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OB Flashcards

(144 cards)

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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
Hypertension in Pregnancy Values
> 140 / 90 (HTN) | > 160 / 110 (Severe)
26
HTN Prevention in High Risk Women
Aspirin 75-150
27
PE Proteinuria
> 0.3g in 24 Hours > 1+ UA > 0.3 Protein / Creatinine
28
What is given in Eclampsia to stop fit?
Magnesium Sulphate
29
Fetus Management in Eclampsia
Deliver once Mother Stabilized
30
Thunderclap headache is Associated with
Sub Arachnoid Hemorrhage | Reversible Cerebral Vasoconstriction Syndrome
31
Reversible Cerebral Vasoconstriction Syndrome
Multifocal Arterial Constriction + Dilation Post Partum
32
RCVS Symptoms
``` Nausea Photophobia Confusion Blurred Vision Thunderclap ```
33
RCVS Treatment
Calcium Channel Blockers Corticosteroids Magnesium Sulfate
34
Infants of HBsAg+ Mothers Precautions
HBIG + First Dose of Vaccine 0/1/6 Months within 12 Hours of Birth
35
Which Hepatitis B Marker Indicates Infection
HBsAg (Surface Antigen) (Acute or Chronic Infection)
36
What is given to Pregnant Mothers with HBsAg
Tenofovir (28th Week - Birth) (To Prevent Mother-Child Transmission)
37
First Trimester HG Cutoff
110
38
Second / Third Trimester HG Cutoff
105
39
Postpartum HG Cutoff
100
40
Aspirin Preeclampsia Prophylaxis
75mg 12 Weeks till Delivery
41
Preeclampsia First Line
Labetalol
42
PE First Line (Asthmatic)
Nifedepine
43
When is external cephalic version Offered To Breech Position Babies ?
36 Weeks
44
Intrahepatic Cholestasis of Pregnancy Management
Ursodeoxycholic Acid For Symptoms | Induction of Labor at 37/38 Weeks (Due to increased risk of stillbirth)
45
Greatest RF of Prolapsed Cord
Artificial Rupture Of Membranes
46
Why is first baby unaffected if RH+
First Baby IgM Produced | Second Baby IgG Produced which cross Placenta
47
Congenital Hemolytic Anemia
Hemolysis that results in Fetal Anemia Two Weeks After Birth | Also Called Erythroblastosis Fetalis
48
Icterus Gravis Neonatorum
Baby is anemic but not jaundiced Hepatosplenomegaly Kernicterus develops if Bilirubin exceeds 20
49
Hydrops Fetalis
Intrauterine Fetal Death | Severe Hemolytic Anemia that leads to HF
50
Function of Direct Coombs Test
Detects Antibodies absorbed to RBC
51
Glycoprotein Produced by Yolk Sac + Fetal Liver
AFP
52
Increased AFP Indicates
NTDs | Turner
53
Decreased AFP Indicates
T21
54
Increase in HCG Indicates (Disease)
Trisomy 21
55
PAPP-A Level in Downs Syndrome
Decreased
56
Estriol Level in Downs Syndrome
Decreased
57
What is the Double Marker Test
hCG + PAPP-A
58
When is the Combined Test Performed?
11-13 Weeks
59
Downs Syndrome Markers
Increased Nuchal Translucency Reduced PAPP-A Increased hCG
60
What is considered Increased Nuchal Translucency
Greater than 3.0mm
61
Combined Test vs Triple Marker Test
``` Combined (NT / PAPP-A / hCG) Triple Marker (AFP / hCG / UE3) ```
62
When are Anomaly Scans done?
1st (11-13 Weeks) | 2nd (18-22 Weeks))
63
When can CVS be Done?
11 Weeks
64
When can Amniocentesis be done?
14-16 Weeks
65
When can Cordocentesis be perfomed?
20 Weeks
66
Folic Acid Recommendation for Epileptic Mothers
5 mg Daily (Preconception - 12 Weeks)
67
Vitamin K Recommendations Epileptic Mothers
``` 20mg Orally (36 Weeks - Delivery) 1mg (IM at Birth) ```
68
Effect of Antiepileptic Medication on POP?
Reduces efficacy | Double Dose
69
Effect of AEDs on Depo-Provera
Reduce interval from 12 to 10 Weeks
70
Management of Preterm Delivery in Woman Who takes AEDs
Double Steroid Dose (25 - 48mg) | Commence Vitamin K (20mg)
71
How are fits in Labor Managed?
IV Diazepam 10-20mg
72
Side Effect of Carbamazepine
Interferes with Folate Metabolism | Take 5mg Folic Acid
73
Which Coagulation Factors Increase in Pregnancy
VII / VIII / IX / X | 7 / 8 / 9 / 10
74
Which Imaging Tool is used to evaluate DVT in pregnant women
Compression Venous US
75
Management according to VTE Scoring
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
Definitive Diagnosis of Pulmonary Embolism
VQ Scan Or Pulmonary Angiography
77
Diagnosis of Antiphospholipid Syndrome
Thrombosis Unexplained Death 10 Weeks 1+ Preterm Births <34 Weeks ACA antibody B2 GP Antibody C Lupus Anticoagulant
78
Antepartum Management APS
24 Urine Collection Maternal Echo (Rule Out Endocarditis) LFT (Biliary Cirrhosis / Budd Chiari / HELLP)
79
Anticoagulation Therapy
Low Dose Aspirin | LMWH (Switch to Unfractionated at 36 Weeks)
80
Asymptomatic Bacteriuria of Pregnancy Management
Ampicillin (10 Days Course)
81
Most Common MO in Pyelonephritis in Pregnancy
E Coli
82
Pyelonephritis Management
Ampicillin
83
Cystitis Management
Nitrofurantoin 100mg Nightly Or Cephalexin 250-500mg Nightly
84
Dichorionic / Diamniotic Split
2 Days
85
monochorionic/diamniotic | placentation
3-8 Days
86
monochorionic/monoamniotic | placentation
9-12 Days
87
Conjoined Twins
12 Days
88
Twin-to-twin transfusion syndrome Treatment
IU Laser Ablation
89
When to Offer Birth d-d m-d m-m
D-D 37 Weeks M-D 36 Weeks M-M 32-34 Weeks
90
M-M Delivery
C Section Only
91
Mode of Delivery in DD & MD
C Section Unless (First Twin Cephalic No Significant Size Difference No Contraindications)
92
Mode of Delivery MM
C Section Only
93
How is Amniotic Fluid Volume Assessed
Single Deepest Pocket | 4 Quadrant Method
94
Single Pocket Measurement
Below 2 Oligohydramnios | Over 8 Polyhydramnios
95
Amniotic Fluid Index
Less than 5 Oligohydramnios | More than 25 Polyhydramnios
96
Polyhydramnios
AFI Greater than 25 | Pocket Greater than 8
97
Fetal Factors in Oligohydramnios
``` Malformations / Anatomic Anomalies Fetal Anemia Multiple Pregnancies Infections Idiopathic ```
98
Treatment options Oligohydramnios
Majority - No Intervention Required Amnioreduction (Therapeutic Amniocentesis) Pharmacological Treatment (Indomethacin)
99
Pharmacologic Treatment of Polyhydramnios
Indomethacin (After 32 Weeks)
100
Oligohydramnios
Vertical Fluid Pocket - Less than 2 | AFI Less than 5cm
101
Oligohydramnios Treatment
Maternal Hydration | Amnioinfusion
102
Define Preterm Birth
Birth before 37 Weeks
103
When does a fetus become viable
24 Weeks
104
Placenta Accreta
Placenta Attaches too firmly to Uterus
105
Placenta Increta
Placenta Attaches deeply into Muscle Wall of Uterus
106
Placenta Percreta
Placenta attaches and grows through uterus | Can be to near organs
107
Vasa Previa management
Planned Cesarian Delivery 34-36 Weeks | CS for Lung Maturity 32 Weeks
108
Placenta Delivery
12-30 Cotyledons 2 membranes 2 Arteries + 1 Vein Cord Insertion
109
When is ECV offered ?
36 Weeks
110
Early detection of Ectopic Pregnancy
5 - 8 Weeks
111
When can a gestational sac be detected
4/5 Weeks
112
When can Yolk Sac be seen
5 Weeks
113
When can Fetal Pole be seen
6/7 Weeks
114
When could cardiac activity be detected
6/7 Weeks
115
Oxytocin Challenge Test
Monitor Fetal HR Changes on CTG in response to Oxytocin | Rarely used nowadays
116
OCT Interpretation
Positive - Decelerations after Uterine Contractions | Negative - No FHR Changes
117
Drugs to induce ovulation
Clomiphene Citrate Tamoxifen Letrozole
118
Clomiphene Citrate method of action
Similar to estrogen | Increases GnRH - Increasing FSH - Increasing Estrogen - Increasing LH - Leading to ovulation
119
Pituitary Gonadotrophins for induction of ovulation
HMG (75 FSH + 75 LH)
120
Ovarian Hyperstimulation
Clomiphene Citrate - Grade 1/2 | Pituitary Gonadotrophins - Grade 3/4
121
hCG for ovulation induction method of action
Strong LH action - Surge - Ovulation | 2 Ampoules 5000IU IM
122
Adjuvant drugs to assist ovulation induction
Bromocryptine - Hyperprolactinemia Metformin - Insulin Resistance Eltroxin - Hypothyroidism CS - Addisons / PCOS
123
When is ovarian drilling done?
Cases requiring large HMG doses | Cases that respond with severe OHSS
124
Define secondary infertility
6/12 Months - Ectopic / Abortion | 1/2 Years - Term Birth
125
Abnormal semen analysis management
Confirm after three months
126
Severe abnormality
Repeat as soon as possible
127
Erectile Dysfunction 1st Line
PDE5 Inhibitors or Vacuum Devices
128
Erectile dysfunction 2nd line
Intracavernous injections | Intraurethral alprostadil
129
Erectile Dysfunction 3rd Line
Penile Prosthesis implantation
130
Primary Syphilis
Genital / Mouth Ulcer
131
Secondary Syphilis
Rash / Constitutional Symptoms / Lymphadenopathy
132
How to screen for syphilis
Specific / Treponemal Test
133
Syphilis Treatment
Penicillin / Doxycyline
134
Syphilis Transmission
Mucosal Lesions Oral / Vaginal / Anal Even with condoms
135
Describe Syphilis Rash
Macular or Papular | Not Itchy
136
Tertiary Syphilis
Neuro Cardio Gummata - Necrotic Skin / Bone
137
Syphilis Direct Test
Treponema Pallidum PCR
138
Syphilis Screening Test and Confirmatory Test
Screening Test - EIA Enzyme Immunosorbent Assay | Confirmatory Test - TPPA - Particle Agglutination Assay
139
What are the treponemal tests
TPPA | EIA
140
Non treponemal tests
RPR / VDRL
141
Syphilis Stages
Primary - Highly Infectious Chancre Secondary - MP Rash Latent - +ve Test / No Signs Tertiary - Neuro / Cardio / Gummas
142
Definitive Syphilis Diagnostic Test
Dark Field Microscopy - Spirochetes
143
Syphilis Serology
EIA - 14/21 Days TPPA - 21/28 Days RPR - 28 Days
144
Treponema Pallidum PCR
Highly Sensitive / Specific | Positive Test = Early Syphilis

Y5 (6 decks)

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