EMQs Flashcards
A woman from India and is on an
enzyme inducing antituberculosis drug,She states she gets irregular bleeding with
POP and wants short-term contraception.?
If they need COCP,( bleeding) then they should have a higher dose such as
50ฮผg ethinylestradiol with a shorter pill free period for 4 days.
best form of contraception : A 38 year old woman with history of breast cancer diagnosed 7 years ago. She has remained disease free for 5 years?
Barrier Method / UKMEC risk 3.
best form of contraception < 18 y ?
1- IMP (1)
2- any + barrier or condom
For older women which cases defined as UKmec 2 ?
- for women> 40 CHC ๐ VTE risk
- For women> 45 DMPA ๐ oestioprosis risk
In the postpartum period for how long you arenโt going to use CHC as a contraceptive?
In breastfeeding women:6 weeks postpartum (UKmec 4)
* > 6 w ๐ UKmec 2
Non breastfeeding: 3 weeks
In which UKmec category is CHC , in smoking women< 35 y ?
2
In which UKmec category is CHC , in smoking women > 35y & < 15 cigarette/ D ?
3
In which UKmec category is CHC , in smoking women > 35y & > 15 cigarette/ D ?
4
In which UKmec category is CHC , in smoking women > 35y & stopped smoking< 1 year ?
3
In which UKmec category is CHC , in smoking women > 35y & stopped smoking> 1 year ?
2
In which UKmec category is CHC, in women with BMI 30-34 ?
2
In which UKmec category is CHC, in women with BMI > 35?
3
emergency contraception as she had unprotected sexual intercourse 4 days ago.?
Ulipristal acetate 30mg (Ellaone) ; up to 120 h
Or : copper coil.
emergency contraception as she had unprotected sexual intercourse 2 days ago.?
Levonorgesterol 1500mg (Levonelle) : within 72 h
A 42 year old lady complains of persistent irregular bleeding with Micronor. She is a chronic smoker and has a BMI of 37?
Desogesterol 75ยตg
( newer generation POP / less side effects)
A 34 year old is 25 days postpartum. She is not breastfeeding and wants to start taking contraception pills. What to choose?
COC with 30ยตg ethinylestradiol
She is having elective caesarean section for breech what is most appropriate
antibiotic regime ?
Single dose IV Ampicillin
Or first generation cephalosporin
She has delivered and sustained a 3rd degree tear. She is being taken to theatre, most appropriate antibiotic regime?
IV Augmentin + IV metronidazole at the time of procedure
A 32 year old patient had manual removal of placenta and is now day 1 post delivery and is well ,most appropriate antibiotic regime ?
No antibiotic
An 18 year old is undergoing surgical termination of pregnancy.
most appropriate
antibiotic regime ?
PR Metronidazole 1gm
woman had her second smear that came back as borderline. High Risk HPV test is positive, what is the most appropriate management plan ?
colposcopy for routine follow up in 6 weeks
woman had her second smear that came back as mild dyskaryosis, High Risk HPV test is positive, what is the most appropriate management plan ?
Colposcopy within 6 weeks
woman has low grade dyskaryosis and High Risk HPV Is negative, what is the most appropriate
management plan ?
Routine recall in 3 years
woman had her first smear which was moderate dyskaryosis , what is the most appropriate
management plan ?
HPV testing in 12 months
woman had her first smear which was high grade dyskaryosi , what is the most appropriate
management plan ?
colposcopy urgently
A 46 year old woman has 3 inadequate smear repeated 3 months apart what is the most appropriate management plan?
referral to colposcopy as routine
A 30 year old woman had LLETZ for CIN 3 , what is the most appropriate management plan?
Colposcopy in 12 months
A 55 year old woman had LLETZ for CIN3 and the deeper margins are not clear of CIN3. What is the most appropriate management plan ?
LLETZ should be repeated
A 54 year old lady presents with postmenopausal bleeding. The pipelle biopsy shows endometrial hyperplasia without atypia. She declines to have a coil.
Continuous oral progesterone therapy
A 45 year old lady has 63% risk of ovarian cancer and 85% risk of breast cancer by age 70.
what is the most appropriate genetic syndrome ?
BRCA 1 Gene Mutation
syndrome, which puts her at high risk of having synchronous endometrial cancer with ovarian cancer. most appropriate genetic syndrome ?
Lynch Syndrome
A 30 year old woman has 27% risk of ovarian cancer and 84% risk of breast cancer.most appropriate genetic syndrome?
BRCA 2 Gene Mutation
A 10 year old girl is found to have germline mutation in the tumour suppressor gene PTEN.
most appropriate genetic syndrome?
Bannayan-Riley-Ruvalcaba Syndrome
A 43 year old woman is found to have an autosomal dominantgastrointestinal polyposis disorder
most appropriate genetic syndrome?
Peutz-Jegherโs Syndrome
) A 19 year old young woman is found to have germline TP53 mutation
most appropriate
genetic syndrome?
Li-Fraumeni Syndrome
enzyme inducing antituberculosis drug (not rifampicin) for the treatment of tuberculosis, best contraceptive? Best emergency contraception?
*DMPA
* Emergency: IUD or double dose Levonorgesterol ( 3000)
๐ฑ Ullipristal is contraindicated
What are the enzyme inducing drugs ?
1- rifampicin ( itโs effect last 28 d after stopping)
2- carbamazepine
3-phenobarbital, phenytoin , topiramate
