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5th year OSCE > obstetrics > Flashcards

obstetrics Flashcards

1
Q

physiological changes in pregnancy

A

BP reduced in 1st and 2nd trimester
blood volume up by 30%
platelet count falls
pulmonary ventilation up by 40%
Ca requirement increased

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2
Q

pre conception care

A

folic acid - 400mg until 12 weeks
if diabetic 5mg from 12 weeks

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3
Q

abdominal discomfort
prelabour rupture of membranes
cord prolapse
tense shiny abdomen
inability to feel fetal parts

A

polyhydramnios
= excess amniotic fluid

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4
Q

investigation for polyhydramnios

A

ultrasound
oral glucose tolerance test
antibody screen

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5
Q

management of polyhydramnios

A

IOL at 40 weeks
amnioreduction can be considered

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6
Q

1st line medication for hypertension caused by pre-eclampsia

A

labetolol

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7
Q

abdominal pain that is unilatelal and lower
amenorrhoea
vaginal bleeding
mass
shoulder tip pain

A

ectopic pregnancy
= ovum implants outside of uterus usually in fallopian tube

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8
Q

investigation for ectopic pregnancy

A

ultrasound
serum hCG

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9
Q

management of ectopic pregnancy

A

methotrexate - single dose
surgery - salpingectomy or salpingotomy

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10
Q

what is a miscarriage

A

loss of a pregnancy at less than 24 weeks

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11
Q

risk factors for miscarriage

A

age > 35
previous miscarriage
smoking
alcohol
illicit drugs
antiphospholipid syndrome
infections

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12
Q

investigation for miscarriage

A

transvaginal ultrasound
speculum
bHCG

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13
Q

management of miscarriage

A

misoprostol
mifepristone
surgical suction

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14
Q

pregnant women with weight loss, dehydration, ketotic breathe, hypotension
cannot keep any foods or liquids down

A

hyperemesis gravidarum

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15
Q

management of hyperemesis gravidarum

A

antiemetic - promethazine
IV fluids
thiamine

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16
Q

women is bleeding PV after 24 weeks differentials

A

placental abruption
placenta praevia
ectropion
polyp

17
Q

pregnant women has
vaginal bleeding
abdominal pain
uterine contraction
lower back pain
woody abdomen on palpation

A

placental abruption

18
Q

investigation for placental abruption

A

clinical
CTG

19
Q

management of placental abruption

A

resus
c-section

20
Q

antepartum bleeding in a mother who has had multiple c-sections

A

placental accreta
= placenta implants deeper through the endometrium making it difficult to separate the placenta after the delivery of the baby

21
Q

painless antepartum haemorrhage, fetal movement present, uterus soft and non tender

A

placenta praevia
= placenta edge is lying directly over cervical os

22
Q

investigation for placenta praevia

A

midtrimester ultrasound

23
Q

management of placenta praevia

A

corticosteroids
magnesium suplhate
c section

24
Q

pregnant mother with severe abdominal pain with shoulder tip pain
sudden collapse
vaginal bleeding
acute abdomen

A

uterine rupture

25
Q

pregnant women after rupture of membranes has a small amount of dark vaginal bleeding
fetal bradycardia

A

vasa praevia
= fetal vessels and transverse membranes below presenting part over cervical os

26
Q

management of vasa praevia

A

corticosteroid
elective c section

27
Q

pregnant women with:
headache
hypertension
visual disturbance
nausea
RUQ pain
oedema

A

pre eclampsia

28
Q

investigation in pre eclampsia

A

BP - elevated
proteinuria
ultrasound

29
Q

management of pre eclampsia

A

aspirin - before 16 weeks in high risk women (obese, diabetics, CKD)
hypertension - labetalol
nifedipine
IV magnesium sulphate - if severe

30
Q

what to give if pregnant mother seizing

A

IV magnesium sulphate

31
Q

post partum haemorrhage management

A

ABCDE
cross match 6 units of packed red cells
warm crystalliod fluid

uterine massage
oxytocin
carboprost
misoprostol
tranexamic acid

surgery

32
Q

post partum mother has vaginal bleeding
abnormal vaginal discharge
lower abdominal pain
fever

A

retained products of conception

33
Q

investigations for retained product of conception

A

ultrasound

34
Q

what is a complication of post partum haemorrhage

A

sheehan syndrome
= drop in circulatory blood volume leads to avascular necrosis of pituitary gland

35
Q

symptoms of sheehan syndrome

A

reduced lactation
amenorrhoea
adrenal insufficiency
hypothyroidism

36
Q
A

5th year OSCE (14 decks)

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