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O&G (Y4) > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

What is the first-line treatment for urge incontinence?

A

Bladder retraining

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2
Q

COCP increases the risk of which cancers?

A

Breast and cervical

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3
Q

What is the first medical option for stress incontinence?

A

Duloxetine

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4
Q

COCP is protective against which cancers?

A

Ovarian and endometrial

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5
Q

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

A

7 days

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6
Q

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

A

Refer for colposcopy

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7
Q

Which features of an ectopic pregnancy may prompt surgical management?

A

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

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8
Q

How long after unprotected sex will levonestrogel be effective?

A

72 hours

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9
Q

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

A

120 hours

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10
Q

What is the screening programme for cervical cancer?

A

Every 5 years for women aged 25-64

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11
Q

How long does it take for DepoProvera to become effective?

A

7 days

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12
Q

whirl pool sign on USS suggests…

A

Ovarian torsion

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13
Q

Where is the most common site for an ectopic pregnancy?

A

Ampulla of the fallopian tube

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14
Q

How are ‘inadequate’ cervical smear resuls managed?

A

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

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15
Q

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

A

Colposcopy

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16
Q

Which features confirm a miscarriage?

A

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

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17
Q

Where is the most common site of ectopic pregnancy?

A

Ampulla of fallopian tube

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18
Q

Give risk factors for ectopic pregnancy.

A 
Previous ectopic
PID
Intra-uterine device
Previous pelvic surgery
Endometriosis
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19
Q

What is the investigation of choice for ectopic pregnancy?

A

TV USS

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20
Q

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

A

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

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21
Q

What is the medical management for ectopic pregnancy?

A

Methotrexate

22
Q

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

A

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

23
Q

Which women should be offered surgical management of ectopic pregnancy?

A

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

24
Q

What is the usual surgical management of ectopic pregnancy?

A

Laparoscopic salpingectomy

25
Q

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

A

SSRI

26
Q

What is the most common cause of first trimester miscarriage?

A

Chromosomal abnormality

27
Q

What is the most common cause of second trimester miscarriages?

A

Incompetent cervix

28
Q

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

A

Threatened miscarriage

29
Q

Early pregnancy vaginal bleeding with open cervical os suggests…

A

Inevitable miscarriage

30
Q

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

A

Incomplete miscarriage

31
Q

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

A

Missed miscarriage

32
Q

Which features indicate a completed miscarriage?

A

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

33
Q

Which examinations should be completed in suspected miscarriage?

A

Vital signs & abdo exam - ectopic

Speculum - os closed or open

34
Q

What are the options for management of miscarriage?

A

Expectant, medical with misoprostol or surgical

35
Q

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

A

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

36
Q

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

A

Pregnancy test 3 weeks later

37
Q

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

A

Anti-D if rhesus negative

38
Q

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

A

No, only increased after 2 or more

39
Q

What is meant by recurrent miscarriage?

A

3 or more miscarriages

40
Q

Give causes of recurrent miscarriage.

A

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

41
Q

Which legislation permits abortion?

A

Abortion Act 1967

42
Q

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

A

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

43
Q

What is the gestational limit for TOP?

A

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

44
Q

What is the medication regimine for medical abortion?

A

Mifepristone then Misoprostol 24 - 48 hours later

45
Q

What is the MOA of Mifepristone?

A

Anti-progesterone which also increases number of prostaglandin receptors.

46
Q

Which women would be eligible for EMAH?

A

Under 10 weeks and pt over 16

47
Q

Which medication is given before surgical abortion?

A

Misoprostol

48
Q

What follow-up is required after medical abortion?

A

pregnancy test 2 weeks later

49
Q

Which surgical technique is used in early surgical abortion?

A

Vacuum aspiration

50
Q

Which surgical technique is used in late surgical abortion?

A

Dilatation & evacuation

51
Q

All women undergoing surgical abortion should receive…

A

Antibiotic prophylaxis & anti-D

52
Q

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

A

4 weeks

O&G (Y4) (3 decks)

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