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GOSH Flashcards

1
Q

What is used to highlight abnormal areas seen in colposcopy?

A

Acetic acid

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2
Q

What investigation is used to diagnose preterm rupture of membranes?

A

Actim-PROM Vaginal Swab
Detects insulin like growth factor binding protein 1 which is present in higher concentrations in the amniotic fluid - positive result = membrane rupture

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3
Q

What medication is first line in gestational hypertension?

A

Labetalol
2nd line if asthmatic is nifedipine

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4
Q

What is the treatment of eclampsia?

A

Magnesium Sulphate

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5
Q

What is vasa praevia?

A
  • Foetal blood vessels running through free placental membranes, and are unprotected by the umbilical cords.
  • The foetal blood vessels run across the birth canal
  • Presents as: dark red vaginal bleeding and acute foetal compromise, CTG sinusoidal pattern
  • Risk Factors: IVF, low lying placenta and multiple pregnancies
  • Babies present with hypoxia and/or severe foetal anaemia
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6
Q

What does a snowstorm appearance with a hyperechoic area interspersed with a multitude of cysts within the uterine cavity on ultrasound indicate?

A

Trophoblastic Disease, hydatiform molar pregnancy

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7
Q

What age do uterine fibroids tend to appear and what would a typical presentation be?

A

30-50
Menorrhagia, dysmenorrhoea and abdominal pain
More common in overweight women

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8
Q

What are the typical symptoms seen in ovarian cancer?

A

Early satiety, abdominal distension and loss of appetite
Early menarche and late menopause are risk factors

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9
Q

What is the first line management for uterine prolapse?

A

Pelvic floor exercises and vaginal pessary

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10
Q

What are the 3 signs of the third stage of labour?

A
  • A gush of blood in the vagina
  • Lengthening of the umbilical cord
  • Globular shaped uterine fundus on palpation
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11
Q

When is gestational diabetes diagnosed?

A

Fasting Glucose > 5.6
2 Hour Plasma Glucose >7.8

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12
Q

What presents as bilateral loss of the red reflexes, purpuric skin lesions covering the torso and a continuous “machine-like” murmur heard on cardiac auscultation of a neonate?

A

Congenital Rubella syndrome

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13
Q

What is continuous machine like heart murmur a sign of?

A

PDA

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14
Q

What is a first degree perineal tear?

A

Tear limited to the superficial perineal skin or vaginal mucosa only

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15
Q

What is a second degree perineal tear?

A

Tear extends to perineal muscles and fascia, but the anal sphincter is intact (episiotomy is anatomically classified as second degree)

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16
Q

What is a 3a degree perineal tear?

A

Less than 50% of the thickness of the external anal sphincter is torn

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17
Q

What is a 3b degree perineal tear?

A

More than 50% of the thickness of the external anal sphincter is torn, but the internal anal sphincter is intact

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18
Q

What is a 3c perineal tear?

A

External and internal anal sphincters are torn, but anal mucosa is intact

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19
Q

What is a fourth degree perineal tear?

A

Perineal skin, muscle, anal sphincter and anal mucosa are torn

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20
Q

What is the next steps for a woman testing positive for HPV, normal cytology and no symptoms?

A

Reassurance and retest in 12 months, continue to test until patient tests negative

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21
Q

What is whirlpool sign on ultrasound indicative of?

A

Ovarian Torsion

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22
Q

What do you typically find on ultrasound with a missed miscarriage?

A

Gestational Sac typically over 25mm
Blighted Ovum Present

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23
Q

What manoeuvre is used for shoulder dystocia?

A

Mc Roberts

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24
Q

What is the treatment of ovarian hyperstimulation syndrome?

A

Fluid resuscitation and drainage of effusion/ ascites if necessary

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25
Q

What is the most common vulval cancer?

A

Squamous cell carcinoma

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26
Q

What is an absolute contraindication to ECV?

A

Antepartum haemorrhage 7 days within time of procedure

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27
Q

What hormone is responsible for linea nigra in pregnancy?

A

Melanocyte Stimulating Syndrome

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28
Q

What does premature ovarian insufficiency present as?

A

Similar to typical menopausal symptoms - vaginal dryness, hot flushes, secondary amenorrhoea and two elevated FSH levels

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29
Q

What does white itchy patches on the genitals indicate? Specifically in older post menopausal women?

A

Lichen Sclerosus

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30
Q

What is occurring if a baby is showing turtle neck position and mother needs to be put in the Mc Roberts position?

A

Shoulder Dystocia

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31
Q

What are the hormone ratios you would expect to see in PCOS?

A

Raised testosterone, low sexhormone binding globulin, raised leutenising hormone and normal follicle stimulating hormone

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32
Q

What is firstline management for PCOS?

A

Weightloss

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33
Q

How long is contraception not need for after pregnancy?

A

First 21 days after delivery

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34
Q

What is the management for cord prolapse during birth?

A

Patient on all fours, on knees and elbows while waiting for emergency c-section

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35
Q

When is gestational hypertension diagnosed?

A

After 20 weeks gestation

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36
Q

What can help to improve the effectiveness of McRoberts Manoeuvre?

A

Suprapubic pressure

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37
Q

What is the treatment for premature ovarian insufficiency?

A

HRT

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38
Q

What genetic condition is an example of hypergonadotrophic hypogonadism and what are the symptoms seen?

A

Turners Syndrome, primary amenorrhoea, short stature and recurrent otitis media

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39
Q

What is the treatment for antiphospholipid syndrome during pregnancy to reduce the risk of miscarriage?

A

Low dose aspirin and LMWH

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40
Q

What causes a baby to have a tense fontanelle, and enlarged lateral and third ventricles?

A

Maternal Rubella

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41
Q

What are the phenotypes of fetal alcohol syndrome?

A

Pan-systolic murmur, thin upper lip, smooth philtrum and small jaw

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42
Q

What is a woody uterus indicative of?

A

Placental abruption

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43
Q

What is the scoring system for PCOS diagnosis ?

A

Rotterdam

44
Q

What is HELLP syndrome?

A

Haemolysis
Elevated Liver enzymes
Low Platelets

45
Q

What HRT is best for women in the menopause that still have regular periods?

A

Monthly cyclical HRT

46
Q

What is the most common ovarian cyst?

A

Follicular cyst

47
Q

What is the treatment for lichen sclerosis?

A

Clobetasol propionate - potent topical steroid

48
Q

What is seen on microscopy for gonorrhoea?

A

Gram negative diplococci

49
Q

What is the management of symptomatic placenta praevia after 34 weeks?

A

Admission

50
Q

What is the firstline examination for endometrial cancer?

A

Transvaginal ultrasound

51
Q

What abnormalities are tested for in the quadruple test?

A

Down syndrome

52
Q

What is the most likely complication of vasa praevia?

A

Foetal death

53
Q

What medication can be given to anaemic women to reduce bleeding while awaiting fibroid surgery?

A

Goserelin - can cause menopausal symptoms

54
Q

What gestation is anti D given?

A

28 and 34 weeks

55
Q

What HPV is associated with genital warts?

A

6 and 11

56
Q

What are the clinical findings seen in endometritis?

A

Fever, secondary PPH, offensive smelling discharge

57
Q

What HRT is recommended for perimenopausal women who have a uterus and no PMH?

A

oral sequential combined hormone replacement therapy

58
Q

What antibiotic is given in preterm rupture of membranes?

A

Erythromycin

59
Q

What does itching on palms and soles indicate in pregnancy?

A

Obstetric cholestasis - aim for delivery between 37-38 weeks

60
Q

How does lymphogranuloma verenum present?

A

Painless ulcer followed by tender inguinal lymph nodes and rectal symptoms

61
Q

What is a radical trachelectomy?

A

Removal of the cervix for cervical cancer which is fertility sparing

62
Q

What medication is used to prevent pre eclampsia in high risk patients?

A

Aspirin

63
Q

What skin lesion would present with dome shaped fleshy papule with central indentation?

A

Molluscum contagiousum

64
Q

What bacteria is the cause of bacterial vaginosis?

A

Gardnella vaginalis

65
Q

What is a large mobile uterus a sign of?

A

Uterine fibroids

66
Q

What are firstline investigations for chorioamnionitis?

A

Blood cultures and broad spectrum antibiotics followed by induction of labour

67
Q

What result would be found in a downs syndrome positive foetus?

A

Low alpha fetoprotein

68
Q

What are the guidelines for COCP with PCOS regarding withdrawal bleeding?

A

Should have a withdrawal bleed every three months to reduce risk of endometrial cancer

69
Q

Treatment for genital warts which are increasing in size?

A

Lmiquimod cream

70
Q

What are multiple ring enhanced lesions in the brain of a HIV positive patient indicative of and what is the treatment?

A

Toxoplasmosis - sulfadiazine and pyramethamine

71
Q

What is first line for symptomatic pre menstrual syndrome?

A

COCP with no break

72
Q

What is another term for molluscs contagiosum?

A

Poxvirus

73
Q

What is Sheehans syndrome and how does it present?

A

Pituitary gland infarction following major obstetric haemorrhage
Results from hypotension following haemorrhage resulting in pituitary necrosis
- PPH, 6 months later no periods present

74
Q

How would toxoplasma gondii present in pregnancy and post birth?

A

Parasite found in cat faeces - asymptomatic or mild flu like symptoms
Baby presents with hydrocephalus, seizure, visual and hearing impairment

75
Q

What is the treatment for candida in pregnancy?

A

Intravaginal Clotrimazole

76
Q

When should progesterone be tested for within the menstrual cycle?

A

7 Days before the end of the menstrual cycle

77
Q

Which ribosome does doxycycline inhibit?

A

30s

78
Q

What medication is given for hyperemesis gravidarum?

A

Oral promethazine or cyclizine

79
Q

What is the medical management of an ectopic pregnancy?

A

Methotrexate

80
Q

What is the firstline treatment for uterine fibroids?

A

IUS

81
Q

What anti arrhythmic can’t be taken while breastfeeding?

A

Amiodarone

82
Q

What antipsychotic medication can you not take while breastfeeding?

A

Lithium

83
Q

What STI is the most common cause for PID?

A

Chlamydia

84
Q

What is the first line management for uterine atony?

A

Uterine massage

85
Q

How long would you delay a smear test after a pregnancy, termination or miscarriage?

A

3 months

86
Q

What is the most common ovarian cancer and the most common subtype?

A

Epithelial, serous cystadenocarcinoma

87
Q

What medication can be used to suppress lactation?

A

Cabergoline

88
Q

What test assesses number of foetal cells in maternal circulation?

A

Kleihauer Test

89
Q

What vitamin is breast milk deficient of?

A

Vitamin K

90
Q

What is the treatment for lymphogranuloma verenum?

A

Doxycycline

91
Q

What hormone would you test for if menopause was suspected post the age of 45?

A

FSH

92
Q

Which twin is more likely to develop foetal hydrops in twin-twin transfusion syndrome?

A

Recipient twin

93
Q

What blood tests would you do to monitor a patient with severe pre-eclampsia?

A

FBC, U&E, transaminases and bilirubin three times per week

94
Q

What is the main complication of ECV?

A

Cord prolapse

95
Q

What gestation can ECV be offered in nulliparous women?

A

36 weeks

96
Q

What is the treatment for pneumocystis pneumonia?

A

Co-trimoxazole and steroids

97
Q

What type of ocarina cancer is more common in premenopausal women?

A

Germ cell tumour

98
Q

What changes are made to levothyroxine in pregnancy?

A

Increase dose by 25mcg as soon as pregnancy is confirmed - foetus uses mothers thyroxine unit week 12

99
Q

Does PCOS increase the risk of endometrial and ovarian cancer?

A

YES

100
Q

How long does it take a postpartum uterus to return to its pre pregnancy size?

A

4 weeks

101
Q

What is Sheehans syndrome?

A

Post part pituitary gland ischaemia, causes reduction in lactation, including hypothyroidism, hypoadrenalism, hypogonadism and growth hormone deficiency

102
Q

What is neageles rule for EDD?

A

Count back three months, add a year and 7 days onto date

103
Q

What is the treatment for obstetric cholecystasis?

A

Ursodeoxycholic acid

104
Q

What is the investigation for placenta praevia?

A

Transvaginal ultrasound

105
Q

What is a nathobian cyst?

A

Small cysts around the cervix where small areas of squamous cells cover columnar

106
Q

How many pulls with ventouse before switching to lower segment caesarean section?

A

3

107
Q
A

Exam Questions (7 decks)

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