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Front 1

What is the cut off week for viability in pregnancy?

Back 1

24 week

Before is Miscarriage

After is still born

Front 2

What are stages of labour

Back 2

Stage 1- latent 0-3cm and active phase 3-10cm dilation

Stage 2- propulsive (full dilation to presenting part engaging), Expulsive (from reaching the pelvic floor to delivery of the baby).

Stage 3- from delivery to expulsion of the placenta

Front 3

What is Macrosomia and what is it associated with?

Back 3

Macrosomia- significantly larger than normal fetus. Commonly due to gestational diabetes.

Front 4

What phase do primary oocytes arrest in?

Back 4

Prophase 1 of meiosis 1

Front 5

What phase do secondary oocytes arrest in?

Back 5

metaphase 2 of meiosis 2 until fertilisation

Front 6

What does progesterone do?

Back 6

It switches the endometrium to it's secretory phase ready for implantation and also prevents uterine smooth muscle contraction.

Front 7

What are the 3 signs of pregnancy?

Back 7

The show- release of the mucus plug

Rupture of membranes- waters breaking

Painful contractions- begin to get progressively closer together.

Front 8

What immunoglobulin is transferred in breast milk?

Back 8

IgA, IgG is transferred across the placenta.

Front 9

Eisenmenger's syndrome

Back 9

Where a long standing left to right shunt causes pulmonary hypotension and eventual reversal of the shunt

Front 10

At what level does the parasympathetic supply to the penis originate?

Back 10

The pelvic splanchnic nerves- S2-S4

Front 11

From which artery does the vessels that supply the erectile vessels branch from ?

Back 11

The internal pudendal artery- this is initiated by the relaxing of the SM by the parasympathetic innervation.

Front 12

Where do the sympathetic fibres that supply the genitals originate from?

Back 12

The preganglionic fibres that leave the spinal cord at the levels T10- L2.

Front 13

Signs and Symptoms of BPH?

Back 13

Slowstream

Hesitancy

Intermittentflow

Terminaldribbling

Emptyingis incomplete

Front 14

What is the significance of meconium in the fetal liquor?

Back 14

Intrauterine fetal stool contains meconium from desquamated bowel cells and is usually released from the fetus during hypoxia. Hypoxia also causes gasping which can cause the fetus to aspirate this meconium which can prevent normal respiration at birth.

Front 15

What is the APGAR score and what does it assess?

Back 15

It is a test used to quickly assess an infant at 1 and 5 minutes of age. It assesses:

Apperance- cyanotic or not

Pulse- heart rate

Grimace- facial response to irritable stimuli

Activity- level of active movement (tone)

Respiration- crying, breathing?

Front 16

What is hypoxia?

Back 16

It is a lack of oxygen supplied to the tissues not lack of oxygen.

Front 17

What is a normal fetal heart rate?

Back 17

120-150 BPM

Front 18

What is a neonate?

Back 18

Neonate- a child which is less than 4 weeks old.

Front 19

Give the three non-enveloped DNA viruses

Back 19

P- Parvovirus

A- Adenovirus

P- Papillomavirus

Front 20

Give the 3 types of subfertility

Back 20

Type 1-Hypopituiatary failure- no LH/ FSH release

Type 2- Hypopituitary dysfunction- low or lack of response to LH/ FSH

Type 3- ovarian failure

Front 21

What do you give in pregnancy for seizures?

Back 21

Magnesium

Front 22

What is Hypermesis Gravidum?

Back 22

More sever morning sickness characterised by nausea and vomiting such that weight loss and dehydration occur- give ondasteron (5-HT3 receptor antagonist).

Front 23

What can be given to induce placental delivery?

Back 23

Oxytocin

Front 24

What are fibroids?

Back 24

They are oestrogen dependent soft tissue tumours which can grow and compress the uterus

Front 25

Why do ectopic pregnancies cause bleeding?

Back 25

Because they stretch the anastomoses of the vaginal and uterine artery which join along the course of the fallopian tubes.

Front 26

What is the most common cause of post partum haemorrhage?

Back 26

Uterine atony

Front 27

What are the 4 causes of primary post partum haemorrhage?

Back 27

4 T's

Tone

Trauma

Tissue

Thrombin

Front 28

Define primary and secondary post partum haemorrhage.

Back 28

Primary- Birth to 24 hours after, >500ml lost

Secondary- excessive blood loss, 24hrs to 6 weeks after

Front 29

What is Scimitar syndrome?

Back 29

Where oxygenated blood from the right lung returns to the venous system.

Front 30

Give 3 bacteria that cause meningitis.

Back 30

Streptococcus pneumoniae

Neisseria meningitidis

Haemophilus influenza B

Front 31

What must be given to help fetal lungs in cesarian section?

Back 31

Glucocorticoids to help induce production of fetal surfactant.

Front 32

What is the definition of small for gestational age?

Back 32

Being less than the 10th centile.

Front 33

Definition of Faltering growth

Back 33

Where the fetus does not achieve that same rate of growth predicted by earlier measurements- does not achieve full growing capacity.

Front 34

Common complications of premature babies

Back 34

Poor temperature control- hypothermia

Hypoglycemia

Polycythemia

Front 35

Why does gestational diabetes cause macrosomia?

Back 35

Due to the baby trying to compensate for the mother by producing more insulin which includes insulin like growth factor which causes the fetus to grow large. This may require induced birth or delivery as placental insufficiency may be an issue.

Front 36

What is a preterm baby?

Back 36

Less than 37 weeks gestation.

<37/40

Front 37

What spinal levels provide parasympathetic innervation to the genitals?

Back 37

T10-L2

Front 38

What is Viagre?

Back 38

It is a PD5 inhibitor

Front 39

What is:

Antepartum haemorrhage?

Intrapartum haerorrhage?

Post partum haemorrhage (primary and secondary)?

Back 39

Antepartum- 24 weeks to birth

Intrapartum- 1st and 2nd stages of birth

Post partum (primary)- more than 500 ml from delivery to 24hrs later.

Secondary- beyond 24 hrs later to 6 weeks.

Front 40

Signs of fetal distress?

Back 40

Tachy or bradycardia

Type 2 decelerations

Meconiumpresent in the amniotic fluid

Reduced baseline variablity

Front 41

What is the definition of infertility?

Primary and Secondary

Back 41

The inability to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.

Primary- never had successful pregnancy

Secondary- had previous successful pregnancies

Front 42

What are the 3 types of classification of subfertility?

Back 42

Type 1- hypopituitary failure- no LH/ FSH release

Type 2- Hypopituitary dysfunction- low or no response to LH/ FSH

Type 3- Ovarian failure

Front 43

How many follicles per ovary is diagnostic of polycystic ovarian syndrome?

Back 43

More than 10 follicles per ovary

Front 44

What is endometriosis and what can it cause?

Back 44

It is where there is the prescence of endometrium outside the uterine cavity causing pain, menorrhagia.

Can also be a cause of infertility.

Front 45

What are fibroids?

Back 45

They are uterine non-cancerous growths in and around the myometrium of the uterus and cause regular, heavy periods.

Trans acid can lighten the bleeding.

Common in Afrocaribeans

Front 46

After what time periods should IVF be offered?

Back 46

After 2 years of unprotected sexual intercourse.

Particularly if they are >36YO or have predisposing factors

Offer to women <40YO who have not concieved after 2 years of unprotected sexual intercourse or after 12 cycles of intrauterine sperm injection.

Offer 3 cycles.

Front 47

What is Clomifene used for?

Back 47

Clomifene- stimulates release of an egg.

Front 48

Give 4 different interventions that can be used for subfertility.

Back 48

Intrauterine insemination- sperm injected into the vagina.

In-vitro Fertilisation- eggs fertilised outside the body and then transferred back into the uterus.

Intracytoplasmic sperm injection- single sperm is injected directly into an egg, for severe deficits in semen quality.

Front 49

What 3 measurements are taken during a sperm count?

Back 49

Motility

Morphology

Volume

Front 50

How many cycles should be offered to women under 40 and over 40 and what are the criteria?

Back 50

Criteria- no success after 2 years of unprotected sexual intercourse and 12 cycles of IUI and no previous IVF.

Women <40YO- offer 3 cycles

Women 40YO-42YO- offer 1 cycle

1.9% success rate in women >45YO

Front 51

Name the 3 non-enveloped RNA and DNA viruses

Back 51

DNA- PAP

Papillomavirus, Adenovirus, Parvovirus.

RNA- REH

Rotavirus, Enteroviruses, Hepatitis A.

Front 52

Why do women get gestational diabetes?

Back 52

In pregnancy the placenta secretes cortisol and other anti-insulin hormones which cause a state of insulin resistance.

Front 53

What is a common complication of gestational diabetes?

Back 53

Macrosomia- the extra sugar goes to the baby and this can exacerbate the ability of the placenta to supply nutrients- birth asphyxia and traumatic birth occur.

Front 54

Why may a HbA1c test give a false negative result in pregnancy?

Back 54

Anaemia may result in pregnancy therefore the Hb will be naturally low.

Front 55

What is the leading cause of neonatal infections?

Back 55

Group B strep. from the normal vaginal bacteria (flora).

Front 56

Which hepatitis is spread via sexual intercourse, is DNA and is tetragenic?

Back 56

Hepatitis B

Front 57

What are the different types of miscarriage?

Back 57

Threatened- light bleeding with cervical Os closed

Inevitable- heavy bleeding with Os open

Incomplete- heavy bleeding, Os open, Some parts passed.

Complete- All parts passed, bleeding has diminished or stopped and Os closed.

Missed- Os closed but no fetal heart trace.

Septic- The contents of the uterus are infected.

Front 58

What do you give Methotrexate for in ectopic pregnancy?

Back 58

Give methotrexate as it is a chemotherapy drug which will cause removal of the ectopic contents.

Front 59

What is placental abruption?

Back 59

It is where antepartum (beyond 24 weeks but before delivery) hemorrhage occurs due to separation of the placenta from the uterine walls.

Front 60

What is the difference between placenta praevia major and minor.

Back 60

Major- the placenta grows over the Os completely.

Minor- the placenta touches the Os.

There is no SM in the lower uterus so at delivery there is lack of SM to contract to stop postpartum bleeding.

Front 61

What is placenta accreta?

Back 61

It is where the placenta inserts onto a scar from an old C-section meaning the placenta doesn't separate well. This must be treated with a hysterectomy (removal of the uterus).

Front 62

Give 3 signs of fetal distress.

Back 62

Meconium- stained liquor with fetal faeces which can be inhaled causing GI problems.

Baseline tachy or bradycardia <100 or >160 bpm.

Reduced baseline variability <5bpm

Decelerations

Front 63

What is uterine atony?

Back 63

It is where the uterus fails to contract after delivery causing excessive postpartum haemorrhage >500ml.

Front 64

List problems with the passages in labour.

Back 64

Contracted pelvis- android not gynecoid shape

Placenta praevia

Fibroids

Front 65

Problems with the powers

Back 65

Uterine inertia

Inco-ordinate contractions

Hypertonic contractions

Uterine rupture

Front 66

Problems with the passengers

Back 66

Number

Position

Size

Front 67

Under what age is sexual intercourse considered rape?

Back 67

13 Years Old

Front 68

What is the Puerperium?

Back 68

It is the time from delivery to 6 weeks after delivery- usually the amount of time for the uterus is involute and for the physiological changes to return to normal.

Front 69

What is thromboembloic disease in pregnancy?

Back 69

It is the increased risk of suffering from an embolism or thrombus formation during and post pregnancy due to increased coaguability.

Front 70

Causes of postpartum complications?

Back 70

•PostpartumHaemorrhage (PPH)•Thromboembolicdisease (TED)

•Psychiatricdisorders

•Pre-eclampsia

•Sepsis-women with infections who deliver at home and fail to seek help.

Front 71

Direct vs Indirect maternal death

Back 71

Direct- occurs as a direct result of the pregnancy.

Indirect- Occurs due to a pre-existing condition.

Front 72

By what day does the neural tube close?

Back 72

Day 28

Front 73

What is birth asphyxia and what does it commonly result in?

Back 73

It is the state or process of being deprived of oxygen which can result in unconsciousness or death.

Hypoxic-Ischemic encephalopathy,

Front 74

Is Gastroschisis or Omanocephele covered in peritoneum?

Back 74

Omanocephele is covered in peritoenum. Gastroschisis isn't as it look like shite.

Front 75

What are the different definitions of:

Still born

Miscarriage

Neonatal death

Infant death

Back 75

Still born- death after 24 weeks

Miscarriage- death before 24 weeks

Neonatal death- baby born alive but dies within first 28 days.

Infant death- death within the first year of life

Front 76

What is a neonate?

Back 76

It is a child that is less than 28 days (4 weeks) old.

Front 77

Why does gestational diabetes lead to macrosomia?

Back 77

The mother produces extra insulin to counteract the high blood glucose, this includes IGF-1 which acts similarly to growth factors causing an enlarged baby.

Front 78

What is Waterhouse- Friderichsen syndrome?

Water= adrenal glands

Frid= Fred West= Infant death.

Back 78

It is adrenal insufficiency in neonates leading to SUDS due to haemorrhag into the adrenal glands due to severe bacterial infection (meningococcus Neisseria meningitidis).

This causes- low BP, Shock, Disseminated intravascular coagulation, coma.

Front 79

Sudden infant death syndrome?

Give 2 risk factors.

Back 79

Is the death of an infant (birth- 1 year) where after full investigation of the death scene, review of clinical history and complete autopsy, a cause can still not be identified.

Risk factors- co-sleeping, low social classes, low birth weight, maternal smoking.

Front 80

Give 2 reasons that SIDS numbers have reduced in recent years.

Back 80

Better awareness- back-to-sleep

Less co-sleeping

Better autopsy process

Front 81

What is the treatment ladder for Pneumonia?

Back 81

Amoxicillin

Clithramycin

Co-amoxiclav

Front 82

What is the difference between Crohn's disease and Ulcerative Colitis interms of spread along the colon.

Back 82

Crohn's- from mouth to anus, but not continous- has skip lesions.

Ulcerative Colitis- continous with no skip lesions but only in the colon/ rectum.

Front 83

What is Scimitar syndrome?

Back 83

It is a cardiovascular abnormality where the oxygenated blood from the right lung drains back into the vena cava on the right side instead of the left atrium.

This presents with a shadow over the right lung- Scimitar sign.

Front 84

Is an expiratory wheeze intra or extrathroacic?

Back 84

Expiratory= intrathoracic

On expiration the alveoli constrict and narrow to help expel the air. On inspiration the opposite occurs and large airways constrict causing an inspiratory wheeze (asthma).

Front 85

Are Cocci Gram +ve or Gram -ve?

Back 85

Cocci are Gram +ve

Front 86

What is long Q-T syndrome and why does it make an infant vunerable?

Back 86

Long Q-T syndrome is a prolonged gap between the Q and T waves which is indicative of an abnormality of the serotoninergic network (including the arcuate nucleus). This causes slower responses to autonomic changes (increase in HR or RR).

Front 87

What is a Wilm's tumour?

Back 87

It is a tumour of the kidneys (nephroblastoma)

Front 88

What is considered a premature birth?

Back 88

Birth before 37 weeks gestation.

Front 89

Small for gestational age?

Back 89

Birth weight below the 10th centile.

Front 90

What is respiratory distress syndrome?

Back 90

Lack of surfactant- mainly in premature babies, causing collapse of the alveoli.

Front 91

What is the main complication of CMV infection?

Back 91

Causes Deafness.

Front 92

What is the definition of fetal growth restriction?

Back 92

Failure to achieve a normal rate of fetal growth.

Front 93

What is the difference between Symmetrical and Asymmetrical IUGR?

Back 93

Symmetrical- both head and abdomen are small

Asymmetrical- Head is spared and is normal size and abdomen is small.

For asymmetrical to occur the restriction must occur early in gestation.

Front 94

Give two ways that IUGR can be assessed.

Back 94

Fetal movements

Ultrasonography

Amniotic fluid volume

Front 95

What does the heel prick test for?

Back 95

Sickle cell anaemia

Cystic fibrosis

Hypothyroidism

phenylketouria

Downs syndrome

Front 96

Causes of intrauterine growth restriction?

Back 96

Cord Stricture

Thrombi in chorionic vessels

Hypercoiled umbilical cord

Front 97

Causes of prematurity

Back 97

Intrauterine infection

Premature rupture of membranes

Uterine fibroids

Cervical incompetence

Placental praevia

Placenta abruption

Induction of labour due to maternal or fetal distress

Front 98

What are the 3 categories of muscoloskeletal disorders?

Back 98

Back pain

Myalgia- muscle aches

Arthralgia- joint aches

Front 99

Most common cause of post partum haemorrhage (>500ml birth to 24 hours after)?

Back 99

Uterine atony

Front 100

Where in the prostate are cancers and BPH usually found?

Back 100

Prostate cancer- peripheral zone- harder to detect

BPH- peripheral zone- causes many S+S

Front 101

What weights define:

Low birth weight

Very low birth weight

Extremely low birth weight

Back 101

LBW- <2500g

VLBW- <1500g

ELBW- <1000g

Front 102

Gestational diabetes

Back 102

Intolerance to carbohydrate of variable severity with first presentation during pregnancy. Control with metformin or insulin and perform a glucose tolerance test 6 weeks after delivery.