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Year 3 > Obstetrics > Flashcards

Obstetrics Flashcards

(56 cards)

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1
Q

Most likely cause of symmetrical growth restriction

A

prolonged period of poor intrauterine growth in early pregnancy
Down syndrome
Maternal hypothyroidism
Malnutrition

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2
Q

most likely cause of asymmetrical small for gestational age

A

placental insufficiency

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3
Q

ligament that connects the uterus to the labia majora and commonly causes pain during pregnancy by its stretch

A

round ligament
pain is sharp, intermittent in lower abdomen/ groin area

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4
Q

medical management of sever pre-eclampsia

A

labetalol

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5
Q

pathophysiology of haemolytic disease of the newborn

A

maternal IgG antibodies against fetal red blood cells

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6
Q

drugs to avoid in pregnancy

A

LAMBAST
Lithium
Amiodarone
Methotrexate
Benzos
Aspirin
Sulphonamides
Tetracyclines

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7
Q

what medication can cause Ebstein’s anomlay ( defect in tricuspid valve) if used in pregnancy

A

lithium

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8
Q

what medication is used for medical termination of pregnancy? and what order

A

MiFepristone = First (antiprogestogen)
MiSoprostol = Second (prostaglandin)

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9
Q

how should premature rupture of membranes be managed?

A

admission, antibiotics and steroids (to promote foetal lung maturation)

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10
Q

management of breech baby >36 weeks

A

external cephalic version

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11
Q

management of postpartum thyroiditis?

A

usually self limiting- provide symptomatic relief e.g. propranolol

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12
Q

what is oligohydramnios?

A

decreased amniotic fluid for gestational age

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13
Q

Causes of oligohydramnios

A

premature rupture of membranes
Potter sequence - bilateral renal agenesis + pulmonary hypoplasia
intrauterine growth restriction
post term gestation
pre-eclampsia

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14
Q

What is the guidance around contraceptive management post partum?

A

IUS - inserted <48 hours or after 4 weeks
COCP- > 6weeks
progesterone only pill - anytime

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15
Q

Management of placental abruption

A

administer steroids- foetal lung development
deliver baby via c-section usually

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16
Q

What type of bleeding is placental abruption

A

painful bleeding

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17
Q

What type of bleeding is placenta praevia

A

painless bleeding

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18
Q

What should be prescribed to moderate to high risk pre-eclampsia patients?

A

low-dose aspirin - 75mg from 12 weeks until birth

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19
Q

Management of endometritis

A

admission - IV clindamycin and gentamicin

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20
Q

Methods of induction

A

membrane sweep
prostaglandin pessary
artificial rupture of membranes + oxytocin
cervical balloon
misoprostol

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21
Q

Does dopamine inhibit or activate prolactin

A

inhibits

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22
Q

First line management of gestational hypertension without proteinuria

A

Oral Labetalol

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23
Q

Management of positive culture of GBS in current pregnancy or previous?

Study These Flashcards
A

IV antibiotics - benzylpenicillin (or vancomycin if allergy) during labour

24
Q

Screening result for down syndrome on quadruple testing (done between weeks 14-20)

Study These Flashcards
A

low AFP, high inhibin, high hCG and low oestriol

25
When is a combined screening test carried out?
between weeks 10 - 13+6 weeks
26
complete molar pregnancy
no presence of normal foetal growth - COMPLETELY no growth snowstorm appearance on US can progress to choriocarcinomas
27
partial molar pregnancy
Some evidence of foetal development with abnormal growth - triploidy chromosome arrangement
28
Management of post partum haemorrhage after ABCDE
bimanual uterine compression - stimulate contraction IV oxytocin and/or ergometrine IM carboprost Rectal Misoprostol Surgical intervention e.g. balloon tamponade
29
Causes of PPH
4 Ts Tone- i.e. uterine atony in most cases Trauma- e.g. perineal tear Tissue - retained placenta Thrombin - e.g. clotting/bleeding disorder
30
first line medication for vomiting in pregnancy
antihistamines - promethazine
31
What is Sheehan syndrome?
anterior pituitary gland damage after significant blood loss
32
woody uterus
think placental abruption
33
medical management of ectopic pregnancy
IM methotrexate
34
What is the safest anti-epileptic to use in pregnancy
lamotrigine
35
name of test that measures b-hCG, PAPPA-A and nuchal translucency
combined test - offered at 11-13+6 weeks
36
PAINLESS abdominal pain and bleeding in later stages of pregnancy
placenta praevia
37
when should at risk patients of pre-eclampsia take aspirin
12 weeks gestation until delivery
38
correct position of women who have cord prolapse
on all fours
39
when should delivery be aimed for with obstetric cholestasis
37-38 weeks
40
what does the combined text consist of
serum oestriol, hCG, alpha-fetoprotein and inhibin A
41
'strawberry cervix' foul smelling discharge
trichomonas vaginalis Tx = metronidazole
42
respiratory system changes in pregnancy
pulmonary ventilation increased and tidal volume (progesterone effects on respiratory centre) - leads to respiratory alkalosis
43
drugs to avoid in pregnancy
ACEi/ARBs - renal hypoplasia androgens - anti-epileptics - cardiac, facial, neural tube defects cancer treatment - multiple defects lithium - CVS defects methotrexate - skeletal defects warfarin - limb and facial defects aspirin - brain and liver damage
44
what pregnancies require 5mg Folic Acid
previous neural tube defect taking anti-epileptics coeliac disease diabetes thalassaemia trait BMI > 30
45
when to offer external cephalic version if baby is breech
>36 weeks
46
what is the definition of large for dates
>2cm fundal height than expected
47
what are the three shunts in foetal circulation
ductus venosus - foramen ovale - ductus arteriosus -
48
management of hypertension in pregnancy
1st= labetalol 2nd = if asthmatic Nifedipine 3rd = methyl dopa
49
management of eclampsia
magnesium sulphate IV bolus 4g over 5-10 minutes if respiratory depression of mother - give calcium gluconate
50
what nutrient is deficient in breast milk and what is done about this
vitamin K - new borns prophylactically injected with vit K after birth
51
when is gestational diabetes diagnosed
24-28 weeks gestation oral glucose tolerance testing is used
52
what are the risk factors for gestational diabetes
family history of diabetes previous macrosomic baby of >4.5kg BMI >30
53
first line strong analgesia management in latent stage of labour
IM diamorphine
54
crown rump length >7mm and no foetal heartbeat
miscarriage
55
when is anti-D needed in misscariage
maternal rhesus -ve and over 12 weeks gestation or <12 weeks and uterine instrumentation
56

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