Brainscape's Knowledge GenomeTM

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


See full index

Final Written > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Well managed epidural analgesia benefits

A

Reduced material and feral acidosis
Increased uteroplacental flow
Reduction in uterine activity
Reduction in incoordinate uterine activity

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

1st stage labour blockade requires which nerves to be blocked

A

T10-L1

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

Second stage labour requires what nerves to be blocked

A

S234

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

What is paracervical block and why shouldn’t it be used in labour

A

Paracervical block is local to the lateral fornix Vagina , blocks paracervical ganglion and provides analgesia to cervix and uterus

Used in gynae procedures

Not used labour as no benefit second stage and can cause profound fatal bradycardia, LAST, Infectuon, and neuropathy

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

Causes of maternal death 2020

A

VTE commonest
Cardiac remains high as indirect cause
SUDEP worryingly high - refer anyone with nighttime or uncontrolled seizures

Other causes, sepsis, mental health, haemorrhage

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

Amniotic fluid embolism presents with

A 
Refecatory hypoxaemia (cyanosis) 
Pulmonary hypertension 
Systemic hypotension 
Petechiae
Seizures 
Foetal distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PDPH when should follow up happen and for how long

A

OOA guidance is reviewed within 24 hours then daily, and continue until headache resolves

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

PDPH conservative treatment

A

Prolonged bed rest not recommended
Hydration
IV fluids only if oral not possible

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

PDPH pharmacological management

A

Simple analgesia
Short term opiods
Caffeine

No evidence for theophylline acth steroids triptans gabapentinoids

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

PDPH invasive treatments

A

No evidence for acupuncture occipital nerve blocks etc

Epidural saline may transiently improve ymsoykms

Epidural blood patch - when conservative therapy ineffective ans woman experiences difficulty performing activities of daily life and caring for her baby

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

EBP timing and steps prior

A

Less than 48 hours reduction in efficacy
No investigations needed prior but if stays after two or is evolving or neurology need scan
Written consent

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

Risks of ebp

A

Repeat Dural puncture
Back pain
Neurological complications

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

Risks of not performing EBP

A

Insufficient evidence but suggestion is reduction headache prevention haematoma

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

What level should EBP be done

A

Same level or one space lower
20ml
Review within 4 hours procedure
Verbal and written advice and write to GP and midwife

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

Pathophyisology of PDPH

A

CSF leak
Reduction in ICO and downward traction on pain sensitive intracranial structures
Cerebral vascular venodilation

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

Differential diagnosis of PDPH

A 
Migraine 
CVT 
SUBDURAL 
SAH 
SOL 
Meninigitis 
Dehydration 
Caffeine withdrawal 
PET 
Tension headache 
Lactation headache
17
Q

Features PDPH

A

Frontonocciputal
Better supine
Pressure over abdomen temporarily relieves pain in some

Other features include 
CN palsies 
Visual disturbabce 
Neck stiffness 
Photophobia
18
Q

Prevention of PDPH

A

Spinal needle selection - smaller gauge and pencil point

Loss of resistance to saline

Replace stylet
? Bevel parrelel to fibres

Senior

19
Q

Define pre eclampsia

A

New hypertension more than 140/90
Over 20 weeks pregnant
Evidence of end organ damage ie proteinuria

20
Q

Initial treatment pre eclampsia

A

Labetalol 200mg oral or IV (incremental 50mg)

Nifedipine 10mg

21
Q

Management of pre eclampsia on labour ward

A 
Antihypertensives 
Limit fluids 1ml kg hr
Foetal assessment 
Inform neonatal team 
Discuss with haematology 
Thromboprophylaxis
22
Q

Ga changes for pre eclampsia

A 
Blunt laryngoscope response with ie opiates 
Avoid ergomettine 
Low volume syntocin infusion 
Senior presence 
Hdu post operatively 
Avoid nsaids
23
Q

Management of seizure in pre eclampsia

A 
100% o2 left lateral 
Magnesium 4 gram over 5 minutes 
1 gram per hour 
Can have further magnesium if needed 
Monitor for OHS and deep tension reflexes
24
Q

Maternal risk factors amniotic fluid embolism

A

Strong uterine contractions
Uterine rupture
Multiparty

25
Q

Foetal risk factors for amniotic fluid embolism

A

Male fetus
Polyhydraminos
Multiple pregnancy
Assisted delivery

26
Q

Immune theory afe

A

Phase 1 foetal cells in maternal blood stream, increased levels pulmonary vasoconstrictors leading to pulmonary hypertension and RV failure

Phase 2 LV failure pulmonary oedema DIC atone haemorrhage

Other theory is mechanical

27
Q

Maternal comorbidities associated with obesity

A 
Gestational diabetes 
VTE 
Cardiomyopathy 
Preeclampsia 
OSA
28
Q

Obstetric complications increased in obesity

A 
PPH 
Preterm labour 
Instrumental delivery 
Induction of labour 
Wound infections
29
Q

Patient factors contributing to difficult airway in pregnancy

A

Difficult face mask ventilation (increased fat stores)
Difficult laryngoscopy (oedema)
Increased reflux ( reduced lower oesophageal tone and angle of his)
Reduced FRC

30
Q

Anaesthetic factors contributing to difficult airway obs

A

Time pressured
Altered drug dosing
Reduced exposure to obs GA
Isolated site

31
Q

Obs difficult airway algorithm

A
  1. Pre induction planning and prep
    RSI and consider 20cm h20 ventilation
    Laryngoscopy 2+1
  2. Declare failed intubation
    Call for help
    Maintain oxygenation
    SGA x2 or FMV
  3. Declare CICO
    100% oxygen
    Exclude laryngospasm
    FONA
32
Q

Measures to minimise airway issues obs GA

A 
Identify at risk patients 
Plan 
Position 
Antacids prophylaxis 
Video laryngoscopy 
Adequate paralysis 
Senior anaesthetist 
Safe extubation plan
33
Q

Risk factors pre eclampsia

A 
Nulliparity 
Multiple pregnancy 
Previous 
Age over 40 
Bmi over 35 
Fix 
Diabetes 
Hypertension 
Renal disease 
Inter pregnancy gap more than ten years
34
Q

Iron deficiency in pregnancy

A

Who says 110

Iron def in obs increases maternal deaths
Low birth weight
Preterm labour

Final Written (12 decks)

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