Quiz 13: Medical problems during pregnancy, labour and the puerperium Flashcards
A patient with cystitis usually complains of:
Headache
Fever and rigors
Dysuria and frequency
Backache
Dysuria and frequency
Cystitis is treated by:
Asking the patient to increase her oral fluid intake
Prescribing a single oral dose of amoxycillin or co-trimoxazole
Giving 2.4 million units of benzathine penicillin intramuscularly
Giving ampicillin 1 g intravenously every 6 hours until the symptoms stop
Prescribing a single oral dose of amoxycillin or co-trimoxazole
A patient with asymptomatic bacteriuria has:
No symptoms
Fever
Nocturia
Lower abdominal pain
No symptoms
It is important to treat patients with asymptomatic bacteriuria in pregnancy because:
The patient is seriously ill
One third will develop septic shock during pregnancy
One third will develop cystitis during pregnancy
One third will develop acute pyelonephritis during pregnancy
One third will develop acute pyelonephritis during pregnancy
How is asymptomatic bacteriuria diagnosed?
By detecting proteinuria
By testing for nitrites and leucocytes in the urine
By examining a sample of urine under the microscope
By culturing a sample of midstream urine
By culturing a sample of midstream urine
Which clinical sign suggests that the patient has acute pyelonephritis?
Tenderness over the bladder
Oedema
Severe tenderness to percussion over one or both renal angles
Severe tenderness in the upper abdomen
Severe tenderness to percussion over one or both renal angles
What is the correct management of a patient with acute pyelonephritis?
Amoxicillin (Amoxil) 3 g as a single oral dose
Amoxicillin (Amoxil) 500 mg 8-hourly by mouth for seven days as an outpatient
The patient must be admitted to hospital and receive amoxicillin (Amoxil) 500 mg 8-hourly by mouth for seven days
The patient must be admitted to hospital and receive an intravenous broad-spectrum antibiotic
The patient must be admitted to hospital and receive an intravenous broad-spectrum antibiotic
What is the definition of anaemia in pregnancy?
A haemoglobin concentration of less than 12 g/dl
A haemoglobin concentration of less than 11 g/dl
A haemoglobin concentration of less than 10 g/dl
Any patient with shortness of breath irrespective of the haemoglobin concentration
A haemoglobin concentration of less than 11 g/dl
What is the commonest cause of anaemia in pregnancy?
Iron deficiency
Folic acid deficiency
Infection
Blood loss
Iron deficiency
The management of anaemia in pregnancy depends on:
The presence or absence of oedema
Whether the patient is pale or not
The presence or absence of shortness of breath and tachycardia
The presence or absence of hypotension
The presence or absence of shortness of breath and tachycardia
What should be the management of an anaemic patient if the haemoglobin concentration is less than 8 g/dl and the gestational age 37 weeks?
Admit to hospital for bed rest and a good diet
Admit to hospital for a blood transfusion
Give an intramuscular injection of iron-dextran (Imferon)
Prescribe 1 ferrous sulphate tablet 3 times a day until delivery
Admit to hospital for a blood transfusion
What should be the management of a patient in the puerperium who has normal observations and has no bleeding, but has a haemoglobin concentration of 9 g/dl?
Reassure her that no treatment is needed.
Give her a blood transfusion.
Advise her to eat a good diet.
Prescribe an oral iron supplement.
Prescribe an oral iron supplement.
Which patients should receive supplementary iron during pregnancy?
All patients
Only patients with a haemoglobin concentration of less than 10 g/dl
Only patients with a full blood count suggesting iron deficiency
Patients from communities where iron deficiency is common or socio-economic circumstances are poor
Patients from communities where iron deficiency is common or socio-economic circumstances are poor
What should be done if a patient has side effects from the iron supplementation?
She should be reassured and the importance of taking the iron tablets should be stressed.
The tablets should be taken with meals.
The iron tablets should be stopped.
The iron tablets should be stopped and metoclopramide (Maxalon) given.
The tablets should be taken with meals.
A patient with asymptomatic heart valve disease:
Must be admitted to hospital for bed rest from 34 weeks gestation
Must be delivered in hospital because of the high risk of pulmonary oedema during labour and the first day of the puerperium
Should be classified as low risk and delivered in a primary perinatal-care clinic
Should be given Syntometrine after delivery to prevent a postpartum haemorrhage
Must be delivered in hospital because of the high risk of pulmonary oedema during labour and the first day of the puerperium
