Brainscape's Knowledge GenomeTM

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


See full index

GOSH > Obstetric history and examination > Flashcards

Obstetric history and examination Flashcards

1
Q

What things should you include in an obstetric history?

A 
PC
Hx of PC
Past obstetric history (many problems are recurrent)
Gynae history
PMH
Drugs/allergies
FHx
SHx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are common obstetric presenting complaints?

A 
HTN (proteinuria with this = pre-eclampsia)
Abdo pain
bleeding
?ruptured membranes
unstable lie
'small baby'
reduced foetal movements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What questions should you ask for someone who presents with bleeding?

A

How much - compared to a period

When did it start

Pain

Is baby moving

Have you had this before

Have you had a scan yet

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

What things must you always ask a pregnant woman about?

A

Pain

Bleeding

Foetal movements (from 26 weeks)

Vaginal loss (bleeding or vaginal discharge)

Headaches

Visual disturbances

Generalised swelling (esp. if high BP)

LL pain/sweeling (esp. if high risk of VTE)

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

What questions should you include in a history of current pregnancy?

A

Dates - LMP
EDD
USS
Certainty of dates

Complications of pregnancy -
Pregnancy symptoms (split in 1st and 2nd half)
Bleeding/BP/anaemia/UTI/IUGR/DM
Antenatal admissions

Antenatal tests and investigations -
USS
Blood tests
Screening (Downs/amnio/CVS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should you include in a past obstetric history?

A

Number of pregnancies (parity)

Details of each pregnancy - 
live/child still alive/ still born
sex/weight/gestation
mode of delivery
complications (ante/post-natal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is parity documented?

A

Para (a) + (b)

a) - deliveries after 24 weeks (live/still born
(b) - losses before 24 weeks (spontaneous/TOP)

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

What should you include in a gynae history?

A

Menstrual cycle and symptoms - IMB/PCB

Smear

Contraceptive Hx

Other gynae problems

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

What are some risks of some drugs being given in pregnancy?

A

teratogenic

organ development and function

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

Someone presents in their last trimester with HTN and proteinuria -what are you concerned about?

A

pre-eclampsia

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

How should your BP be effected by pregnancy?

A

It should not - it should be the same as it was before pregnancy

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

What PMH would you want to know about in a pregnant woman?

A

Past gynae and surgical Hx (previous operations/treatment)

Medical problems: IHD/DM/BP/Asthma/Epilepsy/Jaundice
DVT/Thrombophilia
Hospitaladmissions

Drugs/allergies:
Pre-conceptual folate

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

If someone has abdo pain at about 8 weeks pregnant, what might you consider as an important differential diagnosis?

A

Ectopic pregnancy

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

What family and social history would you ask about in an obstetric Hx?

A

Twins

Medical problems: DM/BP/Pre-eclampsia

Inherited diseases

Occupation

Smoking/alcohol

Relationships/accomodation

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

What is unstable lie?

A

Foetus adopts unusual positions within uterus

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

What is unstable lie?

A

Foetus adopts unusual positions within uterus

Important towards the end of the pregnancy

17
Q

When do we give weight to reporting of reduced foetal movements?

A

28 weeks

18
Q

What would you consider as an important differential for someone who presents with:
Painless bleed which
Starts around 26-28 weeks

A

Low lying placenta

Lies over cervical Os

19
Q

What is another way of referring to pre-eclampsia?

A

PET

20
Q

What are some symptoms of pre-eclampsia?

A 
HTN
Headache
Blurred vision
Flashing lights
Swelling
Jitters

Epigastric reflux-type abdo pain
OR
RUQ pain

21
Q

When is a dating scan generally done? When would this be done earlier?

A

12 weeks (11-14 weeks)

Ectopic
Threatened miscarriage
If you can’t rely on dates

22
Q

When do the complications of ectopic pregnancy classically start?

A

7-8 weeks

23
Q

What does IUGR stand for?

A

intra-uterine growth description

24
Q

Why is it important to find out whether a patient has had a C-section?

A

If they have, there is a suspicion of high-risk for next pregnancies

25
Q

Why is it important to find to about previous surgery?

A

May be scarring - important if you have to do operative delivery

26
Q

What is the recommended dose of folate that pregnant should started on pre-conception/at conception?

A

400 micrograms

some exceptions require 5g

27
Q

How can stressful job impact a woman’s pregnancy/foetal development?

A

Small babies and pre-term births

28
Q

What are the different stages of obstetric examination?

A

Position patient at back raised, position that is comfortable for them

Hands: pulse

Face: conjunctiva (anaemia, jaundice)
Inside mouth and tongue
lymphnodes

Expose adequately

Inspect: 
Six and shape of uterus
prominent veins
stretch marks
line from typhoid process to pubic symphysis

measure fundal height
palpate for presenting part
palpate for foetal back
palpate for foetal lie

heart sounds

calves (swelling)

BP and urine dip

GOSH (33 decks)

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