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Specialities > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

RF of SGA

A

Major- >40, smoke >11, previous SGA or stillbirth, HTN - if so umbilical at 26-28

Minor 3x- uterine 20-24 then if abnormal

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2
Q

What is needed to see for viable pregnancy

A

Yolk sac and gestational sac- if not PUL- Bhcg 48hrs

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3
Q

Last fatal movement

A

24 weeks

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4
Q

PEC diagnosis alternative

A

Headache, RUQ instead of proteinuria or organ dysfucntin

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5
Q

Ectopic treatment

A

<1000 IU/L: expectant management
<1500 IU/L: patient’s choice between methotrextate and expectant management
1500-5000 IU/L: patient’s choice between methotrexate and surgery
>5000 IU/L: surgery
NB: The ectopic pregnancy must not be larger than 35mm, there must be no visible heartbeat, and no pain or haemodynamic instability, otherwise surgery is indicated

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6
Q

Ectopic vs PID

A

Ectopic- bowel

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7
Q

When to take 5mg folate

A

HIV on cotrimox, DM, Obese, previous NTD, epilepsy

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8
Q

VTE prophylaxis

A

3RF- 28w until 10d
4RF- 12w until 10d
VTE/previous - 6w pp

RF- 35, 30 BMI, parity 3, smoker, PEC

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9
Q

When can’t you give steroids before

A

24w

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10
Q

When is AFP raised

A

Abdminal wall defect, pat, NTD

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11
Q

Hypoechoic bowel

A

CF, DS, CMV

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12
Q

Increased nuchal fold

A

DS, CHD, Abdo wall

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13
Q

People who need OGTT

A

Obese, asian, FH, >4.5kg- 24-28w

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14
Q

When can return to pre pregnancy insulin

A

As soon as eating

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15
Q

How to treat epilepsy initially

A

As if eclampsia- MgSO4

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16
Q

Molar follow up

A

In specialist centre- normal level of bhcg for 6m before next pregnancy
Methotrexate if rising

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17
Q

Aspirin 75mg is given to

A

If 2 of fat, forty, FH, first

Chronic HTN, kidney, DM, PEC in previous

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18
Q

Signs of MgSO4 OD and tx

A

Hyporelfexia and resp depression

Ca gluconate

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19
Q

When to stop Mgso4

A

24hrs after last seizure or birth

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20
Q

Mx of Hep B

A

Can do vaginally, IVIG and vaccine at birth

Vaccine at 1m and 6m

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21
Q

Who require IP ABx

A

GBS swab, previous child with infection, pre term

22
Q

Signs of AFL

A

jaundice, epigastric pain, vomitting, hypoglycaemia, thirsty

23
Q

Measuring baby

A

CRL <14, FL, AC, HC after

24
Q

Birth of twins timing

A

MCMA: 32 to 33+6 weeks
MCDA: 36 to 36+6 weeks
DCDA: 37 to 37+6 weeks

25
Q

When to give emergency cerclage

A

16-28w dilated cervix, enraptured

26
Q

Diagnosing pre term LABOUR

A

> 30w- TVUSS- <15mm

27
Q

Diagnosing PPROM

A

Speculum

IGFBP1

28
Q

PPH management

A

Bimanual, oxytocin, ergo (not if asthmatic/HTN), carboprost (not in asthmatic)
Massage, oxytocin, Balloon tamponade

29
Q

Ix of recurrent Misccariage

A

Cytogenic analysis of POC, pelvic USS, APL ab, BV- cause not usually found

30
Q

Dose of anti D and kleinhauer

A

Kleinhauer test only >20w- give anti D within 72 hours of events
<20 w 250, > 500U

31
Q

Rash Presents at umbilicus

A

Pemphigus gestinalis

32
Q

What to give with ECV and when can’t do

A

Tocolytics- nifedipine
B agonist- terbutaline

Cant do ECV if ROM or multiple

33
Q

What type of speculum are there

A

Cusco- normal speculum

Sims- for prolapses ?

34
Q

When to use surgery for miscarriage

A

haemorrhage or infection surgery is better

35
Q

When sterilisation works for women

A

Laprascopic- contraception for next menstrual period, hysteroscopic- 3months

36
Q

Perineal tear grades and tx

A

1- vaginal muscoa, 2 perineal muscle, 3a external b >50% external c internal, 4 anal mucosa

1- no repair
2- midwife
3-4- clinician in theatre

37
Q

When to use prophylactic cerclage or vag progesterone

A

<25mm cervical and hx of miscarriage or PROM

38
Q

When don’t you have to give anti D in rheas negative

A

Small bleed <12w

39
Q

When can you use forceps

A 
Fully dilated
OA- keiller for OP
ROM
Cephalic
Engaged
Pain releif
Sphincter empty
40
Q

PP grades

A

1- away from os
2- on internal os
3- partial cover
4- full cover

41
Q

Purpuric foliccularis

A

Pruritic follicular eruption with papules and pustules mainly on the trunk
Looks like acne
Resolves within weeks of delivery

42
Q

Mx of dead foetus after abruption

A

Induce vaginally

43
Q

When to give Abx for mastitis

A

Infected nipple fissure
Symptoms do not improve or are worsening after 12-24 hours despite effective milk removal
Bacterial culture is positive.

44
Q

Mx of uterine hyperstimulisation

A

Stop Oxytocin
Check CTG
Maybe give tocolytics

45
Q

What condition can be caused by GDM

A

NTD, fetal respitaroy Syndrome

46
Q

When to screen thyroid at booking

A

DM, AI, first FHx, prev or current thyroid

47
Q

What condition can cause RDS

A

GDM

48
Q

Pregnant Wirth fibroid- fever and vomitting

A

red degeneration, resolves 5-7d

49
Q

When to stop lmwh

A

24hrs before delivery

Wait until 2hrs before giving epidural

50
Q

Headache and neurology post part- dx and tx

A

central venous sinus thrombus
MRI
IV UF heparin

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