Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ADELE-Repro Ramblings > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

What are the trimesters by weeks?

A

1st trimester- 0-13wks
2nd trimester- 13-28wks
3rd trimester- 28-40wks

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

What might a low serum progesterone indicate?

A

Ectopic pregnancy

Miscarriage

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

The fundus of a pregnant uterus is normally palpable for a singleton pregnancy at how many weeks gestation?

A

12wks

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

The trophoblast accomplishes implantation and develops ——–

A

Into fetal portions of the placenta

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

What do the timbre do?

A

Sweep ovum into oviduct, carried along by smooth muscle contraction and cilia

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

What day after fertilisation does the blastocyst attach to the lining of the uterus?

A

Day 5-8

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

When the free floating blastocyst adheres to the endometrial lining what penetrates the endometrium?

A

Cords of trophoblastic tissue

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

By what day is the blastocyst completely buried in the endometrium?

A

Day 12

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

What is the placenta derived of?

A

Trophoblastic and decimal tissue

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

From what week of pregnancy is the placenta functional?

A

Functional by the 5th week

Sole source of nutrients from week 6

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

What is the function of the placenta?

A 
Hormone production
Gas exchange
Fetal homeostasis
Nutrient transport to fetus
Waste product transport to fetus
Acid base balance
Transport of IgG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the outermost fetal membrane around the embryo called?

A

Chorion

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

What allows trophoblastic nutrition for the first 4-12 weeks of pregnancy until placental diffusion happens?

A

The syncytiotrophoblasts invading decide and breaking down capillaries to form cavities filled with maternal blood

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

What does each placental villi contain?

A

Foetal capillaries

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

Progesterone stimulates decimal cells to concentrate —— ——-

A

Glycogen proteins and lipids

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

HCG signals the corpus lute to continue secreting ——

A

progesterone

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

Umbilical blood is O2 rich before the exchangeTRUE/FALSE

A

FALSE - maternal blood is o2 rich

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

In what vessel does the fetal O2 saturated blood return to the fetus?

A

Umbilical vein

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

The supply of the fetus with O2 is facilitated by which 3 factors?

A

Fetal Hb
Higher Hb
Bohr effect

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

In which trimester is high glucose needed?

A

3rd trimester

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

What are the two effects of HCG?

A

Prevents involution of corpus luteum

Effect on the testes of a male fetus- development of sex organs

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

From what week in pregnancy is human chorionic somatomammotropin produced?

A

From week 5 of pregnancy

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

What are the three effects of human chorionic sommatomammotropin?

A

Growth hormone like effects
Decreased insulin sensitivity in mother
Involved in breast development

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

What are the 3 effects of progesterone in pregnancy?

A

Development of decidual cells
Decreases uterus contractability
Preparation for lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does the estriol level indicate?

A

Viability of fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

3 effects of estradiol in pregnancy

A

Enlargement of uterus
Breast development
Relaxation of ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the maternal cardiovascular adaptations to pregnancy?

A

CO–> Increases 6-24wks, decreased
HR–> Increased
BP–> Decreased, steady increase from 22wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What hormone causes the respiratory maternal changes?

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are two problems that underweight women face when trying to get pregnant?

A

Reduced fertility
Hormone imbalance that affect ovulation
(Underweight women are more than 2x likely to take more than a year to get pregnant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the risks for the baby if the mother is overweight?

A 
Stillborn
Metabolic abnormalities
Defects
High birth weight
Diabetes
Cardio-metabolic abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why is reduced fetal growth associated with a number fo chronic conditions later in life?

A

This increased susceptibility is due to adaptations made by the foetus in an environment limited by its supply of nutrients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the dose of vitamin b (e.g. folic acid) given during pregnancy?

A

400ug (5mg if obese, diabetic or history of NTD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What can vitamin D deficiency cause in the mother?

A

Gestational diabetes
Pre-eclampsia
Bacterial Vaginosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the dose of vitamin d supplementation given?

A

10ug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How can the risk of iron deficiency be reduced?

A

iron supplementation -300mg
At risk if young age of first pregnancy
Have increased intervals between your births

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

TRUE/FALSE A high dose of vitamin A is teratogenic

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When breastfeeding how many extra calories do you need to have per day?

A

640

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the anabolic and catabolic phase of pregnancy?

A

Anabolic- wk1-20

Catabolic- wk21-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the average wt gain in pregnancy

A

24lbs (can be 75lbs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the fat gain per day in the last 4 weeks of pregnancy?

A

7g per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the vitamin supplements given as part of the healthy start scheme?

A

70mg VitC
10ug Vit D
400ug folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the incidence of baby blues?

A

50% of women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How long does baby blues last?

A

3-10 days

self-limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the onset of postnatal depression?

A

2-6wks postnatally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the lifetime risk of depression in those with postnatal depression?

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How does postnatal depression present?

A 
Lack of enjoyment
Wt loss
tearfullness
Irritability
Anxiety
Poor sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

When does puerperal psychosis present?

A

<2 weeks after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How does early puerperal psychosis present?

A

Sleep disturbances, confusion and irrational ideas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How does puerperal psychosis present later?

A

Mania, delusions, hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the lowest risk SSRI?

A

Sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Why should benzodiazepines be avoided?

A

1st trimester- fetal malformations
2nd trimester- floppy baby syndrome
3rd trimester- lethargy, wt loss and accumulation of drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Why should clozapine be avoided in pregnancy?

A

Risk of agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What can lithium toxicity mimic?

A

PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Lithium should be avoided in breastfeeding TRUE/FALSE

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

All antipsychotics are excreted in breastmilk TRUE/FALSE

A

TRUE- monitor for signs of sedation/lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What day does the neural tube close?

A

Day 28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Sodium valproate is dangerous in breastfeeding TRUE/FALSE

A

NA TIS GRAND

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is there a risk of if breastfeeding and on Lamotrigine?

A

Steven-Johnson syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the 5 risks of alcoholism in pregnancy?

A 
Miscarraige
Fetal Alcohol Syndrome
Withdrawl
Wernicke's encephalopathy
Korsakoff Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Heparin does not cross the placenta

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Why are ACEi/ARB teratogenic?

A

Renal hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

how is lithium teratogenic?

A

Cardiovascular defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

In pregnancy there is increased plasma volume and fat stores. IS THIS A LIE?

A

THIS IS TRUE

Therefore there is decreased protein binding and increased free drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the period of greatest teratogenic risk?

A

4th-11th weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

the risk of medication passing on in breast milk is usually similar to in utero TRUE/FALSE

A

FALSE

Milk exposure usually less than in utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the safest drug for nausea and vomiting in pregnancy?

A

Cyclizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is the safest drugs for pregnancy women with UTI

A

Nitrofurantoin

In 3rd trimester Trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

If pain in pregnancy what is the best drug to use?

A

Paracetamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

If heartburn in pregnancy what is the best drug to use?

A

Antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is fore milk rich in?

A

Protein rich

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is hing milk rich in?

A

Higher fat content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

At what week is chorionic villus testing done?

A

12wks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the miscarriage risk from chorionic villus testing?

A

1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

At what week gestation is amniocentesis testing done and where are the cells taken from?

A

15wks gestation

Skin/Urine cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the miscarriage risk with amniocentesis testing?

A

0.5-1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the difference between a mutation and a polymorphism?

A

Mutation- De-novo, bigger, affects known gene and previously reported in same phenotype

Polymorphism- Normal parent has it, smaller, “empty” genetic region and previously reported as a polymorphism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is aCGH for?

A

Chromosome deletions/duplications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is a robertsonian translocation?

A

Two acrocentric chromosomes stuck end to end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

If there is a condition that is X-linked such as duchesses can do non-invasive fetal sexing at how many weeks?

A

8wks

if boy then invasive testing, if a girl then stop worrying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

TRUE/FALSE

There is a slight risk of preterm labour if there is previous TOP

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What does the Fraser guidelines rate to?

A

The contraceptive and sexual health in under 16 year old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

In order to meet gillick competence what 5 points must be met?

A

1-Understand info given to them
2-Must be acting in their best interest
3-Advise that they are best to tell parent/guardian but do not have to do so
4-If without care their physical/mental health would suffer
5-If they will continue to be at risk then you should provide care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

With TOP the later the gestation the more painful and longer it takes TRUE/FALSE

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What sample is taken to screen for chlamydia and gonorrhoea?

A

Urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What sample is taken to screen for Hepatitis, HIV and Syphillis?

A

Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What sample is taken to test for herpes?

A

Swab of the genital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What drugs should be given pre TOP?

A 
Antibiotic prophylaxis - Metronidazole and Azithromycin
Anti D (if rhesus -)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is counted as early, late and mid trimester for medical TOP?

A

Early- <9 weeks
Late- 9-12 weeks
Mid-trimester 12-24wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What are the two drugs used in medical TOP?

A

1-oral MIFEPRISTONE

2- 24-48h later Prostaglandin e.g. MISOPRISTOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What types of surgical TOP can be carried out and when?

A

Manual vacuum aspiration (MVA) 6-12wks

Dilation and evacuation 13-24wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is used for cervical priming in surgical TOP?

A

Vaginal prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

2-3 weeks after TOP give a regular pregnancy test TRUE/FALSE

A

FALSE

give a low-sensitivity pregnancy test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

When should anti-D be given?

A

Within 72h of any event that could cause fetal -maternal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What are the 3 indications for treatment?

A

1-Confirm or refute diagnosis
2-Determine extent of disease
3-Assess response to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Why should a brief abdominal exam be conducted before transabdominal exam?

A

Ensure no hydronephrosis
Detect early ascites
Ensure pelvic abnormality is not secondary to upper abdominal pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

How is the transvaginal transducer different than the one used in abdominal scanning?

A

Higher frequency ultrasound, has a shorter wavelength and better spatial resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

For all US examinations need to have an empty bladder TRUE/FALSE

A

FALSE
TA- full bladder, “acoustic window”
TV-Empty bladder as if full it will be uncomfortable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the normal appearance of the endometrium on an US scan?

A

Trilaminar appearance (bright visible line in the centre of the uterus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Name 3 things that imaging is great at in relation to repro?

A

1-Post-surgical complications
2-Staging of gynaecology malignancy
3-Assessing response to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is a radiological way of diagnosing endometriosis?

A

Diagnostic laparoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What colour does fat look on T1 weighted scans?

A

White

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What are ovarian teratomas otherwise known as?

A

DERMOID CYSTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Where is the tissue that makes up dermoid cysts derived from?

A

Ectoderm, mesoderm and endoderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What does hysterosalpingography test?

A

Tubal patency in patients with infertility

105
Q

How are HSG preformed?

A

Cervix is cannulated and a radiopaque contrast instilled to fill the uterine cavity

106
Q

How does ovarian cancer spread?

A

Disseminated peritoneal spread

107
Q

TRUE/FALSE Malignant pleural effusions can occur as a result of ovarian cancer spread

A

YUP TOTALLY TRUE (Via pleural-peritoneal communications)

108
Q

What radiology is used for initial diagnosis and then what radiology is used for staging of ovarian cancer?

A

Initial diagnosis- US

Staging- CT

109
Q

How are the mets from cervical cancer radiologically assessed?

A

MRI for local disease

CT for distant mets

110
Q

What scanning is best for establishing abnormally thickened endometrium/

A

TVUS

111
Q

What radiology is used to determine the degree of myometrial invasion?

A

MRI scanning

112
Q

What scanning is used in endometrial cancer to look for distant nodal mets and pulmonary mets?

A

CT

113
Q

What is used to establish gestation accurately?

A

CRL until 13 weeks

HC after this

114
Q

What is the equation used for sensitivity?

A

True positive / (positive + false negative)

115
Q

What is the equation used for specificity?

A

True negative/ (negative + false positive)

116
Q

What does naegele’s rule predict?

A

An estimated due date based on the onset of the woman last menstural period (add 280 days)

117
Q

What percentage of people deliver 37-40wks

A

97%

118
Q

TRUE/FALSE

In most women as the womb grows upwards the placenta moves with it so that it is in a normal position before birth

A

TRUE

119
Q

What is placenta praevia?

A

Placenta attached very low on uterine wall, can cause severe bleeding

120
Q

What percentage of babies born with Down syndrome had a normal anomaly scan?

A

50%

121
Q

What test is done in the first trimester for Down syndrome?

A

US to measure nuchal thickness

122
Q

What is a normal nuchal thickness?

A

<3.5mm normal when CRL between 45-84mm

123
Q

The Down syndrome screening test is more accurate the older the mother is TRUE/FALSE

A

TRUE

124
Q

What is maternal serum AFP raised in/

A 
Multiple pregnancies (physiological)
Gastroscesis and spina bifida (due to amniotic fluid mixing)
125
Q

At 15-20wks a blood sample can be taken to test for Down syndrome by measuring which two things?

A

HCG

AFP

126
Q

Risk of Down syndrome is higher if serum levels are —— and maternal age is —–

A

Serum low

maternal high

127
Q

What is non-invasive pre-natal testing?

A

Test that identifies pregnant women who are at higher risk of having a baby with certain genetic and chromosomal conditions

128
Q

What is trisomy 18 also known as?

A

Edwards syndrome

129
Q

What is Pataus syndrome also known as?

A

Trisomy 13

130
Q

Maternal anaemia is due to ———- deficiency

A

B12/IRON/FOLATE

131
Q

When does vitamin D have to be given?

A

If there is a rhesus negative mother with a rhesus positive baby

132
Q

Briefly describe the mechanism of Rh

A

At birth Rh+ baby bloods enters mothers causing production of antibodies

Antibodies initially IgM (so no problem as too big to cross the placenta)

In later pregnancies Rh antibodies attack the baby’s blood cells causing Rh disease

133
Q

At what level is gestational diabetes diagnosed?

A

> 5.6mmol/l OR 2-hour 75g OGTT >7.8mmol/l

134
Q

What are the RF for gestational diabetes?

A
  1. BMI >30kg/m2
  2. Previous macroscopic baby/gestational diabetes
  3. FHx diabetes
  4. Minority ethnic family origin with a high prevalence of diabetes
135
Q

If there is a single SFH plot below the 10th centile OR serial measurement of slow/static growth then what is the next step?

A

US measurement of fetal size

136
Q

What is hypertension defined as?

A

> = 140/90 mmHg on 2 occasions OR >160/110mmHg once

137
Q

Hypertension affects what percentage of pregnancies?

A

10-15%

138
Q

If BP is still not normal 3 months post delivery what is the diagnosis

A

Retrospective diagnosis of pre-existing hypertension

139
Q

Which part of pregnancy do PET and PIH affect?

A

The second half

140
Q

Why are B-Blockers avoided in pregnancy?

A

May inhibit fetal growth

141
Q

If needed to treat pre-exisiting hypertension what drug could be used?

A

Labetalol

Methydopa

142
Q

Pregnancy induced hypertension has better outcomes than preeclampsia. What is the but?

A

15% progress to PET

143
Q

What is the most common cause of iatrogenic prematurity?

A

Pre eclampsia

144
Q

What is pre eclampsia defined as?

A

Pregnancy induced hypertension and proteinuria

145
Q

Proposed pathophysiology of pre eclampsia?

A

Anti androgenic state associated with widespread endothelial dysfunction

146
Q

PET is a widespread manifestation with multi system disorder. Name them alll

A 
Renal blood flow and CFR decrease
Headache, visual disturbance and N&amp;V
Epigastric/RUQ pain
Brisk reflexes/clonus, confusion, fits
Placental abruption, IUGR and stillbirth
147
Q

Woman at high risk of pre-eclampsia should take 75mg of what daily from 12wks to birth

A

Aspirin

148
Q

Who is at high risk of preeclampsia?

A

Hypotensive, CKD, Autoimmune conditions, diabetes

149
Q

What are moderate risk factors for preeclampsia?

A

1st pregnancy, 40 years+, BMI >35, FHx of pre-eclampsia, multiple pregnancy, pregnancy interval 10y+

150
Q

What will the urine protein- creatinine ratio (PCR) be if they have PET?

A

(PCR) >30mg/mmol

151
Q

If patient has PET what will there be on US?

A

Notching

152
Q

What is eclampsia?

A

Emergency

Tonic clonic seizure + pre-eclampsia

153
Q

How do you treat eclampsia?

A

Vasodilatory e.g. IV Labetalol, hydralazine & C-Section
Magnesium Sulphate
If repeated seizures then diazepam

154
Q

What do you use if there is magnesium sulphate toxicity?

A

Calcium gluconate

155
Q

What is HELLP?

A 
H-Haemolysis
E-Elevated
L-Liver enzymes
L-Low
P-Platlets
156
Q

What is the cure for HELLP?

A

Delivery of the fetus

157
Q

What is the leading cause of maternal deaths in the UK?

A

Cardiac disease

158
Q

TRUE/FALSE If patient has pulmonary hypertension advise against pregnancy

A

TRUE

159
Q

if cyanotic and uncorrected congenital heart disease then increased risk of….

A

IUGR

160
Q

What percentage of people with Marfans have cardiac involvement?

A

80%

161
Q

If the pregnant patient has mitral stenosis then what should they watch for?

A

Dyspnoea
Orthopnoea
PND

162
Q

How do you treat SVT?

A

Vagal manœuvres and/or adenosine

163
Q

TRUE/FALSE Poorly controlled asthma poses a greater risk to pregnancy than the drugs used to treat it

A

TRUE

164
Q

What is the commonest chronic medical disorder to complicate pregnancy?

A

Asthma

165
Q

Why are asthma attacks rare in pregnancy?

A

Due to endogenous steroids

166
Q

What are the treatment steps for asthma?

A
  1. SABA
    • inhaled steroid
    • LABA
  4. ^ Steroid dose if LABA not working or ineffective
167
Q

Why should you beware new onset asthma in pregnant women?

A

Pulmonary oedema can cause wheezing too

168
Q

What is the increase in risk of VTE in pregnancy?

A

4-6x increased risk

169
Q

85-90% of DVTs occurring during pregnancy arise in which leg?

A

Left leg

170
Q

What are the 3 things included in Virchow’s triad?

A

Hypercoaguability
Venous stasis
Vascular damage

171
Q

What is the presentation of DVT?

A

Swelling, Oedema, leg pain/discomfort, tenderness, increased leg temp, lower abdominal pain, elevated WCC

172
Q

How do you test for DVT?

A

Compression Duplex US

MRI and Venography (if iliac vein thrombosis suspected)

173
Q

What is the presentation of VTE?

A

Dyspnoea, Chest pain, faintness, collapse, haemoptysis, ^ JVP, focal signs in the chest and symptoms/signs ass with DVT

174
Q

The mother is at significant risk of VTE if she has 2+ RF. Name all da RF

A 
Obesity
Age >35y
Smoking
Para >3
Previous DVT/VTE
C-section
175
Q

If the mother is determined to be at significant risk of VTE then she is treated with…

A

Thromboprophylaxis with LMWH

176
Q

Why is warfarin avoided?

A

Early pregnancy- teratogenic

Late pregnancy- Risk of haemorrhage

177
Q

TRUE/FALSE

RA is made much worse during pregnancy

A

False

Usually alleviated

178
Q

Methotrexate is CI in RA TRUE/FALSE

A

TRUE (Use sulfasalazine instead)

179
Q

Why are NSAIDs not used in the 3rd trimester of pregnancy?

A

Can cause premature closure of ductus arteriosus

Associated with renal impairment in the newborn

180
Q

What is APS?

A

Anti-phospholipid syndrome

Acquired thrombophilia with variable severity and presentation

181
Q

How does APS present?

A

Anterior/venous thrombosis
Recurrent early pregnancy loss usually preceded by FGR
Placental abruption
Severe early-onset pre-eclampsia
Severe early onset fetal growth restriction

182
Q

How is APS diagnosed?

A

aPL on two tests taken >8wks apart +- past arterial/venous thrombosis or recurrent pregnancy loss

183
Q

How is APS treated?

A

aspirin 75mg daily from conception
heparin from when fetal heart identified
postpartum use heparin or warfarin

184
Q

TRUE/FALSE

With epilepsy seizure frequency drastically increases during pregnancy?

A

FLASE

IT DOES NOT AT ALL (increase in seizures in 10%)

185
Q

If do get seizures in pregnancy these should be terminated as soon as possible using what?

A

Benzodiazepines

186
Q

How much folic acid should those with epilepsy get?

A

5mg daily

187
Q

Aside from epilepsy what are some causes of seizures in pregnancy?

A 
Eclampsia
Stroke
Infection
Cerebral vein thrombosis
Intracranial mass
Hypoglycaemia
Drugs and withdrawl
Postural puncture
Pseudoseizure
188
Q

How common is bleeding in early pregnancy?

A

20%

189
Q

What are causes of bleeding in early pregnancy?

A

Implantation bleeding
Chorionic haematoma
Cervical causes (infection, malignancy, polyp)
Vaginal causes (infection, malignany-rare)
Unrelated ( haematuria, PR bleeding)

190
Q

If bleeding is profuse then what should be administered?

A

Ergometrine 0.5mg IM

191
Q

What is miscarriage?

A

The loss of a pregnancy before 24wks gestation

192
Q

Pregnancy test may remain positive for several days after a pregnancy loss TRUE/FALSE

A

TRUE

193
Q

What are the symptoms of miscarriage?

A

Bleeding 1st symptom
Positive UPT
Varied gestation
Period cramping

194
Q

Severe emotional upset can cause a miscarriage TRUE/FALSE

A

TRUE

195
Q

What is the pathophysiology of miscarriage?

A

Bleeding form placental bed or chorion causing hypoxia and villous/placental dysfunction. This causes embryonic demise.

196
Q

What percentage of threatened miscarriages will settle?

A

75%

197
Q

What is the management of early fetal demise?

A

Mifepristone or Misoprostol

198
Q

How long might a lady bleed for after medical management for miscarriage?

A

3 weeks

199
Q

What is recurrent miscarriages defined as?

A

The loss of 3+ consecutive pregnancies before 24wks gestation with the same biological father

200
Q

Diabetes increases miscarriage risk TRUE/FALSE

A

FALSE

Not if it is well controlled (The same goes for thyroid problems and PCOS)

201
Q

Treatment for antiphospholid syndrome?

A

Aspirin from the day of positive pregnancy

LMWH from when the fetal heartbeat is seen until delivery

202
Q

Diagnostic criteria for antiphospholid syndrome

A

Presence of antibodies on 2 occasions plus one of the following….
…..3+ consecutive miscarriages <10wks
…. 1 fetal loss 10wks+
….1+ births to normal foetus >34/40wks with severe pre-eclapmsia/growth restriction

203
Q

In those with inherited thrombophilia what it used to reduce the risk of miscarriage?

A

Heparin

204
Q

Pregnancy after tubal ligation is more likely to be ectopic TRUE/FALSE

A

TRUE 9x more likely

205
Q

Where are 97% of ectopic pregnancies?

A

Tubal

206
Q

Signs and symptoms of ectopic pregnancy

A

Amenorrhoea, vaginal bleeding
Pain: Non specific unilateral lower abdominal + shoulder tip pain
Diarrhoea, loose stools and/or vomiting, dizziness, collapse
Cervical excitation w or wo adnexal tenderness

207
Q

What would be your spot diagnosis?

Young sexually active woman with abdominal pain, bleeding, fainting and D&V

A

Ectopic pregnancy

208
Q

Hormone levels can distinguish where the pregnancy is TRUE/FALSE

A

WISE UP

no but TVS can

209
Q

If there is hypovolaemic shock in an ectopic pregnancy what is the preferred management?

A

Surgical

210
Q

When should medical management for ectopic pregnancy be followed?

A

If woman is stable, asymptomatic/mild symptoms, low levels of bhCG (<3000IU) and ectopic is small (<3cm)

211
Q

What would medical management of ectopic pregnancy look like?

A

Methotrexate IM as a single dose
(do hCG levels on days 4 and 7)
As tetrogenic need to use reliable contraception for 3months afterwards

212
Q

What is hydatidiform mole?

A

Where the foetus doesn’t develop properly in the womb and a lump of abnormal cells grows instead of a healthy foetus

213
Q

A molar pregnancy is very vascular although it is not premalignant. TRUE/FALSE

A

FALSE
very vascular
pre-malugnant

214
Q

What is a complete mole?

A

Mass of abnormal cells in womb, no foetus develops. Egg without DNA, 1 or 2 sperm fertilise

215
Q

What does a complete mole look like on US?

A

Snowstorm appearance

216
Q

What does a complete mole look like?

A

A bunch of grapes filling the endometrial cavity

due to the overgrowth of placental tissue with chorionic villi swollen

217
Q

What is a partial mole?

A

An abnormal foetus starts to form but it can’t survive or develop into a baby

218
Q

Molar pregnancies make lots of hCG giving rise to exaggerated pregnancy symptoms and a strongly positive pregnancy test. From which tissue is it derived?

A

Chorion

219
Q

What makes molar pregnancies more common?

A

Asian
Extremes of reproductive age
Previous molar pregnancy

220
Q

Why might you get hypothyroidism with a molar pregnancy?

A

hCG resembles TSH

221
Q

After a molar pregnancy when should the hCG return to normal?

A

within 6 months

222
Q

What is implantation bleeding?

A

Bleeding when a fertilised egg implants into the uterine wall, 10 days post-ovulation

223
Q

How can an implantation bleed be differentiated from a period bleed?

A

Implantation-10 days post ovulation, Light/brownism, limited, soon signs of pregnancy
Period- 2wks post ovulation, heavier, bright red

224
Q

What is chorionic haematoma?

A

Pooling of blood between endometrium and the embryo due to separation

225
Q

What is the risk with a large haematoma?

A

Source of infection

226
Q

What is the most common cause of bleeding in the last months of pregnancy?

A

Cervical ectropian

227
Q

What is trichomoniasis known affectionately as?

A

Strawberry vagina

228
Q

What is antepartum haemorrhage (APH)?

A

Bleeding from the genital tract >= 24wks and before the end of the second stage of labour

229
Q

What is Keilhauer test?

A

Blood test that measures the amount of fetal haemoglobin transferred from fetus’ to mothers’ bloodstream

230
Q

Name 4 causes of APH?

A

Placental abruption
Placenta praevia
Uterine rupture
Vasa praevia

231
Q

What is placental abruption?

A

Separation of a normally implanted placenta- totally/portially before the birth of the foetus
CLINICAL DIAGNOSIS

232
Q

What is couvelaire uterus?

A

Life-threatening
loosing of the placenta causes bleeding that penetrates into the uterine myometrium forcing its way into the peritoneal cavity

233
Q

What are the symptoms of placental abruption?

A

Severe abdo pain-continuous
Bleeding
Preterm labour
May present with collapse or backache

234
Q

If you have a previous abruption what is the chance of recurrance?

A

10%

235
Q

What is placenta praevia?

A

Placenta lies directly over the internal os

236
Q

What is the cause of 40% of APH?

A

Placental abruption

237
Q

What is the cause of 20% of APH?

A

Placenta praevia

238
Q

Presentation of placenta praevia

A

Painless bleeding >24wks

Usually recurrent

239
Q

What is placenta praevia confirmed by?

A

TV US

240
Q

If you suspect placenta praevia preform a vaginal exam immediately true/false

A

FALSE
c’mon what ya playing
DO NOT PERFORM A VAGINAL EXAM until placenta praevia is excluded

241
Q

TRUE/FALSE

C-section is associated with increased risk of placenta praevia in subsequent pregnancies

A

TRUE

242
Q

What scan should be done if placenta accrete is suspected?

A

MRI

243
Q

Management fo placenta praevia?

A

Antenatal corticosteroids
Tocolysis
MgSO4

244
Q

When can you do a vaginal delivery with placenta praevia?

A

If placenta >2cm from os and no malpresentation

245
Q

What is uterine rupture?

A

Full thickness opening of the uterus

246
Q

What are the signs of uterine rupture?

A 
Loss of contractions
Acute abdomen
PP rises
Peritonism
Fetal distress/IUD
247
Q

What is used to confirm vasa praevia?

A

TV US

248
Q

What is type 1 vasa praevia?

A

Where the vessel is connected to a velamentous umbilical cord

249
Q

What is type 2 vasa praevia?

A

When it connects the placenta with a succenturiate or accessory lobe

250
Q

What is vasa praevia?

A

Where fetal blood vessels run near/across the opening of the internal os

251
Q

What is the presentation of vasa praevia?

A

Painless vaginal bleeding
Rupture of membranes
Fetal bradycardia

252
Q

What is PPH defined as?

A

Blood loss equal or exceeding 500mls after the birth of a baby

253
Q

Do most women respond to the utero-tonic agents used with PPH?

A

Yes, yes they do

254
Q

What is the number that is the border between a minor and a major PPH?

A

1000ml

255
Q

What are the four T causes of PPH?

A

Tone- 70%
Trauma-20%
Tissue-10%
Thrombin- <1%

256
Q

How can PPH in most cases be avoided?

A

Active management of the 3rd stage

Syntocinon/Syntometrine

257
Q

What drug can be used in PPH to try and stop the bleeding?

A

Ergometrine IV

258
Q

When does placenta accrete occur?

A

When the placenta goes too deeply into the uterine wall

259
Q

What are the two major RF for placenta accrete?

A

Placenta praevia

Prior caesarean delivery

ADELE-Repro Ramblings (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions