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Question 1

Polyhydramniosis cause?

Answer 1

Not drinking, oeseophageal atresia

Peeing too much, infection
(TORCH)

Macrosomia, large for dates, big baby lots of fluids

Question 2

Problems of polyhydramniosis?

Answer 2

Transverse lie as too much fluid

Premature rupture of membranes due to pressure

Question 3

Management of polyhydramniosis?

Answer 3

Amnioreduction: needle to aspirate some of the fluid off

Question 4

Management of gestational diabetes?

Answer 4

Diet controlled

Metformin

Insulin

Question 5

If you’ve migraine without aura, can you have the COCP?

Answer 5

Yes unless you’re over 35

Question 6

Doses of folic acid?

Answer 6

400mcg low risk

5mg

Question 7

What drugs can cause gynaecomastia in men?

Answer 7

Spironolcatone
Alcohol
Anti-psychotics

Question 8

What’s the test they do at pre 14 weeks to look for Down’s syndrome called? What’s it involve?

Answer 8

Combined test pre 14 weeks

USS nuchal translucency
Bloods: bHcG and pregnancy ass. plasma protein A (PAPPA)

Question 9

What’s the test they do after 14 weeks to look for Down’s syndrome called? What’s it involve?

Answer 9

Quadruple test
b HCG
oestriol
inhibin A
Alpha fetoprotein

Question 10

Ways you can give prostaglandin?

Answer 10

Gel
Pessary
Tablet

Question 11

Drugs contraindicated in first trimester?

Answer 11

Sodium valp
ACEi
B blockers
Diuretics

Question 12

What happens if a lady has an abnormal smear?

Answer 12

If its dyskaryosis without HPV - nothing

If you’ve HPV - refer to colposcopy

If you’ve severe dyskaryosis - refer

Question 13

What happens at colposcopy clinic?

Answer 13

Speculum to look at cervix

Use a microscope to look

Acetic acid onto cervix:
- white changes if there’s transitional cells (as there’s more keratin)

Iodine onto cervix:

• normal cells stain orange-brown
• abnormal don’t (they have less glutamine)

Take a biopsy of zone

LETT’s procedure/loop diathermy

Question 14

What is LETT’s procedure? When is it done?

Answer 14

Diathermy tool that’s loop shaped
To remove area
Send off for histology

Question 15

What’s a problem with LETT’s procedure?

Answer 15

higher risk of preterm labour, due to cervical incompetence

Question 16

DVT risk score, and what is in it?

Answer 16

Well’s score

Active cancer
Recent immobility, paralysis
Recent abdo, pelvic surgery or bedridden for 3+ days
Previous DVT

Swollen whole leg
3cm bigger than other calf
Pitting oedema
Swollen superficial veins
Local tenderness

Question 17

Complications of diabetes in pregnancy?

Answer 17

Pre-eclampsia

Macrosomia
Shoulder dystocia
Miscarriage
Congenital abnormalities: cardiac, neural tube
Polyhydramniosis

Fetal hypoglycaemia
Jaundice

Question 18

How would you investigate the fetus for reduced fetal movements?

Answer 18

CTG
USS
Doppler to look for reduced end diastolic flow in umbilical arteries

Question 19

What’s karyotyping?

Answer 19

Chromosomal analysis

Question 20

Which endocrine condition do down’s children get which affects their intellectual development?

Answer 20

Hypothyroidism

Question 21

Features of fetal CMV infection?

Answer 21

Microcephaly
Hepatomegaly
Jaundice
Low birth weight
Seizures
Hearing, visual problems
Learning difficulties

Question 22

Features of fetal rubella infection?

Answer 22

Classic triad:

1. Sensorineural deafness
2. Eye problems (cataracts)
3. Congenital heart disease (p. artery stenosis, PDA)

Others:
Jaundice
Low birth weight
Microcephaly
Spleen, liver, bone marrow problems

Question 23

Features of fetal toxoplasmosis infection?

What type of bug is it?

Answer 23

Hydrocephalus
Epilepsy
Hearing loss
Learning difficulties
Miscarriage, stillbirth

Parasite

Question 24

Features of maternal SLE?

Answer 24

If poorly controlled

Higher risk of miscarriage and stillbirth
Pre-eclampsia
Premature delivery
Low birth weight
Birth defects, learning difficulties

Question 25

Management of hypertension in pregnancy?

Answer 25

Labetolol
Methyl-dopa
Mag sulfate

Question 26

Management of hypothyroid in pregnancy?

Answer 26

Propothiouracil

Question 27

Who should take aspirin in pregnancy? When? What dose?

Answer 27

Anyone with increased risk of pre-eclampsia

• diabetes
• autoimmune (SLE, anti-phospholipid)
• previous gestational HTN
• CKD

75mg from week 12 until delivery