Obstetrics passmed Yr5

Question 1

Reducing the risk of hypertensive disorders in pregnancy
women with the following should take

Answer 1

aspirin 75-150mg daily from 12 weeks gestation until the birth

Question 2

drugs you can give in pre-eclampsia

Answer 2

labetalol
Nifidipine - asthmatic
hydralazine

Question 3

if chicken pox exposure occurs in preg - when and what should you give

Answer 3

antivirals or VZIG (if available) should be given at days 7-14 post-exposure, not immediately

Question 4

Which of the following presentations has the greatest mortality and morbidity?

Answer 4

footling

Question 5

massive post partum h with abnormal placenta implantation of the uterine wall. Previous ultrasound showed an ordinary lie of the placenta. what is most likely cause

Answer 5

placenta accreta

Question 6

The most common cause of PPH by far is

Answer 6

uterine atony- Inadequate uterine contractions

Question 7

mx of pph steps

Answer 7

ABC approach
lie flat
roup and save
commence warmed crystalloid infusion

palpate the uterine fundus and rub it to stimulate contractions

catheterisation to prevent bladder distension and monitor urine output

IV oxytocin: slow IV injection followed by an IV infusion
ergometrine slow IV or IM (unless there is a history of hypertension)

carboprost IM (unless there is a history of asthma)

misoprostol sublingualand tranexamic acid

surgical: if medical options fail to control the bleeding then surgical options
intrauterine balloon tamponade

B-Lynch suture, ligation of the uterine arteries or internal iliac arteries

hysterectomy is sometimes performed as a life-saving procedure

Question 8

pop most common side effect

Answer 8

irregular vaginal bleeding is the most common problem

Question 9

mirena effect on periods

Answer 9

Initially irregular bleeding later followed by light menses or amenorrhoea

Question 10

Combined oral contraceptive pill portective against what cnacer

Answer 10

protective against ovarian and endometrial cancer

Question 11

COCP increases risk of what cancer

Answer 11

breast and cervical

Question 12

when swtiching from pop to cocp do you need addtional contraception and for how long

Answer 12

When switching from a traditional POP to COCP (with correct prior use) 7 days of barrier contraception is needed

Question 13

do women with bacterial vaginosis need tx

Answer 13

omen with asymptomatic bacterial vaginosis do not usually require treatment unless they are undergoing termination of pregnancy

Question 14

after two does of IM adrenaline what do you do if no recovery

Answer 14

Seek help

Refractory anaphylaxis
defined as respiratory and/or cardiovascular problems persist despite 2 doses of IM adrenaline
IV fluids should be given for shock
expert help should be sought for consideration of an IV adrenaline infusion

Question 15

following an acute anaphylactic reaction what is the best way to test for an allergic reaction confrimed

Answer 15

Anaphylaxis - serum tryptase levels rise following an acute episode

Question 16

contact dermatitis

Answer 16

skin patch

Question 17

all patients with a new diagnosis of anaphylaxis should be referred to a

Answer 17

specialist allergy clinic

Question 18

premature labour what can you give to stop/slow it

Answer 18

Admit and administer tocolytics and steroids

abx if signs of infection

Question 19

how long do you carry on magnesium treatment in eclampsia

Answer 19

Magnesium treatment should continue for 24 hours after delivery or after last seizure

Question 20

vte risk what hrt

Answer 20

Transdermal estradiol and levonorgestrel