Obstetrics Flashcards
A woman who booked with your clinic at 8 weeks by dates had an initial haemoglobin of 11g/dl. She has a reasonable diet and complains of fatigue at 28 weeks gestation. She looks pale so you retest her blood count which comes back as a haemoglobin of 10g/dl.
Which of the options below is most appropriate?
a. Do a serum folic acid test
b. Give her folic acid tablets
c. Do her iron levels and give iron tablets
d. Give her folic acid tablets
e. Cross match blood
c. Do her iron levels and give iron tablets
A 40 year old woman with 4 uncomplicated vaginal deliveries books at 34 weeks gestation by dates complaining of a dark red vaginal bleed which is continuous and associated with unremitting severe abdominal pain.
On examination the uterus is appropriate for dates but is firm and tender. The nursing staff are unsure about hearing a fetal heart or not. Which of the possibilities below is the most likely diagnosis?
a. Placenta praevia
b. Vasa praevia
c. Vaginal infection
d. Cervical polyp
e. Ruptured uterus
f. Abruption
g. Vaginal infection
f. Abruption
A woman in her first pregnancy is routinely blood typed on booking at 12 weeks gestation and found to be Rh negative. The father is tested and he is also Rh negative.
Which of the following steps are most appropriate for her further management?
a. Anti-D at 28 weeks and 34 weeks
b. Serial amniocentesis from 24 weeks
c. Anti-D at 28, 34 weeks and delivery
d. Anti-D at delivery only
e. No intervention
e. No intervention
An 18 year old primigravid woman presents at 36 weeks gestational age complaining of swelling of her ankles and fingers but no other symptoms.
On examination, she has a blood pressure of 160 / 110 mm Hg with evidence of oedema affecting both legs to the level of the knee. Her urine shows 1 + proteinuria.
Her pregnancy prior to this presentation had been normal.
Which of the options below is the most likely diagnosis?
a. Chronic renal disease
b. Chronic hypertension
c. Imminent eclampsia
d. Pre-eclampsia
e. HELLP syndrome
d. Pre-eclampsia
A 25 year old woman who has had a normal previous pregnancy, delivering a 3500g infant presents for the first time in her second pregnancy at 12 weeks amenorrhoea and on routine urine testing she has one plus (+) glycosuria.
Her next routine appointment is in 2 weeks time.
What is your most appropriate response from the options below?
a. Place her on a calorie restricted diet
b. Order a glucose tolerance test
c. Do a blood sugar level immediately
d. Ask her to bring an early morning specimen of urine at her next visit
e. Order a random blood sugar level
e. Order a random blood sugar level
A healthy 30 year old woman in her first pregnancy is diagnosed with twins at 14 weeks gestation by ultrasound.
She consults you about potential problems that may arise during the pregnancy.
She asks you what the most likely complications could be.
Which from the list below would you choose to discuss with her?
a. Congenital abnormalities
b. Deep vein thrombosis
c. Chromosomal abnormalities
d. Preterm labour
e. Placental abruption
d. Preterm labour
A woman in her first pregnancy presents at 28 weeks gestation by sure dates in preterm labour and it appears she is going on to deliver. You administer tocolytics and decide on steroid administration to enhance maturity.
Which fetal/neonatal system below is likely to benefit most?
a. Haemopoetic
b. Hepatic
c. Neurological
d. Cardiovascular
e. Respiratory
e. Respiratory
In a regionalised system of perinatal care such as the Western Cape, most pregnant women are initially seen for their booking visit by nursing staff.
At which of the following venues are the majority of women booked?
a. Local clinics (Midwife Obstetric Units)
b. Secondary hospitals
c. Community hospitals
d. Regional hospitals
e. Referral hospital
a. Local clinics (Midwife Obstetric Units)
A patient should be transferred from a clinic to hospital when she develops risk factors.
When this occurs, it should only be done
a. When her condition is stable
b. If there is a doctor to accompany her
c. If she is in acute need of tertiary care
d. When an ambulance is available
e. If there is a sister to accompany her
a. When her condition is stable
A woman of short stature is booked in your hospital. She has an uncomplicated labour until the second stagewhen she requires a forcepts delivery for dealy. This is followed by a postpartum haemorrhage. Although the uterus appears well-contracted, she continues to bleed. You take her to theatre for further management.
What is the most appropriate first step from the choices below?
a. Give fresh frozen plasma
b. Inspect the vulva / vagina for bleeding lacerations
c. Evacuate the uterus
d. Transfuse O-negative blood
e. Check for a clotting disorder
b. Inspect the vulva / vagina for bleeding lacerations
