Passmed 1 Flashcards
Repair of perineal tears
1 - no repair needed
2 - on ward by midwife/dr
3/4 - in theatre under general by trained clinitian
What combination of results from her combined test indicate a higher chance of Down’s syndrome?
Thickened nuchal translucency, increased B-HCG, reduced PAPP-A
low AFP
What is used as GBS prophylaxis
benzylpenicillin
what is oligohdramnios
reduced amniotic fluid
causes of oligohydramnios
premature rupture of membranes fetal renal problems e.g. renal agenesis intrauterine growth restriction post-term gestation pre-eclampsia
What does a positive fetal fibronectin test indicate and how should it be managed
preterm labour
admit and give 2 doses IM steroids (lung maturation)
what maternal signs indicate TTTS
sudden increase in abdomen, breathlessness
when is AFP raised/lowered
raised in neural tube defects
lowered in downs
what is the cutoff used postpartum to determine if iron should be given
100g/L Hb
what sign would suggest erb’s palsy
adduction and internal rotation of the arm, with pronation of the forearm
(waiters tip)
What terminology is used to describe the head in relation to the ischial spine?
Station
what are the reference ranges for diagnosing gestational diabetes
‘5678’
fasting glucose is >= 5.6 mmol/L, or
2-hour glucose level of >= 7.8 mmol/L
what is the first drug given to manage major PPH
IV oxytocin
what is the first line antihypertensive in pre-eclamptic women with severe asthma
nifedipine
how will a hydratidiform mole present
Bleeding in first or early second trimester associated with exaggerated symptoms of pregnancy e.g. hyperemesis. The uterus may be large for dates
serum hCG is very high
how will an ectopic pregnancy present
6-8 weeks amenorrhoea with lower abdo pain and sometimes bleeding
shoulder tip pain
cervical excitation
How will a threatened miscarriage present
painless vaginal bleeding at 6-9 weeks
how will a missed/delayed miscarriage present
Light vaginal bleeding and symptoms of pregnancy disappear
how will vasa praevia present
Rupture of membranes followed immediately by vaginal bleeding. Fetal bradycardia is classically seen
how does a galactocele present
firm, non tender breast lump in women who have recently stopped breastfeeding
due to occlusion of lactoferrous duct
what are the SSRIs of choice for breastfeeding women
paroxetine
sertraline
Ectopic pregnancy in which location is most associated with an increase risk of rupture
isthmus
how long after delivery can the COCP be restarted (if no breastfeeding etc), and why
3 weeks, due to inc VTE risk
how will ovarian hyperstimulation syndrome present
ascites, vomiting, diarrhoea, high haematocrit
potential side effect of ovarian induction
what are the two main causes of pulmonary hypoplasia
oligohydramnios
congenital diaphragmatic hernia
what is the most important risk factor for cervical cancer
HPV inf (16,18 and 33)
what is the leading differential in a girl with amenorhoea but painful cycles and normal sexual characteristics
imperforate hymen
what cardiac anomaly is turners syndrome associated with
aortic coarctation
when does the first stage of labor end
cervix is fully dilated (10cm)
what is the safest method of contraception in someone who is at high risk of breast cancer
copper coil
what blood test should be considered in women with repeat vulvovaginal candidiasis
HbA1c - exclude diabetes
what is the cervical screening timeline
Age 25 years: first invitation.
Age 25-49 years: screening every 3 years.
Age 50-64 years: screening every 5 years.
what are the risk factors for DDH
Female breech presentation \+ve FHx oligohydramnios high birth weight
what are the characteristics of williams syndrome
short stature
elfin faecies
bubbly and friendly
learning difficulties
what cardiac abn is associated with williams syndrome
supravalvular aortic stenosis
what is a risk factor for cervical ectropion
COCP
when is IUD insertion contraindicated
Active PID or active STI
what is a red flag for Hirschsprung’s disease
passage of meconium >48hrs afterbirth
what is the teratment for vaginal vault prolapse
sacrocolpoplexy
what medications may help to reduce the size of uterine fibroiuds before surgery
GnRH agonists (-relin)
how long after taking ulipristal acetate can hormonal contraception be started
5 days
what are the long terms risks or complications of PCOS
inc risk endometrial cancer, heart disease, metabolic syndrome
after giving birth, how long will women not require contraception for
21 days
what is the most common cause of PID in the UK
chlamydia trachomatis
who is ulipristal acetate not suitable for
patients with severe asthma who require glucocorticoids for symptom control
what is the time limit for copper IUD insertion
within 5 days of unprotected sexual intercourse or within 5 days fo the earliest estimated date of ovulation, whatever is later
what heart lesion is associated with duchene muscular dystrophy
dilated cardiomyopathy
when is ECV offered
nulliparous - 36w
multiparous - 37w
what is the triad of symptoms in shaken baby syndrome
Retinal haemorrhages, subdural haematoma and encephalopathy in child (0-5y)
when can an intrauterine device be inserted after birth
whithin 48hrs or after 4 weeks
when switching from POP to COCP, how long is barrier protection needed
7 days
what is the most common identifiable cause of post coital bleeding
cervical ectropion
when should progesterone levels be tested
7 days before end of cycle
