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patient MCQ > Pregnancy care > Flashcards

Pregnancy care Flashcards

1
Q

what OTC medicine is licensed to treat morning sickness?

A

no OTC,

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2
Q

how many people get morning sickness?

A

80%

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3
Q

is morning sickness most common in your first or second pregnancy

A

first

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4
Q

which women are at risk of having morning sickness

A

first child
more than one child
experience sickenss with the contraceptive pill

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5
Q

if a pregnant lady experiences hyperemesis (protracted and severe) vomiting what do we do

A

admission to hospital for antiemetics and rehydration

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6
Q

2 tips to help with morning sickness?

A

small frequent meals to keep up blood sugar
biscuits by the bed eat in the morning and wait for 20 minutes to get up
avoid spicy food
avoid alcohol, tea, coffee or milk
suck sugar sweets for travel

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7
Q

when in pregnancy does MS occur

A

round week 5 and ends at about 12 weeks

can sometimes return in the last 3 months

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8
Q

what can the GP prescribe for morning sickness?

A

antihistamines such as promethazine
antiemetics prochlorperazine and domperidone
NOT OTC

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9
Q

can vitamin B6 (PYRIDOXINE) be used to help pregnancy? what type of medication is it (legally)?

A

GSLif under 50mg

NO, its associated with peripheral neuropathies

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10
Q

mechanisms of morning sickness?

A

high levels of human chorionic gonadotriphin stimulate the ovaries to produce oestrogen and progesterone in early pregnancy, but these decrease once the placenta is sufficiently developed to produce the hormones itself
low blood sugar in the morning

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11
Q

symptoms of gastro-oesophageal reflux?

A

burning discomfort in the epigastrum caused by gastric juices moving into the oesophageal sphincter

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12
Q

why is GOR common in pregnancy

A

raised progesterone levels reduce smooth muscle tone

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13
Q

can you give high sodium antacids in pregnancy for GOR?

A

try to avoid as can increase BP- will state which in the BNF

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14
Q

what can you commonly recommend for GOR in pregnancy?

A

gaviscon

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15
Q

what type of antacid shouldnt you give for pregnancy GOR

A

products with bismuth, potentially neurotoxic

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16
Q

how to antacids and aliginates work?

A

precipitate out and form a sponge like raft with buoyancy by CO2 trapped in the matrix
plug in the LOS

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17
Q

dose of gaviscon in pregnancy

A

10-20ml after meals and at bedtime QDS

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18
Q

can you give histamine h2 agonists?

A

not licensed so GP

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19
Q

advice to give pregnant lady with GOR?

A

Ø Eat frequent, small meals to avoid distending the stomach
Ø Do not eat late in the day — give yourself at least three hours after a meal before going to bed
Ø Use extra pillows in bed to sleep in a raised position.
Ø Avoid alcohol, coffee and chocolate — all act to relax the lower oesophageal sphincter

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20
Q

when should you refer a pregnant lady with GOR

A

if combination of lifestyle advice and OTC meds doesnt work

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21
Q

why can the frequency of migraines reduce in pregnancy?

A

due to intracranial vascular changes medicated by P and O so attacks tend to improve

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22
Q

when do headaches tend to get worse in pregnancy?

A

second trimester

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23
Q

3 things which causes backache in pregnancy?

A

strain on the muscles of the back as the uterus enlarges and grows forward

weight gain
in the last 3 months the hormone relaxin softens the muscles and ligaments in readiness for labour so they stretch= back ache

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24
Q

what you can give OTC for headache and backache in pregnancy? dose?

A

paracetamol 1000mg QDS

25
Q

what shouldn’t you recommend OTC headache and backache in pregnancy? why

A

aspirin or ibuprofen/ NSAIDs

delay labour and increase risk of haemorrhage in labour

26
Q

can you give codeine and dihydrocodeine for headache and backache

A

yes but if taken near term it can cause respiratory depression in the new born.

27
Q

when is constipation most common in pregnancy? caused by (2)?

A

later stages due to pressure on the GIT

increased progesterone levels decrease intestinal motility

28
Q

recommendations to pregnant lady with constipation?

A

increase fluids

increase fibre- FIRST LINE

29
Q

OTC relief for constipation in pregnancy?

A

bulk formin laxatives e.g. ispaghula husk
lactulose
docusate
both have slow action 48 hours to work

30
Q

what can ispaghula husk cause when treating constipation OTC?

A

abdominal distension and discomfort

31
Q

how does lactulose work?

A

non absorbed disaccharide which increases intestinal bulk by attracting water into the colon by osmosis

32
Q

which laxatives can you not recommend in pregnancy? why?

A

STIMULANT
senna- theoretical risk of stimulating uterine contractions and inducing early labour- little evidence
but one or two doses can be tried if the gentler laxatives fail

33
Q

why are haemorrhoids common in pregnancy

A

due to straining

34
Q

what can pharmacists recommend in minor cases of haemorrhoids?

A

bland haemorrhoidal cream or ointments e.g. anusol- contains bismuth oxide (neurotoxic) but acts locally so should be okay

35
Q

non analgesic relief of haemorrhoids

A

ice pack

36
Q

how much more common is candidiasis in pregnancy, why?

A

2-10 times more common

due to vagina being rick in glycogen

37
Q

how many women experience varicose veins in pregnancy, what can we recommend

A

10-20%

support hosiery

38
Q

how many women can suffer from leg oedema, recommend?

A

80%

rest with legs raised and avoid tight clothes

39
Q

how many suffer from muscle cramps in the calf? when? recommend?

A

1/3
later in pregnancy (common at night)
massage and stretching of the muscles during attacks
increasing intake of calcium and potassium

40
Q

what is the itching condition common in pregnancy called? how common?

A

pruritus gravidarum

in 20%

41
Q

why is pruritus common in pregnancy? when does it occur

A

from the third month onwards

due to oestrogen induced cholestasis/ hormone changes

42
Q

what can be given OTC for pruritus

A

soothing lotions such as oily calamine

43
Q

if a lady presents with pruritus what must you do

A

give relief, refer to midwife or GP

44
Q

why must you refer a woman with pruritus?

A

potentially serious especially if experienced with jaundice
can indicate obstetric cholestasis- renal impairment with leads to billirubin build up in the blood= can cause still birth
must be closely monitored

45
Q

hyperpigmentation, when can this occur and why?

A

due to hormone changes
fade within a few weeks of delivery but can stay
due to increased levels of melanocyte sstimulating hormone and oestrogen

46
Q

changes in pregnancy regarding hyperpigmentation?

A

darker nipples and genitalia
linea nigra- dark line down the abdomen
melasma= brown patches on the face

47
Q

what causes stretch marks?

what can prevent them?

A

overstretching of the elastic tissue in the skin
replaced by collagen scar tissue
start red and fade to silver but may never disappear
exercise

48
Q

is anything licensed in the UK to stop/ get rid of stretch marks

A

no

49
Q

advice a pharmacist can give regarding stretch marks

A

massaging skin with produces containing vitamin E, cocoa butter, collagen and elastin propeietary products

50
Q

what has been used to reduce scarring after pregnancy?

A

tretinoin

51
Q

TF: most OTC remedies for coughs and colds are C/I in pregnancy

A

FALSE

52
Q

what to recommend for dry coughs and sore throat in pregaqncy?

A

simple linctus

sucking on non medicated pastals- help by keepinhg the inflammed tissue of the pharynx moistured

53
Q

what to recommend for chesty coughs in pregancy

A

steam inhalations e.g. methol or oil based decongestants

works by liquefying and expectorating pharyngeal mucus

54
Q

what should be avoided in pregancy for coughs and colds

A

systemic sympathomimetic decongestents as they can increase BP

55
Q

role of the pharmacists in managing minor ailments in pregnancy?

A

respond to symptoms
be aware of oTC medications which cannot be used in pregnancy
lifestyle advice

56
Q

exhaustive list of the minor ailments pregnant women can experience?

A 
monring sickness
GOR
headache and backache 
constipation 
haemorrhoids
candidiasis 
varicose veins, oedema and muscle cramps
pruritus 
stretch marks and hyperpigmentation 
coughs and colds
57
Q

can you give OTC medication for candidiasis?

A

NO must refer as OTC produces for thrush arent licensed in pregnancy, GP must prescribe

58
Q

can thrush harm babies?

A

no but can potentially be passed to the baby as it passes the birth canal

59
Q

what is the GP likely to prescribe in candidiasis in pregnancy?

A

imidazole antifungal

patient MCQ (22 decks)

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