Gap deck Flashcards
Which test is thebest way to detect ovulation
Day 21 progesterone
serum progesterone level will peak 7 days after ovulation has occurred. The length of the follicular phase of the menstrual cycle can be variable, however, the luteal phase (after ovulation) remains constant at 14 days. Therefore, in a 35-day cycle, given that the luteal phase always lasts for 14 days, the follicular phase will be 21 days (ovulating on day 21). Therefore, the progesterone level will be expected to peak on day 28.
Atrophic vaginitis is treated with?
Topical oestrogen creams along with lubricants and moisturisers
Which drugs can help premenstrual syndrome?
SSRI
. They can be taken continuously or just during the luteal phase (for example days 15–28 of the menstrual cycle, depending on its length). The prescription should be for an initial 3 month period and patients should be monitored closely during initiation.
Most common type of ovarian pathology associated with Meigs’ syndrome
Fibroma
Most common benign ovarian tumour in women under the age of 25 years
Dermoid cyst (teratoma)
The most common cause of ovarian enlargement in women of a reproductive age
Follicular cyst
Treatment for vaginal candidiasis (thrush) in pregnancy
Local treatment - clotrimazole pessary (e.g. clotrimazole 500mg PV stat)
oral treatments are contraindicated in pregnancy
Contraindicated antibiotics in pregnancy
ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
Contraindicated psych drugs in pregnancy
lithium, benzodiazepines
6 drugs (AACCMS) contraindicated in pregnancy
Aspirin Amiodarone (arrhythmias) Carbimazole (antithyroid) Methotrexate (rheumatoid arthritis, psoriasis) Sulfonylureas (T2DM) Cytotoxic drugs (cancer tx)
how does preeclampsia cause oligohydramnios
due to hypoperfusion of the placenta.
why does diabetes cause polyhydramnios
there is foetal polyuria due to foetal hyperglycaemia.
5 causes of oligohydramnios
premature rupture of membranes
fetal renal problems e.g. renal agenesis
intrauterine growth restriction
post-term gestation
pre-eclampsia
Primary treatment of stage2-4 ovarian cancer
surgical excision of tumour +/- chemotherapy
woman is >50 years old, amenorrhoeic for >12months. Does she need contracpetion
no, she is assumed menopausal
woman is <50years old, amenorroeic for 16months. does she need contraception
yes - contraception neesd to continue until amenorrhoeic for 24months
what forms of contraception are safe to use alongside sequential HRT
all progesterone-only methods
What combination of results from combined test at 12wk US would have indicated a higher chance of Down’s syndrome?
Down’s syndrome is suggested by ↑ HCG, ↓ PAPP-A, thickened nuchal translucency
When are offered triple/quadruple test?
15-20wks if women book later in pregnancy and havent had 11-13+6week combined test screening
What is the most common identifiable cause of postcoital bleeding?
Cervical ectropion
Main complication of induction of labour and its tx
Uterine hyperstimulation which is characterised by too frequent or prolonged uterine contractions that can cause significant foetal distress. The treatment of uterine hyperstimulation requires administering tocolytic agents to relax the uterus and slow contractions.
First line method of inducing labour
Vaginal prostaglandins (ripen cervix and stimulate contractions)
VBAC is contraindicated in…
patients with
- previous vertical (classical) caesarean scars
- previous episodes of uterine rupture
- patients with other contraindications to vaginal birth (e.g. placenta praevia).
Characteristic sign of placenta praevia & diagnositc investigation?
painless vaginal bleeding.
definitive diagnosis of placenta praevia is through ultrasound scan imaging.Transvaginal ultrasound scans be safely performed at 20 weeks, in addition to the abdominal ultrasound scan to help improve the accuracy of localisation and RCOG guidelines state that they should be used to confirm the diagnosis of placenta praevia.
