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Health screening Flashcards

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1
Q

Purpose of screening

A

Detect those at risk for early treatment/diagnosis

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2
Q

When is CST offered

A

10 to 14 weeks

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3
Q

Factors for screening
THE CONDITION (3)

A

Well known
Severe consequences
Frequent presentations

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4
Q

Factors for screening
THE TREATMENT (2)

A

Effective treatment available
Evidence early diagnosis improves outcomes

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5
Q

Factors for Screening
THE SCREENING TEST (3)

A

Simple and acceptable
Benefits should outweigh risks
Accurate

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6
Q

What is specificity

A

Correctly detecting health as non-affected

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7
Q

Sensitivity/detection rate

A

Correctly identifying as affected

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8
Q

False positive

A

Not affected, but identified as so when they are healthy

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9
Q

False negative

A

mislabelling as healthy when they are affected by the condition

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10
Q

To be a good screening test (3)

A

High sensitivity
High specificity
(Avoid missing and over diagnosing)
Therefore cost effective

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11
Q

Risks of screening (3)

A

Overdiagnosis
Overmedicalisation
Increased anxiety

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12
Q

Benefits of screening (3)

A

Early diagnosis
Treatment can be applied to prevent complications
If not treatment available allows for decision making

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13
Q

Uk antenatal and newborn screening (6)

A

Fetal anomaly (scan and chromosomal testing)
Genetic RBC disorders (sickle cell and thalassaemia)
Screening for HIV, Hep B, syphilis as infectious diseases in pregnancy
Anomaly screening after birth (NIPE)
Newborn blood spot test for inherited metabolic diseases
Newborn hearing test for detection of congenital deafness

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14
Q

Other screening in pregnancy

A

Preeclampsia
Rh neg
Growth restriction (GAP chart)
Glucose tolerance
Anaemia
Mental health
Gender based violence
GBS

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15
Q

First trimester antenatal care at ? Weeks

A

8-10 weeks - booking appt
11-14 - dating scan/cubs

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16
Q

Second trimester care schedule

A

16 weeks
20 weeks (anomaly scan)
25 weeks

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17
Q

Booking bloods test

A

Infectious disease screening
Blood group
FBC

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18
Q

What in booking appt? (9)

A

Full obstetric/medical/family history
Gender based violence
Mental health screening
Baseline height/weight/BMI
Baseline observation- BP/pulse/urinalysis
Booking bloods
Urine culture
Co monitoring (smoking)
VTE risk assessment

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19
Q

What is VTE risk assessment

A

For Venothromboembolism

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20
Q

11-14 weeks dating scan looks at (4)

A

Single vs multiple pregnancy
Dating/EDD
Early anomaly screening
Chromosomal anomalies (CST)

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21
Q

At what weeks CST?

A

11-14 weeks

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22
Q

What happens at 16 week appt (3)

A

BP
Urinalysis
Mental health and wellbeing

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23
Q

What is 20 week scan?

A

Detailed- looks at 11 anomalies

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24
Q

What at 25 week appt? (5)

A

BP
Urinalysis
SFH (Symphysis-Fundal Height)
Fetal movements and auscultation
Mental wellbeing

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25
What is SFH
Symphysis fundal height
26
3rd trimester antenatal care schedule
28 weeks 32 (prims only) 34 weeks 36 38 40 41
27
What at 28 week appt? (6)
BP Urinalysis SFH Fetal movements and fetal auscultation Mental Wellbeing Bloods
28
Which bloods at 28 weeks
Rh antibodies (if rhesus negative) FBC Glucose test (if risk factors)
29
Who is 32 week appt for?
Prims only
30
What in 32 week appt
BP Urinalysis SFH Fetal movements and fetal auscultation mental health and wellbeing
31
What in 34 week appt? (7)
BP Urinalysis SFH Fetal presentation Fetal movement and fetal auscultation Weight Mental wellbeing
32
36/38/40/41 weeks what happens (7)
BP Urinalysis SFH Fetal presentation Fetal movement and auscultation PPH risk Mental wellbeing
33
Postnatal care mother at birth (3)
Observation VTE risk Blood loss
34
Postnatal care of infant at birth
Initial Newborn Examination (6hrs)
35
Postnatal mother day 1-3 (3)
VTE Blood loss Mental wellbeing
36
Postnatal day 1-3 infant
Full feeding assessment NIPE <72hr
37
Postnatal day 4-10 mother
VTE risk asses Mental wellbeing Postnatal check
38
Postnatal day 4-10 Infant
Weight loss Newborn blood spot Hearing test (by day 28)
39
Topics covered in health education 1st trimester
Nutrition and exercise in pregnancy Vaccination in pregnancy Folic acid/healthy start Place of birth Infant feeding
40
Health education second tri
Building loving relationships Safer sleep Fetal movement Skin to skin importance
41
Health education 3rd tri
Antenatal workshops Birth preference Postnatal self-care - baby blues Care of newborn Vit K prophylaxis Antenatal colostrum harvesting Induction of labour Membrane sweeps
42
What does NIPE stand for?
Newborn and Infant Physical Examination
43
NIPE - congenital anomalies in which 4 areas
Eyes Heart Hips Testes
44
When NIPE?
6 to 72 hr
45
Why no NIPE before 6 hrs
Baby still adapting to extra uterine life so may not be reliable
46
Why NIPE 2 at 6 to 8 weeks?
Some conditions may not be apparent until then
47
Who can carry out NIPE
Qualified midwives and physicians
48
Who is developmental dysplasia of hip most common in
Premature and breech babies
49
Newborn blood spot tests for what?
Sickle Cell Disease Cystic fibrosis Congenital Hypothyroidism (CHT) 6 inherited metabolic disorders (PKU, MSUD, HCU, IVA, GA1, MCADD)
50
When is newborn blood spot offered
DAY 5
51
If one parent is CF carrier what is chance of child having?
No chance as is a recessive characteristic so both would need to be carriers
52
What CST test for (3)
Chromosomal - Downs, Patau, Edwards
53
What does CST look at?
Nuchal Translucency and serology
54
What does QT test for?
Downs
55
When can QT be carried out
15-20 weeks
56
Can 20 week scan screen for Downs
No
57
Can 20 week scan screen for Edwards and Patau's
Yes
58
Benefits of Chromosomal Screening
- if diagnostic tests advised - prepare/make decisions - early diagnosis
59
When is Beta thalassaemia tested for?
In pregnancy for mother Both parents need to be carriers for baby possibly be affected
60
Purpose of Fetal Anomaly Scan
To screen for 12 main congenital anomalies ie cleft lip, pataus, Edwards, downs, serious cardiac, open spina bifida Not for gender - and some trusts won't discuss
61
How to obtain good heel prick sample (6)
1) clean with water 2)warm & dry 3) lancet 4) form droplet & tap on card 5)air dry sample 6) plaster on foot
62
Risks of heel prick test
Low, not risk free Bruising Excessive bleeding if blood clotting disorder Unlikely to put too deep
63
How can CF be diagnosed antenatally
CVS and amniocentesis

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