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Leeds MBCHB Year 4 GOSH > General Gynae > Flashcards

General Gynae Flashcards

1
Q

PMS management for: mild, moderate and severe symptoms

A

Mild: lifestyle (complex carbs)
Moderate: COOP
Severe: sertraline

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2
Q

3 red flags for menorrhagia that would indicate TV USS

A

IMB, postcoital bleeding, pelvic pain/ discomfort

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3
Q

All women with menorrhagia require

A

FBC

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4
Q

First line treatment in women with menorrhagia that do not need contraception

A

TXA/ mefenamic acid

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5
Q

First, second and third line treatment in women with menorrhagia that need contraception

A

1: IUS
2: COOP
3: long acting progesterone (DEPO)

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6
Q

Mullerian agenesis presentation

A

Teenagers presenting with amenorrhoea and no pain

From lack of uterus

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7
Q

Clomifine

A

Anti-oestrogen used to treat fertility issues in PCOS

Metformin second line

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8
Q

What do women with PCOS undergoing IVF, are particularly at risk of it:

A

Ovarian hyperstimulation syndorme

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9
Q

Common pattern of endometriosis pain

A

With period/ cyclical

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10
Q

First line investigation in infertile women after 1 year

A

Day 21 progesterone

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11
Q

CA125 used to measure

A

Ovarian cancer

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12
Q

3 components to risk malignancy index and for what cancer

A

Ovarian

Ca125, US findings, menopausal status

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13
Q

How long after termination will HCG test be positive

A

Upto 4 weeks

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14
Q

In molar pregnancy high levels of HCG can imitate what hormone

A

TSH

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15
Q

Management for all cases of secondary dysmenorrhoea

A

Referral to gynaecologist

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16
Q

Management of ectopic pregnancy with heart beat

A

Surgical

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17
Q

Turners syndrome chromosomes

A

45X

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18
Q

Cord prolapse management

A

Hand into vagina to elevate the presenting part

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19
Q

Treatment given to all HIV patients with CD4 < 200 to prevent ?

A

Pneumocystis jirovceii pneumonia

Co-trimoxazole (septrin)

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20
Q

Changes to smear testing in women with HIV

A

Every year as high risk HPV

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21
Q

When is zidovudine used in labour

A

C section in women with viral load >10000 (very high)

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22
Q

Drug given to children of HIV mother

A

Zidovudine for 4 weeks if low viral load

Zidovudine, lamivudine and nevirapine for 4 weeks if high viral load

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23
Q

Can HIV be passed on in breast feeding

A

Yes - even if undetectable

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24
Q

What is Fitz Hugh Curtis syndrome

A

Complication of PID

Inflammation and infection of liver cavity causing adhesions

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25
Q

Hypermesis gravidarum diagnostic criteria

A

5% weight loss
Dehydration
Electrolyte imbalance

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26
Q

First line pregnancy anti-emetic

A

Prochlorperazine

Ginger and acupressure on PC6 wrist

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27
Q

FSH levels in menopause

A

Very high (>40)

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28
Q

How to determine if pregnancy of unknown location is viable

A

Monitor HCG over 48 hours. Should double. (>63% acceptable)

Ectopic will be less

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29
Q

Medical management of pregnancy termination drug

A

Methotrexate (cannot conceive for a further 3 months)

30
Q

Missed miscarriage

A

Fetus no longer alive - no symptoms

31
Q

Threatened miscarriage

A

Vaginal bleeding, CLOSED CERVIX, fetus alive

32
Q

Inevitable miscarriage

A

Vaginal bleeding, OPEN CERVIX

33
Q

Investigation to diagnose miscarriage

A

TV USS

34
Q

Difference between triple and quad testing for Downs

A

Quad includes Inhibin A which makes it slightly more sensitive

35
Q

Low AFP likely to indicate

A

Downs

36
Q

AFP, estriol and HCG readings in Downs

A

AFP low
Estriol low
HCG high

37
Q

AFP, estriol and HCG readings in Edwards

A

All low

HCG high in Downs

38
Q

Edwards karyotype

A

trisomy 18

39
Q

Can COOP be prescribed while breast feeding

A

UKMEC 4 up to 6 weeks the UKMEC 2

40
Q

SSRI choice in pregnancy

A

Sertraline

41
Q

1st and 2nd line mx of endometriosis

A

Paracetamol/ NSAIDS
COOP

3: POP/ depo/ implant
4: GnRH analogues

42
Q

Methotrexate use before pregnancy - management

A

MAN AND WOMEN must stop using it 6 months before

43
Q

Rokitansky’s protuberance is associated with

A

Teratoma

44
Q

Likely diagnosis in pregnancy women with low grade fever and severe abdominal pain

A

Red degeneration of fibroids

45
Q

Cancers associated with BRACA1/2

A

Breast and ovarian

46
Q

Main risks for COOP

A

VTE, CV conditions, breast and cervical cancer

47
Q

Ovarian cancer - 2 main risk factors

A 
Many ovulations (nuliparity, early menache, late menopause)
FH - BRACA 1/2
48
Q

FSH and LH in menopause

A

High

Low oestrogen which would normally provide negative feedback as less ovarian follicles developing -> less granulosa cells

49
Q

Endomertial cancer risk factors

A 
Many ovulations (nuliparity, early menache, late menopause)
High oestrogen (obesity, HRT, PCOS)
DM, tamoxifen
50
Q

Endometrial cancer classic symptom

A

Post menopausal bleeding

51
Q

Percentage weight loss after birth that is pathogenic and management

A

10%

Referral to midwife led breastfeeding clinic

52
Q

Continuous dribbling incontinence after childbirth

A

Vesicovaginal fistula

53
Q

Medical advantage of transdermal HRT

A

Reduces VTE risk

54
Q

Cancers associated with HRT

A

Breast (risk normal 5 years after stopping)

Endometrial (reduced by progesterone)

55
Q

Cabergoline

A

Stops lactation

56
Q

Drug of choice to stop lactation

A

Cabergoline

57
Q

Why do males not develop a uterus or other female sex organs

A

Anti-Mullerian hormone

58
Q

Vaginal agenesis cause

A

Failure of the Mullerian ducts to properly develop

59
Q

clomifine use

A

Infertility in women who do not ovulate

60
Q

COOP increases risk of which cancers

A

Breast and cervix

61
Q

HRT: adding a progesterone increases the risk of ?? and ?? UNLESS ??

A

Breast Ca VTE unless transdermal

62
Q

Medical management of miscarriage

A

Vaginal misoprostol alone

63
Q

Ulipristal contraindication

A

Severe asthma

64
Q

Polycythemia is associated with which GOSH condition

A

Uterine fibroids secondary to autonomous EPO production

65
Q

How long until IUS is effective

A

7 days (same as implant, IUD and Depo)

66
Q

All women in pre-term labour should be offered ABX?

A

True - benzyl penicillin

67
Q

What week before should consider IV steroids

A

24-34 - offer

34-36 - consider

68
Q

Key monitoring of women on MgSO4

A

Deep reflexes every 4 hours

69
Q

When should mgso4 be given for neuroprotection

A

24-30 - offer

30-34 - consider

70
Q

Size of fibroids after menopause

A

Decrease (more LH and FSH)

71
Q

Everyone should get 2 USS - at around what weeks

A

12 and 20

Leeds MBCHB Year 4 GOSH (10 decks)

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