Clinical

Question 1

List a couple of areas in a gynaecological history that differ than a standard history?

Answer 1

Sexual history

Obstetric history

Question 2

What specific questions are also important to ask about in a gynae history?

Answer 2

• Last menstrual period
• Cycle
• Contraception
• Last smear

Question 3

What specific conditions can be asked about in a gynae history?

Answer 3

• Menorrhagia
• Prolapse
• Pelvic pain
• Early pregnancy bleeding

Question 4

What consideration must be taken in a gynae examination?

Answer 4

Intimate examination - sensitivity (chaperone etc)

Question 5

What two types of speculum may be used?

Answer 5

Cuscos

Sims

Question 6

What type of examination should be done prior to a vaginal examination?

Answer 6

Abdominal examination

Question 7

What should be examined in a vaginal examination?

Answer 7

• Position of uterus
• Size of uterus
• Mobility of uterus
• Adnexal masses
• Tenderness/cervical excitation

Question 8

What is the term for the number of pregnancies reaching viable gestational age in an obstetric history?

Answer 8

Parity

Question 9

List some relevant information in past obstetric history?

Answer 9

• All previous pregnancies and outcomes
• Date
• Type of delivery
• Live births/still births
• Weight and sex of baby
• Any problems encountered during pregnancy/delivery/postnatally

Question 10

What is included in an obstetric examination?

Answer 10

General exam including BP
Abdominal exam
Fetal Heartbeat
Urine

Question 11

Where is fundal height measured?

Answer 11

Top of fundus to pubic symphisis

Question 12

What are the types of ways in which the baby can lie in the uterus?

Answer 12

Longitudinal/oblique/transverse

Question 13

What are the types of ways in which the baby can present in the uterus?

Answer 13

Cephalic/breech/transverse

Question 14

What hormone forms the basis of pregnancy tests?

Answer 14

B-hCG

Only produced from trophoblast cells. If positive, placental cells are present

Question 15

When does a threatened miscarriage progress to inevitable?

Answer 15

If the cervix has already begun to dilate

Question 16

What risk is associated with incomplete abortion/miscarriage?

Answer 16

Risk of ascending infection

-Septic abortion

Question 17

List some examples of neonatal morbidity associated with prematurity?

Answer 17

• Respiratory distress syndrome
• Intraventricular haemorrhage
• Cerebral palsy
• Nutrition
• Temperature control
• Jaundice
• Infections
• Visual impairment
• Hearing loss

Question 18

What are some clinical features of Down’s Syndrome?

Answer 18

Epicanthic folds
Single palmar crease
Broad nostrils
Duodenal atresia

Question 19

What may be suspected if lack of fetal heart movement is seen on a scan in pregnancy?

Answer 19

Intrauterine Death (IUD)

Question 20

Where would a baby be admitted to after birth in a mother that is an intravenous drug user?

Answer 20

Neonatal unit to be treated for withdrawal

Question 21

What is APGAR scoring used for?

Answer 21

APGAR is a scoring system for the clinician to tell how well the baby tolerated birthing process/how it is coping outside the womb.

Question 22

What components are measured in APGAR?

Answer 22

Activity
Pulse
Grimace response
Appearance 
Respiration

Question 23

What should be used to screen for Gestational Diabetes?

Answer 23

HbA1c estimation

Oral Glucose Tolerance Tests

Question 24

Which women may benefit from screening for ovarian cancer?

Answer 24

High risk women

• cancer gene mutation carriers
• 2 or more relatives

Question 25

What would be involved in a screening for ovarian cancer?

Answer 25

Pelvic examination

• US scanning of ovaries
• CA 125