practice exam 2023 Flashcards

(34 cards)

1
Q

list risk factors for GDM

A

BMI >30, previous LGA, previous/family hx GDM, PCOS, multiple, Aboriginal and Torres Strait Islander, Asian, Indian, Pacific Islander, mat age >40

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2
Q

outline the BGL levels after OGTT that lead to diagnosis of GDM (fasting, 1 hour, 2 hours)

A

fasting: 5.1-6.9
1 hour: >10
2 hours: 8.5-11

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3
Q

what is the target BGL range in GDM

A

4-7mmol/L

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4
Q

what is the end product of fat metabolism?

A

ketogenesis

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5
Q

when is glucagon secreted?

A

in response to drop in BGL

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6
Q

list fetal/neonatal problems assoc with GDM

A

LGA, IUGR, prematurity, birth trauma, hypoglycaemia, RDS, stillbirth

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7
Q

list maternal risks from GDM

A

PET, IOL, instrumental birth, CS, HTN, preterm, polyhydramnios, PPH, infection, birth trauma

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8
Q

list CV changes that occur in pregnancy

A

increase in plasma vol, O2 consumption, HR, heart size, SV, CO, reduced Hb

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9
Q

what is the definition of HTN in pregnancy

A

sBP of 140 or >, and/or dBP 90 or >

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10
Q

list the organ systems involved in PET and a clinical symptom of each

A

renal: proteinuria
neuro: headaches
hepatic: sudden increase transaminases w or w/out RUQ pain
pulmonary: pulmonary oedema
haematological: haemolysis
uteroplacental: FGR

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11
Q

what is first line treatment of acute HTN in pregnancy?

A

hydralazine 20-30mg

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12
Q

what is the loading dose of mag sulf?

A

4g IV over 20mns via controlled infusion device

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13
Q

what are key clinical indications of mag sulf overdose?

A

muscle weakness, loss of reflexes, vomiting, flushing

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14
Q

list fetal/neonatal complications related to obesity in pregnancy

A

LGA, stillbirth, hypoglycaemia, fetal anomalies, preterm, jaundice, RDS

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15
Q

list maternal complications related to obesity in pregnancy

A

miscarriage, stillbirth, GDM, HTive disorders, depression, anxiety, prolonged pregnancy, CS, IOL

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16
Q

how often should pregnant women be weighed?

17
Q

what is the appropriate weight gain for a woman with BMI >30?

18
Q

name the steps and examples for the 5As framework

A

asses: assess for behavioural health risks and factors
advise: give specific, personalised, clear behavioural change advice
agree: collaboratively select goals and methods
assist: assist pt to achieve goals through skills, confidence and support
arrange: arrange follow up contacts for ongoing assistance and support

19
Q

identify maternal risks assoc with post-dates pregnancy

A

IOL, instrumental birth, increased risk PPH, CS, perineal tears, stress and anx

20
Q

list methods used for managing post-dates pregnancy

A

membrane sweep, IOL, CS, expectant management, fetal monitoring, cervical ripening

21
Q

list reasons for woman to contact/present to hospital when post-dates

A

ROM, PV bleeding, DFM, contractions

22
Q

list physical manifestations of tocophobia

A

SOB, tachycardia, need to remove self from situation

23
Q

identify aspects of midwife role in helping reduce/manage stress in antenatal period

A

support and prepare partner/family to support mother and baby, facilitate connections to community social support

24
Q

define trauma

A

deeply disturbing or distressing experience, physical, psychological, mental, spiritual, cultural or social

25
list predisposing factors for PTSD following birth trauma
previous trauma, limited support, depression/anxiety, distress in labour, obstetric emergency, infant complications
26
compare baby blues and PPD
baby blues: onset 2-5 days post birth, lasts up to 2 weeks, cry for no apparent reason, mood swings, overwhelmed PPD: onset within first 3-6 months, lasts months to years if untreated, have thoughts of harming self/baby, guilt, sleep/appetite disturbances, feel inadequate
27
list observations indicating difficulty with mother/infant bonding and attachment
inappropriate response to baby cues, saying baby has thoughts, ignoring the baby, fear of harming the baby
28
when is OGTT normally done and when can it be done if risk factors identified?
normally 24-28K, if risk factors can be done with first bloods or at booking-in (rpt if normal)
29
compare medication management in GDM for VB and ELCS
VB: cease metformin/insulin when labour established CS: cease metformin 24hrs before, usual insulin the night before then cease
30
how often should BGL be monitored during labour for women with GDM?
2/24
31
when should PP OGTT be done and how often lifelong screening?
6-12weeks PP and lifelong every 3 years
32
List maternal and neonatal risk factors for hypoglycaemia
maternal: GDM/DM, intrapartum glucose administration, beta blockers, valproate, family hx metabolic disorders neonatal: prematurity, SGA/IUGR, LBW, LGA, hypothermia
33
list prevention for neonatal hypoglycaemia
keep warm, keep dry, early S2S, feed within first hour, do not separate mother and baby
34