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Fourth Yerar > GOSH > Flashcards

GOSH Flashcards

1
Q

What is the most common cause of reduced variability on CTG (short term)

A

Sleeping fetus

We worry if decreased variability for longer than 40 mins

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2
Q

When should u be careful about ABX on contraception

A

If you ar taking an enzyme inducing Abx e.g rifampicin during the pill free period then you need to use condos for 7 days

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3
Q

When can you take the COCP post-partum

A

UKMEC4 if BF<6weeks
UKMEC2 if BF 6wks-6months PP

Also shouldn’t be used in first 21 days PP at all

If started after day 21 additional contraception is needed for first 7 days

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4
Q

What week can pregnant women not fly from

A

32 weeks

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5
Q

When do you do a fetal blood sampling after CTG interpretation vs emergency C-section

A

I think mostly go for c-section

Fetal blood sampling can be useful in a non-reassuring CTG (vs abrnomal CTG) but often delivery is prioritized

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6
Q

What in a history would stop you giving labetalol in a pregnant lady for hypertension in pre-eclampsia

What do y give instead

A

Asthma!

Give nifedipine instead (ccb)

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7
Q

When do you get a tender cervix

A

PID most commonly

Also in ectopic, endometriosis, appendicitis, ovarian torsion

I guess anything that inflames the peritoneal area

No tender cervix in a miscarriage

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8
Q

Exaggerated symptoms of pregnancy e.g. excessive vomiting plus bleeding plus large fetus

A

Hydatiform mole

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9
Q

When is surgical Mx indicated over medical in ectopic

A

Symptoms (pain)
Over 35mm
Visible fetal heartbeat
HCG over 5000

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10
Q

Step wise approach to managing PPH

A

ABCDE
Warmed Crystalloid infusion (fluids)
Mechanical= rubbing up the fundus, catheter
Medical= IV oxytocin
Surgical= IU balloon tamponade

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11
Q

What is Sheehan’s syndrome

A

Necrosis of the pituitary gland following hypovolaemic shock as part of PPH

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12
Q

What do you give in magnesium sulphate induced respiratory depression

A

Calcium gluconate

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13
Q

What is HELLP syndrome

A

Haemolysis
Elevated Liver enzymes
Low Platelets

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14
Q

What blood test results in Edwards

A

Everything low

Same tests as downs which is high hCG and high inhibin

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15
Q

Stepwise investigations for reduced fetal movements

A

Handheld Doppler
If no HB then USS
If HB then CTG for at least 20 mins

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16
Q

First line in infertility in PCOS after weight loss advice

A

Clomifene

Anti-oestrogen

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17
Q

Drugs In an MTOP

A

mifepristone followed by prostaglandins after 36-48hrs e.g. misoprostol

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18
Q

What makes you do LSCS over external cephalic version

A

Breech but waters ruptured

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19
Q

Cutoffs for Hb levels

A
  • First trimester= 110
  • Second or third trimester= 105
  • PP= 100
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20
Q

When does pregnancy increase blood pressure

A

After 20 weeks

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21
Q

Skin tears after birth Tx

A

Category 1= involving skin only- no repair needed
Category 2= skin and perineal muscle- repair on maternity ward
Category 3= skin, perineal muscle and anal sphincter complex- repair in theatre
Category 4= skin, perineal muscle, anal sphincter, rectal mucosa- repair in theatre

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22
Q

How do you treat thrush in pregnancy

A

Clotrimazole pessary, not oral fluconazole as it is associated with congenital abnormalities

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23
Q

How do you investigate duchenne muscular dystrophy got confirm the diagnosis

A

Genetic analysis

Creatinine kinase is also a strong indicator

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24
Q

What do you give in urge incontinence when oxybutinin is contraindicated

A

Mirabegron

CI as fall risk I’m elderly

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25
Q

When do you induce labor in cholestasis of pregnancy and why

A

37

Increased risk of stillbirth

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26
Q

How do you deliver the next baby with a classical c-section scar

A

C-section

Vaginal birth is contraindicated

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27
Q

What are the 2 indications for big dose of folic acid (5mg)

A

anti-epileptic medication

Obese (>30 BMI)

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28
Q

Medical Mx of MTOP

A

Oral mifepristone
AND
Vaginal prostaglandins (e.g. Misoprostol)

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29
Q

What do you do if a woman has a temp of >38 in labor anf why

A

Give prophylactic benzylpenecillin to prevent GBS infection

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30
Q

How much weight needs to be lost PP for midwife referral

A

10 %

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31
Q

Breathlessness and sudden abdomen increase in size, presenting between weeks 16 and 26

A

Twin to twin transfusion syndrome

1 foetus is a donor which recieves less nutrients and the other becomes fluid overloaded

On USS one foetus will have empty bladder

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32
Q

2 stages of stage 1 of labor

A

Latent= 0-3cm dilation

Active= 3-10cm

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33
Q

How long can you forget your patch change before consequences

A

48 hours

Same as COCP

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34
Q

What happens if 2 COC pills are missed in week 3

A

Omit pill free period

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35
Q

Does hormonal contraception increase risk of breast cancer

A

Yes

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36
Q

What is the difference between partial and complete hydatiform mole

A

Complete is when 2 sperm fertilize an empty ovum

Partial is when 2 sperm fertilize a functional ovum

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37
Q

Enlarged and boggy uterus gonad

A

Adenomyosis

Endometrial tissue growth in muscular wall (myometrium)

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38
Q

Do you get dysmenorrhea in PID and endometriosis

A

Yes in endometriosis
No in PID

Good way to distinguish

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39
Q

What do you give pregnant women with thrush

A

Clotrimazole pessary

Oral fluconazole is CI due to risk of congenital abnormality

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40
Q

Which hormone is the best evidence of ovulation

A

Progesterone

Peaks at day 21

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41
Q

Which blood disease is a CI for expectant Mx of a miscarriage

A

Von Willebrand Disease

Give misoprostol PV

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42
Q

What’s the best form of contraception for someone taking anti-epileptic drugs

A

Copper coil

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43
Q

Which contraception is linked with weight loss

A

Depo injection

Definitely more common to gain weight with it tho

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44
Q

What is the classic presentation of placental abruption vs placenta praevia

A

Constant lower abdominal pain

woman may be more shocked than is expected by visible blood loss

Tender, tense uterus* with normal lie and presentation.

Fetal heart may be distressed

Placenta praevia= Vaginal bleeding, no pain. Non-tender uterus* but lie and presentation may be abnormal

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45
Q

How do you manage fibroids

A

Manage the symptoms e.g. if menorrhagia treat the pain

If really big and lots of symptoms consider surgical removal

Consider GnRH analogues to reduce hormonal effects

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46
Q

What is the smear regime if you are HIV positive

A

Smear every year

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47
Q

Snow storm appearance on obs USS

A

Complete hydatiform mole

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48
Q

What cancer risks come with COCP

A

Increases risk of cervical and breast cancer (ones we screen for)

Decreases risk of uterine and ovarian cancer

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49
Q

What is the first line medication for hyeremesis gravidarum

A

Cyclizine

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50
Q

Which Abx do you prescribe in preterm PROM

A

Erythromycin

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51
Q

Do you give aspirin in pregnancy

A

Usually avoided but given in pre-eclampsia

Avoid in breastfeeding

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52
Q

what are the indications for emergency C-section in placenta praevia

A

active labor

refractory life-threatening maternal hemorrhage

a category III fetal heart rate tracing

significant vaginal bleeding at ≥34+0 weeks of gestation.

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53
Q

How do you manage placenta praevia in outpatients after a bleeding episode

A

Counseling:
- Avoid excess physical activity, including sexual intercourse
- call their provider promptly if bleeding or labor occurs.

A course of antenatal corticosteroid therapy is administered.
Anti-D immune globulin is administered to RhD-negative patients

Planned C-section at 36/37

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54
Q

What is first line meds in HG and what drug class is it

A

Promethazine

Antihistamines are first-line in the management of nausea & vomiting in pregnancy/hyperemesis gravidarum

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55
Q

MMR vaccine schedule

A

1234
12 months, 3-4 years

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56
Q

Loose stool following gastroenteritis

A

Transient lactose intolerance is a common complication of viral gastroenteritis

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57
Q

How to manage someone on NOACs e.g. apixaban in pregnancy

A

Switch to heparin e.g enoxaparin

LMWH does not cross the blood brain barrier so is safe in preg

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58
Q

What is the organism that causes GBS

A

Streptococcus agalacticae is the bacterium which causes Group B Streptococcal disease (GBS)

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59
Q

Breast and endometrial cancer risk in oestrogen and combined HRT

A

HRT- increased risk of breast cancer
increased by the addition of a progestogen
the risk of breast cancer begins to decline when HRT is stopped and by 5 years it reaches the same level as in women who have never taken HRT

increased risk of endometrial cancer
oestrogen by itself should not be given as HRT to women with a womb
reduced by the addition of a progestogen but not eliminated completely
the BNF states that the additional risk is eliminated if a progestogen is given continuously

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60
Q

Breast, endometrial and ovarian cancer risk in combined/ oestrogen-only HRT

A

Breast:
- combined= increased risk. Risk reduces when you stop and increases the more you take it
-oestrogen only= slightly increased risk (less than combined), reduces

Ovarian:
- both slightly increase the risk, reduces

Endometrial:
- combined has no effect
- oestrogen only increases the risk (only given when patient has had a hysterectomy)

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61
Q

Specific requirement to be eligible for oestrogen only HRT

A

Has to have had a hysterectomy

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62
Q

COCP Breast, cervical, ovarian, endometrial cancer risks

A

Increased risk of breast and cervical cancer (ten years after stopping the risk is back to baseline)

Decreased risk of ovarian and endometrial cancer (stays when stop taking)

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63
Q

POP breast, cervical, endometrial cancer risk

A

Less well known that COCP

Breast: slightly increased risk (similar to combined pill)
Cervical: unsure
Endometrial: unsure but think it reduces like COCP

64
Q

Which hormone is rasised significantly in menopausal people

A

FSH

65
Q

Which hormones does the nexplanon contain

A

Progesterone

66
Q

Breech in labour?

A

LSCS within 75 mins

You can’t do external cephalon version once waters have broken as u need the water to help turn

67
Q

How do u diagnose BV

A

Thin white fishy discharge

Clue cells on microscopy

PH more than 4.5

history, vaginal examination and microscopic examination. Microscopy is the preferred method for diagnosis whereby a high vaginal smear (HVS) is gram stained and evaluated for: The presence of ‘clue cells’ – vaginal epithelial cells studded with Gram variable coccobacilli.

68
Q

Which infection gives a strawberry cervix

A

Trichomonas vaginalis

69
Q

How to treat gonorrhoea

A

IM ceftriaxone 1g stat

Presents with discharge , IMB, dypareunia, dysuria

Gram negative diplodocus

70
Q

Which UKMEC is wheelchair use

A

3

71
Q

Which organism causes scarlet fever

A

Streptococcus pyogenes

72
Q

What size foetal sac for surgical management of ectopic

A

35

73
Q

What HCG level for wxtopic surgical management

A

5000

74
Q

Which female cancer is hereditary non-polyps is colorectal carcinoma (HNPCC)/ Lynch syndrome a strong risk factor for

A

Endometrial cancer

75
Q

How do you describe the baby’s head orientation during labour

A

Left or right OCCIPUT anterior or posterior

Look where the occiput is when looking up at the mother lying on her back

If the baby’s head is on your left then its left occiput anterior/posterior

76
Q

What non hormonal treatment can you give in vasomotor symptoms of menopause

A

SSRIs e.g. fluoxetine

77
Q

Hb cut offs in preg

A

115 for non-pregnant women, 110 in early pregnancy, 105 in later pregnancy, and 100 after childbirth.

78
Q

Ondansetron in pregnancy ?

A

there is an association with a small increased risk of cleft lip/palate in the newborn if used in the first trimester

Discuss before use

79
Q

How logn does it take for the POP to be effective

A

2 days

80
Q

6 risk factors for shoulder dystocia

A

Large for Gestational Age
Diabetes
Maternal BMI

Slow progress in second stage of labour
Assisted delivery e.g. forceps, ventouse

Previous shoulder dystocia

81
Q

What can you do positionally for the mum in shoulder dystocia

A

McRobert’s manouvre

Legs extended then flexed onto her chest

82
Q

4 risk factors for cord prolapse

A

When membranes are ruptured artificially (ARM)

PROM
Pre-term baby
Non-longitudinal (position of the baby)

83
Q

How do you manage cord prolapse

A

LSCS

Don’t touch the cord as it causes more vasospasm

Can lift baby’s head up so its not touching the cord

If SVD is quicker than predicted time for LSCS then continue with SVD

84
Q

Name 4 drugs given to manage PPH and what they do

A

Syntocinon relaxes vascular smooth muscle

Ergometrine causes strong uterine contractions

Carboprost and Misoprostol are synthetic prostaglandins which also causes uterine contractions (think MTOP)

85
Q

First line antiemetic in vomiting in pregnancy

A

Promethazine

86
Q

Drug management for postpartum thyroid it is

A

Propranolol

87
Q

Fasting glucose threshold for insulin vs lifestyle modifications

A

7 mmol/L
You can plus or minus add metformin

88
Q

What is the main drug management for hypertension in pregnancy

A

Labetalol

Nifedipine if it is unsuitable

Only give if BP is persistently above 140/90

89
Q

What do all the hormones do in the menstrual cycle

A

FSH causes the maturation of an egg in the ovary
LH stimulates the release of the egg (stimulates ovulation)

oestrogen is involved in repairing and thickening the uterus lining,
progesterone maintains the uterine lining

In regnancy HCG maintains the corpus luteum which secrets progesterone keeping the lining thick

90
Q

In which paeds rash is the palms and soles typically spared

A

Scarlet fever

Treat with Oral Pen V for 10 days

Safe to return to school after 24 hours

91
Q

Which Abx for GBS prophylaxis

A

Benzylpenecillij

92
Q

What is the hormonal level changes in turners

A

increased FSH and LH

In primary amenorrhoea to compensate for lack of oestrogen and progesterone

93
Q

Can you breastfeed if u have hepatitis b

A

Yepatitis B

94
Q

What is gold standard for diagnosing Hirschsprungs

A

Rectal biopsy
Lack of ganglion in nerve cells

95
Q

Which organism causes PID most commonly

A

Chlamydia

96
Q

Is smoking a risk factor for pre-eclampsia

A

No

Neither for HG

97
Q

How to manage someone with moderate - high risk of pre-eclampsia

A

Give aspirin 75-150mg daily from 12 weeks until delivery

98
Q

Pregnancy flying advice

A

If carrying twins don’t fly after 32 weeks

37 weeks for one child pregnancy

99
Q

Medical Mx of missed miscarriage

A

Oral mifepristone + 48 hours later, misoprostol (vaginal, oral or sublingual) unless the gestational sac has already been passed

For an incomplete misacarriage you can give a single dose of misopsrostol

100
Q

Complications of surgical management of miscarriage

A

Complications include intrauterine infection (3%), damage to the cervix/trauma, haemorrhage and retained products (5%).

101
Q

Complications of medical management of miscarriage

A

Can be complicated by heavy bleeding and moderate abdominal pain. There is a 5% incidence of retained products/failure of treatment.

102
Q

How to manage an incomplete miscarriage medically

A

Misoprostol

Antiemetics and analgesia

No need for mifepristone, used in missed miscarriage

103
Q

4 indications for surgical
mx of ectopic

A

Significant pain.
Adnexal mass of 35 mm or larger.
Fetal heartbeat visible on an ultrasound scan.
Serum hCG level of 5000 IU/L or more.

104
Q

medical Mx of ectopic,
MTOP drugs,
missed and incomplete miscarriage drugs

A

methotrexate for ectopic

MTOP= misoprostol and mifepristone

incomplete MC= just misoprostol

missed MC= Oral mifepristone + 48 hours later, misoprostol (vaginal, oral or sublingual)

105
Q

when do you do surgical termination

A

by choice- no indication for either

vacuuming up until 14 weeks

after 14 weeks dilation and evacuation

also do it if medical doesnt work

106
Q

medical termination before and after 10 weeks

A

oral mifepristone

48 hours later give misoprostol

if after 10 weeks more likely to have to give a second dose of misoprostol

107
Q

Ondansetron pregnancy

A

In first trimester small risk of cleft palate / lip

Cyclising or promethazine are first line in vom in pregnancy

108
Q

Medical Mx of eclampsia

A

an IV bolus of MgSo4

4g over 5-10 minutes should be given followed by an infusion of 1g / hour

treatment should continue for 24 hours after last seizure or delivery (around 40% of seizures occur post-partum)

109
Q

How long do you give after MTOP for negative pregnancy test

A

4 weeks

If still positive after that then refer

110
Q

How do you investigate and manage preterm prelabour rupture of membranes

A

STERILE speculum to look for pooling of amniotic fluid (don’t do bimanual)

Can swab using Amnisure if can’t tell

Admit them and CTG them

Oral erythromycin for 10days

Anetnatal corticosteroids give to reduce risk of respiratory distress syndrome

Longer you wai5 for delivery = increased risk of chorioamnionitis but low risk of RDS

111
Q

How to treat gonorrhoea

A

Ceftriaxone 1g IM stat

Chlamydia is doxy 100mg BD for a week or azith if pregnancy

Syphillis is IM benzathine benzylpenecillin stat

112
Q

How to treat syphillis

A

Syphillis is IM benzathine benzylpenecillin stat

113
Q

How to treat chlamydia

A

Chlamydia is doxycycline 100mg BD for a week or azith if pregnancy

114
Q

When is the booking clinic and what happens

A

Usually between 8-12 weeks

Ideally before 10 weeks

Baseline assessment and plan pregnancy:
- booking bloods: sickle cell and thalassaemia screen, blood group and rhesus D status, FBC for anaemia, infections (HIV, Hep B, Syphilis)
- pre-eclampsia screen- risks and symptoms
- general check e.g. height and weight

Prophylactic meds may be given e.g. aspirin for pre-ec, LMWH for VTE

115
Q

What bloods are taken at the booking appt (8-12 weeks ideally before 10 weeks)

A
  • FBC for anaemia
  • group and save for blood group
  • Rhesus D status
  • screening for thalassaemia and sickle cell
  • screening for infectious diseases (HIV, Hep B, Syphillis)
  • potentially screening for downs if after 11 weeks (combined test)
116
Q

What is Rhesus status and why is it important in pregnancy

A

Everyone is either Rh+ or Rh-. If you are Rh- you don’t have Rh antigens on your blood cells. Therefore if you encounter blood that is Rh+ then you create antibodies to attack it.

If you are Rh- and your unborn baby is Rh+ then if your blood were to mix (e.g. during birth, bumps etc) then you would become sensitized and have antibodies saved up.

If you were then to become pregnant again with a Rh+ baby then it can harm the baby and cause Rhesus disease (hemolytic disease of the fetus and newborn (HDFN)) which can potentially be life threatening

So anti-D prophylaxis is given to stop this response to Rh- women

117
Q

When do they screen for Down’s, Edwards and Patau’s syndrome

A

Between 11-14 weeks

So just after booking scan which is 8-12 weeks

Combined USS (for nuchal translucency) and maternal blood tests

downs causes increase nuchal translucency and PAPP-A but high HCG

If they can’t do the USS then they do a triple/quad blood test between 15-20 weeks

118
Q

When is the dating scan and how does it work

A

Between 10 and 14 weeks

So hopefully just after booking clinic (8-12) and ?same time as down’s/edwards/pataus screening (11-14 weeks)

Calculates gestational age using the Crown-Rump Length

Also identifies twins

119
Q

How do blood group compatibilities work

A

If you are A blood group then you have antibodies vs B group

If you are B blood group then you have antibodies vs A group of

If you are AB blood group then you have no antibodies vs anything (can receive any)

If you are O blood group then you have antibodies vs both A and B so can’t receive any (apart from O) but you can give to anyone

If you are Rh-ve you wont be able to accept from Rh+ve but you can give to anyone as you will develop antibodies vs Rh+ve blood

If you are Rh+ve then you can receive from anyone but wont be able to give to Rh-ve people

120
Q

When are anti-D injections given to Rh-ve women

A

28 weeks
Birth

This is to prevent Rh-ve women becoming sensitized to a potentially Rh+ve baby- this could cause serious effects in future pregnancies (Rh disease)

121
Q

When is the anomaly scan and what is it

A

Usually 20 weeks (between 18-21)

Detailed USS which looks for 11 conditions (fetal anomalies) e.g. heart conditions, exomphalos, spina bifida, Edwards/ Pataus

May also be able to find out gender of baby

122
Q

Vaginal delivery after C-section

A

Yes after one

No after 2

123
Q

Risks/ disadvantages of C-section

A

More pain

More bleeding

Risk of infection

Risk of harm to surrounding organs

Small risk of cutting baby if pressed up against womb

Longer recovery in hospital (3- days)

124
Q

Advantages of HRT

A

Reduction in vasomotor symptoms

Improved mood

Improvement of urogenital symptoms

Reduces the risk of developing osteoporosis

Cardiovascular protection

125
Q

Which two vaccines are offered to all pregnant women

A

Whooping cough (16 weeks onwards)

Influenza during autumn/ winter

126
Q

How do you assess BBV risk during a sexual history

A

Sexual contact with HIV positive person
Sexual activities with MSM
Sexual activities with someone outside the UK
IV drug use
Paying/ being paid for sex
Blood transfusions/ tattoos/ piercings abroad

127
Q

How do you counsel someone with an STI

A

Treat the infection (in pregnancy chlamydia is oral azithromycin 1g orally for one day then 500mg orally for 2 days)

Encourage to go to SH clinic for screening for other STIs
Partner notification- SH clinic will be able to help with that (anyone slept with in last few months)

Offer follow up to check Sx/ partner notification/ re-check for infection

128
Q

What would you seek specialist advice for in UTI in pregnancy

A

Catheter-associated UTI

Recurrent UTI (refer to obs)

Underlying urinary tract abnormality

Suspected serious underlying cause

129
Q

Which Abx UTI in pregnancy

A

CKS SAYS NITROFURANTOIN 100mg BD for 7 days

Nitro for first 2 trimesters

?trimethoprim for last (decreases folate in first tri)

Avoid nitro in third tri as it can reduce RBC around delivery time

130
Q

Syntometrine contraindications

A

Hypertension

Increases blood pressure

Causes uterine contractions

131
Q

Which antibiotics are CI in pregnancy

A

Trimethoprim in 1st trimester
Nitro in 3rd trimester

Tetracyclines cause neonatal tooth discoloration

Co-amoxiclav increases risk of NEC

132
Q

How do you treat chorioamnionitis

A

Cefuroxime 1.5g TDS IV
And
Metronidazole 500mg TDS IV

133
Q

How to treat endometritis

A

Co-amoxicillin 1.2g I TDS

Or

Clindamycin and Metronidazole if penicillin allergic

134
Q

How to calculate fetal engagement

A

Palpate the presenting part of the fetus (usually the head)- this mean closest to the vagina

If it is the head and you can feel the whole head then it is five fifths palpable and so not engaged

If you can’t feel the head at all then it is zero fifths palpable and fully engaged

135
Q

How to twll between placenta praevia and placental abrupt ion

A

Placental abruption is painful uterus with bleeding

Placenta praevia is painless bleeding

136
Q

How to manage uterine inversion

A

When the fundus of the uterus falls into the vagina turning it inside out

Johnsons maneuvre- pushing the uterus back up in to the abdomen

If that fails then hydrostatic pressure methods- filling the vagina up with water

If they both fail then surgery

137
Q

How to manage uterine inversion

A

When the fundus of the uterus falls into the vagina turning it inside out

Johnsons maneuvre- pushing the uterus back up in to the abdomen

If that fails then hydrostatic pressure methods- filling the vagina up with water

If they both fail then surgery

138
Q

Most common tocolytics given to stop Labour

A

Nifedipine (ca channel blocker)

Indomethacin (NSAID)

B2 agonist e.g. terbutaline

139
Q

What steroid, dose and frequency in premature labour

A

Betamethasone 12mg IM x 2 doses, 24h apart

140
Q

What dose of Enoxaparin as a prophylactic and therapeutic regime in pregnant women VTE

A

Prophylactic= 0.5mg/kg/day

Therapeutic= 2mg/kg/day

141
Q

RCOG guidelines for PPH stepwise approach

A

Non-pharmaceutical first e.g. uterine compression, catheter with balloon

Then Syntocinon 5 units IV infusion

then ergometrine

Then Carboprost

Then misoprostol 1000micrograms rectally

Then surgical intervention

142
Q

RCOG guidelines for PPH stepwise approach

A

Non-pharmaceutical first e.g. uterine compression, catheter with balloon

Then Syntocinon 5 units IV infusion

then ergometrine

Then Carboprost

Then misoprostol 1000micrograms rectally

Then surgical intervention

143
Q

CI of ergometine

A

Hypertension

144
Q

CI of Carboprost

A

Asthm

145
Q

How to treat lichen sclerosis of the vulva

A

Potent topical steroid e.g. dermovate

Prevents scarring and reduces the risk of vulval cancer

146
Q

What is the most common type of ovarian cancer in different demographics

A

Epithelial is the mst common type overall, much more common in post-menopausal women

Germ cell is the most common type in younger women around <40 (around 10% of all OC)

147
Q

COCP and VTE contraindicated?

A

COCP is contraindicated when there has been a first degree relative who has had VTE under the age of 45

148
Q

How to treat Trichomoniasis

A

Metronidazole either 2g oral stat or 7 day 500mg BD

149
Q

Previous GBS management

A

Give mum intrapartum prophylactic Abx (Benzylpenecillin)

150
Q

Gram negative diplococci which organism

A

Neisseria gonorrhoea

Treat with ceftriaxone

151
Q

When to refer for no fetal movements

A

24 weeks

152
Q

Whirlpool sign on USS

A

Ovarian torsion

153
Q

Hyper echoic mass on pelvis USS

A

Fibroids

154
Q

Need for contraception after the menopause rules

A

12 months after the last period in women > 50 years
24 months after the last period in women < 50 years

155
Q

Reactive arthiritis typical presentation

A

1 to 4 weeks following a genitourinary or gastrointestinal infection

The classic triad of symptoms is:
- conjunctivitis- can’t see
- urethritis- can’t pee
- arthritis- cant climb a tree

156
Q

How long does it take for IUS to be effective

A

7 days

Same as COCP and implant

Fourth Yerar (5 decks)

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