GOSH msut knows Flashcards
Painless bleeding in presence of bradycardia
Vasa praevia
10 - 13+6 weeks?
Early scan to predict dates
Booking scan (4321)
4 blood (FBC, rhesus, blood group, alloantibodies)
3 virus (hepB, HIV, syphilis)
2 UTI (dipstick, culture)
1 full physical examination (breast, BMI, BP)
Large uterus for date?
Complete hydatidiform
post cervical tx? When is next smear done?
6M later
- just note that its 12M after CIN1 detected and no tx done (should clear itself in 1 year)
pH of ? in labour is considered normal?
> 7.2
acidotic if less => Deliverey
Resp depression post MgSul in eclampsia?
Calcium Gluconate
Mg OD => Ca Gluc
An ultrasound is indicated if lochia persists beyond
6 weeks
postpartum thyroiditis treatment?
Propranolol
years for cervical screening
25-49 = /3 years cervical // 50-64 = /5 years
Supressing lactation drug?
Cabergoline
High FSH?
Premature Ovarian Insuf
Turners
When to start aspirin for prior pre-eclampsia prophylaxis?
12weeks → 75mg aspirin for the rest of pregnancy
most common type of ovarian cancer?
Serous carcinoma
Topical eflornithine?
Hirsutism PCOS
Kleihauer test?
Foetal blood in mum
Exomphalos
Bowel where lung is
Does COCP increasae risk of ectropion
yes
VEAL CHOP
- Variable decelerations ⇒ Cord compression
- Early Decelerations ⇒ Head Compression
- Accelerations⇒ OKAY!
- Late decelerations ⇒ Placental insufficiency
Polyhydramnios increases risk of what type of bleed?
Abruption
Most common site of ectopic pregnancy
Ampula
Mittelschmerz 1st line
NSAIDS
High LH - FSH ratio
PCOS
High FSH - LH ratio
Premature Ovar + Turners
Is hyperflexia seen in Pre-eclampsia?
yes
-PPH 1st + 2nd line
fundus stimulation → Oxytocin
WHAT TO GIVE in
Most common cause of pyrexia in women post birth?
Endometritis
Clindamycin +Gent
Boggy uterus w/ pain + bleeding
Adenomyosis
How long + What is tx for metronidazole for STI
500mg BD 5 days
dont forget abstinence for 1 week
5 breast feeding drugs to avoid?
Tetracyclines
Benzo
Carbimazole
Gliclizide
Lithium
For suspected premature opvarian insuf. what should we measure?
FSH
1st line tocolytic in preterm labour?
Nifedipine oral
If in contact with chickenpox >20wks, what should we do?
Maternal AB then aciclovir if negative
Main complication of vasa praevia?
Foetal blood loss => death
ovarian hyper stim can be caused by what type of therapy?
IVF
What happens to weight in overian hyper stim as a complication of IVF?
weight gain rapid
Oesophageal atreasia can cause what complication in mothers?
Polyhydraminios
think that they cannot swallow it so they piss it out and it just stays there
Where do we do LA for instrumental delivery?
Pudendal nerve (S2-S4)
If b-HCG does not drop after evacuation of Hydatidiform mole, what should we suspect?
Choriocarcinoma
How do we manage CIN1?
50-60% of CIN 1 will spontaneously regress within 2 year so CONSERVATIVE managemnet + 6M repeat cytology
BCG that doubles over 48 hours?
Pregnancy success
Do we give Abx for GBS carrier for C-sec?
No -> only for vaginal deliveries
Denies insulin with gestational diabetes
Gliblenclamide (sulph)
Most common fibroid?
Intramural
Has HIV with booking scan what to start them on? (2)
(TED) tenofovir
disoproxil / emtricitabine
When placenta hasnt been delievered that leads to PPH?
Acreata
Transient bradycardia requires forceps?
Nope
Poly / oligo as a RF for breech?
Both RF
If the antibodies are positive for VCV do they need aciclovir?
No
Ergometrine CI in what BP?
Hypertension
Turners leads to what (gonadotrophic + gonadism)
Hypergonadotrophic hypogonadism
High FSH + LH with no ovarian response
Itchy purple rash vagina?
Lichen Planus (another PP)
Other than cyclizine, what is the other 1st line to give in hyperemesis gravidarum?
Oral Promethazine
Who cannot have ergometrine?
who cannot have carboprast
^^ both for medical Mx of PPH
Hypertension => Ergo CI
Carboprast => Asthma CI
Stress vs urge incontinence graph?
PVES + PABD => Spikey Stress
PVES + PABD =< flat oxybutynin
COCP after 50?
nah avoid switch them
18-21 week?
Anomaly scan
inducing withdrawal bleed on COCP for PCOS every?
3M
<4mm endo?
discharge
leucocytes without nitrites?
No UTI
do those with overactive bladder have involuntary peeing?
no
hand like a waiter?
Erb palsy => shoulder dystocia
does PCOS or anastrozole increase endometrial cancer risk?
PCOS (x3)
chandelier sign?
PID
ECV offered when for nulliparous + multiparous
Nulliparous => 36+
multiparous => 37+
when do we offer intrapartum ABx for GBs?
onset of labour
miscarriage above what week = anti-D
> 12weeks
On any form of enzyme reducing drug (carbamazepine) what to give contraception?
IUD
What to give for polyhydramnios?
Indomethacin
pre-menopausal having symptoms of menopause what HRT?
Cyclical
experiencing any symptoms such as pain do we do expectant management for ectopic?
No -> methotrexate if pain for ectopic
definition of hyperemesis gravidarum?
<20wks vomiting
<25 with abnormal cervix?
colposcopy
when should gestational diabetic women give birth no later than?
40+6
umbolical cord prolapse assocaited with?
Polyhydramnios
Oligohydramnios associated with what hypoplasia?
Foetal pulmonary hypoplasia
increase of 60% HCG?
viable uterine pregnancy
latent stage analgesia?
Established labour analgesia?
diamorphine IM
Epidural
ventouse increases risk of?
PPH
endometriosis needs to be present for how long?
6M
haem cyst mx?
conservative + admission
how long Abx chorioamnio
10 days
VDRL + TPHA previous infection?
VDRL (active infection) => none
TPHA (IgG) => High
topimerate?
Why dont we typically give it
Prophylaxis of migraines
=> teratogenic
multiple pregnancy increaes risk of VTE?
yes
Low BMI DOES NOT inc. risk
if CIN when to see them again?
12M
most common type of vaginal cancer?
ARe they secondary or primary?
most common => SCC
Where they tend to be secondary (85%)
nulliparity RF for praevia?
no
adenomyolysis vs endo?
Adeno => Asymptomatic (no associated with subfertility) // can still lead to bleeding
corpus leuteum producing … for stromal hypertrophy and increased blood supply?
progesterone
ovulation hormone/
LH
positive asymptomatic bacteriuria screening what to do next?
repeat culture and begin ABx guided
most common cause of polyhydramnios?
idiopathic
is 1st pregnancy a Rf for pre-eclampsia?
yes - think helen
(mod risk)
>35BMI / 40+ years old / multiple pregnancies
pregnancy interval of more than 10 years RF for pre-eclampsia? or is it sooner?
10+ years => RF
Screening for blood tests in pregnancy occurs when?
Booking + 28wk
1st line for heavy bleeding
IUS
vaginal PE2?
IOL
uterine leimyomas =>
Fibroids
=> non-tender on palpation
=> Adenomyosis tender on palpation
average ABPM measurement of > 135/85mmHg under 60?
Pharmacological tx
Ovarian hyperthecosis?
Think of this when PCOS is in post menopausal women
suppressed gonadotrophins (LH+FSH) with low oestradiol + normal thyroids
Annorexia
Placenta praevia risk factors (3)
multiparity
multiple pregnancy
Scars C sec uterine
Potter sequence
Bilateral Renal Agensis + pulmonary Hypoplasia + Oligohydramnios
when is pudendal given?
2nd stage labour
rash starts on the abdomen, spares the umbilicus, and may spread to the thighs or buttocks
PUPPP Polymorphic eruption of pregnancy
Raised LH + FSH + low oestridiol
Premature OS
Pre menopausal women presenting with abnormal vaginal bleeding should have a …
Post menopausal women presenting with abnormal vaginal bleeding should have a …
Chylam
enddometrial / cervical cancer work up (colposco)
Heart issues:
Foetal alcohol syndrome:
DiGeorge syndrome:
Turner syndrome:
Noonan syndrome:
Edward’s syndrome:
Patau syndrome:
FAS => VSD
George => Aortic arch defects
Turner => biscuspid Aorta + coarc
Noonan => P.stenosis
Edwards => Septal
Patau => dextro
mx child vborn with hep B mother
vaccine to child immediately
0,5 Immunoglobulin within 12hrs
does T2DM increase risk of endometrial cancefr
yes + PCOS
Indomethacin at … weeks gestation is associated with the closure of ductus arteriosus and oligohydramnios. … is the agent of choice in this scenario and will typically be used to delay labour for 48 hours
> 32 wks
Nifidipine
if they had gestational diabetes before what tests we doing
16wk + 24-28GOTT
RF doesnt warrant booking test OgTT
ondansetron risk in 1st trimester
cleft risk
monitoring LMWH pregnancy
peak anti-Xa activity
latent stage labour pain killer
IM diamorphine
syphilis tx in pen allergy
doxy
why co-amoxiclav avoided in pregnancy
NEC
endometritis abx choice
Co-amoxiclav
(if pen. allergic: clindamycin & metronidazole)
endometrial & cervical cancer staging
MRI
ovarian cancer staging
CT