Specialties Flashcards
Premature infant, respiratory distress, chest X-ray shows ground glass appearance…
Surfactant deficiency
Surfactant deficiency risk factors
Prematurity
C-section
Male gender
Sepsis
Prophylaxis of surfactant deficiency
Give the mother steroids (prednisolone) to increase surfactant production in the infant
Jaundice <24hr is always…
Pathological
Which tests do you want to do for a jaundiced baby?
FBC
Coombs
Bilirubin levels
Causes of macrocytic anaemia
Alcohol
B12 deficiency
Folate deficiency
B12 deficiency symptoms
Neurology: peripheral neuropathy, depression
Angular stomatitis
Glossitis
What test do you need to do after 1st seizure?
ECG
What test do you need to do after 2nd seizure?
EEG
What test should you do for a focal seizure?
MRI head
Treatment for absence seizure
Sodium valproate
Lamotrigine
Side effects of sodium valproate
Weight gain
Hair loss
Liver damage
Tonic clonic seizure treatment
Carbamazepine
Note that it’s a CYP450 inducer
Refractory epilepsy drug
Phenytoin
Management of septic arthritis
Joint aspiration (USS guided if needed, also lets you see effusion) IV antibiotics 4-6w
After how many weeks can placenta previa be confirmed?
24 weeks
Management of placental abruption
C section
Features of vasa previa
Vaginal bleeding
Foetal bradycardia
When should you offer C-section
HIV with high viral load
Breech twin presentation
Breech when ECV has failed
Causes of uterine rupture
Retained Tissue
Reduced Tone
Trauma
Increased risk of uterine rupture if previous…
C-section
Previous C-section, offer what next birth?
CTG
Because of risk of uterine rupture
Frothy green discharge
Dyspareunia
Strawberry cervix
Trichomonas vaginalis
Trichomonas treatment
Metronidazole
Sx of symptomatic gonorrhoea
Dysuria
Foul-smelling discharge
Salpingitis increases your risk of …
Ectopics
Symptoms of chlamydia
Infertility
Discharge
Dysuria
Treatment for chlamydia
Azithromycin
Symptoms of bacterial vaginosis
Fishy smell
Green discharge
Itchy burning vagina
White discharge
Candidiasis
Treatment for overactive bladder
Bladder retraining
Oxybutynin
Cause of overactive bladder
Detrussor overactivity
Normal CTG heart rate for foetus
100-160bpm
If PROM, should you do a vaginal examination?
NO
May induce infection
Where does fertilisation usually occur?
Ampulla of fallopian tubes
How can you induce pregnancy?
Stretch and sweep
Prost x2
AROM (amnihook)
Oxytocin infusion
Signs of uterine hyperstimulation
7< contracts in 15 minutes
STOP INFUSION!
Marker for ovarian cancer
CA125
At how many weeks can you offer IOL?
42w
Score to determine if the pregnancy will progress
Bishop’s score
Rubella during pregnancy can cause what for the baby?
Cataracts
Jaundice
Hepatomegaly
Listeria in pregnancy puts mother at risk of…
Miscarriage
Parvovirus can cause X in pregnancy
Hydrops fatalis
At what dilation is it considered active labour?
4cm
Symptoms of endometriosis
Abdominal pain Dyspareunia Secondary dysmenorrhoea Subfertility Fixed, retroverted uterus Adnexal tenderness
Most common causes of PID
Chlamydia
Gonorrhoea
What Ix can you do for high risk of Down’s syndrome?
Choronic villus sampling
How are perineal tears graded?
1 = skin 2 = perineum but no anus involvement 3a = external sphincter affected 3b = internal 3c = internal 4 = involves everything
What test can you do to determine if anti-D is required?
Kleihauer
Sx of cervical cancer
Bleeding
Post-coital bleeding
Pain
RF for cervical cancer
Smoking
HPV
Unprovoked, painless bleeding in placenta previa, what should you do?
Admit them
High risk of further bleeding
Significant bleeding -> C section
Cut off for being called a miscarriage
<24 weeks
RF for miscarriage
LLETZ
Anti-phospholipid syndrome
TORCH organisms
What is chorioamnionitis?
Infection of the amniotic membranes
Sx of chorioamnionitis
Fever
Abdo pain
Uterine tenderness
Foul-smelling liquor
Mx of chorioamnionitis
Amoxicillin
Why are pregnant women more likely to get UTIs?
Progesterone dilates the uterine system
Increases UTI and increases ascending renal infections
Symptoms of ovarian torsion
Vomiting
Pain
What do B-HCG levels do in a normal intrauterine pregnancy?
Double
What happens to serial B-HCG in an ectopic
It tails off slowly
Doesn’t double
Dysmenorrhoea causes
Endometriosis
Cervical cancer
PID
HELLP stands for
Haemolysis
Elevated liver enzymes
Low platelets
Symptoms of HELLP syndrome
Nausea
Vomiting
RUQP (because haemorrhage of liver capsule)
Can lead to DIC and renal failure
Need senior help
Pregnancy with jaundice, proteinuria, epigastric pain
Acute fatty liver of pregnancy
Severe itching in pregnancy can be
Obstetric cholestasis
Cut off for PPH
500ml
Sx of vaginal prolapse
Discomfort
Dragging
Lump
Sx of cystocele
Incontinence
Discomfort
Dragging
Lump
How would you expect b-HCG to change with time in an intrauterine pregnancy?
Doubling
Causes of primary dysmenorrhoea
Endometriosis
PID
When is the pregnancy viable?
24w
How does acute fatty liver of pregnancy present?
Presents like cholestasis Epigastric pain Malaise N&V JAUNDICE Proteinuria
When should you deliver with obstetric cholestasis?
37-38w
Post-coital bleeding could be
Ectopion
Cervical dysplasia
First thought if post-menopausal bleeding?
Endometrial carcinoma
Signs of preeclampsia
Hypertension Proteinuria Hyperreflexia Headache Oedema Vision changes
Ix for infertility
Hysterosalpingogram
Sort out any obvious causes = PCOS
Difficult to palpate the presenting part, appears to be a balotable object. What is going on?
Breech
Crampy pains
Bloody mucus
Bloody show (loss of mucous plug)
Sx of PID
Abdominal pain
Dyspareunia
Purulent discharge
Mx of PID
Ceftriaxone
Down’s testing
Nuchael translucency = screening
Quadruple test
Choronioc villus sampling = 11-14w
Amniocentesis = 15w (risk of miscarriage)
What increases the risk of endometrial cancer?
Increased oestrogen exposure
Indications for emergency C-section
Breech
Transverse lie
High HIV viral load
Mx of herpes
Aciclovir
When can you give VZVIG?
Up to 10 days post-exposure
Sx of fibroids
Bleeding
Infertility
Bloating
Mx of stress incontinence
Pelvic floor exercises
Duloxetine
Surgical
What can you test for premature ovarian failure (<40yo)
FSH
Sx of premature ovarian failure
Hot flushes
Loss of libido
Menopause =
12mo of amenorrhoea
Complications of placenta accreta
Haemorrhage
Non-separation
Definition of increta
Myometrium only (not all the layers)
How quickly should the placenta be delivered after the birth?
30 minutes
Mx of menorrhagia
Mirena coil
CIN Mx
Ablation
Agglutination
Cone biopsy
Components of the quadruple test
High B-HCG, Low AFP, Low oestradiol
PPROM, what examination do you want to do?
Sterile speculum
HSV in pregnancy results in X in the newborn
Encephalitis
Sharp sudden abdo pain
Shock
Bit of blood vaginally
Placental abruption
Eclampsia Mx
Magnesium sulphate
How can you delay labour?
Toxolytic medications = atosiban (inhibitor of oxytoxin)
Deliver Rh infant, what should you give
Post-natal anti-D Kleihauer test (determine how much and if truly necessary)
Stage 3 ovarian cancer = where?
Confined to abdomen
Bad HPV =
16 and 18
Associated with cervical cancer
Ix for endometrial cancer
USS
Hysteroscopy
Endometrial biopsy with pipelle
Cut off for endometrial hyperplasia on TVUSS
4mm