Integration day stuff

Question 1

Pregnancy checks

Answer 1

Blood pressure
FBC
Rhesus D status and antibody screen
Haemoglobinopathies
Ultrasound
Oral glucose in high risk groups

Question 1

Pregnancy checks

Answer 1

Blood pressure
FBC
Urinalysis
Rhesus D status and antibody screen
Haemoglobinopathies
Ultrasound
Oral glucose in high risk groups

Question 2

Ultrasound checks for baby

Answer 2

Viability - 6 weeks
Dating
Combined screening
all done before 14 weeks

Question 3

What is combined screening used for?

Answer 3

Chromosomal abnormalities - nuccal thickness
95% accurate

Question 4

Risk assessment when use

Answer 4

Vulnerbale mothers
Risk to self or others
MDT meeting - holistiic, shared decision making

Question 5

What can sertraine cause in baby?

Answer 5

Persistent pulmonary hypertension
Withdrawal in baby

Question 6

High risk mental health refer in pregnancy

Answer 6

Bipolar
Schizophrenia
Fmaily history of these esp related to pregnancy

Question 7

Post natal risk factors that increase mental health

Answer 7

Lack of sleep
Stress of new responsibility
Physiological changes
Social isolation from normal life/routine

Question 8

What medications for mental health are safe in pregnancy?

Answer 8

None - transplacental transfer
Breast feeding - if dont then withdrawal

Question 9

Contraindicated mental health medications in pregnancy

Answer 9

Sodium valproate

Question 10

Conditions for taking soidum valproate

Answer 10

Long term refractory bipolar
Long term contraception in place
Yearly check ups

Question 11

Slight contraindication in pregnancy mental health

Answer 11

Lithium
Carbamazipine
New generation antipsychotics

Question 12

What thoughts can be normal and not qualify as a depressive episode?

Answer 12

Suicidal, harming the baby
Low self esteem

Question 13

What mental health condition can often occur after pregnancy and pose risk to baby and mother?

Answer 13

Depression and psychosis

Question 14

What is quite safe in pregnancy?

Answer 14

ECT
SSRIs

Question 14

What is quite safe in pregnancy?

Answer 14

ECT
SSRIs

Question 15

MSE

Answer 15

Appearance
S
E
Perecption
Thoughts
Insight
Cognition

Question 15

MSE

Answer 15

Appearance
Speech
Emotions
Perecption
Thoughts
Insight
Cognitione

Question 16

Postpartum psychosis

Answer 16

Restless - pacing etc
Hallucinations/delusions

Question 17

Where do mothers with significant mental health problems to?

Answer 17

Mother and baby units

Question 18

Target for referral for new mother mental health issue

Answer 18

2-4 weeks

Question 19

Signs of domestic abuse in pregnancy

Answer 19

Multiple DNAs
Late presentation
Multiple presentations with vague symptoms and no findings
Demeanour

Question 20

When do you have to refer for safeguarding?

Answer 20

Pregnancy or child involved
Risk of public harm eg violence, STI and not getting treatment, driving
When women involved on own get consent, if none then still alert

Question 21

What can tocophobia lead to?

Answer 21

Intense dread of children that can lead to:
Women avoiding pregnancy
Terminating an otherwise wanted pregnancy
Demanding a C section in fist or subsequent pregnancies

Question 22

Impact of tocophobia

Answer 22

May decrease chance of uncomplicated vaginal delivery May preduct postntala depression Psychological input beneficial - counselling/CBT Elective X section

Question 23

What is primary tocophobia?

Answer 23

Nulliparous women Transmission of fear of childbirth over generations History of sexual assault or traumatic gynaecological examination

Question 24

What is secondary tocophobia

Answer 24

Following prev traumatic delivery Occurs with depressive illness, anxiety or PTSD

Question 25

What website to use for teratogenic drug check?

Answer 25

BUMPs - Best use of medicines in pregnancy

Question 26

What can sodium valproate cause in a foetus?

Answer 26

Foetal Valproate Syndrome - FVS

Question 27

What does foetal valproate syndrome cause?

Answer 27

Birth defects Lifelong alterations to learning and behaviour Ranges from mild to serious

Question 28

Birth defects linked to exposure to sodium valproate in the womb

Answer 28

spina bifida, heart defects, cleft lip and palate, hypospadias (where the hole in the penis is in the wrong place), and abnormalities of the finger ASD, ADHD

Question 29

When is most risky time to take teratogenic drug in prengnanxy?

Answer 29

First 12 weeks - internal organs form Any stagenfor neurological comps incl learning and behavioural chages

Question 30

Can you cannulate pregnant women in emergency situations with severe needle phobia?

Answer 30

Yes - deemed not to have capacity as needle phobia dominating thinking - amounts to involuntary compulsion therefore should not be prevented from safe delivery because of this. Most of the time patient is too unwell to consent anyway.