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3818 > perinatal healthcare > Flashcards

perinatal healthcare Flashcards

1
Q

What should pregnant women take to avoid neural tube defects and its dose?

A

Folic acid 500mg

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2
Q

Which of these is NOT a vitamin pregnant women should consider taking?
A. Vit A
B. Iron
C. Vit D
D. Ca
E. Iodine

A

Vit A - pregnant women actually shouldn’t take this because high doses has little to no benefit and may cause harm

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3
Q

What vitamin should pregnant women take to avoid infant neurodevelopment?

A

Iodine

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4
Q

What defect in pregnancy is associated with lack of iodine?

A

Infant neurodevelopment

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5
Q

Why/when should pregnant women take vit D?

A

Only if they’re deficient in vit D

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6
Q

Effects of Ca in pregnancy?

A

Reduces gestational hypertension and pre-eclampsia

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7
Q

What supplement should pregnant women take to reduce gestational hypertension and pre-eclampsia?

A

Ca

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8
Q

What is tested to see if pregnant women need to take iron?

A

Haemoglobin

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9
Q

What can the rise in human chorionic gonadotrophin (HCG) cause in pregnancy?

A

Nausea and vomiting in pregnancy (NVP)

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10
Q

What is hyperemesis gravidarum (HG)?

A

Severe form of nausea and vomiting in pregnancy (NVP)

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11
Q

What is the name given to the severe form of nausea and vomiting in pregnancy (NVP)?

A

Hyperemesis gravidarum (HG)

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12
Q

Which is NOT a sx of hyperemesis gravidarum (HG)?
A. Dehydration
B. Electrolyte abnormalities
C. Severe nausea and vomiting
D. Inability to eat/drink properly
E. Inhibition of growth of foetus

A

E - NVP actually doesn’t harm the baby

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13
Q

What is used to assess the severity of NVP?

A

Pregnancy unique quantification of emesis (PUQE-24 or PUQ) score

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14
Q

What are some non-pharmacological measures for NVP/HG?

A
  • Change activities to minimise fatigue
  • Maintain hydration and nutrients
  • Acupressure bands
  • Review multivitamin usage like iodine/folic acid
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15
Q

Which potentially needed mineral/vitamin can aggravate NVP?

A

Iron

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16
Q

Which 2 complementary medications are safe for the indication of NVP and hyperemesis gravidarum (HG)?

A

Ginger and B6 - pyridoxine

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17
Q

What is the first-line treatment for NVP or HG?

A

Doxylamine

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18
Q

Which pregnancy category is doxylamine?

A

A

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19
Q

What is also a first-line treatment for HVP/HG after doxylamine?

A

Metoclopramide

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20
Q

What can doxylamine be combined with for NVP/HG?

A

B6 - pyridoxine

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21
Q

What can metoclopramide be combined with for nausea associated with migraines?

A

Paracetamol

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22
Q

Why is metoclopramide+paracetamol not recommended for NVP?

A

Because it is an unnecessary dose of paracetamol. Women can also take other paracetamol tablet without knowing it’s already in the combination, which leads to toxicity

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23
Q

What is the second-line treatment for NVP/HG?

A

Ondansetron

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24
Q

What pregnancy category is ondansetron?

A

B3

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25
Q

What is the main side effect of ondansetron?

A

Constipation

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26
Q

Define antiemetic

A

Prevents vomiting

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27
Q

What causes reflux and heartburn in pregnancy?

A

The baby’s growing size and hormones putting pressure on oesophageal sphinter

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28
Q

3 drug classes for reflux and heartburn in pregnancy, and which one is first-line?

A

Antacids (first-line), H2 antagonist, PPI

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29
Q

Rising levels of P in pregnancy cause a reduction in gastric motility and increase gastric transit time. What does this cause for pregnant women?

A

Constipation

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30
Q

How can pregnant women change their supplementation to fix their gestational constipation?

A

Replace iron with iodine or folic acid

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31
Q

Which of these is not a management strategy for gestational constipation?
A. Increase iron supplements
B. Increase fluid uptake
C. Increase fibre
D. Reduce caffeine
E. Regular exercise

A

A - iron actually induces constipation

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32
Q

What are some medical options for gestational constipation? (3)

A
  • Bulk-forming laxatives (psyllium)
  • Osmotic laxatives (macrogol, lactulose, sorbitol)
  • Stimulants
33
Q

Define haemorrhoids

A

Enlarged, swollen veins around anus with anorectal bleeding, painful bowel movements, anal pain and itching

34
Q

What can hormonal changes and pressure changes in blood flow, sometimes from constipation cause?

A

Haemorrhoids

35
Q

Medications for haemorrhoids (2)?

A

Topical steroids and topical anaesthetic

36
Q

Does E. coli-induced UTI cause harm to baby? What can it cause?

A

No

37
Q

Does pyelonephritis-induced UTI cause harm to baby? What can it cause?

A

Yes - associated with low birth weight

38
Q

Which of these is NOT a medical tx for UTI in pregnancy?
A. Doxycycline
B. Nitrofurantoin
C. Cefalexin
D. Trimethoprim
E. Amoxicillin+clavulanate

A

A - long term use actually causes harm to baby

39
Q

What antibiotic is used in gestational UTI when the pathogen is resistant?

A

Amoxicillin or amoxicillin+clavulanate

40
Q

What are the 3 first-line drugs for gestational UTI?

A
  • Nitrofurantoin
  • Cefalexin
  • Trimethoprim
41
Q

What deficiencies are a cause of anaemia?

A

Iron, folate, and B12 deficiency

42
Q

Why is anaemia common is pregnancy? (2 reasons)

A

Because there is 3x the demand for iron in pregnancy, particularly in the 2nd/3rd trimester
Also because there might be a reduction in iron from the diet due to NVP

43
Q

What happens when there is pulling of blood on the surface of veins as a result of insufficient valves that normally prevent blood from draining down the back of legs?

A

Varicose veins

44
Q

SE of varicose veins? (3)

A
  • Itching
  • Aching
  • Swelling in feet/ankles
45
Q

What is defined as a multi-system disorder involving hypertension + an organ system/the foetus?

A

Pre-eclampsia

46
Q

What medication is used in mod-high risk pre-eclampsia?

A

Low dose aspirin

47
Q

What supplementation can be used to reduce hypertension and pre-eclampsia

A

Ca

48
Q

Which BP medications are C/I in pregnancy?

A

Diuretics, some beta blockers, ACEI, -sartans

49
Q

Which 2 beta blockers are the only 2 of that class to be safe in pregnancy?

A

Labetalol and oxprenolol

50
Q

What meds to use for VTE?

A

Low molecular weight heparin (LMWH) or SC heparin

51
Q

When should you stop using heparin for VTE? Why?

A

Onset of labour to minimise bleeding complications

52
Q

What meds to use postpartum for VTE that is safe in breast-feeding?

A

Low molecular weight heparin (LMWH) or warfarin

53
Q

What is defined as signs and sxs of discomfort and pain around pelvis and lower back that can radiate to upper thighs and perineum?

A

Pelvic girdle pain

54
Q

What does OGTT stand for

A

Oral glucose tolerance test

55
Q

Which is NOT a GDM risk factor?
A. Age
B. Family history
C. PCOS
D. Being overweight
E. Previously large baby
D. Previous GDM
F. Unhealthy diet

A

F - pretty sure you can have a hectic diet and still get it in pregnancy

56
Q

What meds can be used for GDM?

A

Metformin and insulin

57
Q

What should pregnant women do with drugs they’re already using for diabetes prior to pregnancy?

A

Replace them with insulin or metformin

58
Q

What is defined as a onset of labour <37 weeks

A

Pre-term labour

59
Q

Which of these is NOT a cause of pre-term labour?
A. Pelvic girdle pain
B. Cervical incompetence
C. Maternal bleeding
D. Placenta insufficiency
E. Infections

A

A - pelvis girdle pain isn’t harmful to mother or baby

60
Q

Define tocolytics

A

Drug class used to suppress pre-term labour

61
Q

What drug class do these drug belong to?
Salbutamol IV, nifedipine

A

Tocolytics

62
Q

Which tocolytic drug is most preferred?

A

Nifedipine

63
Q

MOA of tocolytics

A

Uterine relaxation in pre-term labour

64
Q

Why give 1 week of antenatal corticosteroids during pre-term labour?

A

To promote foetal lung maturity and prevent respiratory distress syndrome (RDS)

65
Q

What drugs are given to prevent respiratory distress syndrome (RDS)?

A

Antenatal corticosteroids - betamethasone or dexamethasone

66
Q

What complementary drugs can be used for pre-term labour?

A

Mg sulfate

67
Q

What are the 4 ways to induce labour?

A
  1. prostaglandin
  2. balloon catheter
  3. artificially breaking the water
  4. oxytocin
68
Q

Which is NOT a way to induce labour?
A. Nifedipine
B. Balloon catheter
C. artificially breaking the water
D. Oxytocin
E. Prostaglandin

A

A - its a medication to stop labour (the opposite)

69
Q

What drug class do these belong to?
DinaPPROSTone, gemePROST

A

Prostaglandin

70
Q

MOA of prostaglandin

A

Softens and dilates cervix and induce uterine contraction

71
Q

How long do you wait before giving oxytocin after already giving prostaglandin?

A

6 hours in between after water is already broken

72
Q

Which is NOT a non-medicated pain relief therapy?
A. TENS machine
B. CPR
C. Acupuncture and acupressure
D. Birth ball
E. Heat packs

A

B

73
Q

What does TENS in TENS machine stand for?

A

Transcutaneous electrical nerve stimulation

74
Q

Which of these is NOT a pain medication for labour?
A. Nitrous oxide gas
B. Non-opioid analgesics
C. Opioids
D. Epidural

A

B - there’s no evidence on this, so not used

75
Q

What opioids are used in labour pains and which is preferred over the other?

A

Morphine (preferred) and pethidine

76
Q

Where is an epidural injected?

A

Small space in back near spinal cord

77
Q

True or False?
Epidural and spinal combination gives the most INFERIOR pain relief for labour compared to everything else

A

False - epidurals are the most superior pain relief for labour

78
Q

What is a downside to using an epidural and why does this happen?

A

It can prolong labour because the loss of sensation of contractions causes the pregnant woman to not know when to push

3818 (8 decks)

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