cOGtext Flashcards
Uncomplicated gonorrhoea treatment?
IM ceftriaxone
Which types of HPV are associated with genital warts?
6 and 11
Which types of HPV are associated with cancer?
16 and 18
How is primary and secondary syphilis diagnosed?
PCR of swab
Incubation period for chlamydia?
3-21 days
In HIV patients, risk of opportunistic infections is greatly increased below what CD4 count?
200
Define HAART HIV treatment?
Highly Active Anti- Retroviral Treatment
3 drugs from 2 drug classes to which virus is susceptible
What is a cephalohaematoma in newborn?
Collection of blood between a baby’s scalp and skull, does not cross suture lines
Swelling in parietal region of newborn which does not cross the suture lines
Cephalohaematoma
How long does it take for a cephalohaematoma to go away?
Up to 3 months
Average rate of cervical dilation expected in primiparous mother?
1cm/hr
Respiratory distress, hypoxia, and hypotension during labour. Diagnosis?
Amniotic fluid embolism
Best option to induce pregnancy in closed firm cervix?
Vaginal prostaglandins
What treatment change should happen in pregnant woman with T2DM?
Convert from oral tablets to insulin therapy
What is first line in treating hypertensive disorders of pregnancy?
Labetalol
How soon after abortion can IUD and IUS be inserted?
Immediately
What volume of amniotic fluid is classed as Polyhydramnios?
> 2litres
How and when to monitor pregnant woman with history of gestational diabetes? (2)
OGTT at booking
OGTT at 24-26 weeks
STI organism: intracellular gram-negative diplococci
Neisseria Gonorrhoeae
STI organism: intracellular gram-negative rods
Chlamydia Trachomatis
Neisseria Gonorrhoeae. Describe organism
Intracellular gram-negative diplococci
Chlamydia Trachomatis: Describe organism
Intracellular gram-negative rods
Classic renal pathology in sickle cell anaemia?
Renal papillary necrosis
sickle cells infarct in kidney
How to investigate tubal patency in patients with known co-morbidities (like previous ectopic, PID, endometriosis)?
Laparoscopy and dye
dye will leak out of non-patent tubes
Is Factor V Leiden a Haemophilic or Thrombophilic disorder?
Thrombophilic (slightly increased tendency to clot)
Is von Willebrand disease a Haemophilic or Thrombophilic disorder?
Haemophilic (increased tendency to bleed)
When to induce labour for macrosomia?
Don’t need to induce, no benefit in doing so
Gold standard investigation of endometriosis?
Laparoscopy
Definitive Tx for Adenomyosis?
Hysterectomy
What is adenomyosis?
Endometrial tissue grows within layers of myometrium
What are the symptoms of adenomyosis? (3)
Identical to endometriosis
Dyspareunia
Dysmenorrhoea
Subfertility
What are the symptoms of endometriosis? (3)
(Identical to adenomyosis)
Dyspareunia
Dysmenorrhoea
Subfertility
Name a test that must be done in all women with heavy menstrual bleeding
FBC
Ehler’s Danlos Syndrome presents with joint hypermobility and elastic skin. What else?
Bruising and bleeding with normal haematological findings
Hepatosplenomegaly
Generalised Lymphadenopathy
New bruising
Must suspect what Dx in children?
Haematological malignancy
Hearing loss worse in pregnancy. Likely Dx?
Otosclerosis
What happens in otosclerosis?
Stapes fuses into surrounding bone
Pathological fracture at what vertebral level suggests malignant rather than osteoporotic change?
T4 or above
Pathological fracture at level T4 or above suggests what cause of weakened vertebrae?
Malignancy
What test is raised in Acromegaly?
IGF-1
IGF-1 is raised in what disorder?
Acromegaly
What volume of blood defines a major PPH?
More than 1000ml
Within what timeframe is a bleed termed primary PPH?
<24hrs after birth
Within what timeframe is a bleed termed secondary PPH?
> 24hrs after birth
How much blood is a mild PPH?
> 500ml- 1000ml
What does APGAR stand for?
Appearance Pulse Grimace Activity Respiration
What is the commonest ovarian cancer?
Epithelial carcinoma (90%)
Name a high risk factor for ovarian cancer
Early menarche
Early menarche increases risk for what cancers?
Ovarian
Breast
Tamoxifen increases risk of what cancer?
Endometrial
Breast cancer drug that increases risk of endometrial cancer?
Tamoxifen
HPV positive patient with negative cytology. When to follow up?
In 1 year
What level of uterine prolapse is seen at the introitus?
2nd degree
What level of uterine prolapse protrudes through vaginal introitus?
3rd degree
Colposuspension treats what problem?
Stress incontinence
Surgical treatment for Stress Incontinence?
Colposuspension
Type of incontinence presenting with nocturia?
Urge Incontincence
STIs not requiring partner notification?
Genital Herpes
HPV
What is procidentia?
When all of uterus prolapses outside vagina
What is it called when all of uterus prolapses outside vagina?
Procidentia
Oral Hairy Leukoplakia is an AIDs defining condition. True or false?
False, as it occurs at CD4+ counts of 200-500
Assoc with EBV
What age smoker can take COCP?
<35
What age non-smoker can take COCP?
<50
What ages of women can take COCP?
<35 smoker
<50 non-smoker
When can IUS/IUD be inserted after abortion?
Immediately after pregnancy confirmed to pass
Commonest site of ectopic pregnancy?
Fallopian tube
Treatment for complete mole?
Surgical evacuation of contents
What structure secretes fluid to lubricate urethra and neutralise pH prior to ejaculation?
Bulbourethral gland
Functions of Bulbourethral gland?
Secretes fluid to lubricate urethra and neutralise pH prior to ejaculation
What structures produce seminal fluid? (2)
Prostate
Seminal Vesicles
When can vacuum aspiration abortion be performed?
Up to 14 weeks gestation
Patient misses one POP. For how long is there no protection from pregnancy?
48 hrs
Most likely gynae cancer with Lynch Syndrome?
Endometrial
Foetal pole is also known as?
Embryo
At what size should foetal pole have detectable heart rate?
> 7mm
Should 5mm foetal pole have detectable heart rate?
No
> 7mm
Should 9mm foetal pole have detectable heart rate?
Yes
> 7mm
Male infertility with Mumps. What is happening?
Mumps orchitis, obstructive infertility
What is meant by multiple pregnancy?
Pregnancy with 2 or more foetuses concurrently (twins triplets etc)
Different to multiparity
Difference between multiple pregnancy and multiparity?
Multiple pregnancy= >1 foetus, eg twins
Multiparity= Previously given birth
What hormone is consistently high in menopause?
FSH
Primary Ovarian Insufficiency is also known as?
Premature Ovarian Failure Early Menopause (<45)
When is menopause considered early?
<45
Technical term for early menopause?
Primary Ovarian Insufficiency
Confirm Primary Ovarian Insufficiency?
2x FSH tests, 2 weeks apart
Should be raised on both
Within what timeframe should a semen sample be analysed?
<1hr after production
At what temperature should semen sample be kept before analysis?
Body temperature
analyse <1hr after production
How long should a diaphragm be left in place after sex?
6hrs
When does more spermicide need to be added to a diaphragm? (2)
If in place for >3hrs
If having sex again
(don’t need to remove diaphragm to add more spermicide)
Does diaphragm need to be removed to apply more spermicide?
No, leave it in place
Define Gravida
Total number of pregnancies, regardless of outcome
NB Includes current pregnancy!
Does Gravida include current pregnancy?
YES!!
What next step should be taken if dyskaryosis is seen on cervical smear test?
Refer for colposcopy
What type of Hormone Replacement Therapy (HRT) has the lowest assoc risk of Venous Thromboembolism (VTE)?
Transdermal patch
Pseudomyxoma Peritonei is associated with what gynaecological malignancy?
Ovarian
What is the key feature of Pseudomyxoma Peritonei?
Cancerous cells produce abundant mucin in peritoneal cavity
Coffee bean nuclei seen on histology. Diagnosis?
Granulosa Cell Sex Cord tumour
Exner bodies seen on histology. Diagnosis?
Granulosa Cell Sex Cord tumour
Pathognomonic histological features of Granulosa Cell Sex Cord tumour? (2)
Coffee bean nuclei
Exner bodies
When gestationally should the uterine fundus be felt at the umbilicus?
22 weeks
When gestationally should the uterine fundus be felt at the symphysis pubis?
12 weeks
Where should the uterine fundus be felt at 12 weeks’ gestation?
Symphysis Pubis
Where should the uterine fundus be felt at 22 weeks’ gestation?
Umbilicus
What duration of active labour increases risk of PPH?
> 12 hours
Most significant risk factors for puerperal psychosis? (3)
Bipolar disorder
Psychotic episode
Family history of these
Primary risk factor of Ovarian Torsion?
Cyst on surface
Why is Ovarian Torsion associated with PCOS?
Cysts are major risk factor for Torsion
First investigation for Urinary Incontinence?
Urine Dipstick
List the cardinal movements of Labour
Engagement Descent Flexion Internal Rotation Extension External Rotation Expulsion
Every Darn Fool In Egypt Eats Raw Eggs
Every Darn Fool In Egypt Eats Raw Eggs. Explain?
Cardinal movements of Labour
Engagement Descent Flexion Internal Rotation Extension External Rotation Expulsion
Every Darn Fool In Egypt Eats Raw Eggs
Say the rhyme for Cardinal Movements of Labour
Engagement Descent Flexion Internal Rotation Extension External Rotation Expulsion
Every Darn Fool In Egypt Eats Raw Eggs
Supply of detrusor muscle?
Parasympathetics from pelvic splanchnic nerves
What drug treatment is recommended for all women with PPH?
Tranexamic acid
Can a woman with pelvic organ prolapse have sex?
Yes but may be uncomfortable
Can a woman with pelvic organ prolapse do weightlifting?
No
Should avoid heavy weightlifting as much as poss- NICE
Name AIDS-defining pneumonias? (2)
Pneumocystis
Recurrent bacterial
AIDS-defining conditions, apart from pneumonia? (2)
Oesophageal candidiasis
Kaposi’s Sarcoma
What BMI should the male partner achieve before IVF treatment is authorised in Scotland?
Any BMI go for it fatty
Gynaecological causes of raised CA125, other than Ovarian Cancer? (3)
Pregnancy
Endometriosis
Fibroids
When is the first trimester of pregnancy in weeks?
0 to 12 weeks
When is the second trimester of pregnancy in weeks?
13 to 28 weeks
When is the third trimester of pregnancy in weeks?
29 weeks to birth