obstetrics

Question 1

complete hydatiform mole vs partial
chromosome?
fetal parts?

Answer 1

partial- 1 egg two sperms, 69 XXX, 69XXY, FETAL PARTS

complete- empty egg, 1 sperm, 46XX, 46XY, all genetic from father

Question 2

indications for induction of labour?

Answer 2

Question 3

methods for induction of labour

Answer 3

Question 4

Postpartum haemorrhage (PPH) is defined ….?

causes of PP?

Answer 4

> 500mL

Question 5

Postpartum haemorrhage (PPH) mx?

Answer 5

Question 6

What advice should be given regarding the prevention of neural tube defects?

Answer 6

all women should take 400mcg of folic acid until the 12th week of pregnancy

HIGHER RISK (ie T1DM, BMI OVER 30): folic acid 5mg 3 months before conception to 12 weeks of pregnancy.

Question 7

woman, pregnant, not had MMR vaccine

advice?

Answer 7

keep away from people who might have rubella and receive MMR post natal

Question 8

Gestational diabetes screening test? weeks?

Answer 8

oral glucose tolerance test (OGTT) at 24- 28 weeks

dx: fasting glucose is >= 5.6 mmol/L
2-hour glucose is >= 7.8 mmol/L

needs insulin

REMEMBER 5, 6, 7 ,8
if fasting <7 can be advised on diet, but repeat glucose in 1-2 weeks. if target not met then metformin, if still not met then add insulin

Question 9

pregnant, under 20 weeks, HTN, tx?

Answer 9

labetalol

Question 10

category 1 vs 2 c section time frame has to be done once decision is made?

Answer 10

30 vs 75 mins

Question 11

baby blues vs postnatal depression vs puerperal psychosis

time frame, presentation?

Answer 11

Question 12

pregnant mum 34 wks, has UTI, positive for Group B Streptococcus (GBS)
mx?

Answer 12

intrapartum iv abx

benzylpenicillin is the antibiotic of choice for GBS prophylaxis

Question 13

pregnant lady has chicken pox or significant exposure, mx depending on weeks of pregnancy?

Answer 13

first check does she have immunity VZI IgG levels

over 20 weeks: acyclovir
under 20 weeks: Varicella-zoster immunoglobulin VZIG

Question 14

Intrahepatic cholestasis of pregnancy
presentation?
mx?

Answer 14

check lfts also

Question 15

Gestation week screening earliest:
Down syndrome screening (nucal)?
anomaly scan?
first dose of anti reusus if woman negative

Answer 15

Question 16

breech management?

Answer 16

<36 turns on its own
36> external cephalic version

Question 17

24-year-old primigravida
mother had seizure during her pregnancy
She has no past medical history
BP is 125/85
No abnormalities are detected on her urine dipstick.
BMI is 38 kg/m².

mx?

Answer 17

A woman at moderate or high risk of pre-eclampsia should take aspirin 75-150mg daily from 12 weeks gestation until the birth

r/f: first pregnancy, BMI >35 kg/m² and family history of eclampsia

Question 18

Women who are at high risk of developing pre-eclampsia should take …?

Answer 18

aspirin 75mg od from 12 weeks until the birth of the baby.

Question 19

What is the first line management for shoulder dystocia?

Answer 19

McRoberts manoeuvre (hyperflexion of the maternal legs) is the first management approach

Question 20

Oligohydramnios is less then ..?ml
causes?

Answer 20

Question 21

when to take aspirin if at risk for pre-eclampsia i.e previous hx or family hx, type 1 or 2 diabetes?

Answer 21

A woman at moderate or high risk of pre-eclampsia should take aspirin 75-150mg daily from 12 weeks gestation until the birth

Question 22

screening tool for postnatal depression

Answer 22

Edinburgh scale

Question 23

patient has pre eclampsia.. mx?

Answer 23

treat with labetalol

Delivery should not be offered to women before 34 weeks unless:
severe hypertension remains refractory to treatment
maternal or fetal indications develop as specified in the consultant plan

Question 24

on methotrexate and wants to have a baby

advice?

Answer 24

Methotrexate: must be stopped at least 6 months before conception in both men and women

Question 25

12 week scan shows high chance and and quad scan of downs, next step?

Answer 25

Non-invasive prenatal screening test (NIPT)- analyses DNA

Question 26

2-day-old baby
rudimentary digits, limb hypoplasia and microcephaly.

what was he exposed to?

Answer 26

varicella zoster

Question 27

pregnant mum, previously has gestational diabetes, when do you seen her?

Answer 27

OGGT asap after booking.

normally you do it at 24-28 wks

Question 28

pregnant
how much vit d?

Answer 28

daily supplement 10micrograms of vitamin D

Question 29

27wks preg, regular weak contractions
premature labour- cervix cm dilated

mx?

Answer 29

Admit and administer tocolytics and steroids

Question 30

when to give anti D?

Answer 30

advise giving anti-D to non-sensitised Rh -ve mothers at 28 and 34 weeks

Question 31

Eclampsia– having a seizure ?

Answer 31

mag sulphate

Question 32

6-day-old baby is found to have congenital cataracts, sensorineural deafness and pulmonary artery stenosis

Answer 32

RUBELLA

ruby eyes, and ears

Question 33

Anti-epileptics in pregnancy

Answer 33

Lamotrigine

Question 34

UTI while breastfeeding?

Answer 34

Trimethoprim

Question 35

HIV positive women can she breastfeed?

Answer 35

NO

Question 36

Neonatal antiretroviral therapy sicne mum has HIV

Answer 36

zidovudine is usually administered orally to the neonate if maternal viral load is <50 copies/ml.

if viral load >50 then triple ART 4-6 weeks.

Question 37

HIV mum, mode of delivery?

Answer 37

Question 38

Down’s syndrome is suggested by
?HCG
?PAPP-A
?nuchal translucency

Answer 38

Down’s syndrome is suggested by ↑ HCG, ↓ PAPP-A, thickened nuchal translucency