SBA

Question 1

What 4 tests make up the Quadruple Down’s syndrome test?

Answer 1

AFP, uE3, hCG, Inhibin A

2x false positives

Question 2

Appropriate management plan for a diabetic, obese expectant mother?

Answer 2

1) 5mg Folic Acid
2) Dietary glycaemic control
3) Pharmacolgical control (insulin, metformin)
4) Regular USS and PET screens
5) Vitamin D 10mg OD
6) Actively delivery before 39 weeks due to increased PPH risk

Question 3

Diagnosis of GDM?

Answer 3

2 hour 75mg OGTT glucose of 7umol/L

Question 4

What screening is performed as part of the booking bloods?

Answer 4

Blood group, rhesus status, haemoglobinopathies (SCC, thalassaemia), Hep B, HIV, Syphilis, Down’s Syndrome, Rubella

Question 5

What are the components of the combined test for Down’s Syndrome?

Answer 5

Performed at 10-13 weeks
1) USS- nuchal thickness
2) Maternal blood test- hCG and PAPP-A
High risk results will lead to amniocentesis

Question 6

Management of PE in pregnancy?

Answer 6

1) Examination
2) ABG
3)

Question 7

Management of minor antenatal bleeding?

Answer 7

Admit, monitor, USS, discharge if bleeding stops for 24 hours

Question 8

Management of PE in pregnancy?

Answer 8

1) Examination
2) ABG
3) V/Q scan most appropriate imaging due to efficacy and minimal radiation
4) Enoxaparin (clexane)

Question 9

Management of late placenta praevia?

Answer 9

C-section

Question 10

Management of cancer during pregnancy?

Answer 10

Only chemotherapy is indicated in pregnant women, in the mid 2nd and 3rd trimester

Question 11

Contraception options after pregnancy?

Answer 11

1) Breast-feeding (not 100%)
2) Sterilisation if C-section
3) Implant
4) Copper Coil
5) Mirena Coil
6) Depo injections

Question 12

Physiological Changes in Pregnancy

Answer 12

Clotting factors VII, X, XII, fibrinogen
Stroke volume increase by 30%
Relative dilution due to increased plasma volume

Question 13

3rd trimester fluid discharge with painless bleeding

Answer 13

Vasa praevia (with SROM)

Question 14

3rd trimester fluid with painful bleeding

Answer 14

Placental abruption

Question 15

Thrombotic Thrombocytopaenic Purpura (TTP)

Answer 15

MAHA
Fever
Thrombocytopaenia
CNS impairment
Kidney impairment

Question 16

3rd trimester fluid with painful, copius bleeding

Answer 16

Placental abruption
Managed with admission, ABCDE, IV access, FBC, cross-match and order 4 pints of blood, CTG and steroids, consult senior colleagues

Question 17

How can Rhesus affect first pregnancy?

Answer 17

Rh-neg mother, Rh-pos child sensitises the mother to a future Rh-pos child

Question 18

Rhesus risk management?

Answer 18

1 injection of anti-D immunoglobulins at 28 weeks

If a sensitising event has occurred booster injections are necessary

Question 19

SLE haematological changes

Answer 19

Haemolytic anaemia
Thrombocytopaenia
Systemic connective tissue disease

Question 20

HELLP Syndrome

Answer 20

Haemolysis
Elevated Liver enzymes
Low Platelets