Obgyn Jumble

Front 1

Postnatal Check for mother at 6 weeks:

Back 1

weight, BP
urine
vaginal discharge, period
wounds
breasts
contraception, sex
+/- pap

Front 2

isoimmunisation

Back 2

development of antibodies to antigen
(eg. Rh incompatibility)

Front 3

Group & Hold

Back 3

Determines ABO group and screening for antibodies to common red cell antigens that can cause transfusion reactions

Front 4

Group & Crossmatch

Back 4

In additionto group & hold, crossmatching involves mixing samples from donor blood with the patient's blood

Front 5

1 unit of blood raises the Hb by

Back 5

1 g/dl (non-bleeding adult)

Front 6

When should you order a group & hold or crossmatch?

Back 6

If the patient needs blood, you should crossmatch the number of units they will need.
Group & Hold if the patient is unlikely to need a blood transfusion but it will reduce the time required for cross-matching later.

Front 7

Infections that can be passed down to the neonate during pregnancy due to transplacental IgG :

Back 7

Toxoplasmosis
Other (varicella, parvovirus, listeria, TB, malaria, fungi)
Rubella
CMV
HSV / HIV
Syphilis

Front 8

Explain the risks of having C-Section

Back 8

TO MOTHER:
General Surgical Risks
- infection
- bleeding (PPH)
- clotting (DVT/PE)
Anaesthetic Risks
-anaphylactic reactions
Injury to adjacent structures
- bowel, bladder
↑ risk of complications in later pregnancies
- uterine rupture
Family Planning
- size of family desired

TO BABY:
- TTN
- RDS
- surgical injury

Front 9

LGA vs. macrosomia ?

Back 9

LGA:
≥ 90th percentile for GA

Macrosomia:
≥ 4000g (or 4500g in USA) regardless of GA

Front 10

clinical sx of ovulatory/anovulatory failure?

Back 10

regular cycles = ovulatory
irregular cycles = anovulatory

Front 11

biochemical factors responsible for growth of the endometrial lining?

Back 11

ovaries (estrogen & progesterone) → PG, cytokines, MMPs → endothelium

Front 12

Breast Feeding OSCE explanation

Back 12

.

Front 13

Signs of Pregnancy

Back 13

Presumptive (skin & mucous membrane changes)
- Chadwick's sign, linea nigra, cholasma
Probable (uterus changes)
Positive (fetal movement & heart beat)

Front 14

gestational sac visualised by US at

Back 14

week 5

Front 15

fetal heart beat visualised by US at

Back 15

6-8 weeks

Front 16

Pfannenstiel incision

Back 16

- horizontal (slightly curved) line just above the pubic symphysis
- commonly used for c-section or hernia repair

Front 17

Role of Theca and Granulosa cells in the ovary

Back 17

Front 18

Cycle Development from primodial follicle to corpus luteum

Back 18

Front 19

Ovarian cycle

Back 19

Front 20

Overview of Menstrual Cycle Diagram

Back 20

Front 21

Steroidogenesis Pathway

Back 21

Front 22

circulating estrogens & androgens are mostly bound to

Back 22

SHBG
serum albumin
+ small unbound fraction (biologically active)

Front 23

Phases of menstrual cycle:

Back 23

Follicular vs. Luteal phase
Proliferative vs. Secretory phase

Front 24

What causes the LH surge which leads to ovulation?

Back 24

a burst of estradiol synthesis at the end of the follicular phase causes +ve feedback on secretion of FSH & LH

Front 25

Hormonally, what happens if fertilisation occurs?

Back 25

placenta → HCG → recues corpus luteum from regression → estradiol & progesterone

Front 26

peak levels of HCG occur at

Back 26

week 9

Front 27

Hormonally, what happens in the 2nd & 3rd trimesters of pregnancy?

Back 27

placenta → progesterone
fetal adrenal gland → DHEA → placenta → estriol

Front 28

Which hormones cause growth & development of breasts during pregnancy?

Back 28

estrogen
progesterone

Front 29

Comment on prolactin levels during pregnancy

Back 29

estrogen → anterior pituitary → prolactin increases steadily during pregnancy

Front 30

Why doesnt lactation occur during pregnancy?

Back 30

estrogen & progesterone block the action of prolactin on the breast

Front 31

What causes lactation after parturition?

Back 31

sharp fall in estrogen & progesterone

Front 32

lactation is maintained by

Back 32

suckling → oxytocin & prolactin secretion

Front 33

Effects of prolactin in suppressing ovulation?

Back 33

inhibits GnRH secretion
antagonizes LH & FSH on the ovaries

Front 34

Absence of adequate amniotic fluid during mid-pregnancy is associated with

Back 34

pulmonary hypoplasia at birth
(incompatible with life)

Front 35

When does engagement of the fetal head occur?

Back 35

primip - 37 weeks
multip - up to the onset of labour

Front 36

How is non-engagement of the fetal head investigated?

Back 36

US

Front 37

What are causes of non-engagement of the fetal head?

Back 37

placenta previa
fetal abnormality

Front 38

Positions of the fetal head (pelvis diagram)

Back 38

Front 39

When is a head considered to be engaged?

Back 39

2/5 palpable (not ballotable)

Front 40

what are the pelvic floor muscles?

Back 40

levator ani
coccygeus

Front 41

Shapes of the female pelvis

Back 41

gynocoid (50%)
anthropoid
android
platypolloid

Front 42

Can one assess pelvic adequacy for childbirth?

Back 42

Not unless there is a gross abnormality (from gait or hx)
- fetal head "moulds" & the joints of the pelvis can move slightly

Front 43

Breech Presentations

Back 43

A - complete (thighs & knees flexed) 5-10%
B - frank (thighs flexed knees extended) 50-75%

Front 44

Fetal Position - diagram of different presentations

Back 44

Front 45

Positions of the fetal head

Back 45

Front 46

5 bones of fetal skull

Back 46

2x parietal
2x frontal
1x occipital

Front 47

4 sutures of fetal skull

Back 47

coronal
frontal
sagittal
lambdoid

Front 48

fontanelle =

Back 48

where 2 or more sutures meet

Front 49

fontanelles of the fetal head

Back 49

anterior fontanelle = bregma (diamond)
posterior fontanelle = lambda (triangular)

Front 50

Regions of the fetal head

Back 50

Front 51

Outline the Stages of Labour

Back 51

Front 52

Types of Twin Pregnancies

Back 52

Front 53

caput succedaneum

Back 53

- occurs when the dilating cervix presses against the fetal scalp, preventing normal venous blood & lymphatic fluid flow → tissue swelling
- soft & boggy
- disappears <24 hours after birth

Front 54

Describe physiological "moulding" of the fetal head during labour

Back 54

- process of slipping/overlapping of the cranial bones
- disappears a few hours after birth

Front 55

types of placenta circulations?

Back 55

uteroplacental (maternal side)
fetoplacental (fetal side)

Front 56

interaction between maternal & fetal blood flow?

Back 56

side by side but in opposite directions (counterflow faciliates exchange)

Front 57

Functions of the placenta

Back 57

- anchor the fetus
- barrier against infection
- gas & substance exchange
- endocrine organ (HCG, estrogen, progesterone)

Front 58

when is oxytocin released by the posterior pituitary?

Back 58

first stage of labour
suckling

Front 59

effect of pregnancy on thyroid

Back 59

thyroid gland enlarges due to ↑ demand

↑ renal clearance of iodine = relative iodine deficiency → ↑iodide uptake → follicular enlargement

slight ↑ in T3/4 & ↓TSH but in normal range

Front 60

Haemodynamic changes in pregnancy

Back 60

↑ plasma volume
↑ red cell volume
↓ platelets
↑ WCC
↑ clotting factors

Front 61

Cardiovascular changes in pregnancy

Back 61

↑ cardiac output
↓ peripheral vascular resistance = ↓BP nu mid pregnancy which returns to normal levels by term

Front 62

Respiratory changes in pregnancy

Back 62

↑ tidal volume
↑ inspiratory capacity
only slight change to RR, therefore breathe more deeply
SOB (↓pCO2)

Front 63

Uterus changes in pregnancy

Back 63

↑ weight x10
stretching
hypertrophy of uterine & ovarian arteries → ↑ uterine blood flow
↑ vaginal discharge due to glandular hypertrophy

Front 64

Urinary tract changes in pregnancy

Back 64

↑ renal blood flow (in line with ↑CO) → ↓plasma creatinine & urea

(creatinine in normal range indicates renal impairment in pregnancy)

Front 65

GIT changes in pregnancy

Back 65

↓ esophageal spincter tone → reflux
↓ gastric emptying
↓ GI motility

Front 66

conception occurs on day

Back 66

14

Front 67

When does implantation occur?

Back 67

6-7 days after fertilisation

Front 68

inner cell mass forms the

Back 68

embryo

Front 69

trophoblast forms the

Back 69

placenta

Front 70

cytotrophoblast produces

Back 70

hCG

Front 71

syncytiotrophoblast produces

Back 71

estrogen & progesterone

Front 72

Pregnancy can be diagnosed by

Back 72

b-hCG
US (FHR)
fetal movements (17-22 weeks onwards)

Front 73

embryo =

Back 73

from fertilisation until end of week 8 of gestation (10 weeks from LMP)

Front 74

fetus =

Back 74

from week 8 of gestation (10 weeks from LMP)

Front 75

miscarriage =

Back 75

delivery <20 weeks OR <400g

Front 76

previable =

Back 76

<24 weeks

Front 77

preterm =

Back 77

<37 weeks

Front 78

term =

Back 78

37-42 weeks

Front 79

post term =

Back 79

>42 weeks