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AKT > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

UTI Tx choice if symptomatic

If asymptomatic

A

if the pregnant woman is symptomatic:
- a urine culture should be sent in all cases
- first-line: nitrofurantoin (should be avoided near term - give amox )
- second-line: amoxicillin or cefalexin
trimethoprim is teratogenic in the first trimester and should be avoided during pregnancy

A symptomatic treat too - to avoid risk of pyelonephritis

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2
Q

When is breast feeding CI

Give 6 drugs

A

galactosaemia, active HIV

The following drugs should be avoided:
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzos
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone

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3
Q

What is G and P

A

Gravity - no of times uterus has been preg

Pariety is number of pregnacies carried to successful age (+ = no of pregnancies lost before 24 weeks)

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4
Q

Who should take aspirin 75-150mg daily from 12 weeks gestation until the birth and why

A

Known HTN, diabetics, CKD, autoimmune disease (SLE, lupus)

To reduce risk of pre-eclapmpis

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5
Q

when is booking visit
What bloods are done

A

8 - 12 weeks

FBC, Rhesus group, Red cell antibodies, haemoglobathy
Hey b, syphillis, HIV
Chalydmyia if <25

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6
Q

What are 5 DDx of bleeding early preg

A

Normal
Miscarriage
Ectopic
Polyps/structural
Trophoblastic disease (++hbcg)

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7
Q

When is anti d give

A

To a rhesus negative mum + positive baby
At 28 + 34
any event mixing may occur

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8
Q

What is in the combined screening test -when
What conditions

A

HCG + PAPPA + nuclear scan
At 11-14 weeks

For downs, 13 or 18

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9
Q

When and what is in the quadruple test

A

14 - 20 weeks
AFP, hCG, uE3, inhibin A
Only for downs

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10
Q

What result is in a positive screen
What are the options (weeks)

A

1:150
(1:100 risk at 40yearsO

CVS at 11-13+ weeks - 2-4% absorption risk
Amniocentesis >15 weeks

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11
Q

When would the following be performed
Early USS
Anomoly scan

A

10 - 13 weeks

18 - 20+6 weeks
- here can spot placenta praverial

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12
Q

When is Hb checked
What are th cut off for iron supplement

A

booking and 28 weeks - start of 3rd trim
<110, <105

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13
Q

How many more extra appointments do first timers get

A

3 - 25, 31 + 40

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14
Q

What immunisations can be giving during preg

A

Influenza
Pertussis at 28-32 weeks

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15
Q

When can mum be referred for ECV

A

36 weeks

(Cant really fly past 32 weeks - need doctors note

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16
Q

When would OGTT be done for those with risk factors for test diabetes

A

24 - 28 weeks

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17
Q

What are some of treatment options for N+ V
When does it peak

A

Ginger, acupressure
Cyclising, promethazine, prochlazeine
9 weeks

Admit if PUQUE >13, ketones, weight loss (hyperemesis)

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18
Q

What anti-d options for depression in preg

A

Really aim for high intensity therapy
Risk benefit ration

Fluoxetine safestest SSRI, but sertaline best for BF
TCAs safest

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19
Q

Itchy rash in palms, if its >36 weeks would consider delivery =>refer

A

Intrahepatic cholestasis of pregnancy
Diprobase and calamine
Test LFTs if <36weeks

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20
Q

Itchy papules to lower abdomen and bum, >35 weeks gets

A

Pruritic uretical papules and plaques of pregnancy
Tx steroids + calamine

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21
Q

Advice to avoid listeriosis and toxo

A

Uncooked red meat
Cat litter
Gardening

22
Q

What would you do if contact or concerns about having rubella or parvoviruses B19

A

Test IgG and IgM

23
Q

What are the antihypertenisves options in preg

Inductions for secondary referral

A

Methyl dopa, nifedipine, labetolol

> 140/90 _ test urine

24
Q

Risks of preceplampisa
Change in booking BP

A

Eclampsia and HELP
Increase 30/15 from baseline

25
Q

How long LMWH if high risk of VTE

A

6 weeks postpartum

10 days intermiediate risk

26
Q

What symptoms would you expect in round ligament pain

A

Lower abdo pain, from uterus into groin
Stitch feeling, resolves quickly

27
Q

When is the post-natal check

A

6 - 8 weeks

28
Q

Contraception guide post pregnancy
- IVD
- POP
- COCP

A
  • within 48hours or 28 days later
  • within 21days (if great, needs 2 days additional if not day 1-5)
  • wait 6 weeks if breastfeeding (as reduces milk supply)
29
Q

Some +ve for BF

A

IQ, OM, leukaemia, obesitiy, new-enetercolitis

Mum reduces breast and ovarian ca

30
Q

Sharp shooting pain after feed + during - ?diagnosis

A

Nipple thrush - topical miconazole mum + baby, oral fluconazole

31
Q

Treatment options for dermatitis on breast

A

Mom eats one for 10days

32
Q

Post-partum exercise advice

A

2 weeks post vaginal
6 weeks post c-section

Low impact - 150mins/week

33
Q

What tests for male and female infertility (1/7 couples)
what is the ovulation test?

What does NHS allow

A

Rubella status, chlamydia screen, mid luteal prog (7 days pre mense)
Day 1 - 5 FSH/LH
? TFT/PRL

Males 0 semen analysis

3 courses under 40 yr after 2 years reg intercourse

34
Q

what vaginal ph would >4.5 indicate

A

BV or TV

4.5 wouls be physiological or possible candida

35
Q

Syphillis features
1 - 2 -3

A

Primary features
chancre - painless ulcer at the site of sexual contact
local non-tender lymphadenopathy
often not seen in women (the lesion may be on the cervix)

Secondary features - occurs 6-10 weeks after primary infection
systemic symptoms: fevers, lymphadenopathy
rash on trunk, palms and soles
buccal ‘snail track’ ulcers (30%)
condylomata lata (painless, warty lesions on the genitalia )

Tertiary features
gummas (granulomatous lesions of the skin and bones)
ascending aortic aneurysms
general paralysis of the insane
tabes dorsalis
Argyll-Robertson pupil

36
Q

what are the 3 main complications of chalymmida

A

ectopic preg
PID
reduced fertility (20%)

37
Q

what would you use a high VS charcol swab

A

BV
TV - posterior forenix
Candiasis (anterio forx)(if need to swab - can also be low vaginal red micropscy swab)

38
Q

When would you repeat chalmydia testing

A

3weeks if preg
offer repeat testin in 3 months for young people (25) or at risk

39
Q

first catch urine for men tests for what
and rules

A

chalymida and gon (but gon would need to repeat swab for mc+s if positive)
no pee 2 hours before

40
Q

what might a strawberry cervix with offenisve discharg eindicate
Treatment

A

TV
metrondiazole 2g stat or 500mg bd for 5-7days

41
Q

uritits swab
- polymorph leuoleutyes
- g-ve intracellular diplocaic
- wet prep

A

NGU (chaly, ureplasma, mycoplasma, HSV, UTI)
gon
TV

42
Q

when should you repeat asyym screening in HIV after exposure

A

3 months

43
Q

tx of chalmydia

A

dox 7 days or azithrmy/eryth if preg for 2 days
no sex 7 days ater treatment

44
Q

treatment for confirmed PID

A

olfaxcin or lev with metro

45
Q

discharge that isent sexually tramistted

A

BV, candidiasis, physiological, FB

46
Q

times when screen for HIV

A

antenatal + TOP
sexual health clinics, TB/hep infections
areas 2/1000

47
Q

risk in UPI with H+ve

A

1 in 50 (not if oral)

48
Q

time line for PEP taking
CD4 levels of AIDs

A

within 72hours
<200

49
Q

what is LGV

A

small papule leading to inguinal LNs, causes by chalymdia in HIV +ve patients

50
Q

time line to use Acicolvir in gential herpes
what type

A

if within 5 days of infection
recurrence self treatment
both 1 + 2

51
Q

HPV numbers that cause warts

A

6 + 11
16 + 18 = cervical cancer

AKT (14 decks)

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