Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproductive Health > Passmed > Flashcards

Passmed Flashcards

(123 cards)

Start Studying
1
Q

What is the most common cause of severe early onset fever in newborn infants

A

Group B strep
< 7 days birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for Group B strep

A

prematurity
prolonged rupture of the membranes
previous sibling GBS infection
maternal pyrexia e.g. secondary to chorioamnionitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should women who’ve hade GBS in prev pregnancy have in next

A

Risk of GBS carraige is 50%
Intrapartum antibiotic prophylaxis offered OR
testing in late pregnancy and antibiotics if still positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When should swabs for GBS be offered

A

35-39 weeks
or 3-5 weeks prior to anticipated delivery date

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When should IAP be offered

A

Women with prev baby with early or late onset GBS disease
Preterm
Pyrexia - >38 degrees - during labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is antibiotic of choice in GBS

A

Benzylpenicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is d-dimer in pregnancy useless

A

will always be positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of pregnancy for intrahepatic cholestasis of pregnancy

A

Induce at 37-38 weeks as increases risk of stillbirth
Increased foetal surveilance before this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is C scetion done in IH cholestasis of pregnancy

A

When non reassuring foetal status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Medical management of IH cholestasis of pregnancy

A

Antihistamines - symptomatic + reassurance
Ursodeoxycholic acid
Colestyramine
Topical emollients
Vit K supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Features of IH cholestasis

A

pruritus - may be intense - typical worse palms, soles and abdomen
clinically detectable jaundice occurs in around 20% of patients
raised bilirubin is seen in > 90% of cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is medroxyprogesterone acetate

A

Depot injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical features of endometriosis

A

chronic pelvic pain
secondary dysmenorrhoea
pain often starts days before bleeding
deep dyspareunia
subfertility
non-gynaecological: urinary symptoms e.g. dysuria, urgency, haematuria. Dyschezia (painful bowel movements)
on pelvic examination reduced organ mobility, tender nodularity in the posterior vaginal fornix and visible vaginal endometriotic lesions may be seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

First line for endometriosis

A

NSAIDs abd/or paracetemol
COCP or progesterogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Secondary treatments for endometriosis

A

GnRH analogues - pseudo menopause - low oestrogen
Surgery - laparoscopic excision or ablation + adhesiolysis + ovarian cystectomy - improves fertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Placental abruption vs placenta praevia

A

Both: vaginal bleeding in pregnancy
Abruption:
Shcok outkeeping with visible loss
Pain constant
Tender, tense uterus
Normal lie and presentation
Foetal heart - absent/distressed
Coag problems
Beware pre-eclampsia, DIC, anuria

Praevia:
Shock in proportion to visible loss
No pain
Uterus not tender
Lie and presentation may abnormal
Foetal heart normally normal
Coag problems rare
Small bleeds before large

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should be avoided in croup

A

Throat examination may obstruct AW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is croup characterised by

A

URTI in infants and toddlers, stridor + laryngeal oedema and secretions caused by parainfluenza virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mild croup features

A

Occasional barking cough
No audible stridor at rest
No or mild suprasternal and/or intercostal recession
The child is happy and is prepared to eat, drink, and play

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Moderate croup features

A

Frequent barking cough
Easily audible stridor at rest
Suprasternal and sternal wall retraction at rest
No or little distress or agitation
The child can be placated and is interested in its surroundings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Severe croup features

A

Frequent barking cough
Prominent inspiratory (and occasionally, expiratory) stridor at rest
Marked sternal wall retractions
Significant distress and agitation, or lethargy or restlessness (a sign of hypoxaemia)
Tachycardia occurs with more severe obstructive symptoms and hypoxaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When prompt admission of croup

A

Any child with moderate or severe croup
<6 months age
Known upper AW abnormalities (laryngomalacia, Downs syndrome)
Uncertainty about diagnosis - acute epiglottitis, bacterial tracheitis, peritonsillar abscess and foreign body inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Emergency treatment croup

A

High flow oxygen
Nebulised adrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Management of croup

A

Single dose oral dexamethasone (0.15mg/kg) to all children regardless of secerity
Prednisolone is alternative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Investgiations - what CXR show in croup
Post ant view - subglottic narrowing - steeple sign Contrast lateral view - acute epiglottitis - thumb sign
26
What cont machinery murmur suggests
PDA
27
What intervention for PDA
Indomethacin - inhibit PGE2 which maintains PDA
27
What intervention for PDA
Indomethacin or ibuprofen - inhibit PGE2 which maintains PDA
28
When use PGE2 in heart failure infant
Complex congenital heart defects - shunt necessary to maintain life eg transposition of great arteries
29
Why is aspirin not given to children under 16
Risk of reyes syndrome
30
What can treat apnoea in neonates
Caffeine citrate
31
What babies is PDA more common on?
High altitude babies, premature, maternal rubella in first trimester
32
Features of PDA
L subclavicular thrill Cont machinery murmur Large volume. bounding, collapsing pulse Wide pulse pressure Heaving apex beat
33
What would poor feeding, grunting and lethargy in a neonate signal
Neonatal sepsis
34
Common oragnsims causing neonatal sepsis
Group B strep - early onset E.coli
35
What is late onset neonatal sepsis cuased by
Transmission pathogens from environemnt post-delivery from contacts Staph pecies - S.epidermis Gram - = psueomonas aeruginosa, klebsiella, enterobacter
35
What is late onset neonatal sepsis cuased by
Transmission pathogens from environemnt post-delivery from contacts Staph pecies - S.epidermis Gram - = psueomonas aeruginosa, klebsiella, enterobacter
36
Risk factors for neonatal sepsis
Mother who has had a previous baby with GBS infection, who has current GBS colonisation from prenatal screening, current bacteruria, intrapartum temperature ≥38ºC, membrane rupture ≥18 hours, or current infection throughout pregnancy Premature (<37 weeks): approximately 85% of neonatal sepsis cases are in premature neonates Low birth weight (<2.5kg): approximately 80% are low birth weight Evidence of maternal chorioamnionitis
37
Presentation neonatal sepsis
Respiratory distress (85%) Grunting Nasal flaring Use of accessory respiratory muscles Tachypnoea Tachycardia: common, but non-specific Apnoea (40%) Apparent change in mental status/lethargy Jaundice (35%) Seizures (35%): if cause of sepsis is meningitis Poor/reduced feeding (30%) Abdominal distention (20%) Vomiting (25%) Temperature: not usually a reliable sign as the temperature can vary from being raised, lowered or normal Term infants are more likely to be febrile Pre-term infants are more likely to be hypothermic The clinical presentation can vary from very subtle signs of illness to clear septic shock Frequently, the symptoms will be related to the source of infection (e.g. pneumonia + respiratory symptoms, meningitis + neurological symptoms)
38
Investigations into neonatal sepsis
Blood culture Full blood examination CRP Blood gas Urine microscopy, culture and sensitivity Lumbar puncture
39
Treatment for neonatal sepsis NICE
IV benzylpenicillin with gentamycin as first line regimen
40
Main complication of GI anaemia
Haemolytic uraemic syndrome
41
What is managemnet of hypospadias
Surgical correction using foreskin remnant after 6 months - normally around 12 months - avoid circumcision
42
What do and what can pulsatile sound in ear be
MRA - MRI of inner ear acoustic neuroma inner ear cnacer
43
What is hypospadias characterised by
Ventral urethral meatus Hooded prepuce Chordee - ventral curvature of penis - more severe Urethral meatus proximal opening if more severe ass conditions - cryptorchidism, inguinal hernia
44
What is the most common side effect first 6 months IUS
Irregular bleeding
45
What are the features of acute fatty liver of pregnancy
jaundice, mild pyrexia, hepatitic LFTs, raised WBC, coagulopathy and steatosis on imaging predominantly non-specific symptoms (e.g. malaise, fatigue, nausea
46
What can severe acute fatty liver disease cause
Pre-eclamspia
47
What resp rate should a child be referred to hopsital with bronchiolitis with
>60
48
What bishop score indicates labour is progressing fine and no interventions are needed
>8
49
What bishops score suggests interventions are needed
<5
50
How long should the first stage of labour last?
Up to 12 hours
51
What is a risk with oxytocin?
Oxytocin infusion carries the risk of uterine hyperstimulation
52
What is a membrane sweep and when is it offered?
Finger seperating chorionic membrane from the decidua Offered from 40-41 weeks in nulliparous women
53
Indications for induction
prolonged pregnancy, e.g. 1-2 weeks after the estimated date of delivery prelabour premature rupture of the membranes, where labour does not start maternal medical problems diabetic mother > 38 weeks pre-eclampsia obstetric cholestasis intrauterine fetal death
54
How is labour induced
PGE2 vaginal suppositry (dipinestrone) Oral PGE1 - misoprostol maternal oxytocin infusion amniotomy ('breaking of waters') cervical ripening balloon
55
NICE recommendations induction of labour
if the Bishop score is ≤ 6 vaginal prostaglandins or oral misoprostol mechanical methods such as a balloon catheter can be considered if the woman is at higher risk of hyperstimulation or has had a previous caesarean if the Bishop score is > 6 amniotomy and an intravenous oxytocin infusion
56
What is uterine hyperstimulation
refers to prolonged and frequent uterine contractions - sometimes called tachysystole
57
Potential consequences of uterine hyperstimulation
potential consequences intermittent interruption of blood flow to the intervillous space over time may result in fetal hypoxemia and acidemia uterine rupture (rare) Manage by: removing the vaginal prostaglandins if possible and stopping the oxytocin infusion if one has been started consider tocolysis
58
What to do if a baby presents with jaundice in first 24 hours
Measure and record the serum bilirubin level urgently (within 2 hours) since this is likely to be pathological rather than physiological jaundice.
59
What should fundal height measure
The week of parity +/- 2cm
60
What is potters sequence
a rare fatal genetic disorder, characterised by severe oligohydramnios, resulting either from polycystic kidney or bilateral renal agenesis. This causes a specific appearance of the newborn, called Potter facies. The affected babies usually die within a few hours of birth or are stillbirths, and have wrinkly skin, low-set ears, flat noses and chins, and widely separated eyes with epicanthic folds.
61
Causes of polyhydraminos
Duodenal atresia Foetal anaemia Maternal diabetes Trisomy 21
62
Causes of oligohydraminos
premature rupture of membranes Potter sequence (bilateral renal agenesis + pulmonary hypoplasia) intrauterine growth restriction post-term gestation pre-eclampsia
63
What is oligohydraminos
500ml at 32-36 weeks and an amniotic fluid index (AFI) < 5th percentile.
64
What is worrying in development?
Referral points doesn't smile at 10 weeks cannot sit unsupported at 12 months cannot walk at 18 months Fine motor skill problems hand preference before 12 months is abnormal and may indicate cerebral palsy Gross motor problems most common causes of problems: variant of normal, cerebral palsy and neuromuscular disorders (e.g. Duchenne muscular dystrophy) Speech and language problems always check hearing other causes include environmental deprivation and general development delay
65
What are half of cord prolapses caused by?
Artificial rupture of membranes
66
Features of foetal varicella zoster syndrome
skin scarring, eye defects (microphthalmia), limb hypoplasia, microcephaly and learning disabilities
67
When can you give oral aciclovir to a woman ant presenting with chickenpox?
> 20 weeks Presents within 24 hours of rash If under 20 weeks should use with caution
68
Why sometimes need to use PPI with SSRIs
Risk of GI bleeding
69
What head circumference presents with fragile X
larger than normal
70
Causes of microcephaly
normal variation e.g. small child with small head familial e.g. parents with small head congenital infection perinatal brain injury e.g. hypoxic ischaemic encephalopathy fetal alcohol syndrome syndromes: Patau craniosynostosis
71
When is bone marrow biopsy required for ITP?
When abnormal features eg splenomegaly, bone pain, and diffuse lymphadenopathy,
72
Physiological features of anorexia nervosa
Features reduced body mass index bradycardia hypotension enlarged salivary glands Physiological abnormalities hypokalaemia low FSH, LH, oestrogens and testosterone raised cortisol and growth hormone impaired glucose tolerance hypercholesterolaemia hypercarotinaemia low T3
73
Drugs to avoid in breastfeeding
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides psychiatric drugs: lithium, benzodiazepines aspirin carbimazole methotrexate sulfonylureas cytotoxic drugs amiodarone
74
What is acute dystonia treated with
Procyclidine (anticholingergic) Caused by first gen anitpsychotics
75
SSRIs in pregnancy
BNF says to weigh up benefits and risk when deciding whether to use in pregnancy. Use during the first trimester gives a small increased risk of congenital heart defects Use during the third trimester can result in persistent pulmonary hypertension of the newborn Paroxetine has an increased risk of congenital malformations, particularly in the first trimester
76
How logn does it take for steroids to be effective in neonate when given to mother for lungs
1-2 dyas
77
When admit w bronchiolitis
Apnoea (observed or reported) Persistent oxygen saturation of <92% in air Inadequate oral fluid intake (<50% of normal fluid intake) Persisting severe respiratory distress, for example grunting, marked chest recession, or a respiratory rate of over 70 breaths/minute
78
Whencan do ECV for transverse lie
when sac not rupturef
79
What is used to reduce risk of blood loss in hystercetomy
GnRH - reduce size of uterus and fibroid - risk of bleeding is related to uterus size
80
What test is done in schools hearing
Pure tone audiometry
81
First line for endometrail cancer
Transvaginal US
82
How long before negative pregnancy test after abortion?
4 weeks If positive before then reassure and repeat at 4 weeks
83
What is used to screen newborns hearing
Otoacoustic emission test
84
What to give IV to women with sev hyperemsis gravidarum
IV saline with potassium chloride
85
Why is IV saline and dextrose contraindicated in hypermesis gravidarum
Women with hyperemesis gravidarum are at risk of hypokalemia and wernickes encephalopathy Therefore only give dextrose if K is normal (otherwise cause hypo as K absorbed into cells) and thiamine supplements
86
Triad of vasa previa
rupture of membranes followed by painless vaginal bleeding and fetal bradycardia.
87
What do NICE recommend for severe pre-eclampsia/eclampsia after 37 weeks gestation?
Delivery within 24-48 hours, therefore give IV magnesium sulphate if within 24 hours or concerned women has eclampsia
88
Symptoms of ovarian hyperstimulation syndrome
shortness of breath, fever, oliguria, and peripheral oedema.
89
What is a side effect of ovarian induction
Ovarian hyperstimulation syndorme
90
What women should take high dose folic acid in pregnancy
Epilepsy (antiepileptics_) Diabetes Obesity Parents have a neural tube defect FH neural tube defects Prev preg with neural tube degect you take anti-retroviral medicine for HIV
91
SSRI discontinuation syndrome symptoms
increased mood change restlessness difficulty sleeping unsteadiness sweating gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting paraesthesia
92
What cardiac problems can citalopram cause?
QT prolongation and torsades de pointes
93
Can you continue breastfeeding on flucloxacillin
YES
94
Why do FBC if taking clozapine and present with tonsilitis?
Risk of agranulocytosis/neutropenia with clozapine, need to check neutropenia isnt causing infection with any infection present with
95
What decelerations on CTG are non reassuring/abnormal
Variable decelerations occurring with over 50% of contractions may be non-reassuring or abnormal depending on their response to conservative treatment. ABNORMAL - single prolonged deceleration over 3 minutes
96
4 features on CTG
foetla HR variability Decelerations Accelerations
97
Abnormal decelerations on CTG
either non-reassuring variable decelerations still observed 30 minutes after starting conservative measures with >50% of contractions or late decelerations not improving with conservative measures, present for over 30 minutes and occurring with >50% of contractions or a bradycardia or single prolonged deceleration for more than 3 minutes.
98
Non reassuring accelerations on ECG
either variable decelerations of ≤60 bpm and taking ≤60 seconds to recover, present for >90 minutes and occurring with >50% of contractions or variable decelerations of ≥60 bpm or taking ≥60 seconds to recover, present for up to 30 minutes and occurring with >50% of contractions or late decelerations present for up to 30 minutes and occurring with >50% of contractions.
99
Reassuring foetal variability CTG
over 5 BPM
100
Non reassuring variability CTG
<5 or >25 for 30-90 mins
100
Non reassuring
<5 or >25 for >25 minutes
101
Non reassuring foetal HR on CTH
161-180 BPM
102
Abnormal HR on CTG
<100 or >180
103
How often monitor blood sugar in pregnancy if diabetes
fast, pre meal, 1 hr post meal and bed time
104
Most important risk of oestrogen only HRT
Endometrial cancer - for women with a womb!!!
105
What painkillers should be avoided with SSRIs?
Triptans
106
Earliest that ECV can be offered
36 weeks
107
When should insulin be started immediately in pregnancy with GDM
If fasting plasma glucose is over 7
108
When should insulin be started immediately in pregnancy with GDM
If fasting plasma glucose is over 7
109
Why is lithium not first line in mania
1-2 week onset of action - longer acting first line is risperidone/Haloperidol/ Olanzapine/Quetiapine
110
Why monitor BMs closely and adjust insulin accordingly if giving steroids in pregnancy
Steroids can cause hyperglycaemia
111
sIGNS OF dehydration on bloods
Low serum urea Raised haematocrit Ketonuria Examination findings
112
Electrolyte imbalances in hyperemesis gravidarum
Hypokalemia Hyponatremia Metabolic alkalosis
113
What score measures HG severity
PUQE
114
First line antiemetics
Cyclizine Prochlorperazine Prometha\inw Chlorproma\ine
115
Second mline antiemttics hyperemesis
Metoclopramide Domperidone Ondanestron
116
Third line antiemetics hyperemsis
Corticosteroids
117
What is the most importnat treatabel cause of miscarriage
Antiphospholipid syndrome (AI disease stopping placental function)
118
Treatment for antiphospholipid syndrime causing miscarriage
Heparin
119
How does antiphospholipid syndrome cause miscarriage and pregnancy problems
Inhibitis trophoblastic function and didfferentiation Acitvation of complement pathways at maternal foetal interface -> local inflam response, VTE
120
How determine viability of pregnancy
Measure crown rump length <7 and no HB = rescan in 7 days >7 and no HB - second opinion, scan in at least 7 days Measure gestational sac if foetal pole not visible <25mm - at least 7 days later rescan >25mm = second opinion, rescan at least 7 dyas later

Reproductive Health (69 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions