Brainscape's Knowledge GenomeTM

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


See full index

Health and Society Year 4 > Obstetrics > Flashcards

Obstetrics Flashcards

You may prefer our related Brainscape-certified flashcards:
Sociology 101 flashcards
1
Q

When are children competent to consent?

A

When they can understand the nature and consequences of treatment

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

4 reasons why you can breech confidentiality for children

A

too immature to understand/ consent (see Frazer guidelines)
force or threat of force dangerous to health
drugs/ alcohol used to influence them
known to police as having abusive relationships with children/young people

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

How old is a child when they are presumed competent to consent to treatment

A

16-18 years

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

When can a child refuse treatment

A

If they are over 18

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

What happens if a competent child refuses treatment

A

A parent/court might allow management in their best interest

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

What is the difference between the frazer guidelines and gillick competence?

A

Frazer guidelines: If under 16 for contraceptives

Gillick competence: General issues around consent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

5 points for frazer guidelines

A 
understand advice
cannot inform parents
dangerous to their health unless they get contraception
have sex anyway
in their best interest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 3 acts are used for consent in people with learning difficulties?

A

learning disability, sex and the law (2005)
sexual offences act (2003)
mental capacity act

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

What do people with learning difficulties need in order to consent to sex ?

A

They need capacity to know the mechanisms and the consequences of sex

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

What would you do if a patient came to you after a rape

A

Refer to sexual assault referral centre (SARC) where a forensic physician does Hx and examination

Checks for pregnancy, HIV, Hep B, suicidal ideation and safeguarding

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

how can you assess the quality of NHS services

A

Number of processes (referral/smears) and Outcome (mortality/morbidity, STI, unplanned pregnancy)

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

4 issues with NHS services

A

societal (less services), cultural (language, modesty), economic (access), political (e.g. law regarding abortion)

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

4 sexual health services

A

GP
Family planning clinics (STI, unplanned pregnancy)
Pharmacies
SARC

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

3 GU services

A

GUM clinic
GP
A&E

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

2 gynae services

A

Gynaecologist

GP

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

4 midwife/obstetric services

A 
Hospital
Antenatal services
Community midwife
GP
Early assessment unit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define stillbirth

A

A baby delivered after 24 weeks with no signs of life

1/200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Defineneonatal death

A

Death of a LIVE BORN infant within 28 days (3/1000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define early neonatal health

A

Within 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define post-neonatal death

A

From 28 days to 1 year (1/1000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define stillbirth rate

A

Number of stillbirths per 1000

4/1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define perinatal mortality rate

A

Number of stillbirths + early neonatal deaths per 1000 total
(7/1000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define infant mortality rate

A

Number of deaths in first year per 1000 live births (4/1000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define maternal mortality rate

A

Within 42 days of TOP/whilst pregnant

9/100,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What recent campaign has reduced infant mortality rate in the UK

A

Sleep campaign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

8 risk factors for stillbirth in the UK

A

Foetal growth restriction (biggest cause)
Congenital abnormality
Multiple birth

Maternal age (<25 or >40), ethnicity (black/Asian have 50% increased risk), poverty, substances, obstetric complications.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

5 causes of stillbirth in the UK
4 causes worldwide
1 key fact about worldwide stillbirths

A
  • 92% occur before onset of labour
  • 54% are unexplained
  • 25% due to asphyxia/ trauma e.g. cord prolapse/ abruption
  • 15% due to congenital abnormalities
  • 10% due to infections

Worldwide, 50% of deaths occur during labour, maternal infections inc malaria, syph and HIV, post term pregnancy and poorly controlled maternal health conditions e.g. NTH, DM
(most are preventable)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

4 biggest causes of neonatal death in the UK and 1 worldwide

A
  • prematurity is biggest killer (resp. disorders followed by neurological disorders)
  • congenital abnormalities (heart, NTD, etc)
  • obstetric complications e.g. shoulder dystocia
  • infections

Globally, majority are due to infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What global percentage of stillbirths occur in low/middle income countries

A

98%

75% in ssa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

8 strategies for prevention of stillbirth in the UK

A

Vit D, folate and iron
Stop smoking (SIDS/ neonatal breathing difficulties), alcohol, medication
Certain foods (raw meat, soft chesses, liver)
Screen for diseases
Breastfeeding
CTG training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

5 ways to reduce perinatal deaths

A
  • thermal protection, dry the goddam baby
  • hygiene
  • breastfeeding
  • assessment
  • prevention (vit K, Hep B and BCG if necessary)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

First down syndrome screening

A

11-14 weeks
Combined test
Increased nuchal BHCG; low PAPP-A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Second down syndrome screening

A

15-20 weeks
Quadruple test
High inhibin A and BHCG, low AFP and low unconjugated oestriol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What happens if there is a low and high chance of downs syndrome
and what are the cut offs?

A

1/150 is cut off

Go for amniocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

2 benefits of screening for downs syndrome

A

Allows the parents to prepare and plan

Gives them an informed choice if they want to terminate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

3 arguments against screening for downs syndrome

A

Risk of false positive and negatives
Spontaneous abortion with diagnostic testing (1%)
Suggesting Down’s syndrome life is less important

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When should you seek fertility help

A

After 1 year of trying (6 months if over 35 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

First line for infertility

A

Lifestyle change

39
Q

Epidemiology of fertility

A

Affects 1/7 couples

84% should conceive within 1 year

40
Q

5 causes of infertility and %

A 
30% male factor
20% ovulation failure
15% tubal damage
20% unexplained
15% other
41
Q

Investigations for infertility

A

Semen analysis
Serum progesterone 7 days prior to next period
Oestrogen
FSH/LH

42
Q

Medication used for infertility where the cause is known

A

Clomifene (SERM, increases HPG axis)

43
Q

How long do you wait after investigations before IVF is considered

A

1 year

44
Q

How many cycles of Intrauterine Insemination (IUI)?

3 criteria

A

Up to 6 cycles

If unable to have vaginal intercourse (e.g. disability)
Condition that means need help to conceive (e.g. STI)
Same sex relationship

45
Q

How many cycles of IVF if below 43 years

A

Up to 3 cycles on the NHS if:
Below 43 years and 2 years of trying with 12 cycles of artificial insemination
Between 23 and 39 AND there is a fertility problem OR infertile for more than 3 years

46
Q

Does any previous self-funded count towards 3 funded by NHS

A

Yes

47
Q

How many cycles of IVF if aged 40-42 years

A

1 cycle of IVF if after 2 years of regular sex or 12 cycles of insemination

  • never had IVF
  • no evidence of fertility problems
  • risks have been discussed
48
Q

2 lifestyle criteria for IVF

A

Non smoking

Healthy BMI

49
Q

Epidemiology of assisted reproduction

A

2% of all babies in the UK

25% success rate

50
Q

What are the 5 stages of IVF?

A 
Ovarian hyperstimulation
Oocyte recovery
Insemination
Embryo culture and transfer
Luteal phase support
51
Q

What happens during ovarian hyperstimulation?

A

GnRH agonist given to cause pituitary downregulation to prevent premature ovulation (increased then decreased oestrogen)
jMG, LH, FAH and hCG to stimulate folliculogenesis

52
Q

When does oocyte recovery occur?

A

34-36 hours after hCG infections

US for transvaginal oocyte recovery

53
Q

Percentage of sperm which fertilise during insemination

A

Put sperm in petri dish with oocytes

50-70% fertilise

54
Q

What happens during embryo culture and transfer

A

Fertilised oocytes examined, selected and inserted into the uterus

55
Q

What happens during luteal phase support

A

Progesterone supplementation to support the pregnancy until 10 weeks (when placenta begins to make progesterone)

56
Q

What is intrauterine insemination (IUI)

A

Separate healthy sperm and inject them into the uterus

57
Q

Benefits and drawbacks of IUI

A

Good for male infertility
If you can’t have sex, same sex or HIV
Cheaper

Worse outcomes

58
Q

What happens during intracytoplasmic sperm injection (ICSI)

A

Same as IVF but sperm are INJECTED into oocytes instead of left to mix in a petri dish

59
Q

2 indications for ICSI

A

Indicated when quality of sperm is poor/low sperm count or when pregnancy has failed in the past

60
Q

What happens during pre-implantation genetic diagnosis (PIGD)

A

Single cell removed from the blastocyst and screened for diseases

61
Q

3 things people can donate
Who uses it?
Ethics?

A

Oocyte, Sperm or Embryo
Same-sex
Ethics of anonymity

62
Q

When would you use surrogacy

A

When the mother can no-longer carry the foetus

63
Q

Legality of surrogacy

A

Surrogate is the legal mother and cannot hand over legal responsibility until 6w postnatal

64
Q

6 risks of IVF to mother

A

ectopic, OVHS, multiple gestation GD, anaemia, pre-eclampsia, miscarriage

65
Q

3 risks of IVF to the foetus

A

Prematurity (and consequences), IUGR, Miscarriage

66
Q

What does the court/adoption agency consider in regards to the child’s welfare in subfertility

A

Effect on child on not being a member or original family
Harm (children’s act 1989) child has suffered or is at risk of suffering
In adoption, child’s religious, racial, cultural and linguistic background

67
Q

3 arguments for IVF

A

Procreative autonomy: respect patient choices, minimalize state interference
Infertility can affect mental health
Welfare interest of future child

68
Q

2 arguments against IVF

A

Embryos have moral status (destruction of embryos)

Harm to those conceive (OHSS, multiple, ectopics)

69
Q

Positive and Negative right of IVF

A
  • Positive rights: no obligation to provide parents with means to have children
  • Negative right: obligation not to interfere with peoples decision to have children
70
Q

What does the HFEA Act 1990 State?

A

no treatment unless welfare of child has been taken into account (including need for a father)
- changed to 2008 to remove father and just supportive parenting

71
Q

Epidemiology of TOP

A

30% of pregnancies terminated

92% before 13 weeks

72
Q

What does the Abortion Act (1990) state about the foetus?

A

Foetus holds no legal status until birth

73
Q

When was the abortion act amended from 28 weeks to 24 weeks

A

1990

74
Q

2 laws regarding medical practitioners in termination

A

Done by a medical practitioner in NHS hospital or licenced premise
Two medical practitioners signs HSA1 agree unless it is an emergency (HSA2)

75
Q

5 key points for TOP

A

A: continuing pregnancy involves greater risk of life to pregnant women than if terminated
B: Termination is necessary to prevent permanent injury to physical/mental health of mum
C: pregnancy < 24w and continuing pregnancy means greater risk than if terminated to physical/mental of pregnant woman
D: < 24w and continuing pregnancy means greater risk to physical/mental heath of existing children of pregnant woman
E: if child was born it would suffer physical or mental abnormalities > seriously handicapped.

76
Q

i. e. > 24w, threatens mums life, permanent injury to mum, child has serious handicap (A,B,E)
i. e. < 24w risk>benefit of preg vs TOP to physical/mental health of mum or her children (C,D)

A

?

77
Q

When can you continue with a TOP in under 16 year olds

A

If Gillick competent AND

  • Girl understands all aspects and implications
  • Cant persuade her to tell her parents/ allow us to tell them
  • Physical/mental health is likely to suffer unless they receive treatment
  • In the best interest of the young person to receive treatment without parents
78
Q

3 routes to get an abortion

A

Contact advisor e.g. British pregnancy advisory service (BPAS), Marie Stopes
GP for referral to abortion service
Visit contraception clinic/ family planning clinic/ sexual health clinic/ Gum for referral

79
Q

Length of time from initial appointment to abortion

A

2 weeks

80
Q

Can a doctor refuse

A

Yes, unless it is an emergency

They need to refer quickly to another person

81
Q

5 things to do prior to TOP

A 
Screen for STO
Discuss contraception
Check smear
Give ABX prophylaxis
Give Anti-D if needed after procedure
82
Q

What infection can you get?

A

Post-operative salpingitis

83
Q

TOP procedure if less than 9 weeks

A

use mifepristone (anti-progesterone – cervix easier to open) followed by misoprostol (prostaglandins) 48h later to stimulate uterine contractions

84
Q

TOP procedure if less than 13 weeks

A

Misoprostol 3h before surgery – reduce cervical trauma

Surgical dilation and suction of uterine contents

85
Q

TOP if more than 15 weeks

A

Surgical dilation and evacuation of uterine contents or late medical abortion (mini-labour)

86
Q

TOP procedure if more than 22 weeks

A

Feticide is performed by using KCL in umbilical vein or foetal heart.

87
Q

4 complications of TOP

A

Infection (10%)
Cervical trauma (1%)
Failed TOP (1%)
Haemorrhage 1/1000)

88
Q

6 arguments for TOP

A
  • respects mothers autonomy
  • prevents harm to mothers health
  • prevents harm to foetus’ health
  • may be due to crime e.g. rape
  • may not be able to cope with a child
  • more backstreet abortions
89
Q

4 arguments against TOP

A
  • Pro-life: ends life of fetus with moral status of a person (their rights)
  • religions reasons
  • abortions for Down’s syndrome – suggest they have a lower moral status than other children
  • subjects more parents to unnecessary procedures.
90
Q

What are the four types of FGM?

A

Type 1: patrial/total removal of clitoris
Type 2: Removal of clitoris and labia minora
Type 3: Narrowing vaginal oriface by cutting labina minora/majora
Type 4: All other harmful procedures

91
Q

?Where is FGM most common and why?

A

Africa, Middle East, Malaysia, Indoesia

Preservation of virginity, promoting hygiene, cultural norms and religion

92
Q

Consequences of FGM for girl

A

Infection, pain, dyspareunia, self-harm, depression

93
Q

Suspect FGM

A

Illegal

Call police

Health and Society Year 4 (9 decks)

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