Tintinalli MCQS Flashcards
(28 cards)
What percentage of women on OCP experience abnormal bleeding in first 4-6 months?
40%
The most common coagulopathy causing heavy uterine bleeding is..
Von Willebrands
Adverse effects of ovarian hyperstimulation syndrome
AKI VTE - Saggital sinus thrombosis Ascites, pulmonary effusion Inc WCC (>25) Hypoalbuminaemia
Which side is ovarian torsion more common on?
Right - 50-70%
What is ovarian hyperstiumulation syndrome?
Iatrogenic condition in women undergoing ovulation induction which is due to exaggerated response to FSH and LH
Risk factors for ovarian torsion
Pregnancy, ovarian hypertstimulation syndrome, large cysts
T or F, N&V is rare in ovarian torsion
False - Present in 60-70% of cases
Can tenderness be bilateral in ovarian torsion?
Yes, 30% of patients have bilateral adenexal tendernes s on bimanual
How useful is doppler ultrasound in ovarian torsion? What percentage does it miss and is a positive study for poor blood flow diagnostic?
Can be missed in 60% of cases. A positive doppler ultrasound is 100% predictive.
Heterotrophic pregnancies occur in what percentage of naturally conceived pregnancy?
1:30,000 (1-3:100 in ARF, 1:3000 in general)
How long can bHCG remain positive after ectopic pregnancy surgery?
2-3 weeks
Where are ectopic pregnancies most commonly located?
80% in ampulla 10% in isthmus
Do the following require Anti-D ?
- Medical termination of pregnancy
- CVS
- Threatened miscarriage
- Complete miscarriage
- Ectopic pregnancy
Anti-D is not recommended for threatened miscarriage if before 12 weeks. Rest get anti-D
Is bleeding or vomiting more common in a molar pregnancy?
Bleeding - 75-95%
Hyperemesis - 26%
Who/when is DKA most common in obstetric patients?
2nd and 3rd trimester or newly diagnosed DM in pregnancy
Do transient hyperthyroidism of hyperemesis gravidarum develop palpable goitre or antibodies?
NO
What is the risk of VTE in a) pregnancy b) postpartum
a) 5x general population b) 60x general population
Is it more common to get left or right sided DVTs, why?
Left side DVTS (90%) is more common due to right iliac artery crosses left iliac vein
Rank the following from most radiation exposure to the fetus to least
- Abdo-xray
- Chest CTPA
- CXR
- CT KUB
- VQ scan
- Head CT
- AbdoCT
- Pelvic x-ray
AbdoCT>CT KUB> VQ SCAN or Abdo x-ray>Head CT>Pelvic x-ray>Chest CTPA>CXR
In placental abruption, how useful is CTG and ultrasound
CTG has 100% negative predictive value for adverse outcomes
U/S high SP, low SN
Do you expect bleeding in placental abruption?
yes (80%), but often mild
Why should ADF not be used in PROM?
Risk of necrotising enterocolitis
PPH Risk factors
Birthweight >4.5kg Pre-eclampsia Prolonged third stage Fetal age <32w Placental praevia Transverse lie Cervical trauma Coagulopathy Previous PPH
Which of the following do not need to be rushed to caesarean section? Complete breech Transverse Footling breech Frank breech Cord prolapse
Complete and frank breech
