Brainscape's Knowledge GenomeTM

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


See full index

3a > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

what is the ideal position for a baby to be in for vaginal delivery?

A

vertex presentation

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

which fontanelle looks like a diamond?

A

anterior

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

causes of polyhydramnios

A 
DITCH
diabetes
idiopathic
twins
congenital abnormalities
heart failure (mother)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when should you induce post dates?

A

41 weeks

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

what does the Rotterdam SHOP consist of

A

string of pearls on USS
hyperandrogenism
oligomenorrhoea
PROLACTIN NORMAL

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

what are the risks of gestational diabetes?

A 
SMASH
shoulder dystocia
macrosomnia
amniotic-polyhydramnios
stillbirth
hypertension and hypoglycaemia in baby
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

whats the difference between the circles and crosses on a growth chart?

A

circles-estimated foetal growth

crosses-fundal height

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

causes of IUGR

A

placental insufficiency: smoking

multiple pregnancy, uterine malformation, infection, labetolol, alcohol

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

what is the normal birth weight?

A

2.5-4kg

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

what is small for dates defined as?

A

under 10th

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

complications of large for dates

A 
birth injury
immature suckling
hypoglycaemia
jaundice
left colon syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how is gestational diabetes managed?

A

diet and exercise control for 2 weeks, if this doesn’t work then insulin/metformin and glibenclamide can be used

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

how many weeks does a baby have to be before it is counted in parity?

A

24weeks

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

when should the first trimester scan be?

A

11-13 weeks

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

when can you do amniocentesis?

A

15-20 weeks

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

when is the second trimester?

A

13-27 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

risks of breech

A

difficulty delivering head
cord prolapse
fetal hypoxia

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

what are the stages of labour and delivery

A 
Every-Engagement
Decent-Descent
Female-Flexion
I-Internal rotation (occ transverse to OA)
Crown-extension during delivery
Rules-Restitution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the indications for induction?

A 
4 Ps
post dates
PROM
pre eclampsia
plus diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

define PROM

A

=SROM rupture of membranes before labour (PROM means pre labour) and over 37 weeks

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

what drug is opposite to oxybutanin

A

terbutaline-a beta agonist so used in hyperstimulation

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

what is the onset of gestational hypertension?

A

24/40 so if it’s detected before this then it must be underlying diabetes

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

when should the combined test be done?

A

10-14 weeks

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

do you need to be concerned about micro and macrovascular complications in gestational diabetes?

A

no

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

what additional risk factors does pre existing DM carry over GDM?

A

congenital abnormalities
miscarriage
NOT IN GDM

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

what does pregnancy cause in diabetics?

A

increased insulin requirements and so hypoglycaemia in early pregnancy
speeds up retinopathy, nephropathy

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

what is the management for any chronic health condition in pregnancy?

A

pre-conception counselling!

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

what is the prognosis of GDM?

A

glucose metabolism returns to normal after metabolism but increased risk of T2DM in the 10 years following the pregnancy

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

when is GDM tested for?

A

24 to 28 weeks with OGTT

then 6 weeks postpartum do another to see if there was underlying DM

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

management of diabetes

A

folic acid
serial growth scans
metformin or glibenclamide
induction at 38-40

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

what is the definition of preeclampsia?

A

140/90 and 300mg of protein in 24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what increases risk of developing pre-eclampsia

A 
young mother
primigravida
last baby over 10 years ago
change in partner from last
chronic hypertension
renal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

4 red flag symptoms of pre eclampsia

A

headache
visual disturbance
RUQ pain
breathlessness (pulmonary oedema)

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

4 red flag signs of preeclampsia

A

clonus
hyperreflexia
fits
periorbital oedema

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

how do you treat a pre eclampsic fit

A

get help
IV magnesium sulfate
IV labetolol or hydralazine

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

pre eclampsia buzz words

A

spiral arteriole persistence
failure of placentation
widespread endothelial dysfunction
multi organ failure

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

what is worrying on Doppler?

A

after 20w absent end diastolic flow

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

what should pregnant women avoid eating?

A 
pate
high mercury fish (shark, swordfish)
unpasteruised milk or juice
liver
uncooked egg
must limit caffeine intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are your differentials for abdominal pain in pregnancy?

A

UTI
stones
cholecystitis
appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what do you give a pregnant woman with a UTI at 21 weeks?

A

trimethoprim

nitro is only for 0-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what are the effects of smoking on a fetus?

A 
placental insufficiency so pre eclampsia
miscarriage
ectopic
stillbirth
SIDS
asthma
otitis media
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

guidelines for alcohol consumption in pregnancy

A

none in first trimester, after: 2U once or twice a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

wat are the effects of alcohol on a fetus?

A

IUGR
prem
stillbirth
FAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what are the features of FAS?

A 
mental retardation: learning difficulties, ADHD
smooth philtrum
low set ears
microcephalus
microganthia
flat nasal bridge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is prematurity defined as?

A

under 37 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is the management of pre eclampsia?

A

hydralazine and nifedipine and labetolol, if hyperreflexic>MgSO4
induce at 37weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

which medications will affect a pregnant asthmatic woman?

A

mainly induction agents:
ergometrine
prostaglandin
labetolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is the only indication for warfarin in pregnancy

A

metal valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

why does obstetric cholestasis occur?

A

more female hormones that the liver has to deal with, it can cause stillbirth and affect fetal heart. Mx=ursodeoxycholic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

how is placenta praevia defined?

A

placenta within 2.5 cm of the os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

give some general complications of antepartum haemorrhage

A

transfusion
DIC
ARDS
acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

risk factors of shoulder dystocia

A 
large foetus
large mother
induction
prolonged labour
GDM
instrumental delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

management of shoulder dystocia

A 
HELPERRR
help
espisiotomy consider
legs into McRobert's
pressure
enter the pelvis
rotational manourvres
remove posterior arm
repeat
(very last-break symphisis or zalvanellis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

complication of shoulder dystocia?

A

Erb’s palsy-arm is extended, internally rotated and wrist is flexed and protonated
PPH, 3+4 tears, PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

when is Guthrie’s test done?

A

5-8 days old or when feeding is established

56
Q

once labour is established, how often do contractions occur?

A

45-60s every 2 to 3min

57
Q

what are the contraindications for induction and vaginal delivery?

A

bishops of under 4
transverse
severe cephalopelvic disproportion
placenta praevia

58
Q

risk factors for prematurity

A 
previous prem baby
black
multiple pregnancy
smoking
genital infection
59
Q

what is the normal birthweight?

A

2.5-4.5kg

60
Q

what does ergometrine do?

A

causes uterus to contract so used in PPH and induction

61
Q

what is given after delivery to mother?

A

IM oxytocin for active managment of the third stage

62
Q

why are NSAIDs contraindicated in the after 27 weeks?

A

they open the ductus arteriosus

63
Q

what are the risks of not breastfeeding?

A

to mother-breast ca

baby: otitis media, T2DM, obesity, SIDS, leukaemia

64
Q

what does APGARs stand for?

A 
appearance
pulse
grimace
activity
respiratory effort
65
Q

what do you do with a low APGARs?

A

0-3 full resus
4-6 some resus-o2 and rub
repeat APGARs at 5 min

66
Q

when is APGARs done?

A

1 min after delivery and 5 min if low

67
Q

when is the baby check done?

A

first 72 hours

6-8 week baby check

68
Q

what medications are used to increase tone in PPH?

A 
ergometrine
misopristol
carboprost
oxytocin
tranexamic acid
69
Q

what are you trying to stimulate by sweeping membranes?

A

Ferguson reflex

70
Q

what does the cytotrophoblst differentiate into?

A

more cytotrophoblast cells
syncitiotrophoblast
extra villus trophoblast

71
Q

what is the role of hcg?

A

its from the trphoblast, it signals the prescence of an embryo and prevents luteal regression

72
Q

which is the main hormone in pregnancy?

A

E3-oestriol

others being oestrodiol and oestrone

73
Q

when does the blastocyst hatch?

A

6th day so this is when implantation happens

74
Q

how many cells are a blastocyst?

A

32-64

75
Q

how is blood supply established?

A

haemochorial placentation

76
Q

what are the risk factors for GDM?

A

previous macrosomic baby
previous GDM
1st degree relative with diabetes
SE asian, carribean

77
Q

what is the cutoff for gestational diabetes?

A

> 5.6 fasting

>7.8 OGTT

78
Q

what bloods would you do if you suspected pre eclampsia and what would you find?

A

FBC (low plts, low hb)
U&Es (raised creatinine and urea)
LFTs (raised AST)

79
Q

what would you worry about in reversed end diastolic flow?

A

could be heart failure-need to get MRI asap

it’s when the line goes beyond the x axis

80
Q

why might a baby be small for dates?

A

SWAN
starved (asymetrical-IUGR so placental insufficiency, maternal disease, pre eclampsia)
wrong dates
abnormal (chromosomal abnormality, abnormal uterus, infection)
normal-constitutional

81
Q

when should a woman be admitted to labour ward

A

when contractions are regular and at 5-10 intervals

82
Q

how many contractions should there be in 10?

A

3, if anymore there’s a risk of fetal distress

83
Q

how long should each stage of labour last?

A

1st nulli-10h; multi-6h
2nd nulli-40min; multi-20min
3rd-15min
so 7 or 11 hours

84
Q

how quickly should someone progress in the active stage?

A

nulli 1cm in 1hr

multi 2cm in 2hr

85
Q

what produces hcg?

A

syncitiotrophoblast

86
Q

what is ritodrine?

A

beta 2 agonist used for tocolysis

87
Q

what is the management of pre-eclampsia in pregnancy?

A

1) oral labetolol or hydralazine if not working
2) steroids at 34+
3) delivery: mild-37w; severe-34-6; any complications-now

88
Q

what prophylaxis should be used in woman with: prev pre htn in pregnancy, CKD, SLE, antiphospholipid syndrome and DM?

A

aspirin 75mg after 12 weeks to reduce pre eclampsia

89
Q

how is antiphospholipid syndrome treated?

A

aspirin or LMWH

90
Q

risk factors for pre eclampsia

A 
previous pre eclampsia in another pregnancy
smoking
multiple pregnancy
CKD
autoimmune disease: SLE or antiphospholipid
DM
chronic htn
age
FHx
first pregnancy
first pregnancy in over 10 years
91
Q

what are the risks of preeclampsia?

A 
PPH
IUGR
HELLP
eclampsia
placental abruption
liver failure
pulmonary oedema
92
Q

3 days post birth, SCBU baby develops sepsis, what is the likely pathogen?

A

after 48 hours-HAI more likely so staph epidermidis or staph aureus

93
Q

what antibiotic is used for GBS prophylaxis?

A

benzylpenicillin

94
Q

when can termination be offered in rubella infection?

A

before 16 weeks

95
Q

how do you treat toxoplasmosis infection?

A

spiramycin

96
Q

abruption risk factors

A 
IUGR
pre eclampsia
HTN
smoking
previous abruption
97
Q

management of OP presentation?

A

may need to induce or use instrumental delivery

98
Q

what does a bishop score of over 9 mean?

A

labour is likely to commence spontaneously

99
Q

what does a bishop score of under 5 mean?

A

induction is needed

100
Q

when should the different forms of induction be used?

A

sweep
vaginal prostaglandins in most, esp nulliparous-need to do CTG 1hr after
amniotomy if prostaglandins aren’t working
oxytocin after SROM or 2 hr after amniotomy-need to cont CTG

101
Q

what increases the risk of shoulder dystocia?

A

high maternal BMI
DM
macrosomnia
prolonged labour

102
Q

what increases the risk of cord prolapse

A

anything that prevents the head from engaging

103
Q

what pH suggests fetal hypoxia

A

under 7.2

104
Q

what should you consider if syntocinin isn’t working?

A

ergometrine unless they’re hypertensive, it will cause severe vomiting

105
Q

investigations in recurrent miscarriage

A

antiphospholipid screen
karyotyping
USS empty uterus

106
Q

what should you do in someone diagnosed with hyperemesis?

A

encourage hydration, exclude things that could dehydrate further like UTI or multiple pregnancy

107
Q

what antibiotic should be given to prevent GBS?

A

IV benzylpenicillin or ampicillin

108
Q

which STI is asso with opthalmia neonatorum?

A

gonorrhoea

109
Q

what does CMV cause in infants?

A

sensorineural hearing loss, CP, mental retardation, jaundice, splenomegaly, IUGR, microcephaly
treat baby with ganciclovir

110
Q

what is measured on the combined test

A

PAPPA A
BETA hcg
nuchal translucency

111
Q

what is measured on the quadruple test

A

unconjugated oestrodiol
beta hcg
inhibin A
AFP

112
Q

when can chemo be used in pregnancy?

A

2nd and 3rd trimester, radiotherapy cannot unless livesaving

113
Q

what considerations are there in the management of an obese pregnant woman

A 
need thrombopropylaxis post delivery
5mg folic acid
10mg vit D
anaestetist rv
active management of the third stage bc at greater risk of PPD
114
Q

what are the values for GDM?

A

2hrs past then 7.8 mmol indicates intolerance

7mmol random also suggests GDM

115
Q

what serum tests are done on booking?

A

syphilis, HIV, hep B, rubella

not CMV or GBS

116
Q

give 2 rfs for accreta

A

prev caesarean

Asherman’s

117
Q

when can you give steroids for lung maturity?

A

only over 24w

118
Q

what investigation can be done in pregnancy for suspected PE

A

VQ scan, MRI not useful, CTPA too much radiation, D dimer isn’t definitive at best of times and is raised in pregnancy anyway

119
Q

what has to be avoided in all women with antepartum bleeding?

A

VE-only if preterm labour is dx

120
Q

what is the conservative managment of someone with PPROM?

A

10d antibiotics, steroids from 24-34w then deliver 34-36w

121
Q

what is the diameter in face presentation?

A

sugmentobregmatic

122
Q

what is the diameter in brow presentation?

A

mentovertical

123
Q

what antibiotic is best to use in UTI during pregnancy?

A

amoxicillin but co amoxiclav is teratogenic

124
Q

causes of miscarriage

A

chromosomal
infective (BV)
uterine abnormalities
thrombophilic abnormalities

125
Q

RFs of miscarriage

A

prev miscarriage
maternal age
smoking

126
Q

how does the definition of PPH change when it was CS?

A

it’s over 1L rather than 500mL

127
Q

how should oxytocin be given when ripening the cervix?

A

titrated up

128
Q

what are the complications of antepartum haemorrhage?

A 
PPH-consumptive coagulopathy
anaemia
IUFD
fetal hypoxia
blood transfusion
129
Q

how do you determine how much anti D IMMUNOGLOBULIN to give?

A

Kleihauer test

130
Q

what is a healthy birthweight

A

2.5-4.5kg

131
Q

when should CTG be used continuously?

A

oxytocin infusion (intermittent with prostaglandin)
epidural
DM
previous antepartum haemorrhage

132
Q

what is the immediate management of fetal distress?

A 
LLP
o2, fluids, stop oxytocin
use beta agonist
VE exam to exclude cord prolapse and rapid progress
fetal blood sampling
133
Q

what are the indications for induction?

A 
41/40
SROM over 24 hours ago
pre eclampsia
DM
IUGR
CI: fetal distress-emergency CS!
134
Q

what should be avoided in SROM?

A

vaginal exam, instead do a CTG

135
Q

what is perinatal morality

A

24 weeks to 28 days

3a (11 decks)

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