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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
What is the most common vulval cancer?
Squamous cell carcinoma
26
What is an absolute contraindication to ECV?
Antepartum haemorrhage 7 days within time of procedure
27
What hormone is responsible for linea nigra in pregnancy?
Melanocyte Stimulating Syndrome
28
What does premature ovarian insufficiency present as?
Similar to typical menopausal symptoms - vaginal dryness, hot flushes, secondary amenorrhoea and two elevated FSH levels
29
What does white itchy patches on the genitals indicate? Specifically in older post menopausal women?
Lichen Sclerosus
30
What is occurring if a baby is showing turtle neck position and mother needs to be put in the Mc Roberts position?
Shoulder Dystocia
31
What are the hormone ratios you would expect to see in PCOS?
Raised testosterone, low sexhormone binding globulin, raised leutenising hormone and normal follicle stimulating hormone
32
What is firstline management for PCOS?
Weightloss
33
How long is contraception not need for after pregnancy?
First 21 days after delivery
34
What is the management for cord prolapse during birth?
Patient on all fours, on knees and elbows while waiting for emergency c-section
35
When is gestational hypertension diagnosed?
After 20 weeks gestation
36
What can help to improve the effectiveness of McRoberts Manoeuvre?
Suprapubic pressure
37
What is the treatment for premature ovarian insufficiency?
HRT
38
What genetic condition is an example of hypergonadotrophic hypogonadism and what are the symptoms seen?
Turners Syndrome, primary amenorrhoea, short stature and recurrent otitis media
39
What is the treatment for antiphospholipid syndrome during pregnancy to reduce the risk of miscarriage?
Low dose aspirin and LMWH
40
What causes a baby to have a tense fontanelle, and enlarged lateral and third ventricles?
Maternal Rubella
41
What are the phenotypes of fetal alcohol syndrome?
Pan-systolic murmur, thin upper lip, smooth philtrum and small jaw
42
What is a woody uterus indicative of?
Placental abruption
43
What is the scoring system for PCOS diagnosis ?
Rotterdam
44
What is HELLP syndrome?
Haemolysis Elevated Liver enzymes Low Platelets
45
What HRT is best for women in the menopause that still have regular periods?
Monthly cyclical HRT
46
What is the most common ovarian cyst?
Follicular cyst
47
What is the treatment for lichen sclerosis?
Clobetasol propionate - potent topical steroid
48
What is seen on microscopy for gonorrhoea?
Gram negative diplococci
49
What is the management of symptomatic placenta praevia after 34 weeks?
Admission
50
What is the firstline examination for endometrial cancer?
Transvaginal ultrasound
51
What abnormalities are tested for in the quadruple test?
Down syndrome
52
What is the most likely complication of vasa praevia?
Foetal death
53
What medication can be given to anaemic women to reduce bleeding while awaiting fibroid surgery?
Goserelin - can cause menopausal symptoms
54
What gestation is anti D given?
28 and 34 weeks
55
What HPV is associated with genital warts?
6 and 11
56
What are the clinical findings seen in endometritis?
Fever, secondary PPH, offensive smelling discharge
57
What HRT is recommended for perimenopausal women who have a uterus and no PMH?
oral sequential combined hormone replacement therapy
58
What antibiotic is given in preterm rupture of membranes?
Erythromycin
59
What does itching on palms and soles indicate in pregnancy?
Obstetric cholestasis - aim for delivery between 37-38 weeks
60
How does lymphogranuloma verenum present?
Painless ulcer followed by tender inguinal lymph nodes and rectal symptoms
61
What is a radical trachelectomy?
Removal of the cervix for cervical cancer which is fertility sparing
62
What medication is used to prevent pre eclampsia in high risk patients?
Aspirin
63
What skin lesion would present with dome shaped fleshy papule with central indentation?
Molluscum contagiousum
64
What bacteria is the cause of bacterial vaginosis?
Gardnella vaginalis
65
What is a large mobile uterus a sign of?
Uterine fibroids
66
What are firstline investigations for chorioamnionitis?
Blood cultures and broad spectrum antibiotics followed by induction of labour
67
What result would be found in a downs syndrome positive foetus?
Low alpha fetoprotein
68
What are the guidelines for COCP with PCOS regarding withdrawal bleeding?
Should have a withdrawal bleed every three months to reduce risk of endometrial cancer
69
Treatment for genital warts which are increasing in size?
Lmiquimod cream
70
What are multiple ring enhanced lesions in the brain of a HIV positive patient indicative of and what is the treatment?
Toxoplasmosis - sulfadiazine and pyramethamine
71
What is first line for symptomatic pre menstrual syndrome?
COCP with no break
72
What is another term for molluscs contagiosum?
Poxvirus
73
What is Sheehans syndrome and how does it present?
Pituitary gland infarction following major obstetric haemorrhage Results from hypotension following haemorrhage resulting in pituitary necrosis - PPH, 6 months later no periods present
74
How would toxoplasma gondii present in pregnancy and post birth?
Parasite found in cat faeces - asymptomatic or mild flu like symptoms Baby presents with hydrocephalus, seizure, visual and hearing impairment
75
What is the treatment for candida in pregnancy?
Intravaginal Clotrimazole
76
When should progesterone be tested for within the menstrual cycle?
7 Days before the end of the menstrual cycle
77
Which ribosome does doxycycline inhibit?
30s
78
What medication is given for hyperemesis gravidarum?
Oral promethazine or cyclizine
79
What is the medical management of an ectopic pregnancy?
Methotrexate
80
What is the firstline treatment for uterine fibroids?
IUS
81
What anti arrhythmic can't be taken while breastfeeding?
Amiodarone
82
What antipsychotic medication can you not take while breastfeeding?
Lithium
83
What STI is the most common cause for PID?
Chlamydia
84
What is the first line management for uterine atony?
Uterine massage
85
How long would you delay a smear test after a pregnancy, termination or miscarriage?
3 months
86
What is the most common ovarian cancer and the most common subtype?
Epithelial, serous cystadenocarcinoma
87
What medication can be used to suppress lactation?
Cabergoline
88
What test assesses number of foetal cells in maternal circulation?
Kleihauer Test
89
What vitamin is breast milk deficient of?
Vitamin K
90
What is the treatment for lymphogranuloma verenum?
Doxycycline
91
What hormone would you test for if menopause was suspected post the age of 45?
FSH
92
Which twin is more likely to develop foetal hydrops in twin-twin transfusion syndrome?
Recipient twin
93
What blood tests would you do to monitor a patient with severe pre-eclampsia?
FBC, U&E, transaminases and bilirubin three times per week
94
What is the main complication of ECV?
Cord prolapse
95
What gestation can ECV be offered in nulliparous women?
36 weeks
96
What is the treatment for pneumocystis pneumonia?
Co-trimoxazole and steroids
97
What type of ocarina cancer is more common in premenopausal women?
Germ cell tumour
98
What changes are made to levothyroxine in pregnancy?
Increase dose by 25mcg as soon as pregnancy is confirmed - foetus uses mothers thyroxine unit week 12
99
Does PCOS increase the risk of endometrial and ovarian cancer?
YES
100
How long does it take a postpartum uterus to return to its pre pregnancy size?
4 weeks
101
What is Sheehans syndrome?
Post part pituitary gland ischaemia, causes reduction in lactation, including hypothyroidism, hypoadrenalism, hypogonadism and growth hormone deficiency
102
What is neageles rule for EDD?
Count back three months, add a year and 7 days onto date
103
What is the treatment for obstetric cholecystasis?
Ursodeoxycholic acid
104
What is the investigation for placenta praevia?
Transvaginal ultrasound
105
What is a nathobian cyst?
Small cysts around the cervix where small areas of squamous cells cover columnar
106
How many pulls with ventouse before switching to lower segment caesarean section?
3
107

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