Obstetrics and Gynaecology

Question 1

What is Anaemia

Answer 1

Low concentration of Haemoglobin in the blood

Question 2

What is the function of Haemoglobin

Answer 2

iron in the cell attracts oxygen and carries it around the body

Question 3

why is anaemia more common in pregnancy?

Answer 3

blood plasma increases due to demand for 2 humans - this waters down the haemoglobin concentration

Question 4

Consequences of anaemia in pregnancy?(5)

Answer 4

1. prematurity of baby
2. blood loss
3. loss of baby
4. baby with anaemia
5. child with developmental delays

(all due to poor nutrition)

Question 5

symptoms of anaemia in pregnancy? (4)

Answer 5

1. SOB
2. Fatigue
3. dizziness
4. pallor

Question 6

when is anaemia monitored in pregnancy?

Answer 6

twice
- booking appointment (8-10 weeks)
- 28 weeks gestation

Question 7

what is the Hb supposed to be at booking and 28 weeks?

Answer 7

booking: >110
28 weeks: >105

Question 8

what does low MCV indicate?

Answer 8

iron deficiency

Question 9

what does normal MCV indicate?

Answer 9

physiological anaemia

Question 10

what does raised MCV indicate?

Answer 10

B12/folate deficiency - intrinsic factor, pernicious anemia

Question 11

drug name for iron tablet?

Answer 11

ferrous sulfate

Question 12

dugs needed for low B12?

Answer 12

IV hydroxcobalamin or oral cyanocobalamin

Question 13

what should all women be taking in regards to anaemia to prevent neural tube defects

Answer 13

folate,5mg if high risk 400mg if low risk

Question 14

issues with atrophic vaginitis?

Answer 14

makes the vaginal pH and microbial flora more inclined to brew infections

Question 14

what is atrophic vaginitis?

Answer 14

when women have a lack of oestrogen causing dryness, thinning and more inflamed vagina, less elasticated as well

Question 15

3 signs of atrophic vaginitis

Answer 15

1. pale and dry
2. reduced skin folds
3. sparse pubic hair

Question 16

treatments for atrophic vaginitis?

Answer 16

rings
pessary
lubricants
moisturisers
oestrogen creams

Question 17

what is the cause of BV

Answer 17

loss of friendly bacteria leading to higher pH causing anaerobic bacteria to multiply

Question 18

what is BV

Answer 18

bacterial vaginosis

Question 19

what bad bacteria is associated to live in BV

Answer 19

1. gardnerella vaginalis
2. mycoplasma hominis
3. prevotella species

Question 20

what good bacteria is lost leading to develop BV

Answer 20

lactobacilli (lac of bacilli)

Question 21

5 risk factors of BV

Answer 21

• multiple partners
• smoking
• copper coil
• excessive cleaning
• antibiotics

Question 22

common presentation of BV?

Answer 22

fishy smelling watery grey discharge

Question 23

test for BV?

Answer 23

pH paper >4.5 = positive for BV

Question 24

what can be found on microscopy if BV is present?

Answer 24

clue cells

Question 25

what are clue cells in the context of BV

Answer 25

epithelial cells from the cervix that have bacteria stuck inside them - usually gardnerella vaginalis

Question 26

treatment for BV?

Answer 26

metronidazole OR clindamycin

Question 27

metronidazole contraindication?

Answer 27

alcohol

Question 28

risks of BV? (5)

Answer 28

miscarriage
preterm delivery
PROM
low birth weight
postpartum endometriosis