passmed

Question 1

Normal laboratory findings in pregnancy: urea, creatinine, urinary protein loss
?? increased or decreased?

Answer 1

Reduced urea, reduced creatinine, increased urinary protein loss

Question 2

The following results would be expected in a trisomy 21 (Down’s syndrome) pregnancy: low or high?
? alpha fetoprotein (AFP)
? oestriol
? human chorionic gonadotrophin beta-subunit (-HCG)
? pregnancy-associated plasma protein A (PAPP-A)
? nuchal translucency

Answer 2

Low alpha fetoprotein (AFP)
Low oestriol
High human chorionic gonadotrophin beta-subunit (-HCG)
Low pregnancy-associated plasma protein A (PAPP-A)
Thickened nuchal translucency

Question 3

Women who are at high risk of developing pre-eclampsia should take aspirin 75mg od from 12 weeks until the birth of the baby. High risk groups include:

Answer 3

hypertensive disease during previous pregnancies
chronic kidney disease
autoimmune disorders such as SLE or antiphospholipid syndrome
type 1 or 2 diabetes mellitus

Question 4

HTN related to pregnancy occurs after what week?

Answer 4

only after 20 weeks

if before: preexisting htn !!!

Question 5

Following chickenpox exposure in a non-immune pregnant woman, …… is only effective up to 10 days post-exposure (<20 weeks pregnant)
-if more than 20 weeks whats the tx?

Answer 5

varicella-zoster immunoglobulin (VZIG)

Aciclovir is used in the treatment of chickenpox infection, along with multiple other viral infections such as herpes zoster. Alternatively, women who are beyond 20 weeks gestation may be offered aciclovir as an alternative to varicella-zoster antibodies.
if the pregnant woman > 20 weeks gestation is not immune to varicella then either VZIG or antivirals (aciclovir or valaciclovir) should be given days 7 to 14 after exposure

Question 6

The Bishop score should be assessed in all women prior to induction of labour. It has the following components:
5

Answer 6

Cervical position (posterior/intermediate/anterior)
Cervical consistency (firm/intermediate/soft)
Cervical effacement (0-30%/40-50%/60-70%/80%)
Cervical dilation (<1 cm/1-2 cm/3-4 cm/>5 cm)
Foetal station (-3/-2/-1, 0/+1,+2)

Question 7

Methotrexate: must be stopped at least ? months before conception in both/man/ woman??

Answer 7

6

both

Question 8

respiratory depression can occur: ….. is the first-line treatment for magnesium sulphate induced respiratory depression (eclampsia)

Answer 8

calcium gluconate

Question 9

tx of gestational diabetes

fasting glucose level is 7.2 mmol/L.

Answer 9

If at the time of diagnosis of gestational diabetes, the fasting glucose level is >= 7 mmol/l immediate insulin (plus or minus metformin) should be started

Question 10

are the SSRIs of choice in breastfeeding women

Answer 10

Sertraline or paroxetine