Short SAQ questions Flashcards
What is the carrier frequency of cystic fibrosis?
1 in 35 in Australia
1 in 25 in New Zealand
What is the carrier frequency of spinal muscular dystrophy?
1 in 50
What is the carrier frequency of fragile X syndrome?
1 in 332
What are the risk factors for placenta accreta spectrum?
- Previous accreta *
- Previous CS *
- Placenta praevia
- Placenta praevia and previous CS *
- Previous uterine surgery *
- ART
- Short inter-pregnancy interval
- CUA
- Increasing maternal age
- Major risks
What are the risk factors for vasa praevia?
- low-lying placenta/ placenta praevia
- bilobed/succenturiate lobe
- velamentous cord insertion
- ART
- Multiple pregnancy (not independent risk factor)
What are the risk factors for placenta praevia?
- Prev CS (increasing risk with increasing # of CSs)
- ART
- Smoking
- Prev praevia
- AMA
- Prev uterine surgery
- Multiple pregnancy
How is BMI calculated?
kg/m2
weigh in kilograms divided by the square of height in metres
What are the risk factors for ovarian torsion?
- Ovarian mass
- Prev torsion
- Ovulation induction
- Pregnancy, particularly 1st trimester
- Long ovarian suspensory ligament
What are possible complications of Dermoid cysts?
- Torsion
- Rupture
- Hyperthyroidism if presence of active thyroid tissue
- Infection
- Malignancy
- Chemical peritonitis
What features increase the risk of a failed operative delivery?
- Suspected fetal macrosomia (>4kg)
- Maternal obesity (BMI >30)
- 1/5th head palpable abdominally
- Malposition >45degrees from occipito-anterior position
- Midcavity, station 0 to +2
- Inadequate analgesia in delivery room
- No descent of vertex with pushing
- Poor maternal effort/pushing
What are the risk factors for shoulder dystocia?
Pre-labour:
- Prev shoulder dystocia
- Fetal macrosomia
- Maternal diabetes mellitus
- Maternal obesity
Intra-partum:
- labour dystocia
- prolonged 2nd stage
- assisted vaginal delivery
- epidural
What are the 5 principles of managing a PPH?
- Recognition
- Communication
- Resuscitation
- Monitoring and investigations
- Management of PPH
What is the definition of sepsis?
Life threatening organ dysfunction caused by a dysregulated host response to infection
What is the rate of reduction of early onset neonatal GBS with use of prophylaxis?
80%
What are the benefits of antenatal corticosteroids in women at risk of preterm birth?
Reduced risk of:
- perinatal death
- neonatal death
- respiratory distress syndrome
- probably reduces the risk of intraventricular haemorrhage
What are the causes of post-menopausal bleeding in order from most common to least common?
- Atrophy
- Exogenous estrogen
- Endometrial/cervical polyp
- Endometrial hyperplasia
- Endometrial cancer
- Cervical cancer
What are the risk factors for endometrial cancer?
- Hyperplasia
- Obesity
- T2DM
- Unopposed oestrogen therapy
- PCOS
- Early menarche/later menopause
- Nulliparity
- Age
- Oestrogen secreting tumour (eg. Granulosa cell tumour)
- Tamxifen therapy
- Genetic syndromes eg. Lynch, Cowden
What prognostic factors for endometrial hyperplasia/cancer are associated with a poor outcome?
- Increasing age (over 65)
- Stage (>1b)
- Increasing myoinvasion
- Vascular invasion
- Tumour extending beyond the fundus
- Grade 3
- Histological subtypes - clear cell, serous, adenosquamous
- Tumour >2cm
Hyperplasia without atypia.
- What is the risk of co-existent invasive endometrial carcinoma?
- What is the risk of progression to invasive carcinoma?
- What is the risk of co-existent invasive endometrial carcinoma? <1%
- What is the risk of progression to invasive carcinoma? <5% over 20 years
Atypical hyperplasia
- What is the risk of co-existent invasive endometrial carcinoma?
- What is the risk of progression to invasive carcinoma?
- What is the risk of co-existent invasive endometrial carcinoma? 25-59%
- What is the risk of progression to invasive carcinoma? RR 14-45
What is endometrial hyperplasia?
Irregular proliferation of the endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium
What is the lifetime risk of uterine cancer?
1 in 45
What is the genetic bases of cystic fibrosis?
Autosomal recessive inheritance of a mutation in the cystic fibrosis transmembrane conductance regulator gene.
Over 1000 mutations have been identified. Phenotype depends of what combination of mutations they have inherited.
What is the anatomical pathology which defines placenta accreta?
Chorionic villi attach to the myometrium. Invasion through nitabuch layer (80% of placenta accreta spectrum)
Nitabuch layer is a fibrous junction of the decidua and cytotrophoblast, prevents excessive penetration of the decidua.