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Year 4 Obs and Gynae > Pass Test Obs > Flashcards

Pass Test Obs Flashcards

1
Q

History of watery vaginal discharge and now tachy flushed and wide pulse pressure

A

Sepsis as had premature rupture of membranes

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2
Q

When does an amniotic fluid embolism occur

A

During labour or up to 48 hours post delivery

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3
Q

When is the spleen used for haematopoesis in a foetus

A

3-6mths

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4
Q

When is the liver used for haematopoesis in a foetus

A

Begins at one month and peaks at 5 moths

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5
Q

When is the yolk sac used for haematopoesis in a foetus

A

Conception to 3 myths

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6
Q

Treat hypertension with preeclampsia

A

Admit and control bP with labetolol (methyldopa/ nifedipine second line)

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7
Q

What pain relief other than paracetamol can be used in pregnancy

A

Codeine phosphate

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8
Q

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

A

Fetal blood sampling as she is fully dilated to asses the babies lactate and pH

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9
Q

What happens at the 11-13 week apt

A

Combined test screening for downs including Papp-a beta hcg and a nuchal translucency

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10
Q

When are you classed as high risk for neural tube defects

A

FH of neural tube defects on mother or fathers side
Previous pregnancy with NT defect
Maternal diabetes
Personal history of neural tube defect

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11
Q

How does a woman with diabetes in pregnancy’s apt’s differ to normal

A

Seen at a joined antenatal and diabetic clinic every one to two weeks

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12
Q

ACE I IN PREGANNCY

A

Contraindicated in all trimesters

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13
Q

When is warfarin safe to use in pregnancy

A

Safe in second trimester only

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14
Q

When do you avoid trimethoprim in pregnancy

A

First trimester

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15
Q

Don’t give labetolol as first line of what

A

The patient is asthmatic

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16
Q

If the placenta hasn’t been delivered naturally within 30 OJ’s what do you do

A

Syntocinin infusion

If in a further 30 mins it hasn’t been delivered then attempt manual removal

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17
Q

If a nipple fissure is present in mastitis then what does this indicate

A

Infective cause so give fluclox

Get a breast milk culture before starting the abx

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18
Q

What are the typical clotting results in DIC

A

PT elevated
APTT elevated
Low platelets
Low fibrinogen

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19
Q

Cellulitis around wound site and pen allergy

A

Oral clarithromycin

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20
Q

When do you first feel fetal movements

A

20 weeks in a prim

16-18 in a subsequent pregnancy

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21
Q

What causes lower back pain in pregnancy

A

In third trimester the relaxation of ligaments causes pain particulalru at night - treat with improved posture flat shoes and a firm mattress

22
Q

When does breast enlargement occur

A

First few weeks

23
Q

When does nipple and areolar darkening occur

A

12 weeks

24
Q

What is diagnostic of poly hydramnios

A

> 2-3 l

25
Q

How is medical termination prescribed as

A

Oral mifepristone and vaginal misoprostol

26
Q

When is AROM used

A

When woman is in active labour and her waters have not broken

27
Q

If bishop score <6 what is used

A

Vaginal PGE2 the reassess after 6 hours

If Bishops still less than 7 after this period of time then further prostaglandin is given

28
Q

First line for hyperemesis

A

Cyclizine / chlorpromazine

29
Q

Define anaemia in the first trimester second trimester and post partum

A

First <11
Second <10.5
Post partum <10

30
Q

Placenta accreta

A

Milder form where they attach to superficial layer of myometrium

31
Q

Placenta percreta

A

Severe form only managed with a hysterectomy

Through all layers

32
Q

Placenta increta

A

Involves muscle layer

33
Q

People who present with primary herpes should be treated with

A

Oral aciclovir
From 36 weeks they should get aciclovir at treatment dose 3 times a day TIL delivery
Vagina delivery

34
Q

Where does choriocarcinoma metastasize to

A

Lungs

35
Q

What does gestational trophoblastic disease have a strong link with

A

Thyroid dysfunction

36
Q

Treat warts in pregnancy

A

Cryoptherapy as podophylin is contraindicated

37
Q

Gonorrhoea treatment in pregnancy

A

Ceftriaxone

38
Q

What is the definition of proteinuria?

A

Persistent urinary protein of >300mg/24 hours

39
Q

If a hypothyroid woman becomes pregnant how would there treatment change

A

Even if euthyroid despite treatment increase dose to 25mcg

40
Q

Define gestationa diabetes

A

Fasting plasma glucose of >5.6

Or a 2 hour plasma glucose of >7.8

41
Q

When in gestational diabetes should women be given insulin

A

Fasting glucose >7

42
Q

What is sheehans syndrome

A

Hypo pituitary secondary to pituitary infarction due to haemorrhaging shock in labour and the peripartum period

43
Q

When can you do CVS

A

11 weeks

44
Q

Which test do you do for a karyotupe

A

CVs

45
Q

What is the quadruple blood test

A

Between 15 and 22 weeks you measure AFP HCG inhibin A and unconjugayed oestriol

46
Q

When should HIV positive woman be given an elective c section

A

Women with HIV and hepatitis C con infection
On zidovudine monotherapy
On HAART whose viral load is >50 copies

47
Q

What is Kleihauers test

A

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

48
Q

What is uterine hyper stimulation syndrome

A

More than 6 in 10 often caused by shtick in infusion so reduce flow rate

49
Q

Breastfeeding and pain relief

A

Ibuprofen

50
Q

What do you do if a patient has been in known contact with slapped cheek and is developing symptoms of it

A

Urgent referral to fetal medicine unit (to be seen within 4 weeks) and so serial uS scans

Year 4 Obs and Gynae (5 decks)

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