Pass Test Obs Flashcards
History of watery vaginal discharge and now tachy flushed and wide pulse pressure
Sepsis as had premature rupture of membranes
When does an amniotic fluid embolism occur
During labour or up to 48 hours post delivery
When is the spleen used for haematopoesis in a foetus
3-6mths
When is the liver used for haematopoesis in a foetus
Begins at one month and peaks at 5 moths
When is the yolk sac used for haematopoesis in a foetus
Conception to 3 myths
Treat hypertension with preeclampsia
Admit and control bP with labetolol (methyldopa/ nifedipine second line)
What pain relief other than paracetamol can be used in pregnancy
Codeine phosphate
Fully dilated and in advanced labour but CtG shows variable decelerations that have not resolved despite a change in the mother’s position - what do you do
Fetal blood sampling as she is fully dilated to asses the babies lactate and pH
What happens at the 11-13 week apt
Combined test screening for downs including Papp-a beta hcg and a nuchal translucency
When are you classed as high risk for neural tube defects
FH of neural tube defects on mother or fathers side
Previous pregnancy with NT defect
Maternal diabetes
Personal history of neural tube defect
How does a woman with diabetes in pregnancy’s apt’s differ to normal
Seen at a joined antenatal and diabetic clinic every one to two weeks
ACE I IN PREGANNCY
Contraindicated in all trimesters
When is warfarin safe to use in pregnancy
Safe in second trimester only
When do you avoid trimethoprim in pregnancy
First trimester
Don’t give labetolol as first line of what
The patient is asthmatic
If the placenta hasn’t been delivered naturally within 30 OJ’s what do you do
Syntocinin infusion
If in a further 30 mins it hasn’t been delivered then attempt manual removal
If a nipple fissure is present in mastitis then what does this indicate
Infective cause so give fluclox
Get a breast milk culture before starting the abx
What are the typical clotting results in DIC
PT elevated
APTT elevated
Low platelets
Low fibrinogen
Cellulitis around wound site and pen allergy
Oral clarithromycin
When do you first feel fetal movements
20 weeks in a prim
16-18 in a subsequent pregnancy
What causes lower back pain in pregnancy
In third trimester the relaxation of ligaments causes pain particulalru at night - treat with improved posture flat shoes and a firm mattress
When does breast enlargement occur
First few weeks
When does nipple and areolar darkening occur
12 weeks
What is diagnostic of poly hydramnios
> 2-3 l
How is medical termination prescribed as
Oral mifepristone and vaginal misoprostol
When is AROM used
When woman is in active labour and her waters have not broken
If bishop score <6 what is used
Vaginal PGE2 the reassess after 6 hours
If Bishops still less than 7 after this period of time then further prostaglandin is given
First line for hyperemesis
Cyclizine / chlorpromazine
Define anaemia in the first trimester second trimester and post partum
First <11
Second <10.5
Post partum <10
Placenta accreta
Milder form where they attach to superficial layer of myometrium
Placenta percreta
Severe form only managed with a hysterectomy
Through all layers
Placenta increta
Involves muscle layer
People who present with primary herpes should be treated with
Oral aciclovir
From 36 weeks they should get aciclovir at treatment dose 3 times a day TIL delivery
Vagina delivery
Where does choriocarcinoma metastasize to
Lungs
What does gestational trophoblastic disease have a strong link with
Thyroid dysfunction
Treat warts in pregnancy
Cryoptherapy as podophylin is contraindicated
Gonorrhoea treatment in pregnancy
Ceftriaxone
What is the definition of proteinuria?
Persistent urinary protein of >300mg/24 hours
If a hypothyroid woman becomes pregnant how would there treatment change
Even if euthyroid despite treatment increase dose to 25mcg
Define gestationa diabetes
Fasting plasma glucose of >5.6
Or a 2 hour plasma glucose of >7.8
When in gestational diabetes should women be given insulin
Fasting glucose >7
What is sheehans syndrome
Hypo pituitary secondary to pituitary infarction due to haemorrhaging shock in labour and the peripartum period
When can you do CVS
11 weeks
Which test do you do for a karyotupe
CVs
What is the quadruple blood test
Between 15 and 22 weeks you measure AFP HCG inhibin A and unconjugayed oestriol
When should HIV positive woman be given an elective c section
Women with HIV and hepatitis C con infection
On zidovudine monotherapy
On HAART whose viral load is >50 copies
What is Kleihauers test
Demonstrated fetal RBCs in maternal blood circulation and according to the test result, anti d is given to the mother to destroy Rh positive fetal cells therefore preventing the mother from forming anti D anibodies
What is uterine hyper stimulation syndrome
More than 6 in 10 often caused by shtick in infusion so reduce flow rate
Breastfeeding and pain relief
Ibuprofen
What do you do if a patient has been in known contact with slapped cheek and is developing symptoms of it
Urgent referral to fetal medicine unit (to be seen within 4 weeks) and so serial uS scans
