GOSH Flashcards
Describe the UK cervical screening programme
Aged 25-49 –> every 3 years
Aged 50-64 –> every 5 years
Screening for gestational diabetes in women with risk factors?
OGTT at 24-28 weeks gestation
Screening for gestational diabetes in women who have previously had gestational diabetes?
OGTT immediately after booking and at 24-28 weeks if the first test is normal.
Give 6 reasons for taking high dose folic acid
1) Obesity (BMI ≥30)
2) Woman is taking antiepileptic drugs
3) Woman has coeliac disease
4) Woman has diabetes
5) Woman has thalassaemia trait
6) Either partner has a NTD, they have had a previous pregnancy affected by a NTD, or they have a family history of a NTD
Why may uterine fibroids grow during pregnancy?
Due to increased oestrogen
Next steps if cervical smear results are HPV positive but normal cytology?
Repeat 12 months later.
If same again –> repeat 12 months later.
If same again –> refer for colposcopy
Next steps if cervical smear results are inadequate (i.e. inadequate sample)?
Repeat in 3 months
If still inadequate –> colposcopy
Mx if a woman with known placenta praevia goes into labour (with or without bleeding)?
Emergency c-section
Define blood loss in PPH
> 500ml after vaginal delivery
Mx of 1st degree perineal tears?
Usually no repair needed
Induction of labour if Bishop’s score is ≤6?
Vaginal prostaglandins or oral misoprostol
Mechanical methods such as a balloon catheter can be considered if the woman is at higher risk of hyperstimulation or has had a previous caesarean
Induction of labour if Bishop’s score is >6?
Amniotomy and IV oxytocin
What is the main complication of induction of labour?
Uterine hyperstimulation
What is 1st line management of postpartum thyroiditis?
Propanolol –> The hyperthyroid phase should be treated with beta blockers and NOT antithyroid drugs.
What terminology is used to describe the head in relation to the ischial spine?
Station
Sex hormone binding globulin concentration in PCOS?
Low
Which hepatitis is routinely screened for during pregnancy?
Hep B
What is the Abx of choice for GBS prophylaxis?
Benzylpenicillin
What are the 3 main types of ovarian cancer?
1) Epithelial cell tumour
2) Germ cell tumour
3) Sex cord tumour
Typical presentation of a germ cell tumour?
1) Younger age (<30)
2) May have FH of ovarian cancer
3) Possible signs:
- precocious puberty
- symptoms of pregnancy
- abnormal vaginal bleeding
Give 2 examples of a germ cell tumour
1) Teratoma (called a dermoid cyst when occurs at birth)
2) Choriocarcinoma
What 3 tumour markers are produced by germ cell tumours?
1) AFP
2) B-HCG
3) LDH
What is a choriocarcinoma?
A rare germ cell tumor of trophoblastic cell.
The abnormal cells start in the tissue that would normally become the placenta.
Typical mx of a germ cell tumour?
Platinum based chemotherapy
Monitoring for recurrence (tumour markers + physical exam)