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O&G Flashcards

(74 cards)

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1
Q

18 weeks ultrasound

A

Anatomy screen

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2
Q

18 weeks ultrasound

A

Anatomy screen

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3
Q

Normal fetal heart rate

A

110 to 160 bpm

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4
Q

Miscarriage definition

A

Loss of pregnancy before 20 weeks

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5
Q

BHCG pattern before 9 weeks

A

SHould double every 48 hours

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6
Q

BHCG after 9 weeks

A

Should plateau (hence not a good marker of fetal growth)

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7
Q

Causes of abnormally high BHCG

A
  • Incorrect dates
  • Molar pregnancy
  • Twins
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8
Q

Implantation bleed

A

Light

10 days into pregnancy

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9
Q

Causes of abnormally low BHCG

A

Wrong dates
miscarriage
ectopic
(repeat after 48 hours)

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10
Q

Fetal heart beat should be seen by what gestation

A

7 weeks

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11
Q

Differntial diagnosis for PV bleeding in pregnancy

A
  • Ectropion
  • Polyps
  • Infecton
  • Cancer
  • intercourse over last 24 hours
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12
Q

Investigations for early pregnancy bleeding

A

BHCG

USS

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13
Q

Threatened miscarriage Features

A 
mild PVB
no pain
Closed cx 
Normal BHCG
Normal USS
Reassure and RhD test
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14
Q

Missed miscarriage definition

A 
Mild to moderate PVB
variable pain
closed cx
low BHCG
Small or absent CRL
absent fHR
abnormal irregular gestation sac
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15
Q

Missed miscarriage management

A

Conservative
Medical: misoprostol loading dose
Surgical: D+C
RhD test

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16
Q

Incomplete miscarriage definition

A 
Heavy bleeding with PVB
Severe pain 
Open cx with clots and blood
Low BHCG
Blood, clots and placenta on USS
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17
Q

Incomplete miscarriage management

A 
ABCDs/resus
Surgical evacuation
Mesoprostol
remove tissue
RhD status
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18
Q

Complete miscarriage definition

A 
Heavy PVB which settles
Severe pain which settles
Open cx
Low BHCG
empty uterus
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19
Q

Complete miscarriage management

A

Reassurance

RhD

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20
Q

Ruptured Ectopic pregnancy presentation

A 
minimal PVB
Uncomfortable/peritonitic, agonising pain
Normal cervix
Low BHCG
Empty uterus, fluid in POD, adnexal mass
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21
Q

Unruptured ectopic presentation

A 
Mild PVB
unilateral adnexl pain
normal cx
low BHCG
empty uterus, adnexal mass
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22
Q

Ectopic management

A

ABCDs/ resus
Methotrexate and confrim BHCG decline
Salpingectomy
RhD

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23
Q

Molar pregnancy findings

A 
mild PVB
Pain
Closed cx
very high BHCG
honey comb or snow storm appearance of uterine cavity
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24
Q

Molar pregnancy management

A

Surgica;: suction and curretage
Follow up BHCG till 0
Histology to determine if complete or partial mole
Can fall pregnant only after 1 year

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25
Anti D timing
After 72 hours
26
Ectopic risk factors
IUCD | Fallopian tube integrity impaired
27
Molar pregnancy definition
Proliferation of trophoblast from placenta | Increased risk of choriocarcinoma in complete mole
28
Molar pregnancy epidemiology
Asian population
29
Definition of term gestation
37 to 42.6 weeks
30
Very preterm definition
<32/40
31
Extremely preterm definition
<28/40 weeks
32
Low birth weight definition
<2.5 kg
33
Very low birth weight definition
<1.5 kg
34
Extremely low borth weight definition
<1 kg
35
Causes of SGA
``` (Maternal vascular disease) Hypertension Pre-eclampsia Smoking DM Chromosomal or congenital abnormalities TORCH infectiosn ```
36
TORCH infections
Toxoplasmosis Rubella CMV HSV
37
Definition of LGA
>90th centile
38
Causes of LGA
Diabetes Beckwith-wiedermann Large parents Hydrops fetalis
39
Short term complications of IUGR
Respiratory distress | Hypoglycemia
40
Causes of IUGR
Uteroplacental insufficiency Congenital infection Chromosomal/genetic disorders
41
Causes of symmetrical IUGR
(early) Infection Genetic disorder
42
Causes of asymmetrical IUGR
Uteroplacental insufficiency maternal malnutrition pre-eclampsia diabetes
43
Contraindications to breast feeding
Anticancer drugs
44
Definition of menorrhagia
Woman describes bleeding as heavy
45
Definition of dysmenorrhoea
Pain with periods
46
Definition of oligoenorrhoea
3-9 cycles per year, irregular, unpredictable
47
Definition of Amenorrhea
no perods for 3 weeks
48
Definition of menopause
No periods for at least 1 year
49
Jadelle
Implant goes in arm Lasts 5 years SIde effects are irregular bleeding
50
Copper IUD
Lasts 10 years | Can make period longer and heavier
51
Mirena
Lasts 5 years Progesterone: thins endothelium, stops ovulation, thickens mucus Some initial bleeding but then reduced Side effects: bloating, breast tenderness
52
Definition of Pre-eclampsia
New hypertension with multisystem effects
53
Pre-eclampsia manifestation: placenta
Fetal growth restriction
54
Pre-eclampsia manifestation: Kidney
proteinuria | Protein:Cr >30
55
Pre-eclampsia manifestation: hematological
Low platelets Heamolysis DIC
56
Pre-eclampsia manifestation: Liver
Elevated transaminases
57
Pre-eclampsia manifestation: Neuro
Headaches, hyperreflexia(3 beats of clonus), visual changes
58
Pre-eclampsia investigations
``` Repeat BP Urine: protein Cr ratio FBC Plt Group and hold Fetal USS CTG ```
59
Pre-eclampsia management
Delivery Antihypertensives: Methyldopa, Labetalol, Nifedipine MgSO4 for seizure prophylaxis
60
BP management on pregnancy
NOT ACEI or diuretics
61
HELLP definition
Haemolysis Elevated liver enzymes Low platelets
62
HELLP management
Deliver
63
Antenatal blood tests
``` Hb MCV Plt Blood group MSU: UTI, bacteuria STI HbA1c USS: confirm dates ```
64
Pregnancy recommendations
Folic acid till 14/40 | Iodine throughout and during breast feeding
65
Diabetes screening date
24 to 28 weeks
66
Downs screening
MSS1 is a T1 blood tests | 11-13/40 USS for nuchal transluscency
67
Definition of antepartum haemorhage
>20/40 till delivery
68
Causes of Antepartum haemorhage
Upper: placental abruption, placenta praviea, fibroids Lower: Cervical cancer, infection, ectropion, cervical polyps
69
Placental abruption presentation
``` PVB if revealed Pain if concelaed rigid tender uterus blood stained liquor fetal distress ```
70
Placental abruption risk factors
``` HTN smoking pre-eclampsia age > 30 previous abruption trauma multiple pregnancies cocaine use Lupus anticoagulant antiphospholipid syndrome ```
71
Placenta praevia definition
Placenta implants into lower uterus
72
Placeta praevia presentation
Painless bleeding (may be provoked by intercourse) recurrent bleeds soft non tender uterus
73
Placenta praevia risk factors
previous c-section or uterine surgery increase parity multiple pregnancy age
74
Placenta praevia management
Monitor fetal growth and deliver by c section

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