Antenatal Care

Question 1

Routine

Answer 1

Routine screening

Mx of current probs

Question 2

3 routine test you must do in pre preg Counselling?

Answer 2

Rubella
Varicella
Pap smear

Question 3

Further assessment prepreg optimization?

Answer 3

DM - oral hypoglycaemia to insulin
Epilepsy - Poly to Mono therapy
Anticoagulation: switched from warfarin to LMW Heparin

Question 4

DM woman how to change Rx prepreg?

Answer 4

Change from oral hypo glycaemics to INSULIN

Metformin ok

Question 5

Prognostic advice for prepreg for renal failure?

Answer 5

Renal failure: creatinine >0.3: pulmonary HT (Mortality 50%)

Treat with surrogacy.

Question 6

Counselling for prepreg?

Answer 6

Pharma: folate(500ug 3/12 before or 5mg) : avoid teratogens
Behavioural: Freq and timing:alcohol, smoking

Question 7

Freq and timing to conceive?

Answer 7

Intercourse 48hrly or daily in the week before ovulation

Question 8

Alcohol

Answer 8

Avoid Worse than cannabis, Heroin

Question 9

6 steps in first antenatal visit

Answer 9

Confirm preg
Gestational age
Screening for probs
Mx of any probs
General advice (OSCE station)
Booking (planning model of care)

Question 10

Pregnancy tests? Which is best?

Answer 10

Serum: hCG 100% (DO THIS.)G
Urinary hCG: cross reacts with LH
Lots of false positives and false negatives

Question 11

Gestational Age? Best?

Answer 11

Ultrasounds 6-12 weeks: Crown rump length. +/-3 days

12-20wks: biparietal diameter. +/- 7 days

Question 12

Naegle’s rule breaks down when?

Answer 12

If cycle longer/shorter than 28 days

Not realizable if unrealizable cycle or recently stopped OCP

Question 13

FHx Social Hx? prepreg?

Answer 13

Alcohol, smoking, illicit, marital, occupation

Question 14

What does gynaecological exam involve?

Answer 14

External inspection
Speculum
Bimanual

Question 15

TEsts at Antenatal visits?

Answer 15

Haematologic: Anaemia: Thal Minor!
Blood bank
Microbiology (rubella, varicella, syphilis, HepB,C, HIV
Cytology: pap
Biochem:
Imaging: U/S

Question 16

Why check MCV?

Answer 16

Thal Minor

Anaemia

Question 17

If preg woman is not immune to varicella?

Answer 17

Hyperimmune ZiG. IVIG

Question 18

HIV in preg?

Answer 18

No breastfeeding, C-section, antiretrovirals

Question 19

Biochem in first antenatal visit?

Answer 19

Trisomy 21 screen

Question 20

Worst epilepsy drug in preg?

Answer 20

Valproate

Question 21

General advice in first antenatal visit?

Answer 21

Diet - 
Mineral vitamin supplementation
Exercise
Smoking
Alcohol
Sex
Working
Meds

Question 22

Diet first antenatal?

Answer 22

Nutrition,
Listeria - Chicken
Avoid salads, soft serve ice cream

Question 23

Why chicken get more likely food poisoning

Answer 23

Cause it’s frozen, doesn’t get cooked thoroughly

Question 24

first antenatal mineral vitamin supplementation?

Answer 24

Iron, calcium, Vit D
Folate?
Iodine?

Question 25

20% of population has this thrombophilia? How to avoid?

Answer 25

Hyperhomocysteinaemia | continue folate and multi it's

Question 26

Exercise first antenatal advice?

Answer 26

Moderate not heavy

Question 27

Heavy alcohol use is defined?

Answer 27

More than 2 SD per day

Question 28

Working? first antenatal advice?

Answer 28

34 weeks, or earlier if increased BP

Question 29

Meds first antenatal advice?

Answer 29

Penicillin.amoxyl Paracetomol: PRN not regular Maxalon

Question 30

2 important conditions first antenatal visit?

Answer 30

Preeclampsia | Placental insufficiency

Question 31

Mx in antenatal

Answer 31

General well being Fetal movements >20 weeks Oedema (preeclampsia, not ankle, look at fingers)

Question 32

Women must have what EVERY visit?

Answer 32

Dipstick to check for protein

Question 33

28 weeks

Answer 33

FBE OGTT Rh anti-D PRN

Question 34

36 weeks tests?

Answer 34

FBE is low at 28weeks GBS: penicillin or erythromycin Anti-D PRN again

Question 35

Mother who wants to deliver 2nd vaginally after C-section?

Answer 35

1/200 risk of death

Question 36

If after 39 weeks gestation, risk of probs?

Answer 36

1/400 of perinatal death

Question 37

PAPP-A should be what level?

Answer 37

Not below 0.42 MoM