O&G 🤰

Question 1

You are working in a rural emergency department without obstetric or paediatric coverage. A 24 year old lady presents with intermittent abdominal cramping. She is 29 weeks pregnant in her first pregnancy and is planning to relocate for the birth after 36 weeks. She has had no vaginal fluid loss or bleeding and is feeling normal fetal movements. Her vital signs are:
T 37.2
P 64
BP 109/72
RR 22
SaO2 99% RA

Other than preterm labour, name one other obstetric condition that requires consideration (1 mark)

Name one investigation that can exclude the diagnosis of preterm labour. Explain the principle of its use (2 marks

A cardiotocograph is performed (above), please interpret and provide summary (6 marks)

Outline the management of preterm labour in this woman (4 marks)

Answer 1

ISLHD 2019.1 (EDviva)

Question 2

A 24 year old woman in her first pregnancy comes to the emergency department with a small amount of vaginal bleeding and lower abdominal cramping. She has no significant past medical history and has been taking folate supplementation since her positive urine pregnancy test 3 weeks ago.

Her vital signs:
T 36.5
P77
BP 102/67
Blood tests show:
Hb 134
A Negative
BhCG 6,440

She has a transvaginal ultrasound

Report states: “There is an intrauterine gestational sac which has a mean sac diameter of 26.2mm but no fetal pole is visualised. There is no evidence of extrauterine pregnancy and no free fluid”

What is the diagnosis and viability of the pregnancy? (2 marks)

What are the 3 management options for this condition? (3 marks)

Regarding surgical management, name 2 absolute indications for its use (2 marks)

The patient requires Rh immunoglobulin, what is the dose and route of this medication? (1 mark)

Answer 2

ISLHD 2019.1 (EDviva)

Question 3

Question 8 (12 marks) 6 minutes A 35 year old female who is 36 weeks pregnant presents to ED

a. List six (6) clinical features that would support the diagnosis of pre-eclampsia. (6 marks)

a. List six (6) clinical features that would support the diagnosis of pre-eclampsia. (6 marks)

Answer 3

Geelong 4