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Yr 5 PACES > Obs VIVAs > Flashcards

Obs VIVAs Flashcards

1
Q

obstetric cholestasis vs acute fatty liver of pregnancy

A

OC: itching + jaundice

AFLP: n&v, abdo pain, jaundice, fever
transaminitis + steatosis

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2
Q

normal physiological skin changes in pregnancy

A

linea nigra
striae gravidarum
striae albicans

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3
Q

cause of itching in obstetric cholestasis

A

bile acids in skin

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3
Q

lack of bile affects absorption of which vitamins

A

fat soluble: A, D, E, K

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4
Q

types of breech presentation

A

frank
flexed
footling

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5
Q

RFs for breech presentation

A

maternal:
multiparity
fibroids
previous Hx
placenta praevia

foetal:
preterm
oligohydramnios
macrosomia
multiple pregnancy

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6
Q

CIs for ECV

A

abnormal CTG
ROM
multiple pregnancy

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7
Q

neonatal resp phenomenon associated w. CS delivery

A

TTN

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8
Q

sensitising events which require anti-D prophylaxis

A

ECV
surgical management of miscarriage/ectopic
abdo trauma
amniocentesis/CVS
antepartum haemorrhage

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9
Q

pathophysiology of gestational diabetes

A

placenta produced progesterone, hCG, cortisol, cytokines = anti-insulin effect
increased insulin resistance

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10
Q

why do neonates of mothers with GDM develop hypoglycaemia

A

maternal glucose crosses placenta but not insulin
foetus produces high levels of insulin

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11
Q

RFs for GDM

A

BMI > 30
macrosomia
FH of diabetes
ethnicity

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12
Q

target level of plasma glucose in GDM

A

fasting <5.3
2hr <6.4

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13
Q

what to arrange at first antenatal visit if pre-existing diabetes

A

digital retinal assessment
renal function
HbA1c

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14
Q

risks of GDM

A

maternal:
trauma
T2DM
pre-eclampsia

foetal:
macrosomia
polyhydramnios
neonatal hypoglycaemia

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15
Q

how often to monitor HIV viral load in pregnancy

A

2 weekly

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16
Q

how to reduce risk of HIV transmission to baby

A

aim viral load <50
ART at birth and for 2-4 weeks
no breastfeeding

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17
Q

if HIV positive, screen for what other infections

A

hep B/C

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18
Q

triad of hyperemesis gravidarum

A

> 5% pre-pregnancy weight loss
electrolyte imbalance
dehydration

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19
Q

SEs of antiemetics

A

cyclizine - anticholinergic
promethazine - sedation

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20
Q

when does normal morning sickness resolve

A

~14 weeks

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21
Q

RFs for hyperemesis

A

molar pregnancy
multiple pregnancy
previous Hx
FHx

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22
Q

complications of hyperemesis

A

maternal:
mallory-weirs tears
muscle wasting
malnutrition

foetal:
LBW
miscarriage/stillbirth

23
Q

causes of symmetric IUGR

A

early pregnancy

chromosomal abnormalities
anaemia
pre-existing medical conditions

24
Q

causes of asymmetric IUGR

A

late pregnancy

smoking
alcohol
placental insufficiency
pre-eclampsia
abruption

25
Q

complications of IUGR

A

short term:
resp distress
hypoglycaemia
jaundice

long term:
CP
diabetes
chronic hypertension

26
Q

how to date pregnancy in 1st and 2nd trimester

A

10-14 weeks: CRL
14-20 weeks: EFW/head circumference

27
Q

how is IOL performed

A

membrane sweep
vaginal prostaglandin
ARM

28
Q

what is a concerning finding on doppler ultrasound of umbilical artery

A

absence/reversal of end-diastolic flow

29
Q

define stages of labour

A

1: passive (0-3/4cm dilation)
active (3/4-10cm dilation)
2: delivery of baby
3: delivery of placenta and membranes

30
Q

causes of prolonged labour

A

malposition
epidural
obstructed labour

31
Q

rate of dilation during 1st stage of labour

A

0.5cm/hour

32
Q

how often to perform vaginal examinations during labour

A

every 4 hours

33
Q

antepartum haemorrhage vs threatened miscarriage

A

threatened miscarriage <20 weeks
antepartum haemorrhage >20 weeks

34
Q

causes of antepartum haemorrhage

A

placental abruption
placental accreta
placenta praevia
vasa praevia
trauma
bloody show
cervical ectropion

35
Q

RFs for placental abruption

A

previous Hx
CS
pre-eclampsia
smoking
cocaine

36
Q

how to prevent PPROM in high risk women

A

prophylactic vaginal progesterone
cervical cerclage

37
Q

what tests for suspected PPROM

A

IGF binding protein-1 test
alpha-microglobulin-1 test

38
Q

common causative organisms of chorioamnionitis

A

GBS
E coli

39
Q

define pre-eclampsia

A

hypertension after 20 weeks + significant proteinuria

40
Q

pathophysiology of pre-eclampsia

A

hypertension -> spiral artery remodelling -> poor placental perfusion -> less nutrients delivered to foetus

41
Q

complications of pre-eclampsia

A

eclampsia
stroke
HELLP

42
Q

what is eclampsia

A

seizures in patient w. pre-eclampsia

43
Q

risks of pre-eclampsia to baby

A

IUGR/LBW
preterm
stillbirth

44
Q

RFs for pre-eclampsia

A

previous Hx
FHx
obesity
hypertension
primip

45
Q

physiological changes to BP in pregnancy

A

falls in 2nd trimester, normalises by term

46
Q

risks of twin pregnancies

A

maternal:
miscarriage/stillbirth
pre-eclampsia
placenta praaevia
anaemia

foetal:
IUGR
TTTS
congenital abnormalities
polyhydramnios

47
Q

ultrasound finding suggestive of MCDA pregnancy

A

lamda sign

48
Q

when to deliver MCDA pregnancy

A

32-34 ELCS

49
Q

RFs for twin pregnancy

A

AMA
IVF
ART

50
Q

conceptus splitting and consequences for pregnancy

A

0-4 days: DCDA
4-8 days: MCDA
8-12 days: MCMA
>13 days: conjoined MCMA

51
Q

indications for EMCS

A

failure to progress
foetal compromise
cord prolapse
placental abruption

52
Q

categories of CS

A

1: immediate threat to life of mother/foetus
2: no immediate threat to life
3: early delivery required
4: elective

53
Q

incision names for CS

A

pfannenstiel (pubic hairline)
Joel-Cohen (MC)

54
Q

percentage of successful VBAC after 1 CS

A

70%

55
Q

layers of CS

A

skin
fat
anterior rectus sheath
rectus muscles
parietal peritoneum
visceral peritoneum
uterine muscle

56
Q

complications of CS

A

acute:
infection
bleeding
longer recovery
scars

long term:
uterine prolapse
placenta praevia
placenta accreta

Yr 5 PACES (5 decks)

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