CLINICAL

Question 1

what happens if preg women is rhesus negative? and why?

Answer 1

issues arise if child is rhesus positive and theirs enters womans blood

anti-D injection given

Question 2

rhesus disease? aka

explain pathology

Answer 2

haemolytic disease

caused by antibody anti-D
happens when your blood group is D negative and baby’s is D positive

can cause

anaemia, jaundice, death - inuterine or post-delivery

Question 3

risks assoicated with multiple preg? 4

Answer 3

miscarriage
fetal growth restrictiion
preterm birth
twin to twin tranfusion syndrome

Question 4

T sign is what? seen in who?

Answer 4

seen in dichroionic twins
not seen in monochorionic twins

its tissue projecting into memebrane

Question 5

trisomy 18?

Answer 5

edwards syndrome

rare genetic condition caused by additonal chormosome 18

Question 6

creatinine level in preg women?

Answer 6

decrease

Question 7

platelet count in preg?

Answer 7

falls

Question 8

symphyseal fundal?

Answer 8

pubic symphysis to fundus using tape

and assessed on growth chart

Question 9

fetal presentations ? 2

Answer 9

breech - bum down

vertex - head down

Question 10

screening in antenatal for what? e/g - 3

Answer 10

infections - hep B, syphilis, HIV

Question 11

first trimester screening carried out when?

Answer 11

10-14 weeks gestation

Question 12

nuchal translucency explain?

Answer 12

measure fluid behind baby neck

Question 13

why is measuring Nuchal translucency important?

Answer 13

size is related with abnormalities and incidence of chromosomal abnormalities

increase in NT size means increase in feotal trisomies

Question 14

non- invasive pre-natal testing?

Answer 14

maternal blood taken

to detect foetal cell free DNA from the placenta

Question 15

diagnostic CVS?

Answer 15

between 10-14 weeks

culturing of cells by needle

Question 16

diagnostic amniocentesis?

Answer 16

15 weeks onwards

culturing of cells by needle

Question 17

screening for NTD means?

Answer 17

neural tube defect

to detect anencephaly and spina bifida - NTD variants

ultrasound - 2nd trimester

Question 18

ultrasound good for what and bad for what in 2nd trimester?

Answer 18

good screening test for major structural abnormalities BUT poor for chromosomal abnormalities - trisomies

Question 19

molar preganncy turn into what?

Answer 19

if not removed can turn malignant

Question 20

what is molar pregannacy?

Answer 20

form of pre-cancer of the placental trophoblast cell

Question 21

d and c?

Answer 21

A dilation and curettage procedure, also called a D&C, is a surgical procedure in which the cervix (lower, narrow part of the uterus) is dilated (expanded) so that the uterine lining (endometrium) can be scraped with a curette (spoon-shaped instrument) to remove abnormal tissues.

Question 22

tidal volume in preg?

Answer 22

decreased

Question 23

fetus to mother exchange of what? 3

Answer 23

CO2
UREA
OTHER WASTE PRODUCTS

Question 24

PLacental transfer of drugs is dependant on? 3

Answer 24

molecular weight of drug - size - smaller will cross

polarity of drug - uncharged will cross

lipid solubility of drug - lipid soluble ones will cross

Question 25

excretion of drug in fetus?

Answer 25

excretion into amniotic fluid - which is recycled back into fetus

Question 26

teratogenicity and fetotoxicity when?

Answer 26

T - first trimester | F -SECOND T

Question 27

IF giving toxic drug to women of child bearing age - what else must u do?

Answer 27

must also prescribe contraception and warn of preg risks

Question 28

second trimester is when?

Answer 28

13-26 weeks

Question 29

organogenesis is when?

Answer 29

3-8 weeks

Question 30

folate antagonism? e/g 2 drugs

Answer 30

folate - key for DNA fomring and new cells forming affected by drugs - methotrexate, trimethoprim result in NTD etc

Question 31

teratogenic drugs classifictaions? 6

Answer 31

``` anticonvulsants - carbamazepine anticoagulants - warfarin antihypertensives - ACEi NSAIDS alcohol retinoids - for acne ```

Question 32

relationship between drugs and lactation?

Answer 32

all drugs taken by mother will appear in breast milk

Question 33

principel to follwo when prescribing drugs during breast feeding mother?

Answer 33

REDUCES INFANT EXPOSURE - HIGH PROTEIN BOUND DRUG - so less free drug in blood - less half- life too