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1

Main risk factors for developing type 2 diabetes after gestational diabetes

-obesity
-use of insulin during pregnancy
-fasting glucose levels from OGTT in pregnancy
-impaired glucose tolerance postpartum
-ethnic group

2

If you have type 1/2 diabetes, you should receive an anomaly scan when?

Week 18

3

Glucose levels to confirm GD

-fasting >5.1
-2 hours: >8.5

4

Target glucose levels for GD

-fasting: 3.5-5.9
-1 hour post prandial:

5

Which illegal drug is defos associated with preterm birth

Coccaine

6

Infections which could cause poor fetal growth

Rubella
CMV

7

How can you assess fetal growth?

-Ultrasound
-Growth charts

8

What are accelerations?

An increase in fetal heart rate at the start of a uterine contraction returning to the baseline rate before or sometimes after the contraction

-indicates good reflex reactivity of the fetal circulation

9

What is loss of baseline variability?

Baseline fetal heart rate/variability of less than 5 beats per minute

10

What are late decelerations?

Decelerations where the lowest point is past the peak of the contraction

-often associated with asphyxia

11

What does the biophysical profile look at?

Ultrasound to asses:
-movement
-tone
-liquor volume
-breathing movements

Score out of 10:
8-10: satisfactory
4-6: repeat
0-2: deliver

12

Gram negative STI

chlamydia

13

Post coital or intermenstrual bleeding
Lower abdominal pain
Dyspareunia
Mucopurulent cervicitis

Chlamydia (female presentation)

14

Urethral discharge
Dysuria
Urethritis
Epididymo-orchitis

Chlamydia (male presentation)

15

How could chlamydia present in neonates?

Conjunctivitis
Pneumonia

16

Reiter's syndrome

Typically affects younger males:

-urethritis
-conjunctivitis
-arthritis

17

Which STI could result in reiter's syndrome?

Chlamydia

18

Which STI could result in Fitz-Hugh-Curtis syndrome?

Chalmydia

19

When do you test for chlamydia?

2 weeks after exposure

20

Chlamydia treatment

Either Azithromycin 1g once, or doxycycline for a week

21

Gram negative intracellular diplococcus

Gonorrhoea

22

Primary sites of infection are the mucous membranes of the urethra, endocervix, rectum, and pharynx

Gonorrhoea

23

Incubation period for gonorrhoea

2-5 days

24

Asymptomatic - ≤10%
Urethral discharge – >80%
Dysuria
Pharyngeal/rectal infections – mostly asymptomatic

Gonorrhoea presentation (males)

25

Asymptomatic (up to 50%)
Increased/altered vaginal discharge (40%)
Dysuria
Pelvic pain (

Gonorrhoea presentation (females)

26

Gonorrhoea treatment

-Cetriaxone
-give azithromycin as well regardless of chlamydia result
-TEST OF CURE IN ALL PATIENTS

27

This is the most highly infectious lesion in syphilia

Condylomata lata (secondary syphilis)

28

How can you look to see if syphilis has relapsed? (clue RPR)

RPR increased by 4 fold suggests relapse (RPR looks for antibodies)

29

Dark microscopy and PCR are used to look at which STI?

Syphilis

30

Patchy alopecia

Syphilis