Gynaecology

Question 1

What is the first-line treatment for urge incontinence?

Answer 1

Bladder retraining

Question 2

COCP increases the risk of which cancers?

Answer 2

Breast and cervical

Question 3

What is the first medical option for stress incontinence?

Answer 3

Duloxetine

Question 4

COCP is protective against which cancers?

Answer 4

Ovarian and endometrial

Question 5

How long does it take for an IUS to be effective contraception?

Answer 5

7 days

Question 6

How should women who test positive for high-risk HPV at 12 and 24 months be managed?

Answer 6

Refer for colposcopy

Question 7

Which features of an ectopic pregnancy may prompt surgical management?

Answer 7

> 35mm in size, heartbeat visible, hCG >5,000IU/L

Question 8

How long after unprotected sex will levonestrogel be effective?

Answer 8

72 hours

Question 9

How long after unprotected sex will UPA be effective as emergency contraception?

Answer 9

120 hours

Question 10

What is the screening programme for cervical cancer?

Answer 10

Every 5 years for women aged 25-64

Question 11

How long does it take for DepoProvera to become effective?

Answer 11

7 days

Question 12

whirl pool sign on USS suggests…

Answer 12

Ovarian torsion

Question 13

Where is the most common site for an ectopic pregnancy?

Answer 13

Ampulla of the fallopian tube

Question 14

How are ‘inadequate’ cervical smear resuls managed?

Answer 14

repeat in 3 months. If still inadequate, refer for colposcopy.

Question 15

hr-HPV positive with abnormal cytology should be managed with…

Answer 15

Colposcopy

Question 16

Which features confirm a miscarriage?

Answer 16

No foetal heartbeat and
CRL > 7mm OR
GS > 25mm

Question 17

Where is the most common site of ectopic pregnancy?

Answer 17

Ampulla of fallopian tube

Question 18

Give risk factors for ectopic pregnancy.

Answer 18

Previous ectopic
PID
Intra-uterine device
Previous pelvic surgery
Endometriosis

Question 19

What is the investigation of choice for ectopic pregnancy?

Answer 19

TV USS

Question 20

In which women with ectopic pregnancy may expectant management be appropriate?

Answer 20

Clinically stable, no foetal heartbeat, GS < 35mm and HCG < 1000

Question 21

What is the medical management for ectopic pregnancy?

Answer 21

Methotrexate

Question 22

In which women may medical management of ectopic pregnancy be suitable?

Answer 22

Can be done if clinically stable, live close to hospital and no visible heartbeat, GS < 35mm and HCG 1000 - 5000

Question 23

Which women should be offered surgical management of ectopic pregnancy?

Answer 23

Significant pain or rupture
Foetal heartbeat
GS > 35mm
HCG > 5000

Question 24

What is the usual surgical management of ectopic pregnancy?

Answer 24

Laparoscopic salpingectomy

Question 25

Which medication may be prescribed to help with vasomotor symptoms of menopause?

Answer 25

SSRI

Question 26

What is the most common cause of first trimester miscarriage?

Answer 26

Chromosomal abnormality

Question 27

What is the most common cause of second trimester miscarriages?

Answer 27

Incompetent cervix

Question 28

Vaginal bleeding but cervical os closed and USS shows viable IUP suggests...

Answer 28

Threatened miscarriage

Question 29

Early pregnancy vaginal bleeding with open cervical os suggests...

Answer 29

Inevitable miscarriage

Question 30

Vaginal bleeding, open cervical os and products of conception seen on exam suggests...

Answer 30

Incomplete miscarriage

Question 31

Non-viable intrauterine pregnancy without symptoms or passage of POC suggests...

Answer 31

Missed miscarriage

Question 32

Which features indicate a completed miscarriage?

Answer 32

POC have passed, cervical os is closed and USS shows empty uterine cavity

Question 33

Which examinations should be completed in suspected miscarriage?

Answer 33

Vital signs & abdo exam - ectopic | Speculum - os closed or open

Question 34

What are the options for management of miscarriage?

Answer 34

Expectant, medical with misoprostol or surgical

Question 35

Under what circumstances should surgical manangement of miscarriage always be offered?

Answer 35

Haemodynamically unstable, significant bleeding with retained POC or in patients which conservative/medical management has failed

Question 36

What follow-up should patients opting for expectant or medical management of miscarriage receive?

Answer 36

Pregnancy test 3 weeks later

Question 37

What should be considered in patients having surgical management of miscarriage?

Answer 37

Anti-D if rhesus negative

Question 38

After one miscarriage, is the risk of further miscarriages increased?

Answer 38

No, only increased after 2 or more

Question 39

What is meant by recurrent miscarriage?

Answer 39

3 or more miscarriages

Question 40

Give causes of recurrent miscarriage.

Answer 40

Genetic factors eg. balanced translocations Thrombophilic disorders such as APS Endocrine - DM, thyroid disorders, PCOS Structural uterine abnormalities

Question 41

Which legislation permits abortion?

Answer 41

Abortion Act 1967

Question 42

Which form needs to be filled in before a TOP is performed?

Answer 42

Certificate A form - needs to be signed by 2 doctors (unless mother’s life is at immediate risk)

Question 43

What is the gestational limit for TOP?

Answer 43

23 + 6 weeks unless threat to maternal life or severe disability (no limit)

Question 44

What is the medication regimine for medical abortion?

Answer 44

Mifepristone then Misoprostol 24 - 48 hours later

Question 45

What is the MOA of Mifepristone?

Answer 45

Anti-progesterone which also increases number of prostaglandin receptors.

Question 46

Which women would be eligible for EMAH?

Answer 46

Under 10 weeks and pt over 16

Question 47

Which medication is given before surgical abortion?

Answer 47

Misoprostol

Question 48

What follow-up is required after medical abortion?

Answer 48

pregnancy test 2 weeks later

Question 49

Which surgical technique is used in early surgical abortion?

Answer 49

Vacuum aspiration

Question 50

Which surgical technique is used in late surgical abortion?

Answer 50

Dilatation & evacuation

Question 51

All women undergoing surgical abortion should receive...

Answer 51

Antibiotic prophylaxis & anti-D

Question 52

Positive PT after TOP can be considered normal for how long after TOP?

Answer 52

4 weeks