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Y3 Revision Points > Reproduction > Flashcards

Reproduction Flashcards

1
Q

What do healthy start vitamins include?

A

Vitamin C, D and folic acid

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2
Q

When to trimesters start/end?

A

First - 0-12w
Second - 12-28w
Third - 28-40w

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3
Q

Name teratogenic drugs and their effect

A 
ACEi - renal agenesis
Warfarin - facial and skeletal defects
Sodium valproate - NT defects
Phenytoin - cleft lip/palate
Lithium - cardiac defects
Methotrexate - skeletal defects
Vitamin A teratogenic but still given to mothers with CF
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4
Q

What is the treatment for a UTI in pregnancy?

A

1st/2nd trimester - nitrofurantoin

3rd trimester - trimethoprim (folic acid inhibitor)

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5
Q

List drugs contraindicated in breast feeding and their effects

A 
Phenobarbitone - suckling difficulty
Amiodarone - hypothyroidism
Cytotoxics - BM suppression
Benzodiazepines - drowsiness
Bromocriptine - suppresses lactation
Tetracyclines - black teeth
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6
Q

What is the guidance for breastfeeding with blood-borne viruses

A

HIV/Hep A/Hep B - don’t breastfeed

Hep C - can breastfeed unless cracked/bleeding nipples

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7
Q

List risk factors for IURG

A

Smoking
IVF
Maternal BMI<18
Previous IUGR

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8
Q

List features of fetal alcohol syndrome

A

Dysplastic kidneys
VSD
Microcephaly
Micrognatha and smooth philtrum

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9
Q

What is done at every appointment during antenatal screening?

A 
Mental health
Maternal screening - movements
BP
Urinalysis
FSH from 24w
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10
Q

What is done at the booking appointment?

A

Bloods - Hb, group, Rh, HIV, Hep B, Hep C, syphilis, thalassaemia, sickle cell
USS - viability scan - single/multiple, CRL, nuchal translucency

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11
Q

List invesitgations for Down’s Syndrome screening

A

Nuchal translucency - >4mm
AFP
hCG
Amniocentesis <15w, chorionic villus sampline <12w

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12
Q

List causes of raised AFP in pregnancy

A

Multiple pregnancy
Gastroschisis
Down’s Syndrome

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13
Q

List causes of increased nuchal thickness

A

Down’s Syndrome

Turner’s Syndrome

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14
Q

What is done at 20w?

A

Anomaly scan - detailed USS for abnormalities

Examination - position, lie, engagement, heart ausculatation

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15
Q

What is involved in 28w screening?

A

Bloods - Hb, antibodies
OGTT if high risk GD
Anti-D injection if Rh- (in deltoid)

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16
Q

Risk factors for pelvic girdle pain in pregnancy

A

Obesity
Hx low back pain and pelvic pain/trauma
Hard physical job
PGP in previous pregnancy

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17
Q

Name some precautions for epidural anaesthetic

A 
Don't lie mother flat - headaches
IV access - risk hypotension
CTG - risk fetal bradycardia
Catheterization - loss of bladder sensation
Must be in obstetric unit
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18
Q

What is breast milk deficient in?

A

Vitamin K

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19
Q

When is the fundus usually palpable?

A

Week 12

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20
Q

List blood cord results in rhesus disease

A

Hb - low
Bilirubin - high
Coombs test +ve

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21
Q

How many early pregnancies miscarry?

A

25%

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22
Q

How is a CTG interpreted?

A
  • Determine Risk
  • Contractions (3-4 in 10 normal)
  • Baseline RAte - 120-160 normal
  • Variability - >5bpm in baseline rate
  • Accelerations - should increase by 15bpm for 15s
  • Decelerations - if early (during contraction) then normal, if late or variable then not good
  • Overall impression
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23
Q

What is the gram film of candida albicans?

A

Gram positive spores and hyphae with budding

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24
Q

How are HPV warts managed?

A

1st line podophyllotoxin

In pregnancy 1st line cryotherapy

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25
Q

How is genital herpes managed in pregnacy?

A

Prophylactic acyclovir from 36w

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26
Q

What is used to measure ovarian reserve prior to IVF?

A

Anti-mullerian hormone

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27
Q

What CD4 count does pneumocystic pneumonia occur? How does it present?

A

CD4<400

O2 exercise desaturation

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28
Q

What CD4 count does cytomegalovirus occur? How does it present?

A

CD4<50

Chorioretinitis

29
Q

What CD4 count does toxoplasmosis occur? How does it present?

A

CD4<150

Cerebral abscesses

30
Q

How is urge incontinence managed?

A

Decrease caffeine
Bladder training
Oxybutinin/miragebron

31
Q

How does mirabegron work?

A

B3 agonist - increases voiding interval, inhibits spontaneous bladder contractions

32
Q

Where does lymph from ovaries drain to?

A

Lumbar nodes

33
Q

Where does lymph from the cervix drain to?

A

Internal iliac nodes

34
Q

What are the boundaries of the pelvic inlet?

A

Anterior pubic symphysis, lateral iliopectineal lines, posterior sacral promontory

35
Q

What are the boundaries of the pelvic outlet?

A

Pubic arch, ischiopubic rami, ischial tuberosities, coccyx

36
Q

What to mesonephric ducts develop into in the male?

A

Vas deferens

37
Q

What to paramesonephric ducts develop into in the female?

A

Vaginal fornix

38
Q

Describe the endometrium and ovaries on USS

A

Endometrium - white lining

Ovaries - black dots inside

39
Q

How are gynae cancers imaged?

A

MRI - staging

CT - metastases

40
Q

What form of contraception has the best efficacy?

A

Subdermal implant

41
Q

How long does the POP take to become active?

A

48h

42
Q

List contraindications for COCP

A 
Migraine with aura
Personal history breast cancer
>40 with high BMI
Smoker >35
Hx thromboembolism
<6w post partum
43
Q

How long to you wait before taking hormonal contraception after UPA or LNG?

A

UPA - 5 days

LNG - don’t have to wait

44
Q

What proportion of couples suffer from infertility?

A

1/6

45
Q

When is embyro transfer most successful?

A

Blastocyst stage

46
Q

When does ovulation occur in relation to menses?

A

14 days before

47
Q

Where does spermatogenesis occur?

A

Seminiferous tubules

48
Q

What does athenospermia mean?

A

Low motility

49
Q

What does teratospermia mean?

A

Abnormal form

50
Q

What does oligospermia mean?

A

Low count

51
Q

What is the failure rate of male sterilization?

A

1:2000

52
Q

What factors are associated with increased regret in sterilization?

A 
Performed at time of childbirth/TOP
<30y
Not in relationship
Few/no children
Coercion by partner/medical personnel
53
Q

Where is the ductus arteriosus? What causes blood to pump through it?

A

Comes off of the pulmonary trunk

Perfused by the right ventricle

54
Q

Where does fluid in the fetal lung come from?

A

Made in the fetal lung

55
Q

List some recommendations for preterm births

A

Delay cord clamping
Maintain temp between 36.5-37.5 deg
Don’t attempt to aspirate meconium while head on perineum
CPR ratio 3:1
Do not give 100% O2 (increased risk retinal haemorrhage)

56
Q 
List changes in pregnancy-
tidal volume
minute volume
RR
vital capacity
functional residual capacity
A 
TV - increased
MV - increased
RR - no change
VC - unchanged
FRC - reduced
57
Q

Which antibiotic is given intra-operatively for a hysterectomy?

A

Co-amoxiclav

58
Q

What does prolactin do?

A

Enlarge mammary glands and preparation for milk production

59
Q

What is the blood supply to the labia and clitoris?

A

Branches from internal pudendal

60
Q

How does placenta accreta present?

A

Bleeding

Doughy abdomen

61
Q

What is Asherman syndrome?

A

Adhesions in uterus - usually after PID

62
Q

What imaging is done for breast assessment <35 and >35?

A

<35 - USS

>35 - mammography

63
Q

How is genital herpes managed in pregnancy?

A

Active lesions - CS

No active lesions - aciclovir prophylaxis and vaginal delivery

64
Q

How is nipple candidiasis managed in breast feeding?

A

Topical miconazole after feeding, miconazole in baby’s mouth

65
Q

Cervical appearance in trichomonas vaginalis

A

Strawberry cervix

66
Q

What drug can you not taken when on tamoxifen?

A

Fluoxetine

67
Q

Describe
Placenta accreta
Placenta increta
Placenta percreta

A

Acreta - superficial myometrium
Increta - half of myometrium
Percreta - full myometrium (transmural)

68
Q

List common preterm complications

A

Sepsis
RDS
Intraventricular haemorrhage
PDA

Y3 Revision Points (6 decks)

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