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obgyn > Inicet > Flashcards

Inicet Flashcards

1
Q

Definition of primary amenorrhea

A

Absence of menses by 13 years and no secondary sexual characteristics
OR
Absence of menses by 15 years but secondary sexual characters present

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2
Q

Investigations for primary amenorrhea

A

1 step-Local examinaton
Ist Inv-USG(look for presence and absence of uterus , ovaries)

2nd Inv-FSH levels

IOC- karyotype

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3
Q

Primary amenorrhea with high FSH means

A

Gonadal dysgenesis,Ex:Turners syndrome

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4
Q

Primary amenorrhea with low FSH seen in

A

Kallman syndrome

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5
Q

Primary amenorrhea with normal FSH

A

Mullerian agenesis

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6
Q

Cancer caused by DES

A

Clear cell cancer vagina

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7
Q

Diseases caused by DES

A

T shaped uterus
CIN
Cervical collar
Cervical hood
Clear cell cancer of vagina
Vaginal adenosis

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8
Q

Most common finding in DES

A

Hypoplastic uterus

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9
Q

Min no of AN visits by WHO and Indian std

A

8&4

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10
Q

Calorie requirement throughout pregnancy

A

Extra 350 kcal

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11
Q

Methods of first trimester abortì on

A

Misoprostol / Migeprestone-upto 9 weeks

Manual vaccum aspiration-60 ml-660 mmHg-double valve vasculation syringe

Suction and Evacuation -600 mmHg

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12
Q

Therapeutic level of MgSO4

A

4-7 mEq/L

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13
Q

Knee jerk is lost at,Resp distress,resp arrest at

A

7-10
>10
>12

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14
Q

Uses of MgSO4

A

Weak tocolytic drug
Prevention of seizures and it’s recurrence
Neuroprotective <32 weeks

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15
Q

Define and give cause for late deceleration

A

Gradual,wide symmetrical starts at the peak of contraction and always ends just after contraction

Cause - uteroplacental insufficiency

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16
Q

What is category 3 FHR and what is its management

A

Late deceleration/Variable deceleration with absent BTBV

Absent BTBV with Bradycardia

Rx-urgent CS
NEVER INDUCTION OF LABOR

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17
Q

What part of HPV virus is used to make vaccine

A

L1 capsid protein make virus like particles

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18
Q

How does HPV cause malignant transformation of cells

A

E6-knocks out P53 gene
E7-knocks out RB
E1 and E2 cause replication of virus

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19
Q

Cancers caused by HPV and characteristic HPE finding

A

Cancers of vulva,vagina,penile,anal,oro pharyngeal

Epitheliotropic(affects squamous epithelium,lies between basal and para basal cells)

HPE - koilocytosis

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20
Q

Vulval cancer most common age group

A

Type 2(non HPV)>Type 1

Type 2-55-65 years,related to non inflammatory conditions like lichen sclerosis

Type 1- HPV related,smoking RF,HPV 16 most common ,seen in younger women

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21
Q

Most common site and presentation of vulval cancer

A

Labia majors>minora

Vulval lesion(maybe with pruritis)

22
Q

Components of BPP
Another name of BPP

A

Amniotic fluid (SDP>2cm - +2)
NST
Fetal tone
Fetal breathing movement
Gross body movements

Mannings score

23
Q

Modified NST

A

BPP+Amniotic fluid

24
Q

When is Chronionic villous sampling done,complications?

A

11–13 weeks
Fetal limb defects
Fastest results

25
Q

When is amniocentesis done,what is early amniocentesis

A

16-18 weeks
Early-11-14 weeks

26
Q

When is fetal blood sampling done

A

Aka cordocentesis
At >18 weeks

27
Q

When and why is fetoscopy done

A

In T2,T3
TTTS-for laser ablation of vessels

28
Q

What is the treatment of mild to moderate anemia according to anemia mukt bharat

A

Mild to moderate—7-10.9%
If POG<34 weeks-oral iron 1 Tab twice a day-check Hb after 1 month

If persisting-consider non compliance,non tolerance,malabsorption-give injectable iron

If POG>34 weeks—injectable iron sucrose 200 mg(max)/day-2-3 times/week OR carboxymaltose 1000mg

29
Q

Treatment of severe anemia

A

If Hb<5%,irrespective ofPOG-blood transfusion
If Hb—5-6.9%~if POG>34 weeks-blood transfusion,if POG<34 weeks—injectable iron

If pt has signs and symptoms of heart failure,irrespective of Hb and POG-blood transfusion (packed cells)

30
Q

What causes non immune hy drops,how to diagnose

A

TORCH infections,especially syphillis(NOT HIV)
Anemia
Trisomies and structural abnormalities

DIGNOSIS
C/f- pleural effusion,pericardial effusion,ascites,subcutaneous edema

USG-placentomegaly,polyhydramnios

If Hb<5%,Hct<15%—hydrops fetalis

31
Q

HCG is structurally and functionally similar to

A

LH

Alpha-LH,FSH,TSH
Beta-LH

32
Q

Vagitus uterinus ?

A

Cry of unborn baby,before ROM,not a sign of fetal distress

33
Q

F/o Turner’s syndrome

A

Webbed neck,short 4th metacarpal,low posterior hairline ,cubitus valgus

45 XO,no Barr body

High FSH,LH(hypergonadotropic hypergonadism)

MC type of gonadal dysgenesis

34
Q

How to diagnose and treat lichen sclerosis

A

It is a white thinned out area on perineum/vulva
Appears as figure of 8 ,if near perinatal area-keyhole like lesion

Aka lichen atrophicus

Asso with pruritus,hyperkeratosis

Localised to labia minora

Dx-Biopsy-loss of rete pegs,significant thinning

Rx-topical steroid-clobetazol

35
Q

What is fetal to placental ratio at birth
When does fetal weight becomes equal to placental weight

A

6:1
17 weeks

36
Q

Which umbilical vein disappears

A

Right

37
Q

Single best criteria to calculate POG

A

Crown Rump Length(7-10 weeks,upto 14 weeks)

38
Q

Goodle sign??Seen at pog

A

Softening of cervix
6th week

39
Q

Hegars sign??Seen at?

A

Softening of isthmus
Seen at 6th week

40
Q

Signs seen at 8th week of gestation

A

Osianders sign,Chadwick’s sign,Palmers sign,Piscaceks sign

41
Q

When is lightening seen

A

3rd trimester

42
Q

Which hormones influence fetal growth

A

Estrogen,Glucocorticoids(for tissue differentiation),Insulin,IGF,Progesterone,TSH

43
Q

Abnormalities caused by I sotretinoin,chloramphenicol,warfarin,thalidomide,tetracycline,misoprostol

A

~Microtia,anotia
~Grey baby syndrome
~Depressed nasal bridge,chondrodysplasia punctata
~Phocomelia
~discoloration of teeth
-Moebius syndrome-underdevelopment of 6th and 7th cranial nerve

44
Q

Teratogenic effects of valorate,phenytoin,benzodiazepines,ACE inh

A

Neural tube defects
CVS defects
Cleft lip,cleft palate
Renal agenesis,Craniofacial abnormalities

45
Q

Fetal Alcohol Syndrome

A

Microcephaly,growth restriction,typical facial features

46
Q

Risk factors for uterine dysfunction

A

Multifetal pregnancy
Macrosomia
Overdistension of abdomen
Obesity
Maternal exhaustion
Abnormal fetal presentation
Shoulder dystocia

47
Q

When and where is perimortem CS done

A

When there are signs of collapse
Perform CPR
Upper segment

48
Q

SSRIs in pregnancy causes

A

Low APGAR score
Persistent Pulmonary Hypertension
Delayed motor development
ADHD

49
Q

In ovarian cancer who is consider as platinum sensitve ,resistent, refractory

A

If cancer recurs beyond 6 months—platinum sensitive—rx:Carboplatin +gemcitabin/paclitaxel

If recurs within 6 months of treatment with platinum compounds-platinum resistant-rx:gemcitabin/paclitaxel/topotecan

If cancer continues to grow on platinum trt-platinum refractory—rx:give non platinum drugs

50
Q

Hormone levels in menopause

A

E2-low-10-20pg/ml
E1-30-70 PG/ml
E2/E1<1
Urine FSH>40IU/L

obgyn (3 decks)

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