Brainscape's Knowledge GenomeTM

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


See full index

Mod B > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Management for hyperemesis gravidarum in the community

A

Oral promethazine / cyclizine
Ondansetron (inc risk of cleft palate tho)

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

Management for hyperemesdis gravidarum on admission

A

IM anti sickness - e.g. promethazine
Fluids - NaCL 0.9%, add KCl, thiamine and folic acid to prevent Wernicke’s

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

Risk factors for hyperemesis gravidarum

A

Multiple pregnancies
Trophoblastic disease
Hyperthyroid
Nulliparity
Obesity

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

Preeclampsia

A

Caused by placental dysfunction (so babies often small)

Presentation:

  • New onset HTN (after 20 weeks) - more than 140/90
  • Proteinuria
  • Organ involvement - e.g. renal insufficiency, liver dysfunction
  • Oedema
  • Visual changes, headache

Investigations:

  • BP
  • FBCs, U+Es, LFTs
  • Urine
  • ?CTG
  • ?Growth scan

Management:

  • Oral labetalol
  • If 160/110 - admit for obs inc catheter. May consider IV antihypertensives, magnesium sulphate, delivery of baby.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

High risk factors for preeclampsia

A
  • Personal history
  • CKD
  • SLE
  • Diabetes
  • HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Moderate risk factors for preeclampsia

A
  • First pregnancy
  • Age 40+
  • 10 years since last preg
  • BMI - 35+
  • FH
  • Multiple pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who gets aspirin during pregnancy for preeclampsia prophylaxis

A
  • If any high risk factors
  • If 2 moderate risk factors

Take from 12 weeks - near delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

HELLP Syndrome

A

Haemolysis
Elevated liver enzymes
Low platelets

Presentation:

  • Nausea and vomiting
  • RUQ pain
  • Lethargy

Investigations:

  • FBC, LFTs
  • Clotting
  • G&S

Management:

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

Causes of PPH

A

Tone - uterine atony (most common)
Trauma - tears
Tissue - retained placenta
Thrombin - clotting/bleeding disorder

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

Definition of PPH

A

more than 500ml of blood loss after vaginal delivery (or 1000ml after C section) within 24hrs

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

Risk factors of PPH

A

Previous PPH
Prolonged labour
Preeclampsia
Older age
Polyhydramnios
Emergency C-section
Placenta praevia, acreta
Macrosomia

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

General causes of female infertility and how to assess

A
  • Ovulation problem - e.g. hypothalamic, PCOS - measure serum progesterone, LH, FSH, US ovaries to count follicles
  • Tubal cause - e.g. PID, endometriosis, adhesions - contrast US
  • Uterine - e.g. adhesions, fibroids - hysteroscopy
  • Unexplained
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Placenta praevia

A

Low lying placenta

Presentation:
- Painless bleeding
- May be shocked

Investigation:
- TVUS - if picked up at 20wks, scan again at 32wks and grade it - keep scanning every 2 weeks. On the final scan at 36/37 weeks - decide how to deliver.

Management:
- grades 3/4 - elective C-section at 37/38 wks - and if labour before then, it’ll be emergency

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

Risk factors for placenta praevia

A

Multiparity
Multiple pregnancy
Previous c-section

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

Risk factors for gestational diabetes

A

BMI of more than 30
Previous macrosmia
Previous gestational diabetes
1st degree relative with diabetes

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

Screening tests for gestational diabetes

A

Booking test and 24-28weeks if at risk

17
Q

Consequences of gestational diabetes

A

Macrosomia
Polyhydramnios
Premature birth
Preeclampsia
Neonatal jaundice
Rarely, stillbirth

18
Q

Preterm prelabour rupture of the membranes (PPROMS)

A

Investigations:
- Speculum - check for pooling of amniotic fluid
- Test fluid for PAMG-1 or IGF binding protein
- US for oligohydramnios

Management:
- Admit for observation
- Give oral erythromycin as risk of chorioamnionitis
- Corticosteroids to prevent RDS
- If more than 34wks, consider delivery

19
Q

When do foetal movements start?

A

18-20wks

20
Q

Risk factors for VTE

A

Age 35+
BMI over 30
Parity over 3
Smokes
Varicose veins
Pre eclampsia
Immobility
FH of unprovoked VTE
Thrombophilia
Multiple pregnancy
IVF pregnancy

21
Q

Risk factors for breech baby

A

Uterine malformations eg. fibroids
Placenta praevia
Polyhydramnios or oligohydramnios
Fetal abnormality
Prematurity

22
Q

Major complication of breech baby

A

Cord prolapse

23
Q

Placental abruption

A

Separation of the placenta from the uterine wall

Presentation:

  • Tense, tender abdo
  • Vaginal bleeding
  • Shock - out of keeping with visible loss - still traps in uterus

Investigation:

  • CTG - monitor foetus

Management:

  • If foetal distress - immediate C-section
  • If no distress - before 36 wks observe and give steroids; if after 36 wks - vaginal delivery
24
Q

Umbilical cord prolapse

A

When the cord descends before the foetus - can cause foetal hypoxia and death

Management:
- Emergency C -section
- In the meantime - get the women to go on all fours, push the presenting part of foetus back in to avoid compression, don’t touch the cord (vasospasm!) and give tocolytics to reduce contractions. Refil bladder to lift presenting part

25
Q

Obstetric cholestasis

A

Build up of bile acids - increased risk of premature and still birth

Presentation:
- After 24wks
- Puritis - no rash
- Fatigue
- Nausea
- RUQ pain
- (v rarely jaundice)

Investigations:
- FBCs, LFTs, bile acids

Management:

  • Chorphenamine to reduce itch
  • Ursodeoxycholic acid - to reduce serum bile acids
  • Early delivery at 37/38 wks
26
Q

Acute fatty liver of pregnancy

A

Presentation:
- 3rd trimester
- Abdo pain, nausea, vomiting
- Headache
- Jaundice
- Hypoglycaemia

Investigations:
- FBC, LFTs

Management:
- Stabilise
- Deliver

27
Q

Options for induction of labour

A
  1. Membrane sweep
  2. If Bishop’s score is less than 6 - vaginal prostaglandins
  3. If Bishop’s score is more than 6 - amniotomy plus oxytocin infusion
  4. Balloon catheter
28
Q

Thresholds for iron treatment

A

First trimester - 110
2nd trimester - 105
3rd trimester and post partum - 100

Mod B (5 decks)

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