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Ned's PassMed notes 2019/20 > Obs doc unknown bits > Flashcards

Obs doc unknown bits Flashcards

1
Q

how many fifths does there have the be for engagement to have occurred

A

need 2/5 to be able to say engagement has occurred

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2
Q

name 2 things that occur in the ampulla

A

fertilisation

ectopic pregnancies

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3
Q

what does blastocyst mean

A

the term used when the embryo has divided into 2 separate cell masses

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4
Q

what happens to BP during pregnancy and why does this occur

A

maternal BP drops during 2nd trimester due to expansion of uteroplacental circulation

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5
Q

is fetal distress an indication to induce labour. true/false?

A

FALSE - fetal distress is a contraindication to inducing labour

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6
Q

what are the 3 components of active management of the 3rd stage of labour

A

syntocinin
ergometrine - C/I’d in hypertension
controlled cord traction

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7
Q

define ‘engagement’

A

when the presenting part enters the pelvis

2/5 engagement

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8
Q

in the stations used to measure descent (-5 to +5), what anatomical landmark is 0

A

ischial spines

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9
Q

what is the acronym to remember cardinal movements of fetal decent

A

‘Don’t Forget I Enjoy Really Expensive Equipment’

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10
Q

what is 1st line to observe fetus in normal labour

A

doppler US!

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11
Q

in normal Labour, how often are fetal obs carried out

A

stage 1 -every 15 mins and at the start of every contraction

stage 2 -at the END of every contraction or every 5 mins

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12
Q

what is the most effective form of analgesia

A

epidural (L3-L4)

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13
Q

which analgesic slows the 2nd stage of labour and increases chance of malpresentation

A

epidural

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14
Q

how is a spinal different from an epidural

A
  1. spinal injected into subarachnoid space

2. spinal has a faster onset of action and doesn’t last as long

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15
Q

what is the analgesic of choice for C sections

A

SPINAL

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16
Q

what roots make up the pudendal nerve

A

S2-S4

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17
Q

at what point in pregnancy is VTE risk highest

A

puerperium

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18
Q

rupture of membranes before what week is classed as PROM

A

<37weeks

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19
Q

what is the main cause of PROM

A

lower genital tract infections

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20
Q

what is classed as failure to progress in the latent stage of the 1st stage

A

> 3-8 hrs to get 4cm dilation

21
Q

how is primary arrest defined

A

<2cm dilation in 4 hours in active phase of stage 1

22
Q

how is secondary arrest defined

A

poor progress of labour after reaching 7cm dilation

23
Q

what does fetal distress indicate

A

fetal hypoxia

24
Q

name 3 signs of fetal distress on CTG

A

bradycardia
loss of variability
late decelerations

25
Q

what should be done if there is confirmed fetal distress

A 
IV fluids and sit mum up 
stop syntoconin 
take fetal blood sample 
consider terbutaline (anti-contraction) 
plan for C section
26
Q

what should a normal fetal blood sample be

A

pH >7.25

27
Q

what is the management for a cord prolapse

A

terbutaline - anti-contractile

category 1 or 2 CS

28
Q

what antibiotic is given in preterm prelabour rupture of membranes

A

erythromycin

29
Q

how does steroid promote maturity of the lungs

A

stimulates surfactant production

30
Q

what is placenta accreta

A

condition where the placenta embeds into the myometrium

31
Q

what feels like a ‘doughy abdomen’ O/Ex

A

placenta accreta

32
Q

what does the uterus feel like on palpitation in a uterine rupture

A

severe pain

33
Q

what does an inverted uterus feel like on palpitation

A

it is not palpable and can be seen at vulva

it is an emergency- high risk of maternal shock and PPH

34
Q

when is the anomaly scan done

A

18-20 weeks

35
Q

what blood markers are HIGH in a fetus with downs syndrome

A

HIGH - `hCG, inhibin A

36
Q

what blood markers are LOW in a fetus with downs syndrome

A

AFP, PAPP-A, estriol

37
Q

what is trisomy 18

A

Edward’s syndrome

38
Q

what growth deficiency is indicative of placental insufficiency

A

asymmetrical - normal sized head, small body - suggests not enough blood flow from placenta

39
Q

describe what happens in a rhesus sensitising event

A

the mothers immune system produces a response against the fetal blood that contains antigens

the mother produces antibodies against the antigens

40
Q

why do sensitising events only really affect future pregnancies after the event

A

initially, IgM is produced by the mother, which doesn’t cross the placenta so fetus isnt affected

But, the mother eventually produces IgG, which can cross the placenta and damage future pregnancies

41
Q

how does the anti-D antibody injection work?

A

the anti D antibodies are given to mothers who don’t have the antigen

this is so that if a sensitising event were to occur, the anti D antibody given would breakdown the fetal antigens in maternal blood

the mother would NOT produce her Own antibodies, so would protect future pregnancies

42
Q

what does a +ive indirect coombs mean

A

mother is sensitised

43
Q

what artery is the standard artery used for doppler

A

umbilical artery

44
Q

what can NSAIDs cause during pregnancy

A

premature closure of ductus arteriosus

45
Q

what UTI antibiotic cannot be given in 1st trimester

A

trimethoprim

46
Q

what should be used for VTE prophylaxis in pregnancy

A

LMWH

47
Q

describe the course of hyperthyroidism in pregnancy

A

typically gets worse in 1st trimester

improves in 2nd and 3rd trimester

48
Q

what is Sheehan’s syndrome

A

anterior pituitary necrosis due to massive hypovolemic shock caused by PPH

causes hypopituitarism

49
Q

how can Sheehan’s syndrome present

A

failure to lactate
slowed mental function, weight gain and inability to stay warm
amenorrhoea or irregular periods

Ned's PassMed notes 2019/20 (17 decks)

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