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BPT Written > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

LLN of platelets in pregnancy

A

> 100

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2
Q

ERV change in pregnancy

A

fall

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3
Q

RV change in pregnancy

A

Fall

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4
Q

IC change in pregnancy

A

small rise

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5
Q

TLC change in pregnancy

A

Overall same (IC rise and FRC fall), maybe small rise

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6
Q

Why do UTIs increase in pregnancy?

A

Progesterone mediated ureteric dilation

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7
Q

Why does ALP rise in pregnancy?

A

placenta produces ALP

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8
Q

Normal urine PCR in pregnancy and why

A

<300, hyperfiltration

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9
Q

Top medical comorbidity affecting pregnancy

A

Asthma

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10
Q

Main change in respiratory physiologyin pregnancy

A

increased TV

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11
Q

Safest inhaled steroid in pregnancy

A

Budesonide

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12
Q

Well controlled asthma reduces the risk of what in a child..

A

Bronchiolitis and croup

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13
Q

Worst AED for pregnancy

A

Valproate

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14
Q

Best single agent for pregnancy

A

Keppra

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15
Q

Anti-epileptic enzyme inducers x4

A

CBZ, Pheyntoin, topiramate, phenobarb

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16
Q

Relationship between eGFR and fertility in prengnacy

A

Lower GFR = worse fertility

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17
Q

What occurs with dialysis and fertility

A

fertility improves

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18
Q

What occurs with transplant and fertility

A

returns

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19
Q

How long should transplants wait until conception

A

2 years +

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20
Q

consequence of early conception post transplant

A

increased graft loss

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21
Q

How much dialysis is needed in pregnancy?

A

> 36 hours/ week, INTENSE

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22
Q

what occurs to GFR in pregnancy in those with CKD

A

falls and often doesn’t recover

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23
Q

what to supplement in obese people in pregnancy

A

folate

24
Q

potential drug to give to Anti-Ro +ve mothers in pregnancy

A

HCQ- reduces risk of heart block in future pregnancies

25
Q

When does CHB manifest in anti-ro/La +ve pregnancies?

A

16-26 weeks

26
Q

How to differentiate pre-eclampsia from lupus nephritis

A

Haematuria/active sediment -> LN
Low complement -> LN
Anti-dsDNA high -> LN
Pre-eclampsia -> raised uric acid, deranged LFTs

27
Q

Pre-eclampsia definition

A

HTN and organ involvement

28
Q

Pre-eclampsia/eclampsia neuro involvement

A

seizures, hyperreflexia, clonus, stroke/ICH/PRES, persistent visual disturbance

29
Q

Major medical risk fx for pre-eclampsia

A

renal disease, obesity, HTN, DM, APLS

30
Q

Major persona/ Fam risk fx for pre-eclampsia

A

first degree relative, primip, previous pre-eclamp

31
Q

Preventative rx of pre-eclampsia

A

Aspirin and calcium

32
Q

Which growth factor is thought to be responsible for pre-eclampsia

A

soluble Flt-1, mopping up PIGF

33
Q

DDx of MAHA in pregnancy

A

HELLP, DIC, AFLP, aHUS, TTP

34
Q

When does HELLP occur in pregnancy?

A

3rd tri

35
Q

When does AFLP occur in pregnancy?

A

3rd tri

36
Q

When does aHUS occur in pregnancy?

A

Post delivery

37
Q

HTN targets in pregnancy

A

SBP 110-140, DBP approx. 85. NOT <80

38
Q

3 most commonly used agents for HTN in pregnancy

A

Methyldopa, labetalol, nifedipine

39
Q

Best PE imaging modality in pregnancy/ why?

A

V/Q - less radiation to breasts. Radiation dose to baby actually lower with CTPA

40
Q

What D-dimer level excludes VTE in pregnancy?

A

<0.5

41
Q

Duration of Rx VTE pregnancy

A

3-6 months until at least 6/52 post-partum

42
Q

Anticoagulants safe in breastfeeding

A

LMWH, warfarin

43
Q

VTE prophylaxis indications in pregnancy

A

Antenatal and post-partum - prev pregnancy or oestrogen provoked VTE, ATIII mutation irrespective of VTE, previous VTE and any thrombophilia

Post-partum only - non-oestrogen provoked PE and no thrombophilia, thrombophilia without VTE history (homozygotes or compound heterozygotes only)

No prophylaxis - heterozygote thrombophilia with no history VTE

44
Q

Define hyperemesis gravidarum

A

Electrolyte abnormality, dehydration or >5% wt loss

45
Q

Rx mild hyperemesis

A

Stop iron, continue iodine and folate, pyidoxine and ginger

46
Q

Rx for severe hyperemesis

A

Cyclizine, steroids (not <10/40)

47
Q

Key Ix for hyperemesis gravid

A

UEC, LFT, TFT, USS (?multiple gestations, GTD)

48
Q

Putative molecule responsible for peripartum cardiomyopathy

A

16kDa prolactin fragments

49
Q

Why does peri-partum CMP deteriorate post delivery?

A

Auto-transfusion of blood back from placenta

50
Q

Which Rx works for peri-partum CMP in a small study?

A

Bromocriptine

51
Q

When to anticoagulate peri-partum CMP?

A

EF<35%

52
Q

When should peri-partum CMP get ICD?

A

LV dysfunction >6/12 post-partum

53
Q

Obstetric cholestatis occurs when?

A

> 30/40

54
Q

Triad of obstetric cholestasis

A

Pruritis soles and palms, elevated ALT/bile acids (>10), normal USS

55
Q

Mechanism of obstetric cholestasis

A

Defect in bile acid transport in mother, with oestrogen also disrupting transport

56
Q

Mx obstetric cholestasis

A

Urso
BA > 40 - deliver 38-39
BA > 100 - deliver 35-36

BPT Written (21 decks)

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