Pregnancy

Question 1

Why is hydralazine prescribed in pre-eclampsia?

Answer 1

Hypertension

Question 2

Why is magnesium sulphate prescribed in pre-eclampsia?

Answer 2

Prevents seizures

Question 3

Why do seizures occur in pre-eclampsia?

Answer 3

Associated with oedema

Question 4

Rhesus +ve baby, Coombs test result?

Answer 4

Positive

Question 5

How long after foeto-maternal transfusion can Anti-D immunoglobulin be admistered?

Answer 5

72 hours

Question 6

Ideal route of IM administration for anti-D immunoglobulins

Answer 6

Deltoid tuberosity

Question 7

3 events where you would administer anti-D

Answer 7

Surgical termination
Abdominal trauma
Miscarriage
Invasive procedure e.g. amniocentesis
Haemorrhage

Question 8

Side effect of beta-blockers in pregnancy ?

Answer 8

May inhibit foetal growth

Question 9

On ACEi or ARBs in pregnancy - what do you do?

Answer 9

Change to labetalol, methyldopa, or nifedipine MR

Question 10

N&V in pregnancy - what to prescribe?

Answer 10

Cyclizine

Question 11

UTI in pregnancy - what to prescribe?

Answer 11

Nitrofurantoin first-line, amoxicillin or cefalexin second-line

Question 12

Effects of amiodarone in breastfeeding

Answer 12

Can cause neonatal hypothyroidism

Question 13

Effects of cytotoxics in breastfeeding

Answer 13

Bone marrow suppression in neonates

Question 14

Effects of bromocriptine in breastfeeding

Answer 14

Suppresses lactation

Question 15

Valproate must be co-prescribed with what?

Answer 15

Effective contraception

can cause neural tube defects - spina bifida and anencephaly

Question 16

Effect of tetracycline on the unborn child?

Answer 16

Staining of bones and teeth

Question 17

Which antiepileptic drug is particularly associated with cleft lip and palate?

Answer 17

Phenytoin

Question 18

Which drug taken during pregnancy can cause vaginal adenocarcinoma?

Answer 18

Stilbestrol (synthetic oestrogen, rarely prescribed now)

Question 19

Which antiepileptic causes neural tube defects - spina bifida and anencephaly

Answer 19

Valproate

Question 20

Clinical features of polyhydramnios

Answer 20

Large for dates
Tense, shiny abdomen
Inability to feel foetal parts
Malpresentation (when your baby is not facing head-first down the birth canal as birth approaches)

Question 21

Polyhydramnios diagnostic criteria

Answer 21

USS confirmation
DVP (Deepest Vertical Pocket) >8cm
AFI (Amniotic Fluid Index) >25
Subjective

Question 22

Non-tender, large-for-dates uterus + vaginal bleeding and hyperemesis

Answer 22

Molar pregnancy

• type of gestational trophoblastic disease
• more common in women under 20 years and over 35 years

Question 23

Antiphospholipid syndrome - what drug is prescribed from 1st trimester ?

Answer 23

Low molecular weight heparin

Question 24

High risk for fetal growth restriction - how often do you get scanned?

Answer 24

Every 4 weeks from 28 weeks

Question 25

Measurements required to calculate EFW (estimated foetal weight)

Answer 25

Abdominal circumference, head circumference, femur length

Question 26

Reduction in DVP (deepest vertical pool - liquor volume) =

Answer 26

Marker of reduced renal perfusion and urine output

Question 27

Ductus venosus doppler relevance?

Answer 27

Direct reflection of foetal heart function

• moderate predictive value of foetal acidaemia and adverse outcomes

Question 28

When is magnesium sulphate prescribed in pre-term birth ?

Answer 28

Up to 33+6 weeks - for foetal neuroprotection

Question 29

When are steroids prescribed in pre-term babies?

Answer 29

Up to 33+6 weeks