Passmedicine Flashcards
Combined test for Downs syndrome consists of what (2)?
US skin for nuchal translucency Blood test (beta-hCG [raised] and PAPP-A [raised])
What does the quadruple test for Downs consist of ? (4)
AFP (low)
Unconjugated oestriol (low)
beta-hCG (high)
Inhibin A (high)
When are the a) combined and b) quadruple tests offered?
a) 10-14 weeks
b) 14-20 weeks
How should GBS+ women be treated?
Intrapartum antibiotics
Sudden abdominal pain in 2nd/3rd trimester; bleeding present in 80% cases and shock may be out of keeping with visible loss
Placental abruption
When are oxytocin and prostaglandins contraindicated in labour?
Fetal distress
Four causes of primary postpartum haemorrhage
Tone
Tissue (retained placenta)
Trauma
Thrombin (coagulation abnormalities)
Which vitamin is potentially teratogenic?
Vitamin A
First-line treatment for pregnancy-induced hypertension
Oral labetalol
Management of seizures in eclampsia
Magnesium sulphate
Most common cause of puerperal pyrexia
Endometritis
Why should trimethoprim be avoided in the first trimester?
Folate antagonist
When do NICE recommend anti-D prophylaxis should be given?
In Rh-ve mothers at 28 and 34 weeks
What is the most likely pathogen in early onset neonatal sepsis?
Group B strep
In monochorionic twin pregnanies what is the aim of regular US monitoring between 16 and 24 weeks?
To detect twin to twin transfusion syndrome
Management of uterine atony
Bimanual uterine compression with oxytocin IV infusion
When should women with risk factors for gestational diabetes be offered a glucose tolerance test?
28-34 weeks
What are the criteria for PCOS diagnosis?
2 of:
polycystic ovaries
oligo-ovulation or anovulation
clinical/biochemical evidence of hyperandrogenism
What is acute pelvic inflammatory disease characterised by?
Lower pelvic pain plus two of: cervical excitation and adnexal tender peritonism raised WCC Temperature higher than 38 Pulse higher than 90
The pregnant uterus- date at which:
a) first becomes palpable
b) reaches the umbilicus
c) reaches the xiphisternum
a) 12 weeks
b) 20 weeks
c) 36 weeks
Why does haemoglobin concentration fall in pregnancy?
Dilution
Symptoms of endometriosis(6)
Abnormal uterine bleeding Dysmenorrhoea Dysparenia Dyschezia Adnexal tenderness Difficulty conceiving
What is the underlying pathophysiology of endometriosis?
Growth of ectopic endometrial tissue, often in the pelvis/ovary
What does HbA1C measure? What is considered as good glycaemic control?
Glycosylated haemoglobin over the past 120 days. less than 6%
Risk factors for placenta accreta? (3)
Past C-section
Asherman syndrome (endometrial adhesions)
Pelvic inflammatory disease
Where do a) endometrial and b) cervical cancers first metastasize to?
a) para-aortic lymph nodes
b) pelvic lymph nodes along the iliac arteries
What are Krukenberg tumours and what do they contain histologically?
Gastric tumours that metastasize to the ovary; signet ring cells
Management of primary first episodes of genital herpes in pregnancy?
Oral aciclovir until delivery and C section
