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Obstetrics Flashcards

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1
Q

For fetal and neonatal alloimmune thrombocytopenia what is the HPA make up of the mother and father for the fetus to be affected?

A

Father HPA-1a positive

Mother HPA-a negative (with anti HPA-1a antibodies)

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2
Q

Which of the following congenital malformations is most likely to be associated with oligohydramnios?

A. Duodenal atresia
B. Unilateral UPJ obstruction
C. Gastroschisis
D. Posterior urethral valves

A

D

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3
Q

What is the risk of admission to SCBU after an elective Caesarean section at 37 weeks

A

12%

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4
Q

Apgar score and cerebral palsy

A

75% of children who develop CP have normal apgar scores

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5
Q

What is the most common mode of transmission of toxoplasma Gondi to women in Australia?

A

Ingestion of undercooked meat

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6
Q

What is most correct with respect to malaria and pregnancy?

A

Quinine can be used if necessary in the treatment

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7
Q

What is the incidence of fetal infection after maternal seroconversion of CMV infection in pregnancy?

A

50%

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8
Q

Which of the following is false regarding NO?

a. NO contracts vascular and uterine smooth muscle
b. NO acts via cGMP?
c. NO synthetase inhibitors do not increase uterine contractile activity in animal studies
d. NO is released by immune cells in response to inflammatory stimuli

A

a.

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9
Q

What is inaccurate for 47XXY?

a. Serious intellectual disability
b. Tall stature
c. Elevated FSH
d. Female fat distribution

A

A

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10
Q

Crossing over of chromosomes occurs during?

A

Meiotic prophase 1

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11
Q

During gestation amniotic fluid becomes…

A

Progressively hypoosmolar, with lower concentrations of K, Na, Cl than in maternal plasma

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12
Q

AFP concentration in amniotic fluid will be elevated in each condition except

a. Dead Fetus
b. Fetus with Spina bifida occulta
c. Myelomeningocele
d. Contamination of amniotic fluid with fetal red blood cells
e. Exomphalos

A

B

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13
Q

In the human Fetus, behavioural state 2F is characterised by

A

Breathing and eye movements with frequent accelerations of the heart rate

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14
Q

True or false?

Reducing triplets to twins between 10-14 gestation leads to a rate of miscarriage of both twins of approx 8%

A

False

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15
Q

True or false?

Atosiban is an inhibitor of oxytocin secretion by the neurohypophysis

A

False.
Atosiban inhibits action of oxytocin and vasopressin. It inhibits oxytocin mediated release of inositol triphosphate from myometrial cell membrane

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16
Q

Which of the following congenital malformations is most likely to be associated with oligohydramnios?

a. Duodenal atresia
b. Unilateral ureteropelvic junction obstruction
c. Gastroschisis
d. Posterior urethral bales

A

D.

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17
Q

Which congenital anomaly is least likely to be associated with polyhydramnios at 30 weeks?

a. Duchenne muscular dystrophy
b. Myotonic dystrophy
c. CDH
d. Hydrocephalus

A

A.

Symptoms begin around 4 years of age

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18
Q

True or false?

Oxytocin is a nonapeptide?

A

True

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19
Q

True or false?

Oxytocin receptor concentrations markedly increase with advancing gestation under the influence of rising progesterone?

A

False

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20
Q

True or false?

Human breast milk has double the vitamin D content in comparison with cows milk?

A

False

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21
Q

True or false?

Sarcoplasmic reticulum calcium uptake enhances the contraction of a myometrial cell?

A

False

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22
Q

True or false? Approximately 25% of babies with HIE will develop cerebral palsy?

A

False.

Higher

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23
Q

True or false? Fetuses with the partial D phenotype will not be affected by haemolytic disease in the presence of maternal anti-d.

A

False

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24
Q

Genetic abnormality most commonly associated with fetal or infantile cystic hygroma is?

A

Turner syndrome (45XO)

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25
True or false. Thyroid hormone has increased concentrations after birth because of a surge in TSH concentrations.
True
26
True or false? Oestriol synthesis in pregnancy is enhanced by aromatisation in the fetal adrenal gland.
False
27
True or false? Reducing triplets to twins at 10-14 weeks is associated with a reduction in perinatal mortality.
False
28
True or false? Relaxin is structurally closely related to growth hormone?
False
29
``` All of the following hormones have a similar structure except? Inhibin A Inhibin B TSH AMF Activin ```
TSH
30
Endothelial growth factor receptors are stimulated by TGF-alpha? True or false
True
31
``` Which compound is at the greatest concentration in blood in physiological conditions? Carbon dioxide Bicarbonate Carbonic acid All are at equal concentrations ```
Bicarbonate
32
In late pregnancy there is a progressive increase in oxytocin, aldosterone and CRH. True or false?
True
33
Peak uterine activity in the third trimester occurs around what time of the day?
Early am
34
AVP is released in response to haemorrhage. True or false?
True
35
What is the fetal scalp pa02 at term?
32mmHg
36
What percentage of fetal cardiac output is directed to the placenta?
40%
37
The basal portion of the fetal cochlea matures before the apical portion. True or false?
True
38
What is the average term cord haemoglobin?
160
39
The D antigen first appears on RBCs at what gestation?
By 30 days, around 5 weeks
40
What is the normal daily requirement of iron in pregnancy?
Intake/consumption of 30mg/day | Absorbed dose of 4-5mg/day
41
Normal non pregnant daily iron requirement?
2mg/day
42
What class of drug is methyldopa?
Alpha 2 adrenergic antagonist
43
Side effects of atosiban?
Hypersensitivity and injection reactions
44
Is Tay Sachs disease autosomal dominant or recessive?
Autosomal recessive
45
Is Duchenne muscular dystrophy autosomal recessive or dominant or x-linked?
X-linked
46
Risk of schizophrenia in offspring if father affected?
5-10%
47
Risk of schizophrenia in offspring if both parents affected?
46%
48
What is Christmas disease also known as?
Haemophilia B. X linked recessive inheritance
49
Recurrence rate of anencephaly after one affected child?
5%
50
What chromosomal abnormality doesn’t increase in frequency with increased maternal age?
Turners XO
51
Low serum AFP, oestrogen and HCG are seen with what chromosomal abnormality?
Trisomy 18
52
Risk of Down syndrome at age 40?
1/100
53
Risk of recurrence of a child born with trisomy 21 if mother known to have a balanced translocation?
10%
54
The risk of omphalocele being associated with a chromosomal abnormality?
60%
55
Which chromosomal abnormalities is omphalocele associated with?
Trisomy 13 and 18
56
Which chromosomal abnormality is cystic hygroma most commonly associated with?
Trisomy 21
57
Chance of recurrence of cardiac lesion of one child affected?
2-5%
58
Concern with use of thiazide diuretics in pregnancy?
Can cause thrombocytopenia, jaundice and electrolyte abnormalities
59
``` Phenytoin is associated with all of the following except? IUGR Mental retardation Spina bifida Cardiac anomalies Cleft palate ```
Spina bifida
60
The S/D ratio of Doppler studies is inversely proportional to?
Gestational age
61
An USS is performed at 28/40 and a hydrocephalus Fetus with ventriculomegaly is diagnosed. The cortical thickness is 1cm. Which of the following is correct? Ventriculoamniotic shunt Cervagem TOP now Wait till 36/49 then LSCS Commence on folic acid before conceiving next time Second weekly cephalocentesis to prevent further cerebral damage
Wait till 36/40 then LSCS
62
If there is 40mls of fetal cells on kliehauer how much anti-D is needed?
7 vials
63
What is the most common Kell phenotype?
kk (75%)
64
What IgG subclasses do anti-D IgG antibodies belong too?
IgG1 and IgG3
65
Is anti-Lewis associated with isoimmunisation?
No
66
Transmission rate to Fetus of HIV if mother is HIV positive?
30%
67
What is the most common manifestation of latent infection with toxoplasmosis?
Chorioretinitis
68
Does heparin or warfarin cause stippling of the epiphysis?
Warfarin
69
What obstetric outcome does zinc deficiency cause?
Premature labour
70
Management of a ruptured liver hematoma?
Pack
71
Most common organisms in chorioamnionitis?
Ureaplasma GBS Peptostreptococcus
72
Is hyponatraemia a complication of beta mimetic to tocolysis?
No
73
What is the most appropriate pharmaceutical for management of head entrapment with breech delivery?
Halothane
74
First sign of coagulopathy with IUD?
Decreased fibrinogen and platelets
75
Most likely presentation to cause locking twins?
Breech-cephalon
76
Placenta cause of IUGR?
Praevia
77
What is the most reassuring test of welfare in a growth retarded Fetus if the test were normal?
US for amniotic fluid index
78
Risk of fetal demise within one week of a BPP of 0/10?
60%
79
Element of the Bishop score more related to a decreased length of labour
Dilation

MCQs (2 decks)

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