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Gynaec Dvt > Dvt > Flashcards

Dvt Flashcards

1
Q

Best day to do fsh

A

Day 3
Normal value less thsn 10 iu
Most common test for ovarian reserve

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2
Q

Best test for ovarian reserve

A

AMH(antimullerian hormone) 1 ng

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3
Q

Primary amenorrhea and raised fsh

A

Gonadal dysgenesis

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4
Q

Primary amenorrhea and low fsh

A

Kall mann syndrome

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5
Q

Normal level of fsh in

A

Pcos
Asherman symd
Mullerian agenesis

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6
Q

Amin role of fsh

A

Seection and growth of dominant follocle

It peaks before ovulation by progestrone

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7
Q

Estrogen

A

Under the influence of fsh ovary produce estrogen
C18 component
Endometrium proliferation
estrogen peak required for LH surge -200 pg X 48 hr

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8
Q

Decreased estrogem causes

A

Hot flishes vaginal atrophy

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9
Q

Estrogen levels in pcos

A

E1 increased
E2 normal
E2 :E1 ratio reversed

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10
Q

LH surge occurs

A

36 hrs before ovulation

Lh peak 12 hrs before ovulation

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11
Q

Which hormone maintain corpoluteum

A

Lh

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12
Q

Lh in pcos

A

Persiaitemly increasing

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13
Q

Persiatance of corpus liteum without pregnancy

A

Halbans disease

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14
Q

Androgen produced by

A

Theca cells under lh surge

Leutinized granulosa cells produce progesterone

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15
Q

Progesterone

A

C 21 compound
Causes secretory changes in endometrium
Cx mucus thick scantvagina intermediate cella
Increased basal body temp

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16
Q

Best test of ovulation

A

Serum progesterone done at day 21

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17
Q

Progesterone challenge test negative menas

A

Estrogen deficiency/endometrium/ hpo axis damage

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18
Q

Pct positive means

A

Anovulation

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19
Q

Peak level of progesterone seen at

A

8 days post ovulation

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20
Q

Day of ovulat

A

Length of menstrual cycle -14

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21
Q

Treatment of choice for hyperplasia without atypia

A

Estrogen

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22
Q

Androgens

A

C19 compounds

Produced by theca cells

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23
Q

Androgens not produced by ovary

A

DHT and DHEAS

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24
Q

Androgens priduced in max amount

A

Androstenidione

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25
Q

Pubic and axilliary hair produced by

A

Androgens or testosterones

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26
Q

In pcos androgens are

A

Mildly reduced(<200ng)

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27
Q

GnrH

A

Decapeptide

Realesed as pulsatile manner at puberty(night by decreased GABA increase in kiss petin)

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28
Q

Ansent gnrh in

A

Kallman ,anosmia

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29
Q

Low frequency pilses of gnrh causes

A

Fsh release

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30
Q

High frequency pilse sof gnrh causes

A

LH release

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31
Q

In case of aub isg shows a growth in uterinecavity what will you do next

A

Hysteroacooy(best)

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32
Q

Any women with more than 45 years with c/o aub ir how willk you proceed

A

Irrepective of usg finding do endometrial biopsy or endometrial aspiration cytology (EAC)-karmans cannula

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33
Q

If patient had post coital bleeding and u see visible growth or abnormal cervix

A

Punch biopsy

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34
Q

Abnormal paps

A

Colpobiopsy

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35
Q

Treatment of choice for preinvasive lesions

A

LEEP

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36
Q

If atypical galdular cells on pap smear

A

Colpobiopsy+endeocerbical curettage+endometrial sampling

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37
Q

Fibroid uterus

A 
Enlarged uterus
Heavy bleeding
More than equal to 35 yrs
Non tender uterus(tender if degeneration or 
Irregular uterus
IOC- USG
Treatment
Asymptomatic fibroid no treatment 
Fibroud perimenopausal no treatment 
Asymptomatic fibroid desire pregnancy-no treatment (except submicosal -hysteroacopic myomevtomy
Intramural blocking b/l cornu myomectomy
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38
Q

Investigationof choice for submicosal fibroid

A

Hysteroacopy

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39
Q

Polyp

A 
Increased size of uterus
Irregular bleding
Peri and post menopausal 
Non tender
Usg- feeder vessel sign

Ioc-hysteroscopy
Treatment of choice - polypectomy

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40
Q

Adenomyosis

A 
Enlarged uterus 
Heavy bleeding(dysmenorrhea
40-45
Tender
Globular
Ioc- mri
Diagnosis- HPE
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41
Q

Usg findings in adenomyosis

A

Venetian blind
Saalt pepper
Poorly defined junctional zone
Treatment of choice-hysterectomy

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42
Q

Treatment of symptomatic traetment

A

Pressure symptoms-given gnrh analogs and antagonist
If menorrhagia- intramural-ocp
Submicosal- hysteroacopic myomectomy

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43
Q

Endometrial hyperplasia without atypia toc

A

Progesterone (mirena)

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44
Q

Hyperplasia with atypia

A

Next step-
D and c with hysteroacopy
If asked toc- hysterectomy

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45
Q

Most common cause of post menopausal bleeding

A

Atrophic endometritis

Endo ca 10%

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46
Q

Mullerian agenesis

A

Ansent uterus
Breast >=thanner 2normalnpubic and axillary hair
Absent vagina46 XX

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47
Q

Androgen insensitivity syndrome

A 
Abseent uterus
No pibic and axillary hair
Braest mor than 2 thanner
Blind ending vagina
46XY
Gonadectomy after piberty
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48
Q

Most common cause of male pseudohermaphrodite

A

Androgen insensitivity syndrome

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49
Q

Most comkon cause of female paeudohermaphrodite

A

CAH- congenital adrenal hyperplasia

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50
Q

Gonadal dusgenesis

A 
Uterus small
Abdent breasovary not visible
Fsh increased 
 Short statute- turner45 x0
Normal stature -pure gonadal dysgeneses
Pure can be xx xy
Xy_swyers- gonadectomy as soon as diagnosis made
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51
Q

Kallman

A 
46xX
Anosmia
Ovaried normal
Uterus present
Fsh low
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52
Q

Imperforate hymen

A

Bulging memrane on l/ e
Normal uterua and normal ovaries
46 xx
Breast development presnet

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53
Q

Features of imperforate hymen

A 
Hematocolpos
Hematometra
Cyclic pain
Acute urinary retension
Mx- cruciate incision
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54
Q

Imperforate hymen vs vaginal septum

A

Trnasverse septum there is no bulge
Cough impulse negative in vaginal septum
Cough impulse preseng in imperforate hymen

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55
Q

Investigation of choice for mullerian anomalies

A

3 D usg

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56
Q

Gold std for mullerian anomalies

A

Mri
If not
Then laproscopy and hysteroscopy

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57
Q

Dippong fundis and wide angle in

A

Bicotnuate uterus

Partialfusion 2 uterine horns 1 cervix

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58
Q

Bi cornuate mx

A

Strass man metroplasty

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59
Q

Complete failure of fusion in which uterine anomaly

A

Didlephius(2 uterine horns and 2 cervix)
Hoghest riak of vaginal septum
Highest risk of U/l renal agenesis(on the side of septum)

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60
Q

Ectopic pregnancy,evtopic ovary and u/l dysmenorrhea are characteriatic of which uterine anomalu

A

Unicornuate
High risk of urinary tract anomalies
Endometriosis
Uterine rupture

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61
Q

All mullerian anomalies have

A

1) Obstruction-cyclic pain,endometriosis,infection aub hemato colos and hematometra
2) urinary tract abnormalities-renal agenesis,horse shoe kidney,ipailateral
3) preg complicatins-abortion,iugr/nal presentation/pph,abnormal or prolonged labour

62
Q

Most common cause of infertility

A 
Ovarian
Pcos-(who grp 2 anovulation)
Doc ocps(for hirsuitism also 2 nd line spironolactone)
63
Q

Doc for ovulation induction

A

Letrozole

More live birth rate and monofoliiculqr development

64
Q

Differential diagnosis for pcos

A

Adult onset CAH-17 ohp test

65
Q

Second line traetment for ovulation induction

A

Gonadotropins>lap ovarian drilling

66
Q

Investyof choice for tubal patency

A

HSG (day 5-day 11)

67
Q

Best test for tubal patency

A

Laparoscopic chromopertubation

68
Q

Hag ahows b/l block next step

A

Laproscopic chromopertubation

69
Q

Hag shows b/l cornual block then

A

Hysteroscopic pic cannulation

70
Q

Bl/ hydrosalpynx toc

A

IVF

Next step -salpinchectomy or tubal clipping

71
Q

Gentinal tb most commonly involved in which organ

A

Fallopian tube
Spread hematogenous
Most common presentation pain and infertility
Normal pv findings

72
Q

Diagnosis of genital tb

A

Endomitral biopsy/PCR of menstrual blood

73
Q

Choclate cyst and adhesions seen in which type of endometriosis

A

Moderate to severe
Treatment of choice-IVF
Donot remove choclate cyat beforeivf

74
Q

Most common cause of male factor infertility

A

Primary hypogonadosm

Testicular/spermatogenesis/non obstructive)

75
Q

Hormonal status in primary hypogonadosm

A

Incraesed fsh
Increased lh
Decreased testosterone

76
Q

Obstructive azoospermia

A

All hormones are normal

Eg cystic fibrosis

77
Q

Moat important hormone differentiating non obstructive and obstructive azoospermia is

A

Fsh

78
Q

Investigation of choice for vaginal discharge

A

Salime microscopy

79
Q

Greyiah white,Foul amelling d/c with ph more than 4.5,no pruritis
clue cells/whiff test

A

Bacterial vaginosis

80
Q

Criteria for bacterial vaginosis

A

Amsel criteria 3

81
Q

Doc for bacterial vaginosis

A

Metronidazole/clindqmycin

82
Q

Important test in bac vaginosis

A

Gramstain

Nugent score score of 7-10

83
Q

Which infection a/w preterm labour

A

Bacterial vaginosis

84
Q 
Greenish yellow foul smelling frothy discharge 
With pruritis,dysuria and dysparunia
Ph> 4.5
O/e 
Strawberry cervix
A

Trichomoniasis

Doc metronidazole

85
Q

Patient presented with pruritis and thickk curdy white scandy diacharge,ph less than 4.5
Non foul smelling
Not std

A

Candidiasis
Doc- fluconozole
Kit 2 green clr- secnidazole 2 gm stat+ t fluconozole 150 mg stat

86
Q

Mechanism of action of emergency contraceptive

A

Inhibit fertilization

87
Q

Most commonly used ec

A

LNG tab 1.5 mg (72 hrs)

88
Q

Most effective ec

A

Cut (5days)

89
Q

Moat effective hormonal ec

A

Ulipristal 30 mg

90
Q

Pcos usg findings

A

12 or more follicles2-9 mm each

Volume of ovary >=10 cc

91
Q

Multiple large follicles

A

Ovarian hyper stimulation symdrome

Highest risk for gonadotropin (hcg)

92
Q

Best therapy for pcos

A

Recombinant fsh but costly

So hmg therapy

93
Q

Late onset ohss causes

A

Pregnancy hcg

94
Q

Hyperpigmented velvety necjk in

A

HAIR AN syndrome— severe pcos (it is the indication for metformin therapy)
Hyperandrogenesim,insulin resistance,acanthosia nicricans

95
Q

Laparoscopic ovarian drilling

A

Surgical ovulation induction
4 holes 40 w current
High risk for ovarian failure

96
Q

Asherman syndrome most comkon cause

A

D and c

Tb schistosomiasis

97
Q

Ipc for asherman sydn

A

Hysteroscopy

Rx- adhesiolysis+ peadiatric foleys and estrogen supplements

98
Q

Banana shaped uterus

A

Unicornuate uterus

99
Q

Golf club tube appearance in hsg

A

Tb

Others tobacco pouch pebble stone lead pipe

100
Q

Leaf kike protozoa with flagella highly motile

A

Trichomonas

101
Q

Complicated candidiasis treatment

A

Boric acid

Causative organisms candida glabrata c.tropicalis

102
Q

Triple line endometruim is at

A

Midcycle due to estrogen

103
Q

Tubal ligation in which serosa opened up ligate and cut tubes and bury the stump by tubal serosa

A

Uchida method
Zero failure
If medial end buried under myometrium(irwing )
If make loop ligate loop and cut loop -pomoroy

104
Q

Tubal ligation in which fimbriae is cut off

A

Kroner method

105
Q

Ligate the two end and cut in between

A

Parkland merhod

106
Q

Place pf tubal ligation

A

Medial 1/3 and lateral 2/3

107
Q

Madlena method

A

Made loop crush the loop and ligate the loop

Failure rate 7%

108
Q

Gollocle like arrangemnet of cells in

A

Granulosa cell tumor
Call exner bodies
Marker-inhibin b

109
Q

Granuloma cell tumour associated with

A

Tumou in uterus becos mc estrogenic tumour

110
Q

Tumour in children with elevated alpha feta protein and schiller duval body(pink cells inside)

A

Yolk sac tumour

111
Q

Tumour marker for young girls with adnexal mass

A

LDH-dysgerminoma
Afp- yolk sac tumour
Inhibin b
Hcg choriocarcinoma embryonal ca

112
Q

Signet ring cell appearance

A

Krukenberg tumour
Most common primary site pylorus of stomach(lymphatic route)
Poor prognonsis kidney ahaped large tumour

113
Q

Investigation for figo 0-5

A

Saline infused sonography

114
Q

Contraindication of hsg

A

Active tb

115
Q

Ioc of endometriosis

A

Laparoscopy

116
Q

Blue berry spots deep ,red flame lesion

Powder burn lesion seen in

A

Endometriosis/emdometrioma

117
Q

Hole in peritoneum called

A

Allen master syndrome due to adhesion

118
Q

Diagnosis of haemoperitoneum(ruptured ectopic)

A

Culdocentesis

119
Q

Couvelaire uterus seen in

A

Abruptio placenta

Concealed abruptio

120
Q

Painless profise bleeding

A

Placenta previa
Mx c section
Expectant manegement-macafee johnososn regimen deadline 37 week

121
Q

Lamba sign in

A

Dichorionic dizygotic

122
Q

Most common monozygotic

A

Mcda

123
Q

Nuchal transulency assaociated with which test

A

Dual test

124
Q

Post coital bleeding

Lesion on cervix what to do next

A

Direct punch biopsy

125
Q

Doyens retractor

A

Retract anterior abdominal wall in c section

126
Q

Episiotomy scissor

A

One narrow blade for vagina

One broad blade for perineum

127
Q

Episiotomy is sutured back by

A

Chromic cat gut 1-0

Rapid vicoryl no 1

128
Q

MVA SYRINGE(manual vacum aspiration )

A

2 valves
600-660 mmhg pressure
Used for mtp upto 12 wks or abortions of first trimester

129
Q

Cuacos speculum

A

Self reataining speculum

130
Q

Ayers spatula and cyto brush

A 
For papsmear(wood)
Cytobrush-for endocerviacal cytology for dysplasia scrrening
131
Q

Intra decidual space/ sac sign

A

Earliest sign of implantion in usg

132
Q

Double decidual space sign

A

Second sign of implantation

133
Q

Double bleb sign

A

Amniotic sac and yolk sac

134
Q

Ring of fire appearanec is seen in

A

Ectopic pregnancy

Also in corpus luteum

135
Q

Spalding sign

A

Intrauterine fetal death

Sign of maceration

136
Q

Velamentous placenta

A

Cord avulsion
Fetal distress
Fetal blood loss

137
Q

APT test used to

A

Diffenretiate maternal blood from fetal blood

138
Q

Apt test positive in

A

Vasa previa

139
Q

Q shaped placenta
Small chorionic plate
Raised membranes all around
Unutilised desidua basalis

A

Circum vallate placenta

Fetus with iugr oligo preterm

140
Q

Leopoeld grip

A

1 fundal grip
2 lateral /umbilical
3-pawlik grip one hamd used for to identify presentation
4-deep pelvic grip facing legs

141
Q

Compression suture in pph

A

B lynch suture during c section

142
Q

Pph suture in normal delivery

A

Haymans suture

143
Q

Hegar dialatore

A

Rapid cervical dialatores
Used for mtp,cervical incompetence
If hegar 8 dialator inserted -hegars teat

144
Q

Purse string suture at portio vaginalis

A

Mc donalds cerclage

145
Q

Pregancy in assymetrical uterus

A

Angular pregnanacy

Piskacek sign

146
Q

Perineal tear

A

1 degree- perinela skin
2-muscles also
3-anal sphincter
4-anal mucosa

147
Q

Pinard maneuver

A

For extended legs

148
Q

Maneuver for extended arm

A

Lovset

149
Q

Pragve maneovout

A

After coming head is delibered

150
Q

Mc roberts maneuvemsv /mauriceau smellie veit

A

Malar flexion shoulder traction

151
Q

I maneuver for shoulder dystocia

A

Mc roberts maneuver

152
Q

Gaskin maneuver

A

Knee hand postion

Gynaec Dvt (1 decks)

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