Exam

Question 1

What are the CI of hysteroscopy?

Answer 1

Pregnancy, infection, cancer

Question 2

What is the disadvantage of SSLF?

Answer 2

Pudendal n -> buttock pain

Question 3

What are the disadvantages of radical hysterectomy?

Answer 3

Ureter & bladder injury
Atonic bladder
Fistula
Obturator n inj
Blood loss, lymphedema

Question 4

How to Ix fistula after radical hysterectomy?

Answer 4

Biochemistry of fluid
Triple swab
Intravenous urogram
Cystoscopy (watery), sigmoidoscopy (fecal)

Question 5

How to Ix PID?

Answer 5

HVS (trichomonas, candida)
ECS (gonorrhea, chlamydia)
Blood: VDRL, HIV screen

Question 6

How to Mx Bartholin abscess?

Answer 6

Not ruptured: marsupialization

Ruptured: ABX, analgesics

Question 7

USG snow storm appearance

Answer 7

Molar pregnancy

Question 8

When is a pregnancy considered non-viable?

Answer 8

Fetal pole >7mm + x FHR
IU GS >25mm + x fetal pole
IU GS <25mm + x interval growth

Question 9

What are the RF of thromboembolism?

Answer 9

Stasis: immobility
Hypercoagulability: estrogen (preg, oral and transdermal contraceptive), mal
Injury: surg, IVDA
Smoking, obesity

Question 10

What are the DDx of APH?

Answer 10

Upper genital tract: placental praevia, placenta abruptio, vasa praevia, uterine rupture, scar rupture
Others: lower genital tract lesion, other holes, APHUO

Question 11

What are the Sx of placenta abruptio?

Answer 11

APH
Uterine tenderness
Woody hard uterus
Fetal distress

Question 12

What are the Sx of placenta praevia?

Answer 12

Painless PVB

Question 13

What are the Sx of uterine rupture?

Answer 13

Easily palpable fetal parts
Loss of station of presenting part
Sudden loss of contractions

Question 14

What are the Sx of vasa praevia?

Answer 14

ROM
Fetal distress
Torrential PVB

Question 15

What are the risks of AMA?

Answer 15

To mother: PET, GDM

To fetus: chromosomal abn, miscarriage/stillbirth, preterm, prolonged labour, increased perinatal mortality

Question 16

What is PET?

Answer 16

Gestational HT + proteinuria (dipstick +1 or above, PCR >30)

After 20w

Question 17

What are the S/S of PET?

Answer 17

Renal: oliguria
Hepatic: epigastric / RUQ pain
Neuro: seizure, headache, visual disturbance, ankle clonus, alt MS, ICH/stroke/HT encephalopathy
Hemat: thrombocytopenia, hemolysis, DIC
Respi: pul edema
Uteroplacental: FGR, UmA abn, placenta abruptio, stillbirth

Question 18

How to prevent PET?

Answer 18

Oral aspirin 100mg daily (12 to 37w)

Question 19

How to Mx pregnant pt w/ pre-existing HT?

Answer 19

HBPM
Each FU: BP, Ur albumin, USG
Oral aspirin 100mg daily

Question 20

What is the risk of atenolol in pregnancy? What drugs can replace it?

Answer 20

IUGR

Labetolol > nifedipine > methyldopa/hydralazine

Question 21

How to Ix PET?

Answer 21

PET blood: CBC, LRFT (high ALT & bilirubin), urate, clotting, x match
Spot UPCR
Fetal: USG, CTG

Question 22

How to Mx eclampsia?

Answer 22

ABC, vitals
Left lateral position, remove hazardous objects
IV MgSO4 then diazepam prn
IV labetolol

Question 23

What is HELLP and what are its features?

Answer 23

Hemolysis, elevated liver enzymes, low plt

• CBC: anemia, thrombocytopenia
• LFT: high ALT, bilirubin
• Hemolysis: high LDH, low haptoglobin, retic
• PET features

Question 24

What are the Cx of HELLP?

Answer 24

DIC, abruptio, kidney failure

Question 25

How to Mx HELLP?

Answer 25

Confirm Dx: blood smear, CBC, LDH, haptoblogin
Monitor & resuscitate
Immediate delivery via C/S

Question 26

How to Mx placenta abruptio?

Answer 26

Resuscitate
Confirm Dx: abdominal exam, USG, CTG
Crash C/S

Question 27

How to Mx preterm labour?

Answer 27

>34w: deliver
<34w:
- Tocolytics (sublingual nifidepine, IV atosiban)
- IM dexamethasone (27-33w)
- IV MgSO4 (neuroprotection <32w)
- ABX (PPROM, IU inf)