Brainscape's Knowledge GenomeTM

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


See full index

Year 4 > Obstetrics and Gynaecology > Flashcards

Obstetrics and Gynaecology Flashcards

1
Q

Investigation of Choice

Suspected Ectopic Pregnancy

A

Transvaginal USS

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

Sensitising Events Rhesus Disease (3)

A

Miscarriage >12 weeks
Abdominal Trauma
Invasive Antenatal Testing

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

Delivery of Anti-D in Rh -VE

Exception

A
  1. At 28 weeks
  2. At birth on confirmation that baby is Rh +VE
    Cannot give to sensitised women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vaccines and Anti-D Injection

A

Cannot give live vaccines e.g. MMR within 3 months of anti-D injection

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

Surfactant Production and Delivery

A

Catecholamines and cortisol released by the foetus at delivery stop the production of surfactant

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

Umbilical Arteries Carry

A

Dexoygenated blood

From foetus to the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Umbilical Vein Carries

A

Oxygenated blood

From placenta to the foetus

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

Result of Reduced Oxygen Delivery to Foetus (2)

A

Reduced growth

Reduced movements

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

Medical TOP

Early VS Late

A 
Early = up to 9+6 
Late = from 10+0
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Medical TOP Regimen

A

Oral anti-progesterone
+
Oral or Vaginal Prostaglandin 24-48 hours later

e.g. 200mg mifepristone + misoprostol

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

Surgical TOP Methods (2)

A

Vacuum Aspiration = 6-12 weeks

Dilation and Evacuation = 13-24 weeks

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

Post-Procedure TOP Care

A

Pregnancy Test should be given at 2-3 weeks
Contraception should be given
Not progesterone contraception - could reverse TOP

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

Transfer to CTG

Indications (5)

A

Decelerations after a contraction
Oxytocin augmentation
Pyrexia 37.5 >2 occassions
FHR <110 or >160

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

Heart Rate Parameters

A 
Normal = 110-160
Non-Reassuring = 161-180
Abnormal = <110 or >180
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Decelerations (pathophysiology, relation to contractions)

  • Early
  • Late
A 
Early = associated with head compression: sync with contraction 
Late = mediated by chemoreceptors, recovery lasts beyond the contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hyperstimulation =

A

> 5 contractions in 10 minutes

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

CTG Signs of Foetal Compromise (3)

A

Absent accelerations
Decreased baseline variability
Shallow decelerations

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

Maternal Cardiac Changes (2)

A

Increased cardiac output - peaks week 24-28

SBP - slight drop in 2nd trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Maternal Respiratory Changes (3)

A

Reduced functional capacity ( < elevation of diaphragm)
Increased tidal volume
Mildly compensated respiratory alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Maternal Endocrine Changes (4)

A

Insulin resistant
Reduced bone density
Increased thyroid hormone requirements
Vitamin D deficiency

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

Maternal Haematological Changes (4)

A

Iron deficiency anaemia
Hypercoagulable
+ WBC
Gestational thrombocytopaenia

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

Definition of Gestational HTN

A

= hypertension + no proteinuria: usually after 20 weeks and resolves within 6 weeks

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

Investigation of Pre-Eclampsia/HELLP

A

Bloods = FBC, LFTs, U&Es, coagulation, blood film

Urinary protein: creatinine ratio

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

Management of Eclamptic Seizures

A

IV MgSO4

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

Blood Sugar Parameters in Diabetes

A

FBG = <5.3

1 hour Post Prandial = <7.8

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

Definition of Peripartum Cardiomyopathy

A

= heart failure 2y to LVSD towards the end of pregnancy
EF usually <45%
Often present in pulmonary oedema/symptoms of cardiac failure

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

Acute Fatty Liver of Pregnancy

  • Presentation (4)
  • Findings (5)
  • Management
A

Pres: vomiting, abdominal pain, encephalopathy, polydipsia

Findings: 
Elevated bilirubin 
Hypoglycaemia 
Elevated AST/ALT
Renal impairment 
Disordered coagulation

Management: supportive, delivery of baby, N-acetylcysteine

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

Examples of Prostaglandins used in Labour (3)

A

Propress
Prostin
Misoprost - medical miscarriage, where intrauterine death has occured

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

Oxytocin

  • Method of Action
  • Foetal Distress
A

Action = stimulates uterine contractility, cervical ripening
= increases contraction frequency and resting tone
FD = bradycardia, transient acidosis

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

Syntometrine

  • Action
  • When to Use
A

= results in sustained tonic uterine contraction

- Only post-natally, if accidentally given antenatal need to deliver immediately

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

Use of Tocolysis

A

Used to halt or slow pre-term labour

e.g. atosiban, ritodrine, terbutaline

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

Pethidine

  • Delivery
  • Foetal Effects
A

= IM injection

Can cause decreased FHR variability: directly acts on the foetal myocardial conducting system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Testing for Chlamydia or Gonorrhoea

  • Male
  • Female
A 
Male = first void urine NAAT 
Female = self-taken vulvo-vaginal swab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describing a foetus as engaged

A

More than 2/5ths of the foetus are in the pelvis

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

Maternal Screening in Pregnancy

A

Sickle Cell and Thalassaemia: should be done by 10 weeks

Infection: should be done by 12 weeks, if refuse re-offer at 20 weeks
HIV, Hepatitis B, Syphilis
Needs to be done every pregnancy

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

If maternal Hepatitis B infection

A

Give foetus vaccine at 0,4,8,12,16 and 52 weeks

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

Combined Trisomy 13, 18 and 21 Testing

A

11-14 weeks

= maternal age + crown-rump length + nuchal translucency + BhCG + PAPP-A

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

Quadruple Testing

A

14-20 weeks

= maternal age + AFP + BhCG + unconjugated oestradiol + inhibin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When is anomaly scan offered?

A

18-20+6 weeks

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

Blood Spot Test Post-Natal

A

Usually between days 5-9

= sickle cell disease, cystic fibrosis, congenital hypothyroidism, IMDs

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

USS for assessment of hip dysplasia

A

Abnormal Exam = USS within 2 weeks

Risk Factors = USS within 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

1st line assessment of Newborn Hearing

A

Automated otoacoustic emission

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

Management of pre-eclampsia and eclamptic seizures

- 2nd Choice

A

Magnesium sulphate
Initial management of seizures = 4g MgSO4 IV over 5 minutes
Can use IV diazepam for prolonged seizures

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

Acceleration Definitions

A

= increase in FHR of at least 15 BPM for more than 15 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Deceleration Definitions

A

= decrease in FHR of at least 15 BPM for more than 10 seconds

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

2nd Stage Decelerations

A

= normal

The variability and baseline should be preserved

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

Limit age for foetal movements

A

24 weeks

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

Lithium in Pregnancy

A

Potentially teratogenic

Try and use other mood stabilisers

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

Epilepsy Medications Safe in Pregnancy (2)

A

Lamotrigine

Levetiracetam

50
Q

Testing for haemoglobinopathies

- Factor

A

Depends on prevalence
High = lab test
Low = questionnaire

51
Q

Testing for Gestational Diabetes

  • Risk Factors
  • Previous Gestation Diabetes
A

RF = OGTT between 24-28 weeks
Previous Gestational = OGTT at/as close as to booking
- Repeat at 24-28 weeks if normal

52
Q

Diagnosis of Gestational Diabetes

A

Fasting glucose >5.6

2 hour glucose >7.8

53
Q

Insulin threshold for Gestational Diabetes

A

Treat with insulin if fasting glucose >7

54
Q

Breech at 36 weeks

A

Offer External Cephalic Version at 37 weeks

55
Q

Giving Anti-D in Rhesus Negative

A

500 units at 28 and 34 weeks

56
Q

Management of DVT/PE

A

LMWH

Titrated to booking weight - dose also depends on whether prophylaxis or treatment dose

57
Q

Heparin and Delivery (2)

A 
Therapeutic = stop 24 hours before delivery 
Prophylaxis = stop 12 hours before delivery
58
Q

Difference between threatened and inevitable miscarriage

A

Cervical os closed and open respectively

59
Q

Partial Molar Pregnancy =

A

= 2 sperm with 1 egg, contains 69 chromosomes, foetal parts may be present

60
Q

Complete Molar Pregnancy =

A

= egg without DNA: no foetus

61
Q

Which cord blood gas best reflects the condition of the foetus?

A

Arterial blood gas

62
Q

Difference between arterial and venous cord blood gas

  • Small
  • Big
A 
Small = suggests chronic problem, compensated 
Big = acute event e.g. cord compression
63
Q

Reducing frequency and intensity of contractions (2)

A
  • Slowing/reducing oxytocin infusions

- Giving an IV fluid bolus

64
Q

When does the autonomic nervous system mature? Order? What does this mean?

A

28 weeks
Sympathetic before parasympathetic
Means that pre-term babies have a higher baseline and reduced variability

65
Q

Association with variable decelerations

A

Cord compression

66
Q

When to avoid methyldopa (2)

A

Liver dysfunction

Post-partum period

67
Q

Immunosupressants (3)

A

Tacrolimus
Azathioprine
MMF - teratogenic, can’t use in pregnancy

68
Q

Drug Levels and Pregnancy

A

As pregnancy goes on haemodiluted and increased renal clearance and metabolism = reduced drug levels

69
Q

Painkiller to avoid in Pregnancy

A

= NSAIDs

70
Q

Strawberry Cervix

A

= trichomonas vaginalis

71
Q

Window Periods

  • Chlamydia
  • Gonorrhoea
  • HIV
  • Syphilis
  • Hepatitis B
A

2 weeks = chlamydia and gonorrhoea
45 days = HIV
90 days = syphilis and hepatitis B

72
Q

Emergency Contraception Time Periods

A

UPA = can be used up to 120 hours
Levonorgestrel = can be used up to 72 hours
Copper Coil = can be used up to 120 hours

73
Q

Investigation to confirm ovulation

A

Midluteal progesterone level

e.g. day 21 in 28 day cycle

74
Q

Normal semen analysis

A

> 15 million sperm count

75
Q

Management of Chlamydia

A

100mg doxycycline for 7 days

76
Q

Management of PID

A

14 days
Doxycycline 100mg bd
Metronidazole 400mg bd
Ceftriaxone 1g IM

77
Q

Management of Syphilis

A

Penicillin G IM

78
Q

Contact Tracing

  • Chlamydia
  • Gonorrhoea
A 
Chlamydia = last 6 months
Gonorrhoea = last 3 months
79
Q

Production of hCG

A

Produced by placental cells to maintain corpus luteum to produce progesterone
Peaks at 9 weeks, from 12 weeks placenta produces progesterone

80
Q

Management of Ectopic Pregnanacy

A 
Medical = methotrexate 
Surgical = laparoscopic, preference is removal or tube
81
Q

Use of Foetal Scalp Electrode

  • When used (3)
  • Contraindications (3)
A 
Used = ruptured membranes, cervix >2cm, presenting part well presented 
Contraindications = HIV, herpes, hepatitis
82
Q

Diagnosis of IUGR (2)

A

Head and abdominal circumferences

USS doppler of umbilical artery

83
Q

Signs of Uterine Rupture (4)

A

Foetal bradycardia
Upward displacement of presenting part
Loss of contractions
Maternal hypotension

84
Q

Management of Premature Ovarian Failure (2)

A

Combined Pill

HRT

85
Q

Types of Breech Presentation (3)

A

Frank
Complete
Footling

86
Q

4 Ts of PPH

A

Tone
Tissue
Trauma
Thrombin

87
Q

Management of Shoulder Dystocia (5)

A 
McRobert's 
Suprapubic Pressure 
Episiotomy 
Internal Manoeuvres 
All Fours
88
Q

Triad for Hyperemesis

A

Dehydration (e.g. ketones in urine)
Weight loss >5%
Electrolyte disturbance

89
Q

Risk associated with ondansetron

A

Cleft palate

90
Q

Delay in return of fertility - contraceptive method

A

Depo-Provera

91
Q

Screening for Abnormalities

A
  1. Screening tests
  2. Non Invasive Pre-Natal Testing
  3. Amniocentesis or CVS
92
Q

Hormonal Options in Chronic Pelvic Pain (2)

A

OCP

GnRH analogue

93
Q

Management of HTN in PET (2)

A
  1. Labetalol

2. Hydralazine

94
Q

Maternal Sepsis ABx (Tayside)

A

IV Co-Amoxiclav and Gentamicin

95
Q

Sheehan’s Syndrome =

- Cause

A

= necrosis of the pituitary gland

Occurs due to hypovolaemia due to PPH

96
Q

Improving Uterine Tone

A
  1. 40 IU oxytocin in 500mls of saline

2. Consider PR Misoprostol or IM carboprost + bimanual compression

97
Q

Copper Coil Time Period Contra-Indications

A

Between 48 hours and 28 days postpartum

98
Q

Stopping the C-OCP before surgery

A

Need to stop 28 days before

99
Q

Management of asymptomatic bacteriuria (pregnancy)

A

Antibiotics

100
Q

Medication used in Stress Incontinence

A

Tolteradine

101
Q

Foetal pole measurement where would expect to see heartbeat

A

> 7mm

102
Q

Time taken for contraceptive to work

A

POP - 2 days

Everything else - 7 days

103
Q

Whirpool Sign =

A

= ovarian torsion

104
Q

Management of

  • Bacterial Vaginosis
  • Trichomonas
A 
BV = metronidazole
Trichomonas = metronidazole
105
Q

Painkiller contra-indicated in pregnancy

A

Aspirin

Can cause Reye’s Syndrome (brain disease, bad)

106
Q

AFP in pregnancy: associations

  • High
  • Low
A 
High = neural tube defects 
Low = Down's Syndrome
107
Q

Management of Premature Rupture of the Membranes

A

Oral erythromycin

108
Q

Boggy, tender uterus =

A

= adenomyosis

109
Q

Infection associated with foetal death and hydrops

A

Parvovirus

110
Q

Switch from rivaroxaban to what in pregnancy

A

LMWH heparin

All NOACs are contra-indicated in pregnancy

111
Q

Contraindication for using ergometrine for active 3rd stage

A

Hypertension

112
Q

Thrush + Pregnant

A

Topical clotrimazole

Oral medications are contra-indicated

113
Q

Mx of fibroids + causing difficulty conceiving

A

Myomectomy

114
Q

Investigation of mild oligozoospermia

A

Repeat sperm analysis after 3 months

115
Q

Risk factor for cord prolapse

A

Artificial rupture of the membranes

116
Q

Which part of the fallopian tube is the most dangerous for ectopic pregnancies?

A

Isthmus

part nearest the uterus

117
Q

<6 weeks pregnant + bleeding

A

= manage expectantly

118
Q

Group B streptococcus =

A

Streptococcus agalacticae

119
Q

<20 weeks pregnant exposed to chicken pox

A

Single dose of immunoglobulin

120
Q

> 20 weeks pregnant exposed to chicken pox

A

Oral aciclovir

Need to present within 24 hours of symptoms

Year 4 (27 decks)

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