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Obstetrics > March 2015 recall > Flashcards

March 2015 recall Flashcards

1
Q

How long do you keep a CTG for?

A

25 years
If problems, indefinitely

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2
Q

Which nerve damaged- following forceps, faecal and urinary incontinence

A

Puedendal nerve (S2-S3)

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3
Q

After vaginal birth, struggling to flex hip, extend knee- which nerve damaged?

A

Femoral (L2-L4)
(this can also be damaged in an abdominal hyst due to retractor)

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4
Q

After lithotomy- foot drop and sensory loss in lateral thigh, which nerve damaged?

A

Common perineal which is a branch of sciatic nerve (L4-S3)

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5
Q

Which nerve is compressed if there is labial numbness?

A

Genito-femoral nerve (L1-L2)
Labial/ femoral triangle

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6
Q

What is the risk of having a baby affected by congenital heart disease?

A

0.8%

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7
Q

What is the risk of death for babys affected by eisenmengers syndrome?

A

25-40%

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8
Q

Which heart conditions is high risk for the mother?

A

Eisenmengers
Marfans (AD)
Peripartum cardiomyopathy
Hypertrophic cardiomyopathy (AD)
Autosomal dominant conditions, 50% that baby will have it

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9
Q

What is the histology behind pemphigoid gestationis?

A

Immune complex deposits, PG factor which is an IgG binds to the BP-180 in the basement membrane of the epidermis separating the layers and forming a blister.
Tx with topical steroids

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10
Q

What is the risk of recurrence with OC?

A

45-90%

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11
Q

How common is pemphigoid gestationis

A

1 in 50,000 pregnancies
Inc risk of SGA

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12
Q

How common is PUPPS?

A

1 in 250 pregnancies

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13
Q

What is the most common symptom in central venous thrombosis?

A

Headache

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14
Q

What is the diameter for face presentation, vertex, deflexed OP and brow presentation?

A

vertex and face- 9.5
deflexed OP- 11
brow- 13.5

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15
Q

What percentage of babies will revert to breech after ECV?

A

5%

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16
Q

How best to date pregnancy using USS?

A

Use CRL up to 84mm length, ~14 weeks
>100mm can measure HC

17
Q

What is the risk of herpes going to the baby if mum had recurrent episode?

A

0-3%

18
Q

What is the risk of herpes going to the baby if mum had primary episode?

A

41%, recommend caesarean section

19
Q

When do you give MgSo4 in PTL?

A

Definitely 24- 30 weeks
Consider 30-34 weeks

20
Q

Which maternal conditions are more common in a male fetus?

A

AFLD (3:1)
OC

21
Q

What is the anti D antibody level needed for referral to a FMU?

A

> 4 for referral
(between 4 and 15, moderate risk of HDFN, >15 severe disease)

22
Q

When to refer anti C antibody level to FMU?

A

> 7.5
(between 7.5 and 20 moderate HDFN, > 20 high risk HDFN)

23
Q

Which antiepileptic drugs need monitoring in pregnancy?

A

Lamotagine

24
Q

Which emergency contraception do you use if your patient is on an enzyme inducer eg antiepileptic?

A

Lng, 3mg (levonelle, double dose)

25
Q

Survival rates for prematurity?
22, 24, 27, 31 weeks

A

22- 10%
24- 60%
27- 89%, ~10% disability
31- 95%

26
Q

How early do you start USS in MCDA twins?

A

From 16 weeks and then every 2 weeks

27
Q

Which patients with HIV would you recommend a CS to?

A

Viral load >400
Concurrent Hep C
Not on ART
Only taking zidovudine

28
Q

Which patients with HIV would you consider CS or vaginal birth?

A

If viral load is between 50 and 399, consider options, discuss with patient, consider length of time on ART, adherence, obstetric factors

29
Q

Which HIV ART do you need to increase your folic acid dose to 5mg?

A

Dolutegravir- they need 5mg a day when trying to conceive and for first trimester
All others just need the usual 400micrograms

30
Q

For patients with HIV, if cs is being performed due to viral load and risk of vertical transmission, which gestation should this be performed?

A

38 weeks

31
Q

When is it indicated to use IV zidovudine for women with HIV?

A

Presenting in labour or planned ELCS with viral load >1000
Untreated women presenting in labour where viral load is unknown
Can ‘consider’ if viral load between 50 and 1000

Obstetrics (10 decks)

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