Cardiovascular changes in pregnancy: Blood Volume: Increases Decreases( Increases, Decreases ) Cardiac Output: Increases Decreases( Increases, Decreases ) Heart Rate: Increases Decreases( Increases, Decreases ) Blood Pressure: Decreases Increases( Decreases, Increases )
Prevalence of heart disease in pregnancy is rising due to which two main reasons?
More women are obese
Women are choosing to have children at older ages
More mothers are on cardiovascular medication during pregnancy
More mothers have cardiovascular risk factors
Palpitations are a common finding in pregnant women and are not normally considered to be pathological
Hypertension is a common finding in pregnant women and are not normally considered to be pathological
If a woman's aortic root is wider than 45mm then she is at a high risk of aortic
Whilst they are considered normal, palpitations experienced by a woman during pregnancy are commonly investigated in order to rule out any potentially sinister connotations. Which investigative measure is most commonly used for this?
ECG
Echocardiography
Thyroid Function Test
Full Blood Count
24 hour ECG
Palpitations in pregnancy are usually exacerbated by rest exercise( rest, exercise ) and relieved by exercise rest( exercise, rest )
NYHA Functional Classification is used to classify symptoms of chest pain and/or breathlessness. Which classes of the NYHA are considered abnormal in pregnancy?
I
II
III
IV
Arterial pH typically increases decreases( increases, decreases ) to become more alkaline acidic( alkaline, acidic ) in pregnancy. PaO2 typically increases decreases( increases, decreases ) whilst PaCO2 typically decreases increases( decreases, increases ) in pregnancy
Breathlessness is an uncommon symptom in pregnancy and should be considered pathological until proven otherwise.
Breathlessness in pregnancy is typically relieved exacerbated( relieved, exacerbated ) by exertion
The period following childbirth whereby the mother's reproductive organs return to normal (typically around 6 weeks) is known as the
If a woman is on long term oral steroids for Asthma, during labour she should be given which medication?
Beclometasone Inhaler
IV Hydrocortisone
IV Fludrocortisone
Oral Prednisolone
Asthmatic women should not discontinue their inhalers during pregnancy as inhaled b2-agonists do not impair uterine activity or delay onset of labour
What is the most common direct cause of maternal death in pregnancy?
Venous Thromboembolism
Diabetes
Hypertension
Asthma
Women who are at a high risk of VTE should receive LMWH Heparin Warfarin( LMWH, Heparin, Warfarin ) throughout pregnancy and for 6 2 12( 6, 2, 12 ) weeks postpartum
At which point are women most vulnerable to VTE?
Pregnancy
Labour
Puerperium
Which LMWH medication is given to women in Tayside as VTE prophylaxis?
The dose of Dalteparin given is dependent on the weight of the woman
Which investigation is used first line to diagnose DVT in pregnant women?
Duplex Ultrasound
Venous Doppler Scan
Arterial Doppler Scan
MRI venography
A pregnant woman is found by a junior registrar to have a completely swollen, erythematous left thigh with severe back pain. Which mode of investigation should be conducted immediately?
MRI Venography
CT Leg
If DVT/PE is suspected in a pregnant woman, D-dimers should be assessed thoroughly and urgently.
Which two investigations are commonplace in the diagnosis of Pulmonary Embolism?
CT Pulmonary Angiogram
Ventilation Perfusion (VQ) Scan
Chest X-ray
MRI Chest
CT Chest
D-dimers
❌: Involves radiation dose to woman and thus increases breast cancer risk ❌: Involves radiation dose to baby and increases risk of abnormality
Warfarin is safe in pregnancy.
Women are able to breastfeed on which of the following anti-coagulant medications?
Warfarin
Dalteparin
Both
Recurrent miscarriages and early onset pre-eclampsia are signs of syndrome
How is Antiphospholipid Syndrome typically managed?
LMWH
LMWH + Low Dose Aspirin
Low Dose Aspirin
Warfarin + LMWH
Warfarin + Low Dose Aspirin
Which anticonvulsant is most likely to cause congenital malformations and should not be prescribed to any woman of childbearing age without highly effective contraception in place?
Sodium Valproate
Lamotrigine
Clobazam
Carbamazepine
Phenytoin
Due to the risk of foetal neural tube defects, women with epilepsy are advised to take 5mg daily of which vitamin prior to conception until at least the end of the first trimester?
Most women with epilepsy tend to have normal vaginal births
Which very serious condition involving hypertension and proteinuria is also known to cause seizures in pregnant women?
Which class of drugs are usually utilised to stop seizures during childbirth?
Benzodiazepines
Anticonvulsants
Steroids
Anaesthetics