Obstetrics

Question 1

Stretch marks on abdomen

Answer 1

Striae gravidarum

Question 2

Butterfly pigmentation of the face (mask of pregnancy)

Answer 2

Chloasma gravidarum

Question 3

Glycosuria

Answer 3

Physiological in up to 50% of pregnancies

Question 4

Nitrates positive during pregnancy

Answer 4

Start antibiotics (if only leukocytes are positive send for further urinalysis before starting treatment)

Question 5

Hepatitis B positive mother

Answer 5

Vaccinate baby at birth and consider IM immunoglobulin

Question 6

Major teratogenic drugs

Answer 6

ACEIs
Retinoids
Sodium valproate
Methotrexate
Trimethoprim

Question 7

CTG

Answer 7

Cardiotocography - records fetal heartbeat and uterine contractions

Question 8

FHR

Answer 8

Fetal heart rate
Bradycardia - less than 110 bpm
Tachycardia - more than 160 bpm

Question 9

SFH

Answer 9

Symphysis fundal height

Question 10

Stages of labour

Answer 10

Stage 1 - begins when the cervix begins to dilate and ends with full dilation to around 10 cm
—Latent phase - onset of painful contractions to around 3 cm dilation (contractions may be less intense and less frequent)
—Active phase - quicker rate of dilation and greater intensity of contractions
Stage 2 - full dilation to delivery of the fetus (strong contractions every 2-3 minutes)
Stage 3 - delivery of the placenta

Question 11

Normal position of the fetal head during descent

Answer 11

Occiput Transverse Position

Question 12

9.5 cm fetal head diameter enabled by flexion of the head

Answer 12

Occipitobregmatic - lowest posterior point of occipital bone to anterior fontanel

Question 13

Biparietal fetal head diameter

Answer 13

9.5 cm

Question 14

Fetal station

Answer 14

Relationship between the presenting part of the fetus and the ischial spines

Question 15

Maternal pyrexia

Answer 15

38. 0 degrees Celcius once

37. 5 degrees Celcius twice, 2 hours apart

Question 16

Normal time for spontaneous onset of labour

Answer 16

Any time after 37 weeks

Question 17

Abnormal labour timescales

Answer 17

Before 37 weeks gestation (pre-term)

After 42 weeks gestation (post-mature)

Question 18

Position that often leads to a prolonged labour

Answer 18

Occipitoposterior

Question 19

Malpresentations

Answer 19

• Brow presentation (rare)
• Face presentation (1 in 500 deliveries)
• Shoulder presentation (very rare, transverse lie)
• Compound presentation (when a hand or foot is present along with the presenting part)
• Breech presentation

Question 20

Horizontal incision made along the suprapubic crease in a lower segment caesarean section

Answer 20

Pfannenstiel incision

Question 21

Two types of C-section

Answer 21

Classical and lower segment

Question 22

Two types of vaginal assisted delivery

Answer 22

Forceps and ventouse

Question 23

Most common drugs used with an epidural

Answer 23

Bupivucaine (local anaesthetic)

Fentanyl (opiate)

Question 24

Define attitude

Answer 24

The relationship of fetal head to spine (e.g. flexed, neutral, extended)

Question 25

EDD

Answer 25

40 weeks from first day of LMP

Question 26

ARM

Answer 26

Artificial rupture of the membranes

Question 27

Most common position of the uterus

Answer 27

Anteverted and anteflexed

Question 28

PIH

Answer 28

Preganacy induced hypertension

Question 29

Common site of headache for pre-eclampsia

Answer 29

Frontal

Question 30

Pre-eclampsia core symptoms

Answer 30

Headache Epigastric pain Visual disturbance Swelling

Question 31

``` Dr C Br A Va D O ```

Answer 31

``` Define risk Contractions Baseline rate Accelerations Variability Decelerations Overall ```

Question 32

CTG accelerations

Answer 32

Defined as an increase in FHR of >15 bpm for >15 seconds

Question 33

Other name for obstetric cholestasis

Answer 33

Intrahepatic cholestasis of pregnancy

Question 34

Lower-segment caesarean section scar

Answer 34

Pfannenstiel scar

Question 35

Combined test for Down's syndrome screening

Answer 35

10-13 weeks - US fetal neck (nuchal translucency) - PAPP-A - Beta hCG

Question 36

Test to measure the degree of transfer of fetal haemoglobin to a mothers bloodstream, usually in Rh-negative mothers

Answer 36

Kleihauer test (or KB test)

Question 37

Gestation prior to which steroids must be given pre-delivery to reduce the risk of neonatal respiratory distress syndrome

Answer 37

34 weeks

Question 38

Quadruple test for Down's syndrome screening

Answer 38

``` 16-19 weeks Unconjugated oestradiol hCG AFP Inhibin A ```

Question 39

Injury to the upper nerves of the brachial plexus (C5-C6), often caused by shoulder dystocia and causing a pronated forearm in the 'waiter's tip' position

Answer 39

Erb's palsy

Question 40

Injury to the lower roots of the brachial plexus (C8-T1), causing a 'claw hand' and supinated forearm

Answer 40

Klumpke's palsy