GOSH 2 Flashcards
What is the 1st line investigation in post-menopausal bleeding?
TV US to look at endometrial thickness –> pipelle biopsy to sample endometrium (can be used to diagnose endometrial cancer in most cases).
What is the next investigation if a pipelle biopsy has been inconclusive when investigating endometrial cancer?
Hysteroscopy with biopsy
Mx of obstetric cholestasis?
Induction of labour at 37-38 weeks (due to increased risk of stillbirth)
Mx of Factor V Leiden in pregnancy?
LMWH antenatally + 6 weeks postpartum
What can be used in management of endometriosis if NSAIDs/COCP/progestogens have not been effective?
GnRH analogues (pseudo-menopause)
Define premature ovarian failure
The onset of menopausal symptoms and elevated gonadotrophin levels before the age of 40 years.
2x samples of FSH required
Give some causes of oligohydramnios
1) PROM
2) Potter sequence: bilateral renal agenesis + pulmonary hypoplasia
3) IUGR
4) Post-term gestation
5) Pre-eclampsia
In a very athletic woman, what causes 2ary amenorrhoea?
Hypothalamic hypogonadism
Is diabetes a high risk factor for pre-eclampsia?
Yes
Are women with autoimmune conditions such as SLE or antiphospholipid syndrome at high risk of pre-eclampsia?
Yes
What are some normal lab findings in pregnancy?
1) reduced urea
2) reduced creatinine
3) increased urinary protein loss
This is due to increased perfusion to the kidneys in pregnancy.
Is aspirin safe in breastfeeding?
No - risk of Reye’s
How long can a urine pregnancy test remain positive following termination?
Up to 4 weeks
Why is COCP contraindicated 21 days post partum?
Increased VTE risk
What is a history of sudden collapse occurring soon after a rupture of membranes suggestive of?
Amniotic fluid embolism
Next step if suspicion of ovarian cancer but there IS an abdominal or pelvic mass?
CA125 and US test can be bypassed and the patient directly referred to gynaecology
Mx of GBS colonisation in pregnancy?
Intrapartum IV benzylpenicillin
What is the gold standard investigation for mycoplasma genitalium?
NAATs
What are 3 key features of 3ary syphilis?
1) Neurosyphilis e.g. labile mood, confusion, delusions, seizures, judgement impairment
2) Aortic aneurysms
3) Gummatous lesions
What is Argyll-Robertson pupil? What is it found in?
A specific finding in neurosyphilis.
It is a CONSTRICTED pupil that accomodates when focusing on a neear objct but does not react to light.
What can increase the risk of genital wart recurrence?
Smoking
1st line management of uncomplicated Mycoplasma genitalium?
Doxycycline for 7 days
Followed by azithromycin for 2 days
Management of complicated Mycoplasma genitalium?
Moxifloxacin 400mg daily for 14 days
What is the protein on the surface of HIV that binds to CD4+?
gp120