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finals > obstetrics > Flashcards

obstetrics Flashcards

1
Q

which contraception is associated most with weight gain

A

injection - depo-provera

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2
Q

best short-term contraception for after birth

A

POP

at increased risk of VTE following childbirth so avoid COCP

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3
Q

how many days is it until each contraception is effective (if not taken/inserted on first day of period)?

A

instantly: IUD
2 days: POP
7 days: COCP, injection, implant, IUS

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4
Q

COCP and cancer risk

A

increased risk of breast and cervical

decreased risk of ovarian and endometrial

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5
Q

COCP 1 missed pill

A

take the last pill even if it means taking 2 in one day
then continue taking pills daily, one each day
no further action is needed

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6
Q

COCP - if 2 or more pills are missed in week 1

A

consider emergency contraception if UPSI in pill-free week or in week 1
use condoms or abstain until she has taken pills for 7 days in a row

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7
Q

COCP - if 2 or more pills are missed in week 2

A

after 7 consecutive days of taking the COCP there is no need for emergency contraception
use condoms or abstain until she has taken pills for 7 days in a row

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8
Q

COCP - if 2 or more pills are missed in week 3

A

finish pills in current pack, then start a new pack omitting the pill free period
use condoms or abstain until she has taken pills for 7 days in a row

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9
Q

when should a double dose of levonorgestrel be used for emergency contraception?

A

BMI >26 or weight >70kg

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10
Q

mode of action of implant

A

inhibition of ovulation

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11
Q

absolute contraindications for COCP

A 
breastfeeding <6 week postpartum
migraine w aura
hx of VTE, stroke or ischaemic heart disease
current breast cancer
>35 years smoking >15/day
any clotting disorders
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12
Q

contraception for trans male (female at birth)

A

avoid COCP
copper IUD does not interfere with hormonal treatments (i.e. testosterone)
POP, implant and injection are thought not to interfere with hormones

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13
Q

contraception for trans female (male at birth)

A

advise to use condoms

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14
Q

how long does IUS last

A

5 years

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15
Q

how long does IUD last

A

5-10 years

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16
Q

delay in changing patch

A

<48h - change patch and no further precautions needed

>48h - change immediately and use barrier protection for 7 days

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17
Q

necessary criteria for lactational amenorrhoea to be reliable method of contraception

A
  1. amenorrhoeic
  2. baby <6 months
  3. breastfeeding exclusively
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18
Q

POP missed pills, what is the ‘safe’ window (i.e. no further action required)

A

desogestrel (Cerazette) has a 12 hours missed pill window

the rest have a 3 hour window

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19
Q

ABX safe in breastfeeding

A

Penicillins
Cephalosporins
Trimethoprim

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20
Q

ABX contraindicated in breastfeeding

A

Ciprofloxacin
Tetracyclines
Sulphonamides

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21
Q

risk factors for 2nd trimester miscarriage

A

Age >35 years
Prev miscarriages
Chronic health conditions
Smoking, heavy alcohol use, illicit drug use
Invasive prenatal genetic tests, e.g. amniocentesis
Large cervical cone biopsy

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22
Q

risk factors for placenta accreta

A

prev. C section

Placenta praevia

23
Q

Bishop score <5 indicates…

Bishop score >=8 indicates…

A

< 5 - labour is unlikely to start without induction
≥ 8 - cervix is favourable and there is a high chance of spontaneous labour, or response to interventions made to induce labour

24
Q

mx if placenta praevia grade III/IV (i.e. covers os)

A

elective C section at 36-37 weeks

25
Q

which contraception should be avoided in menorrhagia

A

IUD

26
Q

vaccines offered to pregnant women

A

pertussis

influenza

27
Q

rash in pregnancy with periumbilical sparing

A

polymorphic eruption of pregnancy

28
Q

what is methotrexate used for in obstetrics

A

medical mx of ectopic pregnancy

29
Q

what is misoprostol used for

A

termination of pregnancy (along with mifepristone causes uterine contractions)
miscarriage

30
Q

what is mifepristone used for

A

termination of pregnancy along with misoprostol

31
Q

when does passage of lochia normally cease

A

4-6 weeks postpartum

ultrasound if persists beyond 6 weeks

32
Q

mx if a woman had group B strep in a previous pregnancy

A

maternal IV ABX prophylaxis during labour

33
Q

when should a woman with pre-eclampsia be admitted

A

all need an emergency secondary care assessment

if BP is >=160/110mmHg they should be admitted and observed

34
Q

mx of cord prolapse

A

presenting part of the foetus should be pushed back into the uterus
tocolytics may be used
if cord is beyond introitus keep warm and moist but do not push back in
ask patient to go onto all fours

35
Q

blistering rash in pregnancy

A

pemphigoid gestationis

36
Q

infections screened for at antenatal appointments

A

hep B
HIV
syphilis

37
Q

causes of raised AFP in prenatal screening

A

neural tube defects
abdominal wall defects
multiple pregnancy

38
Q

causes of reduced AFP in prenatal screening

A

Down’s syndrome
trisomy 18
maternal diabetes

39
Q

next mx step if late decelerations present on CTG

A

foetal blood sampling

40
Q

contact w chickenpox <20 weeks not immune no rash

A

VZIG within 10 days

41
Q

contact w chickenpox >20 weeks not immune no rash

A

VZIG or antivirals 7-14 days after exposure

42
Q

contact w chickenpox and develops rash

A

oral aciclovir within 24 hours of rash

43
Q

which beta-hCG is used to measure for ectopic

A

urine beta-hCG

44
Q

when is magnesium sulphate given in pre-eclampsia

A

severe hypertension
eclampsia (seizure)
if birth is planned within 24h
concern that eclampsia may develop

45
Q

mx to stop smoking in pregnancy

A
  1. behavioural therapy

2. nicotine replacement therapy

46
Q

when is screening for Down’s performed

A

11-13+6 weeks

47
Q

what organism causes group B strep

A

Streptococcus agalacticae

48
Q

causes of increased nuchal translucency

A

Down’s syndrome
congenital heart defects
abdominal wall defects

49
Q

time until effective IUD (if not first day period)

A

instantly

50
Q

time until effective POP (if not first day period)

A

2 days

51
Q

time until effective COC, injection, implant, IUS (if not first day period)

A

7 days: COC, injection, implant, IUS

52
Q

when is contraception needed postpartum

A

no contraception is needed until 21 days postpartum unless relying on lactational amenorrhoea

53
Q

when can external cephalic version be attempted

A

> 36 weeks of pregnancy and early labour provided amniotic sac has not ruptured and patient is not in active labour
if in active labour and transverse lie is found do emergency c-section

finals (25 decks)

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