Corrections 2 Flashcards
What ovarian tumour is associated with the development of endometrial hyperplasia?
Granulosa cell tumour
When can the COCP be prescribed postnatally:
a) breastfeeding
b) not breastfeeding
a) 6 weeks
b) 3 weeks
UKMEC of the COCP 6w to 6m postnatally if breastfeeding?
UKMEC 3
When can the IUS/IUD be inserted after birth?
Within 48h or after 4 weeks
How long after insertion does the IUS take to become effective?
7 days
How long after insertion does the implant take to become effective?
7 days
Mx of CIN?
LLETZ
Mx of stage IA cervical cancer:
a) gold standard
b) in women wishing to preserve fertility?
a) Hysterectomy +/- lymph node clearance
b) Cone biopsy and close follow up
What is indicated in stage IA2 tumours in cervical cancer?
Nodal clearance
Radical trachelectomy is also an option for A2
Mx of stage IB tumours in cervical cancer?
radiotherapy with concurrent chemotherapy is advised
What is the commonly used chemotherapeutic agent in stage IB tumours in cervical cancer?
Cisplatin
Mx of stage II and III tumours in cervical cancer?
Radiation with concurrent chemotherapy
At what crown rump length is cardiac activity expected
7mm
Ulipristal and breastfeeding?
breastfeeding should be delayed for one week after taking ulipristal
What is used in intrauterine balloon tamponade?
Intra-uterine Bakri catheter
What score on the Edinburgh Postnatal Depression Scale indicated a ‘depressive illness of varying severity’?
> 13
Antimuscarinics and IOP?
Antimuscarinics can cause a rise in IOP (and worsen glaucoma) due to dilation of pupil
Mx of pregnant women with new-onset HTN after 20 weeks of pregnancy?
Urgent 2ary care referral
Why is trace glycosuria common in pregnancy?
Due to increased GFR and reduced in tubular reabsorption of filtered glucose
Thyroid scintigraphy in de Quervain’s (subacute) thryroiditis?
globally reduced uptake of iodine-131
Which diabetes medication is safe in breastfeeding?
Metformin
Which diabetes medications are not safe in breastfeeding?
- gliclazide
- exanatide
- liraglutide
- sitagliptin
Is gestational diabetes treated with short or long acting insulin?
Short acting only
Define prolonged rupture of membranes
When the amniotic sac breaks more than 18h prior to delivery
Prelabour ROM vs preterm prelabour ROM?
Prelabour ROM: >37 weeks gestation, the waters break before labour.
Preterm prelabour ROM: <37 weeks gestation.
Mx of prelabour ROM?
- Expectatnt mx for 24h (60% of women will go into sponaneous labour)
- Offer IOL after 24h (as infection risk increases)
Mx of premature prelabour ROM?
- Confirm PPROM (sterile speculum)
- Admission
- Oral erythromycin should be given for 10 days
- Steroids
- Consider delivery at 34w
Mx of a woman with known placenta praevia who goes into labour (with or without bleeding)?
Emergency c-section
Mx of chlamydia in pregnancy?
Amoxicillin, azithromycin or clarithromycin
Microscopy findings in trichomonas?
Flagellated protozoa
Give 4 causes of a false positive VDRL/RPR?
SomeTimes Mistakes Happen
SLE
TB
Malaria
HIV
Mx of stage 2-4 ovarian cancer?
Surgical excision
What is a CTG sinusoidal trace usually due to?
Foetal anaemia e.g. vasa praevia
Women who have been treated for CIN require follow up cervical screening.
When should this follow up be?
6 months after treatment for a test of cure cervical sampe
What Abs are found in 90% of patients with postpartum thyroiditis?
TPO
Management of gestational diabetes if fasting plasma glucose is <7 mmol/l?
1) Trial of diet and exercise for 1-2 weeks
2) If targets not met –> add metformin
3) If still not met –> add insulin
What is the most acceptable macrolide Abx in pregnancy?
Erythromycin
Management of LGV?
Doxycycline 21d
Mx if a primary attack of herpes occurs during pregnancy at >28 weeks gestation?
Elective caesarean section at term
Mx of 1ary herpes infection in 3rd trimester of pregnancy?
Oral aciclovir 400mg TDS until delivery
What is the investigation of choice in genital herpes?
NAAT
Is trimethoprim in breastfeeding safe?
Yes
What investigations are recommended for all pre-menopausal women with complex ovarian cysts?
- hCG & AFP
- serum Ca-125
What is b-HCG levels for expectant, medical and surgical management of an ectopic?
Expectant: <1000
Medical: <1500
Surgical: >5000
Is migraine with aura a contraindication for HRT?
No (unlike the COCP)
However, topical preparations are preferred rather than oral.
