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YEAR 3 NICE > last min gynae > Flashcards

last min gynae Flashcards

1
Q

Inhibin selectively inhibtis

A

FSH

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2
Q

thec cells produce andogens from cholesterol by

A

LH

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3
Q

drop in what causes dom follicle

A

FSH

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4
Q

whats most likely to be the dom follcile

A

high conc of FSH induced LH receptors

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5
Q

inhibin acts to decrease

A

FSH

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6
Q

androgens rise during ovulation - thought to be important in libido

A
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7
Q

LH surge is the best predictor of imminent ovulation and this principle is used in ovulation predictor tests.

A
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8
Q

ovulation occurs when

A

12 hours after the Lh surge

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9
Q

high levels of porgesteron during teh – phase supress LH and FSH

A

luteal

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10
Q

decrease in what causes menstruation

A

progesterone

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11
Q

7 day before period progesterone

A

assesses ovualtion

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12
Q

when is the endometrium in the proliferating vs secretory pahse

A

follicular phse - proliferatin
luteal - secretory

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13
Q
  • is the formation of a specialised glandular epithelium and is an irreversible process and apoptosis occurs if there is no embryo implantation.-
A

decidualisation

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14
Q

menstruation is how long after ovualtion

A

14

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15
Q

mefenamic acid is a

A

prostaglandin inhibitor - act by increasing the ratio of vasconcstrictor to vasodilator ratio

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16
Q

Nsaids such as mefenamic acid is contraindicaed if hsitory of

A

duodenal ulcers or severe asthma

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17
Q

why GnrH analogue bad long temr

A

osteoporosis - however can combine with HRT

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18
Q

GNRH decrease

A

FSH and LH

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19
Q

examples of gnrh analogues

A

buserelin and goserelin

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20
Q

most common reasons for cervical ectropion

A

preg or pill

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21
Q

women with PMB over what age should have 2 week by US for endometrial cancer

A

55

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22
Q

most common cause of post menstual bleedig

A

atrophic vaginits

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23
Q

exception to doing US for if got post mentrual bleeding

A

if on tamoxifen - as they will have a thickened endometrium so need direct visualisation by hysterocscopy and endoemtrial biopsy

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24
Q

first line for endometrial hyperplasia

A

MIRena

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25
Q

LH and FSH in PCOS

A

LH are very high and FSH are low or normal

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26
Q

clomifene works by

A

blcokign oestrogen negative feedback so more gnrh and more FSH and LH

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27
Q

best thing for acne in PCOS

A

Co-cyrprindol (diannette)

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28
Q

dysmenorrhoea

A

excessive pain during menstrual period

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29
Q

primary dysmenorrhoea - usually appears 1-2 years after menarche

A

secondary dysmenorrhoea- starts many yeats after starting menarceh

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30
Q

uterus appears large and globualr

A

adenomyosis

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31
Q

endometrium in muscle layer of uterus

A

adenomyosis

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32
Q

nsaids such as mefenamic acid and ibuprofen are first line for

A

dysmenorrohoea

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33
Q

absent uterus

A

mullerian agenesis

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34
Q

mx for kallamn

A

HRT

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35
Q

ashermann syndrome

A

secondary to endometrial infection or durgery - secondary amenorrheoa

36
Q

climateric is

A

time around the beginning of the menopause

37
Q

mx can be avoid what in start of menopause

A

spicy foods

38
Q

main medical mamagement for troublesome menopasue symptoms

A

HRT

39
Q

oestrogen only hrt given if not got

A

uterus

40
Q

hrt oestogen patches avoisd

A

first past metabolism

41
Q

when given continous vs cyclical hrt

A

contunous - menopausal
cyclical - perimenopsual who still get pridso

42
Q

what decreases risk HRT causing endoemtrial cancer

A

adding progesterone if got a uteurs

43
Q

Suspected pregnancy

Breast cancer

Endometrial cancer

Active liver disease

Uncontrolled hypertension

Known VTE

Known thrombophilia e.g. factor V leiden

otosclerosis

A

absolute contrainicatiosn to HRT

44
Q

cigarette appearance

A

lcihen scleorus

45
Q

what is common in lichen sclerosus

A

splitting of the skin and often leads to superficial dyspareunia

46
Q

mx of lcihen sclerossus

A

high dose steriods and emollient s– dermovate (topical steriod)

47
Q

pagets disease is often a sign of

A

malignancy elsewhere in teh body

48
Q

mucin in epdeirmis in

A

pagets

49
Q

Benign ovarian cysts are < 5cm in maximum diameter, are physiological and tend to resolve over 2-3 menstrual cycles.

A
50
Q

what tumour markers recommeded for all pre menopausal woman with compelx ovarian cyst

A

ca125, afp, beta hcg

51
Q

It is the most common benign ovarian tumour in women <30years

A

dermoid cysts- as they tend to be big they are more likely to present with torsion

52
Q

if mucinois cysts rupture they can cause

A

pseudomyxoma peritoneii

53
Q

tender nodualrity on posterior fornixx

A

endometriosis

54
Q

us shows whirpool sign

A

ovarian torsion

55
Q

average labour for first time mums is

A

10hrs and for multi parous women is 5.5

56
Q

1st stage of labour

A

no more than 12hrs in 1st time mum
or 10 in second

57
Q

early latent phase

A

dilates up to 4cm

58
Q

cord isnt clamped until

A

pulsations have ceased

59
Q

There are 3 classic signs to indicate separation of the placenta and membranes:

The uterus contracts, hardens and rises
Umbilical cord lengthens permanently
There’s a gush of blood variable in amount
Placenta and membranes appears at introitus.

A
60
Q

increased hyaluronic acid causes cervix to ripen

A
61
Q

enagment -

A

passage of widest diamter of the presenting part below the pelvic inlet

62
Q

need to catheterise before using froceps as bladder needs to be empty

A
63
Q

chignon

A

swelling on babys head

64
Q

caput succdenaemum

A

present at brith

65
Q

what haematoma develops several hours after birth

A

cephalohaemtoma- swelling is firm

66
Q

caput succedaneum

A
  • often occurs due to pressure of the presenting part agaginst the cervix
  • soft puffy swellign
67
Q

how to induce labour if memebranea are intact

A

prostaglandin E2 - pessary most commonly used

68
Q

negative nuber if above spine

A
69
Q

women on anticonvulsants can only take

A

opiates

70
Q

patietn controleld - pethidine, morphine and remifentatanil (very fast acting and good) -last one

A
71
Q

ferguson refex - increased uterine contraction due to oxytocin

A
72
Q

continous electrical fetal monitoring done if

A

below 37 or after 42

73
Q

A terminal bradycardia is when the baseline fetal hear t rate drops to below 100beats per minute for more than 10minutes. A terminal deceleration is when heart rate drops and does NOT recover for more than 3 minutes.

A

indicators for emergency c section

74
Q

early decelartion often due to

A

head compression

75
Q

fetal sleeping - reduced varaibility usually lasts no longer than

A

40 misn

76
Q

variable deceleration idnciates

A

cord compression=Cord compression which initially compresses the umbilical vein causing acceleration which is a healthy response. The occlusion of the umbilical artery results in a rapid deceleration. When pressure on the cord is reduced, another acceleration occurs and baseline rate returns.

77
Q

mx of variable deveeraltions

A

change position of mother

78
Q

sinusoidal pattern on partogram

A

urgent c section

79
Q

early deceleration are physiological

A
80
Q

variable deceleration

A

change position of mother

81
Q

amnioscope detects

A

fetal Ph

82
Q

reversible causes of death that can be added to the list in preg

A

eclampsia and intracranial haemorrhaeg

83
Q

most common cause of maternal cllapse - ahemorrhage

A

most common cause of direct maternal death - thromboemmbolism

84
Q

aortic dissection can have

A

wide pusle pressure

85
Q

ejection systolic murmurs are common in preg

A
86
Q

malg sulphate drug toxicity in presence of renal impairemnt

A
87
Q

in cpr if cardaic output not restored after 3 mins of cpr then do

A

c secction

YEAR 3 NICE (14 decks)

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