Sept 2020 recall

Question 1

Risk of placental abruption if 1 or 2 previously?

Answer 1

1= 4.4%
2= 25%

Question 2

Still birth rate at 39 weeks

Answer 2

1/200
0.5%

Question 3

Risk of parvovirus transmission?
<15 weeks
>15 weeks
Term

Answer 3

< 15 weeks= 15%
>15 weeks = 25%
term= 70%
Infection prior to 20 weeks has a 5-10% fetal loss
3-10% risk of hydrops

Question 4

If maternal chickenpox 4 weeks before delivery what is the risk to baby?

Answer 4

50% risk of infection
23% risk of congenital varicella syndrome
This is higher risk is 7 days within delivery- all of these babies need VZIG prophylaxis on delivery

Question 5

Prevalence of 3/4th degree tear following a forceps

Answer 5

6.7% with an episiotomy
21% without an episiotomy

Question 6

Risk of PPH with physiological 3rd stage?

Answer 6

29/1000
(13/1000 with active)

Question 7

What is the detection rate of a quadruple test?
And a triple test?

Answer 7

Quadruple- 70-75%
Triple- 90%

Question 8

What is the detection rate of the combined test with twins?

Answer 8

72%

Question 9

Which medications put you at higher risk of GDM?

Answer 9

Olanzapine

Question 10

Advice to a pregnant woman taking mesalazine?

Answer 10

At risk of neonatal bloody diarrhoea
(same with sulfasalazine)
Avoid >3g/ day due to risk of nephrotoxicity

Question 11

What is the main effect on vit D to calcium?

Answer 11

Vitamin D increases Calcium absorption in the small bowel

Question 12

What drug is recommended alongside carbetocin in caesarean section to reduce blood loss?

Answer 12

TXA

Question 13

What is the risk effect to the fetus from a VQ?

Answer 13

10x the radiation to fetus

Question 14

What are the platelet thresholds or an operative birth, epidural and vaginal birth

Answer 14

Operative birth: >50
Epidural >80
Vaginal >40

Question 15

What cardiac condition is di george associated with?

Answer 15

truncus arteriosus

Question 16

Which SSRI is the most teratogenic (linked with cardiac abnormality)

Answer 16

Paroxetine

Question 17

What is the FBC of b thalassaemia look like?

Answer 17

Low MCH (amount of haemoglobin in a sample), low MCV, normal ferritin
Hb will be higher if only a trait
Can be 20-80 if major

Question 18

What does an FBC look like in sickle cell?

Answer 18

anaemia 60-80
high reticulocyte suggests haemolysis and can be suggestive of a sickling crisis

Question 19

What does the newborn heel prick spot test screen for?

Answer 19

Sickle cell (1 in 2800), thyroid disease (1 in 2000), PKU (1 in 10,000), CF (1 in 2500), MCADD (fatty acid metabolism), Homocystinuria (babies can develop problems with their eyes), glutaric aciduria, isovaleric acidaemia (can’t break down breast milk), maple syrup urine disease (can’t break down ketoacids)

Question 20

Risk to woman with Turners in pregnancy?

Answer 20

coarctation
dissection

Question 21

What are CF patients more at risk of in pregnany?

Answer 21

GDM

Question 22

When would you deliver a patient with red cell autoantibodies?

Answer 22

Typically between 37 and 38 weeks

Question 23

How soon after an acute MI should you aim for delivery?

Answer 23

Aim to delay 2-3 weeks following treatment for MI

Question 24

What is the increased risk of wound infection in morbid obesity? (how many x more)

Answer 24

7x more likely

Question 25

What is the risk of taking leflunomide in pregnancy?

Answer 25

Extremely teratogenic.
Father can not have taken it for 3 months
Mother can not have taken it for 2 years, otherwise will need a ‘wash out’ with cholestyramine