Pregnancy

Question 1

Which hormones does beta HCG bear resemblance to?

1. CRH, LH
2. CRH, TSH
3. Prolactin, TSH, FSH
4. TSH, LH, FSH
5. LH, Growth Hormone

Answer 1

4. TSH, LH, FSH

B HCG can stimulate increased T3 and T4 production in the thyroid gland (i.e. in molar pregnancy

Question 2

Indications for surgical management of ectopic pregnancy?

Answer 2

> 1500 IU/L B-hCG
35mm ectopic pregnancy
Symptomatic i.e. causing pain

If less than 1500 IU\L BhCG, less than 35 mum and asymptomatic then methotrexate is first line

Question 3

Obstetric Cholestasis Management

Answer 3

Labor should be induced at 37 weeks
Ursodeoxycholic Acid
vit k supplementation

symptomatic : antihistamine and menthol cream

Question 4

What treatment reduces the risk of pre-eclampsia and when should it be initiated?

Answer 4

Aspirin (75mg daily from 12 weeks until birth)

Question 5

GBS positive swab in pregnancy.

Management

Answer 5

Intrapartum IV Benzylpenicillin (or clindamycin)

Question 6

Antenatal Calendar:

8-12 weeks

Answer 6

Booking visit

Booking bloods/ urine:

FBC, ABO, Rh,
Hepatitis B, Syphylis, Rubella
HIV
urine culture

Question 7

Antenatal Calendar:

10-13+6 weeks

Answer 7

Early scan for dates and multiple pregnancy

Question 8

Antenatal Calendar:

11-13+6 weeks

Answer 8

Down’s syndrome screening

Question 9

Antenatal Calendar:

16 Weeks

Answer 9

Blood results

BP and urine dipstick

Question 10

Antenatal Calendar:

18-20+6

Answer 10

Anomaly scan

Question 11

Antenatal Calendar:

25 weeks (if primip)

Answer 11

Routine: BP, Urine dip, Symphysis- Fundal height

Question 12

Antenatal Calendar:

28 weeks

Answer 12

Routine care
Bloods : FBC and red cell antibody detection

Anti-D In Rh -ve women

Question 13

Antenatal Calendar:

31 weeks (if primip)

Answer 13

Routine care: BP, urine dip, SFH

Question 14

Antenatal Calendar:

34 weeks

Answer 14

Routine care
2nd anti-d for rh-ve women
Info on labour expectations

Question 15

Antenatal Calendar:

36 weeks

Answer 15

Routine care
Check presentation (and ECV if breach)
Info - breast feeding, vit k and baby blues

Question 16

Antenatal Calendar:

38 weeks

Answer 16

Routine care

Question 17

Antenatal Calendar:

40 weeks if primip
41 weeks

Answer 17

Routine care

Discussion about plans for prolonged pregnancy

Question 18

Smear advice during pregnancy

Answer 18

Wait until three months as results may be difficult to interpret.

Question 19

When is parvovirus B19 infectious up to

Answer 19

From three weeks before the rash appears to when rash appears

• not infectious once rash is there

Question 20

Heritability of Haemophilia A

Answer 20

X Linked recessive

- All female offspring of affected men will be carriers