Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

reproduction > obsterics > Flashcards

obsterics Flashcards

1
Q

combined test for down syndrome done when

and quadruple test done

A

10-14 weeks

14-20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

combined test
triple test
quadruple test

A

hCG+PAPP-A(high #hCG, low pappa)
hCG+APF+uncong oestriol
hCG+APF+uncong oestriol+ inhibin A(uncong low, low AFP, high hCG, high inhibin A )
thickened nuchal translucency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

maternal group B strep(GBS) is a risk factor for neonatal sepsis

A

observe the baby for 24hrs if more than two risk factors empirical antibiotic treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

antibiotic of choice for GBS prophylaxis

A

benzylpenicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

antidiabetic safe for breastfeeding

A

metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

testing for gestational diabetes

A

if had before OGTT at booking repeat at 24-28 weeks

normally at 24-28 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

antidepressant of choice in postnatal depression

A

sertraline or paroxetine since low milk plasma ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

antihypertensive of choice for pre-eclampsia

A

oral labetalol or nifedipine/hydralazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when and how much aspirin is given to women with a risk of preeclampsia

A

moderate risk at 12 weeks start 75mg OD until birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the most common cause of mastitis

A

staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

a first-line antibiotic for mastitis

A

oral flucloxacillin for 10-14 days if penicillin-allergic give erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

the standard dose of folic acid

A

0.4mg(400mcg) preconception until 13 weeks pf pregancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

women with a higher risk of neural tube defect(NTD)

A 
take 5mg of folic acid 
risk factors include- 
previous NTD 
DM
on antiepileptic 
obese 
HIV +ve 
sickle cell/thalasemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

layers cut through for lower segment c section

A

ant. rectus sheath- rectus abdominis muscles- tranversalis fascia- extraperitoneal connective tissue- peritonium- uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

indication for forceps delivery

A

fetal distress
maternal distress
failure to progress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

the requirement for forceps delivery

A 
FORCEPS nmumonic 
F-ully dialted cervix
O-A position 
R-uptured membranes
C-ephalic presenation 
E-ngaded presenting parts
P-ain relief 
S-hincter(bladder empty )
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

puerperal pyrexia definition

A

temp >38c in first 14 days following delivery
cause by endometritis
tx iv clindamycin and gentamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

McRoberts maneuver with suprapubic pressure

A

flexion and abduction of maternal hips increases AP angle of pelvis indicated in shoulder dystocia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

station

A

head in relation to ischial spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

bishops score used for

A

assessment to see if induction of labor is required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

painless vaginal bleed after 20 weeks

OE non tender uterus, high presenting part and abnormal fetal lie

A

placenta previa

routine US scan at 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

chorioamnionitis

A

potentially a life-threatening emergency
result of bacterial infection of amniotic fluid/membranes/placenta
risk factor preterm premature rupture of membranes
tx prompt deliver and iv antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

risk for VTE in pregnancy

A

give LWMH antenatally and postnatally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

postnatal depression assessment tool

A

Edinburgh scale or PHQ9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

hCG

A

secreted by syncytiotrophoblasts maintains productions of progesterone by corpus luteum and itsmaintainance and detected on day 8 in maternal blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Spontaneous abortion

A

Threatened miscarriage - painless vaginal bleeding typically around 6-9 weeks
Missed (delayed) miscarriage - light vaginal bleeding and symptoms of pregnancy disappear
Inevitable miscarriage - complete or incomplete depending or whether all fetal and placental tissue has been expelled.
Incomplete miscarriage - heavy bleeding and crampy, lower abdo pain.
Complete miscarriage - little bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Ectopic pregnancy

A

Typically history of 6-8 weeks amenorrhoea with lower abdominal pain (usually unilateral) initially and vaginal bleeding later. Shoulder tip pain and cervical excitation may be present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Hydatidiform mole or molar pregnancy

A

Typically bleeding in first or early second trimester associated with exaggerated symptoms of pregnancy e.g. hyperemesis. The uterus may be large for dates and serum hCG is very high
on US it resembles a solid collection of echos with small anechoic spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Placental abruption

A

Constant lower sudden abdominal pain in 3rd trimester and, woman may be more shocked than is expected by visible blood loss/blood loss not necessary. Tender, tense uterus* with normal lie and presentation. Fetal heart may be distressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Placenta praevia

A

Vaginal bleeding, no pain. Non-tender uterus* but lie and presentation may be abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Vasa praevia

A

Triad- Rupture of membranes followed immediately by painless vaginal bleeding. Fetal bradycardia is classically seen
fetal blood vessel cross or run near internal orifice of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

diagnosis for hyperemesis gravidarum

A

5% pre-pregnancy weight loss and dehydration and electrolyte imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

first line treatment for hyperemesis

A

antihistamines

cyclizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

substance abuse in pregnancy

A 
Smoking	
Increased risk of miscarriage 
Increased risk of pre-term labour
Increased risk of stillbirth
IUGR
Increased risk of sudden unexpected death in infancy
Alcohol	
Fetal alcohol syndrome (FAS)
learning difficulties
characteristic facies: smooth philtrum, thin vermilion, small palpebral fissures
IUGR & postnatal restricted growth
microcephaly

Binge drinking is a major risk factor for FAS

Cannabis
Similar to smoking risks due to tobacco content

Cocaine
Maternal risks
hypertension in pregnancy including pre-eclampsia
placental abruption

Fetal risk
prematurity
neonatal abstinence syndrome
Heroin	
Risk of neonatal abstinence syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

pregnancy safe antiepileptic

A

lamotrigine at low doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

UTI drug safe in pregnancy

A

nitrofurantoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

cause of PPH

A

atony of uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

when should EVC be offered

A

at 36 weeks for nulliparous

at 37 weeks for multiparous

39
Q

initial management of primary PPH

A

give oxytocin 10 units or syntometrine or egomertine 500 microgms
IM carboprost

40
Q

placental abruption

A 
seperation fo normal sited placenta from the uterine wall 
clinical feautures 
shock 
pain 
woody uterus/firm
tender and tensed uterus
blood seen is dark red
41
Q

lochia

A

Lochia may be defined as the vaginal discharge containing blood mucous and uterine tissue which may continue for 6 weeks after childbirth

42
Q

degree of perineal tear

A

first degree: superficial damage with no muscle involvement
second degree: injury to the perineal muscle, but not involving the anal sphincter
third degree: injury to perineum involving the anal sphincter complex (external anal sphincter, EAS and internal anal sphincter, IAS):
3a: less than 50% of EAS thickness torn
3b: more than 50% of EAS thickness torn
3c: IAS torn
fourth degree: injury to perineum involving the anal sphincter complex (EAS and
IAS) and rectal mucosa

43
Q

the main cause of chord prolapse

A

artificial rupture of membranes

44
Q

anti D is given to whom?

A

Rh -ve mothers who are not sensitized at 28 and 34 weeks

45
Q

vaicella zoster exposure in pregnant women

A

give single dose varicella-zoster immunoglobulin up to 10 days after contact
aciclovir is only given 24hrs after the onset of rash in pregnant women with chickenpox

46
Q

management of preterm prelabour rupture of membranes

A 
admission 
observation 
oral erythromycin to prevent infection 
antenatal corticosteroids dexamethasone  to reduce respiratory distress syndrome 
consider delivery at 34 weeks
47
Q

antenatal care timetable

A

8 - 12 weeks (ideally < 10 weeks)
Booking visit
general information e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
BP, urine dipstick, check BMI
Booking bloods/urine
FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies
hepatitis B, syphilis
HIV test is offered to all women
urine culture to detect asymptomatic bacteriuria

10 - 13+6 weeks
Early scan to confirm dates, exclude multiple pregnancies

11 - 13+6 weeks
Down’s syndrome screening including nuchal scan

16 weeks
Information on the anomaly and the blood results. If Hb < 11 g/dl consider iron
Routine care: BP and urine dipstick

18 - 20+6 weeks
Anomaly scan

25 weeks (only if primip)
	Routine care: BP, urine dipstick, symphysis-fundal height (SFH)

28 weeks
Routine care: BP, urine dipstick, SFH
Second screen for anemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron
First dose of anti-D prophylaxis to rhesus negative women

31 weeks (only if primip)
	Routine care as above

34 weeks
Routine care as above
Second dose of anti-D prophylaxis to rhesus negative women*
Information on labour and birth plan

36 weeks
Routine care as above
Check presentation - offer external cephalic version if indicated
Information on breast feeding, vitamin K, ‘baby-blues’

38 weeks
Routine care as above

40 weeks (only if primip)
	Routine care as above
Discussion about options for prolonged pregnancy

41 weeks
Routine care as above
Discuss labour plans and possibility of induction

48
Q

hep b in pregnancy

A

all women should be screened
safe for breastfeeding
babies born to hep b mothers should be given complete course of vaccination and immunoglobulin

49
Q

absolute contraindication of induction of labour and vaginal birth

A

previous classical c-section

50
Q

methods of induction of labour

A

membrane sweep
intravaginal prostaglandins
breaking of water
oxytocin

51
Q

what reduces the risk of hyperemesis

A

smoking

52
Q

woodscrew maneuver can be best described as

A

putting a hand in the vagina and rotating the fetus 180o to dislodge anterior shoulder from symphysis pubis

53
Q

most common cause of fever in newborn infant

A

group B strep

54
Q

lisinopril should be avoided in preeclampsia

A

because it is feto toxic

55
Q

management of chord prolapse

A

push back presenting part of fetus
tocolytics
instrumental vaginal delivery possible
c-section

56
Q

clinical features of cholestasis in pregnancy

A 
itching
jaundice 
obstructive LFT
normal WBCs 
no evidence of coagulopathy
57
Q

women with abdominal trauma during pregnancy

A

should get ABO and Rhesus because Rh -ve women should be given anti D

58
Q

The following drugs can be given to mothers who are breastfeeding:

A

antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin

59
Q

The following drugs should be avoided:

A 
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone
60
Q

avoid liver in antenatal diet

A

cause it contains vitamin A which is a teratogen

61
Q

Conditions which all pregnant women should be offered screening

A 
Anaemia
Bacteriuria
Blood group, Rhesus status and anti-red cell antibodies
Down's syndrome
Fetal anomalies
Hepatitis B
HIV
Neural tube defects
Risk factors for pre-eclampsia
Rubella immunity
Syphilis

The following should be offered depending on the history:

Placenta praevia
Psychiatric illness
Sickle cell disease
Tay-Sachs disease
Thalassaemia
62
Q

Conditions for which screening should not be offered

A 
Bacterial vaginosis
Chlamydia
Cytomegalovirus
Fragile X
Hepatitis C
Group B Streptococcus
Toxoplasmosis
63
Q

do not perform ECV if

A

have ruptured during active labour and membrane

64
Q

medication used to suppress lactation

A

cabergoline

65
Q

NICE recommendation for CTG monitering when

A 
suspected chorioamnionitis or sepsis
severe hypertension 160/110
oxytocin use
meconium 
fresh vaginal bleeding develops in labour- a sign of placental rupture or previa
66
Q

metoclopramide is prescribed with caution

A

because it can have extrapyramidal side effects in young women

67
Q

erbs palsy (waiters tip)

A

due to upper brachial plexus damage caused by shoulder dystocia
characteristic adduction and internal rotation of arm and pronation of forearm

68
Q

klumpke palsy

A

is due to damage to the lower brachial plexus leading to claw hand appearance

69
Q

the highest risk of neonatal hemorrhage

A

prolonged ventouse delivery

70
Q

Risk of prematurity

A 
increased mortality depends on gestation
respiratory distress syndrome
intraventricular haemorrhage
necrotizing enterocolitis
chronic lung disease, hypothermia, feeding problems, infection, jaundice
retinopathy of newborn, hearing problems
71
Q

AFP levels indiacte

A

raised in Neural Tube defects, abdominal wall defects and multiple pregnancies
decreased in Down syndrome, trisomy 18 maternal diabetes, edwards syndrome

72
Q

Distinguishing placental abruption from praevia

Placental abruption
shock out of keeping with visible loss
pain constant
tender, tense uterus*
normal lie and presentation
fetal heart: absent/distressed
coagulation problems
beware pre-eclampsia, DIC, anuria
A 
Placenta praevia
shock in proportion to visible loss
no pain
uterus not tender*
lie and presentation may be abnormal
fetal heart usually normal
coagulation problems rare
small bleeds before large
73
Q

rubella not routinely screened in booking visit

A

so contact health protection unit in all rubella related cases

74
Q

abdominal pain in early pregnacy

A

Ectopic pregnancy
This is the single most important cause of abdominal pain to exclude in early pregnancy

0.5% of all pregnancies are ectopic

Risk factors (anything slowing the ovum’s passage to the uterus)
damage to tubes (salpingitis, surgery)
previous ectopic
IVF (3% of pregnancies are ectopic)

A typical history is a female with a history of 6-8 weeks amenorrhoea who presents with lower abdominal pain and later develops vaginal bleeding
lower abdominal pain: typically the first symptom. Pain is usually constant and may be unilateral. Due to tubal spasm
vaginal bleeding: usually less than a normal period, may be dark brown in colour
history of recent amenorrhoea: typically 6-8 weeks from start of last period; if longer (e.g. 10 wks) this suggest another causes e.g. inevitable abortion
peritoneal bleeding can cause shoulder tip pain and pain on defecation / urination

Miscarriage
	Threatened miscarriage
painless vaginal bleeding occurring before 24 weeks, but typically occurs at 6 - 9 weeks
cervical os is closed
complicates up to 25% of all pregnancies

Missed (delayed) miscarriage
a gestational sac which contains a dead fetus before 20 weeks without the symptoms of expulsion
mother may have light vaginal bleeding / discharge and the symptoms of pregnancy which disappear
when the gestational sac is > 25 mm and no embryonic/fetal part can be seen it is sometimes described as a ‘blighted ovum’ or ‘anembryonic pregnancy’

Inevitable miscarriage
cervical os is open
heavy bleeding with clots and pain

Incomplete miscarriage
not all products of conception have been expelled

75
Q

abdominal pain in late pregnancy

A

Labour Regular tightening of the abdomen which may be painful in the later stages
Placental abruption Placental abruption describes the separation of a normally sited placenta from the uterine wall, resulting in maternal hemorrhage into the intervening space

Occurs in approximately 1/200 pregnancies

Clinical features
shock out of keeping with visible loss
pain constant
tender, tense uterus
normal lie and presentation
fetal heart: absent/distressed
coagulation problems
beware pre-eclampsia, DIC, anuria
Symphysis pubis dysfunction Ligament laxity increases in response to hormonal changes of pregnancy
Pain over the pubic symphysis with radiation to the groins and the medial aspects of the thighs. A waddling gait may be seen
Pre-eclampsia/HELLP syndrome Associated with hypertension, proteinuria. Patients with HELLP also have haemolysis, elevated liver enzymes and a low platelet count.

The pain is typically epigastric or in the RUQ
Uterine rupture Ruptures usually occur during labour but occur in third trimester
Risk factors: previous caesarean section
Presents with maternal shock, abdominal pain and vaginal bleeding to varying degree

76
Q

abdominal pain at any point in the pregnancy

A

Appendicitis
most common non-obstetric surgical emergency
Higher morbidity and mortality in pregnancy
Location of pain changes depending on gestation, moving up from the RLQ in the first trimester to the umbilicus in the second and the RUQ in the third
Urinary tract infection (UTI) 1 in 25 women develop in UTI in pregnancy
Associated with an increased risk of pre-term delivery and IUGR

77
Q

blood sugar testing for type I diabetic pregnancy women

A

daily fasting, premeal, 1 hr post-meal and bedtime measurement

78
Q

intrahepatic cholestasis of pregnancy

A

ictching with jaundice

79
Q

increased nuchal translucency seen in

A

down syndrome,
congenital heart defects
abdominal wall defects

80
Q

Sheehan syndrome

A

a complication of severe PPH causing ischemic necrosis of pituitary gland leading to
lack of postpartum milk production and amenorrhea

81
Q

calcium gluconate used to treat

A

Magnesium sulfate induced respiratory depression

82
Q

ergometrine

A

avoided in hypertension

83
Q

amniotic fluid embolism

A

this is when fetal cells/amniotic fluid enters mothers bloodstream occurs 30mins after labour
SS- respiratory distress, hypoxia, hypotension, cyanosis, bronchospasm, tachycardia

84
Q

vaginal prostaglandin gel used

A

to help make the cervix more favorable

85
Q

epidural analgesia is contraindicated in

A

coagulopathy

86
Q

oligohydramnios

A

condition where there is a deficiency of amniotic fluid(less than 500ml at 32-36weeks) caused by renal agenesis

87
Q

streptococcus agalacticae causes

A

GBS

gram +ve anerobic cocci

88
Q

carboprost is contraindicated in

A

asthama

89
Q

contraindicated in breastfeeding

A

lithium

90
Q

macrocytic anemia with hypersegmented neutrophils

A

folate deficiency

91
Q

MMR vaccine

A

should not be administered to womwn know to be pregnant or attempting to become pregnant for 28 days

92
Q

causes of placental abruption

A

cocain abuse (hyperreflexia and dialted pupils )
pre eclampsia
HELLP

93
Q

methotrexate is used to treat rheumatoid arthritis

A

both men and women should stop it before

reproduction (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions