 
Sleep cycle of fetus 
Hunger and thirst
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5
Q

indications for BPP

A
  1. abnormal or atypical NST
  2. post term pregnancy
  3. decreased fetal movement
  4. uroplacental insufficiency
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6
Q

what is looked at in BPP

A

AFV - 2X2
Breathing - one episode in 30 sec
Limb movement - 3 movements
fetal tone - one episode of extension followed by flexion

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7
Q

score BPP

A

8 - good
6 - try again in 24 hours
0-4 - delivery

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8
Q

adverse fetal outcomes in HTN with pregnancy

A

IUGR
oligohydramnios
Absent / reversed umbilical artery end diastolic flow

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9
Q

if severe hypertension in pregnancy

A

> 160/ 110

  • lebatolol
  • nifedipine
  • hydrazine
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10
Q

magnesium sulfate toxicity

A
  1. flushing
  2. hyporeflexia
  3. Somnolence
  4. Respiratory and cardiac depression
  5. weakness
  • increased risk of toxicity if using CCB or renal disease

Tx - STOP MgS
GIVE calcium gluconate

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11
Q

eclampsia before 20 weeks

A

think antiphospholipid syndrome

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12
Q

blood test for APS

A

1lupus anticoagulant

  1. anti cardiolipin
  2. anti B2 glycoprotein
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13
Q

threatened abortion

A

PVB and cramps
Cervic is soft and closed
US - viable fetus
Tx - watch and wait

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14
Q

inevitable abortion

A 
PVB and cramps 
Cervix closed until product begin to expel 
US shows nonviable fetus 
Tx - watch and wait 
2. misoprostol 
3. D and C +- oxytocin
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15
Q

incomplete

A 
PVR VERY heavy 
Cervic is open 
US - products of conception 
Tx: 
1. 2. 3. watch and wait, misoprostol or D and C
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16
Q

Complete

A

Bleeding and passage of sac and placenta
Cervic open
US - no products of conception
Tx- expectant management - no D and C needed

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17
Q

Missed abortion

A

No bleeding ( fetal death in utero)
Cervix closed
US - SGA with no fetal heart activity , nonviable fetus
Tx watch and wait, misoprostol, D and C

18
Q

Recurrent abortiopn

A

> 3 consecutive spontaneous abortion

- evaluate mechanical genetic and environmental

19
Q

Septic abortion

A

contents of uterus - infected

Treatment - DC and antiobitocs

20
Q

methotextrate indication for ectopic pregnancy

A
  1. < 3.5 cm unreputure extompic
  2. no hepatic , renal or hematologic disease
  3. B HcG < 5000
  4. no fetal heart rate
  5. Willing to follow up
21
Q

twin twin transfusion

A
  • monochromic twins

- material blood from donor twin passes through placenta into vein of recipient twin

22
Q

treatment of TTT syndrome

A

amniocentesis - decompress polyhydraminios of recipient town and decrease pressure in cavity on placenta
- intrauterine transfusion to donor if necessary

23
Q

polyhydramnios

A 
idiopathic 
MOM 
- Type 1 DM 
Maternal - fetal 
- multiple gestation 
- choriangiomas 
FETUS 
- chromosomal anomaly 
- malformation lung 
- anencaphly, hydrocephalus
- TEF , duodenal atresia, fascial clefts
24
Q

oligohydramnios

A 
-idiopathy 
MOM - UPI, MEDS (ACE inhibitor ) 
FETUS 
- renal agenesis 
- Demise / chronic hypoxemia ( blood shunt away from kidney to perfuse brain) 
- IUGR 
- Ruptured membrane 
- Amniotic fluid normally decrease 35K
25
Q

complicated variable decelerations

A

< 70bpm and <60s

  • loss of variability or decrease in baseline after decelerations
  • biphasic deceleration
  • slow return to baseline
  • baseline tachycardia or bradycardia
26
Q

early decelerations

A

benign - head compressions

27
Q

later deceleration

A

usually a sign of uretoplacenta insufficiency
- fetal hypoxia and academia
maternal hypotension
- uterine hypertonus

28
Q

use of tocolytics

A
  1. absence of maternal or fetal contraindications
  2. preterm labour
  3. cervical dilaitation <4cm
29
Q

c/i tocolytics

A

mom - bleeding, maternal disease , preeclampsia or eclampsia
Fetus - fetal demise , IUGR , severe congenital abnormalities

30
Q

most common RF for preterm labour

A
  • previous preterm labour
31
Q

criteria for EVC

A
  • < 37 weeks
  • singleton
  • unengaged presenting part
  • reactive NST
32
Q

criteria for vaginal breach delivery

A 
> 36 weeks 
complete or frank breech 
EFW 2500 - 3800 g 
continuous fetal monitoring 
2 obstetrician 
ability to perform emergency C/s if necessary
33
Q

when do you do a CS during vaginal breech delivery

A

fetus not descending to the perineum in the second stage of labour after 2 hours in absence of active pushing or vaginal delivery

34
Q

c/i to vaginal breech delivery

A

cord compression
clinically inadequate maternal; [e;vis
detal factors affecting delivery

35
Q

obstetrical causes of DIC

A

Abruption
Gestation HTN
Fetal demise
PPH

36
Q

risk factors for Umbilical cord prolapse

A
  • prematurity / PROM
  • fetal malpositio
  • low lying placenta
  • polyhydraminos
  • multiple gestation
37
Q

risk factor for uterine rupture

A

uterine scarring
excessive uterine stimulation - prolonged oxytocin
uterine trauma - operative equipment , ECV
uterine abnormalities
Multiparty

38
Q

complications of uterine rupture

A

maternal mortality , hemorrhage
fetal distress
Amniotic fluid ambles
hysterectomy - if excess and uncontrolled haemorrhage

39
Q

risk factors for amniotic fluid embolus

A
  • placental abruption
  • rapid labour
  • multiparty
  • uterine rupture
  • uterine manipulation
40
Q

clinical Amniotic fluid embolism

A
  • sudden onset SOB
  • Cardiovascular collapse (hypotension, hypoemia
  • Seizure - 10%
  • ARDS or Left ventricular dysfunction
41
Q

uterine atony

A
  • labour
  • uterus
  • placenta
  • maternal factors
  • halothane anesthesia

MCCEE Questions (4 decks)

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