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Y5 > OB > Flashcards

OB Flashcards

1
Q

Congenital Rubella Triad

A

Congenital Heart Disease
Cataract
Deafness

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2
Q

Extent of Damage In Rubella

A

First Trimester - Severe Damage
11 - 20 Weeks - Deafness Risk Only
20+ Weeks - Minimal Damage Risk

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3
Q

Slapped Cheek / Fifth Disease Caused By

A

Parvovirus B19

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4
Q

Most Common Congenital Infection

A

Cytomegalovirus

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5
Q

Fetal Varicella Syndrome (4)

A

Dermatomal Skin Scarring
Eye Defects
Limb Hypoplasia
Neurologic Abnormalities

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6
Q

Congenital Toxoplasmosis Triad

A

Intracranial Calcification
Hydrocephalus
Choroidoretinitis

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7
Q

Ophthalmia Neonatorum Management

A

Resolves Spontaneously

Saline / Water Only

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8
Q

Gonococcal Neonatal Conjunctivitis Presentation

A

Within 5 Days

Purulent Discharge

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9
Q

Chlamydial Neonatal Conjunctivitis Presentation

A

6 - 14 Days After

Mucopurulent

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10
Q

Gonococcal Neonatal Conjunctivitis Diagnosis & Treatment

A

Microscopy + Culture

Cefotaxime

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11
Q

Chlamydial Neonatal Conjunctivitis Diagnosis & Treatment

A

NAAT

Erythromycin / tetracycline

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12
Q

Umbilical Granuloma Management

A

Silver Nitrate

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13
Q

Sepsis

A

Infection + Systemic Manifestations of Infection

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14
Q

Severe Sepsis

A

Sepsis + Organ Dysfunction / Tissue Hypoperfusion

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15
Q

Septic Shock

A

Hypoperfusion despite adequate Fluid Replacement

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16
Q

Butterfly Pigmentation of Face

A

Chloasma Gravidarum

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17
Q

Urinary Changes In Pregnancy (2)

A

Dilation of Ureters (Estrogen Effect)
Increase in Micturition Frequency
(Due to pressure of uterus on Bladder)

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18
Q

GIT Changes in Pregnancy

A 
Emesis
Ptyalism (Increased Salivation)
Heart Burn (Relaxation of Sphincter)
Reduced Gut Motility / Constipation
Gall Bladder Relaxation (Stone Formation)
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19
Q

Hematological Changes In Pregnancy

A

Increase in Clotting Factors 5/8/10 / Fibrinogen
Protein C Resistance
Reduced Protein S
Venous Stasis

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20
Q

Gestational Hypertension

A

Hypertension Only Occurring < 20 Weeks

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21
Q

Preeclampsia

A

Hypertension + Proteinuria >20 Weeks

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22
Q

Eclampsia

A

Preeclampsia + Seizures

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23
Q

Chronic Hypertension

A

HT Diagnosed Before Pregnancy or <20 Weeks

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24
Q

Superimposed PE

A

Preeclampsia + Chronic HTN

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25
Q

Hypertension in Pregnancy Values

A

> 140 / 90 (HTN)

> 160 / 110 (Severe)

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26
Q

HTN Prevention in High Risk Women

A

Aspirin 75-150

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27
Q

PE Proteinuria

A

> 0.3g in 24 Hours
1+ UA
0.3 Protein / Creatinine

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28
Q

What is given in Eclampsia to stop fit?

A

Magnesium Sulphate

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29
Q

Fetus Management in Eclampsia

A

Deliver once Mother Stabilized

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30
Q

Thunderclap headache is Associated with

A

Sub Arachnoid Hemorrhage

Reversible Cerebral Vasoconstriction Syndrome

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31
Q

Reversible Cerebral Vasoconstriction Syndrome

A

Multifocal Arterial Constriction + Dilation Post Partum

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32
Q

RCVS Symptoms

A 
Nausea 
Photophobia
Confusion
Blurred Vision
Thunderclap
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33
Q

RCVS Treatment

A

Calcium Channel Blockers
Corticosteroids
Magnesium Sulfate

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34
Q

Infants of HBsAg+ Mothers Precautions

A

HBIG + First Dose of Vaccine 0/1/6 Months within 12 Hours of Birth

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35
Q

Which Hepatitis B Marker Indicates Infection

A

HBsAg
(Surface Antigen)
(Acute or Chronic Infection)

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36
Q

What is given to Pregnant Mothers with HBsAg

A

Tenofovir
(28th Week - Birth)
(To Prevent Mother-Child Transmission)

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37
Q

First Trimester HG Cutoff

A

110

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38
Q

Second / Third Trimester HG Cutoff

A

105

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39
Q

Postpartum HG Cutoff

A

100

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40
Q

Aspirin Preeclampsia Prophylaxis

A

75mg 12 Weeks till Delivery

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41
Q

Preeclampsia First Line

A

Labetalol

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42
Q

PE First Line (Asthmatic)

A

Nifedepine

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43
Q

When is external cephalic version Offered To Breech Position Babies ?

A

36 Weeks

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44
Q

Intrahepatic Cholestasis of Pregnancy Management

A

Ursodeoxycholic Acid For Symptoms

Induction of Labor at 37/38 Weeks (Due to increased risk of stillbirth)

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45
Q

Greatest RF of Prolapsed Cord

A

Artificial Rupture Of Membranes

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46
Q

Why is first baby unaffected if RH+

A

First Baby IgM Produced

Second Baby IgG Produced which cross Placenta

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47
Q

Congenital Hemolytic Anemia

A

Hemolysis that results in Fetal Anemia Two Weeks After Birth

Also Called Erythroblastosis Fetalis

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48
Q

Icterus Gravis Neonatorum

A

Baby is anemic but not jaundiced
Hepatosplenomegaly
Kernicterus develops if Bilirubin exceeds 20

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49
Q

Hydrops Fetalis

A

Intrauterine Fetal Death

Severe Hemolytic Anemia that leads to HF

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50
Q

Function of Direct Coombs Test

A

Detects Antibodies absorbed to RBC

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51
Q

Glycoprotein Produced by Yolk Sac + Fetal Liver

A

AFP

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52
Q

Increased AFP Indicates

A

NTDs

Turner

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53
Q

Decreased AFP Indicates

A

T21

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54
Q

Increase in HCG Indicates (Disease)

A

Trisomy 21

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55
Q

PAPP-A Level in Downs Syndrome

A

Decreased

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56
Q

Estriol Level in Downs Syndrome

A

Decreased

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57
Q

What is the Double Marker Test

A

hCG + PAPP-A

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58
Q

When is the Combined Test Performed?

A

11-13 Weeks

59
Q

Downs Syndrome Markers

A

Increased Nuchal Translucency
Reduced PAPP-A
Increased hCG

60
Q

What is considered Increased Nuchal Translucency

A

Greater than 3.0mm

61
Q

Combined Test vs Triple Marker Test

A 
Combined (NT / PAPP-A / hCG)
Triple Marker (AFP / hCG / UE3)
62
Q

When are Anomaly Scans done?

A

1st (11-13 Weeks)

2nd (18-22 Weeks))

63
Q

When can CVS be Done?

A

11 Weeks

64
Q

When can Amniocentesis be done?

A

14-16 Weeks

65
Q

When can Cordocentesis be perfomed?

A

20 Weeks

66
Q

Folic Acid Recommendation for Epileptic Mothers

A

5 mg Daily (Preconception - 12 Weeks)

67
Q

Vitamin K Recommendations Epileptic Mothers

A 
20mg Orally (36 Weeks - Delivery)
1mg (IM at Birth)
68
Q

Effect of Antiepileptic Medication on POP?

A

Reduces efficacy

Double Dose

69
Q

Effect of AEDs on Depo-Provera

A

Reduce interval from 12 to 10 Weeks

70
Q

Management of Preterm Delivery in Woman Who takes AEDs

A

Double Steroid Dose (25 - 48mg)

Commence Vitamin K (20mg)

71
Q

How are fits in Labor Managed?

A

IV Diazepam 10-20mg

72
Q

Side Effect of Carbamazepine

A

Interferes with Folate Metabolism

Take 5mg Folic Acid

73
Q

Which Coagulation Factors Increase in Pregnancy

A

VII / VIII / IX / X

7 / 8 / 9 / 10

74
Q

Which Imaging Tool is used to evaluate DVT in pregnant women

A

Compression Venous US

75
Q

Management according to VTE Scoring

A

Admitted Pregnant - LMWH
2 - LMWH 10 Days Post Partum at least
3 - LMWH 28 Weeks till 6 Weeks Post Natal
4+ - LMWH Antenatal Period + 6 Weeks Post

76
Q

Definitive Diagnosis of Pulmonary Embolism

A

VQ Scan
Or
Pulmonary Angiography

77
Q

Diagnosis of Antiphospholipid Syndrome

A

Thrombosis
Unexplained Death 10 Weeks
1+ Preterm Births <34 Weeks

ACA antibody
B2 GP Antibody
C Lupus Anticoagulant

78
Q

Antepartum Management APS

A

24 Urine Collection
Maternal Echo (Rule Out Endocarditis)
LFT (Biliary Cirrhosis / Budd Chiari / HELLP)

79
Q

Anticoagulation Therapy

A

Low Dose Aspirin

LMWH (Switch to Unfractionated at 36 Weeks)

80
Q

Asymptomatic Bacteriuria of Pregnancy Management

A

Ampicillin (10 Days Course)

81
Q

Most Common MO in Pyelonephritis in Pregnancy

A

E Coli

82
Q

Pyelonephritis Management

A

Ampicillin

83
Q

Cystitis Management

A

Nitrofurantoin 100mg Nightly
Or
Cephalexin 250-500mg Nightly

84
Q

Dichorionic / Diamniotic Split

A

2 Days

85
Q

monochorionic/diamniotic

placentation

A

3-8 Days

86
Q

monochorionic/monoamniotic

placentation

A

9-12 Days

87
Q

Conjoined Twins

A

12 Days

88
Q

Twin-to-twin transfusion syndrome Treatment

A

IU Laser Ablation

89
Q

When to Offer Birth
d-d
m-d
m-m

A

D-D 37 Weeks
M-D 36 Weeks
M-M 32-34 Weeks

90
Q

M-M Delivery

A

C Section Only

91
Q

Mode of Delivery in DD & MD

A

C Section Unless
(First Twin Cephalic
No Significant Size Difference
No Contraindications)

92
Q

Mode of Delivery MM

A

C Section Only

93
Q

How is Amniotic Fluid Volume Assessed

A

Single Deepest Pocket

4 Quadrant Method

94
Q

Single Pocket Measurement

A

Below 2 Oligohydramnios

Over 8 Polyhydramnios

95
Q

Amniotic Fluid Index

A

Less than 5 Oligohydramnios

More than 25 Polyhydramnios

96
Q

Polyhydramnios

A

AFI Greater than 25

Pocket Greater than 8

97
Q

Fetal Factors in Oligohydramnios

A 
Malformations / Anatomic Anomalies
Fetal Anemia
Multiple Pregnancies
Infections
Idiopathic
98
Q

Treatment options Oligohydramnios

A

Majority - No Intervention Required
Amnioreduction (Therapeutic Amniocentesis)
Pharmacological Treatment (Indomethacin)

99
Q

Pharmacologic Treatment of Polyhydramnios

A

Indomethacin (After 32 Weeks)

100
Q

Oligohydramnios

A

Vertical Fluid Pocket - Less than 2

AFI Less than 5cm

101
Q

Oligohydramnios Treatment

A

Maternal Hydration

Amnioinfusion

102
Q

Define Preterm Birth

A

Birth before 37 Weeks

103
Q

When does a fetus become viable

A

24 Weeks

104
Q

Placenta Accreta

A

Placenta Attaches too firmly to Uterus

105
Q

Placenta Increta

A

Placenta Attaches deeply into Muscle Wall of Uterus

106
Q

Placenta Percreta

A

Placenta attaches and grows through uterus

Can be to near organs

107
Q

Vasa Previa management

A

Planned Cesarian Delivery 34-36 Weeks

CS for Lung Maturity 32 Weeks

108
Q

Placenta Delivery

A

12-30 Cotyledons
2 membranes
2 Arteries + 1 Vein
Cord Insertion

109
Q

When is ECV offered ?

A

36 Weeks

110
Q

Early detection of Ectopic Pregnancy

A

5 - 8 Weeks

111
Q

When can a gestational sac be detected

A

4/5 Weeks

112
Q

When can Yolk Sac be seen

A

5 Weeks

113
Q

When can Fetal Pole be seen

A

6/7 Weeks

114
Q

When could cardiac activity be detected

A

6/7 Weeks

115
Q

Oxytocin Challenge Test

A

Monitor Fetal HR Changes on CTG in response to Oxytocin

Rarely used nowadays

116
Q

OCT Interpretation

A

Positive - Decelerations after Uterine Contractions

Negative - No FHR Changes

117
Q

Drugs to induce ovulation

A

Clomiphene Citrate
Tamoxifen
Letrozole

118
Q

Clomiphene Citrate method of action

A

Similar to estrogen

Increases GnRH - Increasing FSH - Increasing Estrogen - Increasing LH - Leading to ovulation

119
Q

Pituitary Gonadotrophins for induction of ovulation

A

HMG (75 FSH + 75 LH)

120
Q

Ovarian Hyperstimulation

A

Clomiphene Citrate - Grade 1/2

Pituitary Gonadotrophins - Grade 3/4

121
Q

hCG for ovulation induction method of action

A

Strong LH action - Surge - Ovulation

2 Ampoules 5000IU IM

122
Q

Adjuvant drugs to assist ovulation induction

A

Bromocryptine - Hyperprolactinemia
Metformin - Insulin Resistance
Eltroxin - Hypothyroidism
CS - Addisons / PCOS

123
Q

When is ovarian drilling done?

A

Cases requiring large HMG doses

Cases that respond with severe OHSS

124
Q

Define secondary infertility

A

6/12 Months - Ectopic / Abortion

1/2 Years - Term Birth

125
Q

Abnormal semen analysis management

A

Confirm after three months

126
Q

Severe abnormality

A

Repeat as soon as possible

127
Q

Erectile Dysfunction 1st Line

A

PDE5 Inhibitors
or
Vacuum Devices

128
Q

Erectile dysfunction 2nd line

A

Intracavernous injections

Intraurethral alprostadil

129
Q

Erectile Dysfunction 3rd Line

A

Penile Prosthesis implantation

130
Q

Primary Syphilis

A

Genital / Mouth Ulcer

131
Q

Secondary Syphilis

A

Rash / Constitutional Symptoms / Lymphadenopathy

132
Q

How to screen for syphilis

A

Specific / Treponemal Test

133
Q

Syphilis Treatment

A

Penicillin / Doxycyline

134
Q

Syphilis Transmission

A

Mucosal Lesions
Oral / Vaginal / Anal
Even with condoms

135
Q

Describe Syphilis Rash

A

Macular or Papular

Not Itchy

136
Q

Tertiary Syphilis

A

Neuro
Cardio
Gummata - Necrotic Skin / Bone

137
Q

Syphilis Direct Test

A

Treponema Pallidum PCR

138
Q

Syphilis Screening Test and Confirmatory Test

A

Screening Test - EIA Enzyme Immunosorbent Assay

Confirmatory Test - TPPA - Particle Agglutination Assay

139
Q

What are the treponemal tests

A

TPPA

EIA

140
Q

Non treponemal tests

A

RPR / VDRL

141
Q

Syphilis Stages

A

Primary - Highly Infectious Chancre
Secondary - MP Rash
Latent - +ve Test / No Signs
Tertiary - Neuro / Cardio / Gummas

142
Q

Definitive Syphilis Diagnostic Test

A

Dark Field Microscopy - Spirochetes

143
Q

Syphilis Serology

A

EIA - 14/21 Days
TPPA - 21/28 Days
RPR - 28 Days

144
Q

Treponema Pallidum PCR

A

Highly Sensitive / Specific

Positive Test = Early Syphilis

Y5 (6 decks)

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