Pass Test Obs

Question 1

History of watery vaginal discharge and now tachy flushed and wide pulse pressure

Answer 1

Sepsis as had premature rupture of membranes

Question 2

When does an amniotic fluid embolism occur

Answer 2

During labour or up to 48 hours post delivery

Question 3

When is the spleen used for haematopoesis in a foetus

Answer 3

3-6mths

Question 4

When is the liver used for haematopoesis in a foetus

Answer 4

Begins at one month and peaks at 5 moths

Question 5

When is the yolk sac used for haematopoesis in a foetus

Answer 5

Conception to 3 myths

Question 6

Treat hypertension with preeclampsia

Answer 6

Admit and control bP with labetolol (methyldopa/ nifedipine second line)

Question 7

What pain relief other than paracetamol can be used in pregnancy

Answer 7

Codeine phosphate

Question 8

Fully dilated and in advanced labour but CtG shows variable decelerations that have not resolved despite a change in the mother’s position - what do you do

Answer 8

Fetal blood sampling as she is fully dilated to asses the babies lactate and pH

Question 9

What happens at the 11-13 week apt

Answer 9

Combined test screening for downs including Papp-a beta hcg and a nuchal translucency

Question 10

When are you classed as high risk for neural tube defects

Answer 10

FH of neural tube defects on mother or fathers side
Previous pregnancy with NT defect
Maternal diabetes
Personal history of neural tube defect

Question 11

How does a woman with diabetes in pregnancy’s apt’s differ to normal

Answer 11

Seen at a joined antenatal and diabetic clinic every one to two weeks

Question 12

ACE I IN PREGANNCY

Answer 12

Contraindicated in all trimesters

Question 13

When is warfarin safe to use in pregnancy

Answer 13

Safe in second trimester only

Question 14

When do you avoid trimethoprim in pregnancy

Answer 14

First trimester

Question 15

Don’t give labetolol as first line of what

Answer 15

The patient is asthmatic

Question 16

If the placenta hasn’t been delivered naturally within 30 OJ’s what do you do

Answer 16

Syntocinin infusion

If in a further 30 mins it hasn’t been delivered then attempt manual removal

Question 17

If a nipple fissure is present in mastitis then what does this indicate

Answer 17

Infective cause so give fluclox

Get a breast milk culture before starting the abx

Question 18

What are the typical clotting results in DIC

Answer 18

PT elevated
APTT elevated
Low platelets
Low fibrinogen

Question 19

Cellulitis around wound site and pen allergy

Answer 19

Oral clarithromycin

Question 20

When do you first feel fetal movements

Answer 20

20 weeks in a prim

16-18 in a subsequent pregnancy

Question 21

What causes lower back pain in pregnancy

Answer 21

In third trimester the relaxation of ligaments causes pain particulalru at night - treat with improved posture flat shoes and a firm mattress

Question 22

When does breast enlargement occur

Answer 22

First few weeks

Question 23

When does nipple and areolar darkening occur

Answer 23

12 weeks

Question 24

What is diagnostic of poly hydramnios

Answer 24

> 2-3 l

Question 25

How is medical termination prescribed as

Answer 25

Oral mifepristone and vaginal misoprostol

Question 26

When is AROM used

Answer 26

When woman is in active labour and her waters have not broken

Question 27

If bishop score <6 what is used

Answer 27

Vaginal PGE2 the reassess after 6 hours | If Bishops still less than 7 after this period of time then further prostaglandin is given

Question 28

First line for hyperemesis

Answer 28

Cyclizine / chlorpromazine

Question 29

Define anaemia in the first trimester second trimester and post partum

Answer 29

First <11 Second <10.5 Post partum <10

Question 30

Placenta accreta

Answer 30

Milder form where they attach to superficial layer of myometrium

Question 31

Placenta percreta

Answer 31

Severe form only managed with a hysterectomy | Through all layers

Question 32

Placenta increta

Answer 32

Involves muscle layer

Question 33

People who present with primary herpes should be treated with

Answer 33

Oral aciclovir From 36 weeks they should get aciclovir at treatment dose 3 times a day TIL delivery Vagina delivery

Question 34

Where does choriocarcinoma metastasize to

Answer 34

Lungs

Question 35

What does gestational trophoblastic disease have a strong link with

Answer 35

Thyroid dysfunction

Question 36

Treat warts in pregnancy

Answer 36

Cryoptherapy as podophylin is contraindicated

Question 37

Gonorrhoea treatment in pregnancy

Answer 37

Ceftriaxone

Question 38

What is the definition of proteinuria?

Answer 38

Persistent urinary protein of >300mg/24 hours

Question 39

If a hypothyroid woman becomes pregnant how would there treatment change

Answer 39

Even if euthyroid despite treatment increase dose to 25mcg

Question 40

Define gestationa diabetes

Answer 40

Fasting plasma glucose of >5.6 | Or a 2 hour plasma glucose of >7.8

Question 41

When in gestational diabetes should women be given insulin

Answer 41

Fasting glucose >7

Question 42

What is sheehans syndrome

Answer 42

Hypo pituitary secondary to pituitary infarction due to haemorrhaging shock in labour and the peripartum period

Question 43

When can you do CVS

Answer 43

11 weeks

Question 44

Which test do you do for a karyotupe

Answer 44

CVs

Question 45

What is the quadruple blood test

Answer 45

Between 15 and 22 weeks you measure AFP HCG inhibin A and unconjugayed oestriol

Question 46

When should HIV positive woman be given an elective c section

Answer 46

Women with HIV and hepatitis C con infection On zidovudine monotherapy On HAART whose viral load is >50 copies

Question 47

What is Kleihauers test

Answer 47

Demonstrated fetal RBCs in maternal blood circulation and according to the test result, anti d is given to the mother to destroy Rh positive fetal cells therefore preventing the mother from forming anti D anibodies

Question 48

What is uterine hyper stimulation syndrome

Answer 48

More than 6 in 10 often caused by shtick in infusion so reduce flow rate

Question 49

Breastfeeding and pain relief

Answer 49

Ibuprofen

Question 50

What do you do if a patient has been in known contact with slapped cheek and is developing symptoms of it

Answer 50

Urgent referral to fetal medicine unit (to be seen within 4 weeks) and so serial uS scans