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Y5 Gynae & Obstetrics > New - Passmed > Flashcards

New - Passmed Flashcards

1
Q

What sign occurs on USS with ovarian torsion?

A

Whirpool sign

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2
Q

What does a fibroid look like on USS

A

Hypoechnoic mass

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3
Q

What does a complete hydriadid mole look like on USS

A

Snowstorm apparance

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4
Q

What does chronic salpingitis look like on USS

A

Beads-on-a-string’ sign refers to a finding in chronic salpingitis, with mural nodules appearing as ‘beads’ and the relatively-thin wall appearing as ‘string’.

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5
Q

When is the booking visit done

A

8-12 weeks

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6
Q

What occurs on the booking visit

A

GENERAL HISTORY

GENERAL INFO:
- e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes

INVESTIGATIONS:
BP, urine dipstick, check BMI
Booking bloods:
- FBC, blood group, rhesus status, red cell alloantibodies,
- haemoglobinopathies
- hepatitis B, syphilis, HIV test
Urine dip and MC&S to detect asymptomatic bacteriuria

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7
Q

When is the dating scan done

A

10-14 weeks

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8
Q

When can the down syndrome screening (w Nuchal translucency) be done

A

11-14 weeks

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9
Q

What do you do at 16 weeks in terms of appointments?

A

Information on the anomaly and the blood results. If Hb < 11 g/dl consider iron
Routine care: BP and urine dipstick

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10
Q

When is the anomaly scan?

A

18 - 21

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11
Q

What is checked at the anomaly scan

A

foetal anomalies
Placental position
Amniotic fluid volume

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12
Q

What occurs at 28 weekls?

A

Routine care: BP, urine dipstick, SFH
Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron
First dose of anti-D prophylaxis to rhesus negative women

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13
Q

what are RF from miscarriage

A

modifiable:
- smoking, alcohol, drugs
- high caffeine intake
- obesity
- infection
- food poisoning

non modifiable:

  • thyroid, HTN, DM
  • unusual uterine shape
  • cervical incontinence
  • medications (methotrexate)
  • advanced maternal age
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14
Q

What does the mother experience in Twin to Twin Transfusion Syndrome

A

sudden increases in the size of their abdomen and/or any breathlessness, which may be the result of polyhydramnios affecting the recipient twin.

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15
Q

What non-HRT med is good at preventing vasomotor sx in menopause

A

SSRI

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16
Q

How do you describe waiter’s tip occurring in Erb’s palsy

A

adduction and internal rotation of the arm, with pronation of the forearm

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17
Q

How do you describe Klumpfe’s palsy

A

Damage to LOWER brachial plexus > affects the HAND

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18
Q

What is another name for trisomy 13

A

Patau Syndrome

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19
Q

What is the cause and presentation of PATAU

A

Failure of midline fusion

7Ps

HoloProsencephaly, microcephaly,
Palate, lip cleft 
Poor eyes (micropthalmia) 
Polydactyly, rockerbottom feet 
Pump disease
PKD 
aPlasia of cutis
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20
Q

What is trisomy 18 name

A

Edward’s syndrome

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21
Q

What are features of EDWARDS

A

PRINCE Ed turned 18

Prominent occiput, microagnatia, cleft lip 
Rocker bottom feet  
Intellectual disability 
Non-dysjunction in meiosis 
Clenched fists 
Ears - low set
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22
Q

Explain fts of Kleinefelters

A

MALE PHENOTYPE, XXY

Testicular dysgenesis
Eucnohnoid growth pattern (tall, slim, long extremities=
Gynaemcomastia and reduced vody hair
Testicular hypoplasia, normal sized penis
Reduced fertility, azozspermia
Osteoporosis

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23
Q

Explain fts of Turners

A 
Female phenotype 
Short stature 
High arched palate, low posterior hairline 
Webbed neck
Wide carrying angle
24
Q

What are gonads like in Turners

A

STREAK gonads (gonadial dysgenesis)

25
Q

What is the genotype in turners

A

45 X

26
Q

What are the three types of incorrect placental invasion into uterus

A

Placenta accreta: though endometrium
Placenta increta: through myometrium
Placenta percreta: through to abdomen

27
Q

What is haematocolpos

A

An inperforate hymen, causing the vagina to become blood filled and dilated with concurrent uterine distension and cyclical abdo pai

28
Q

How do you manage haematocolpos

A

hymenectomy

29
Q

What are the layers that you cut through in C section

A 
Skin 
Fascia (Camper, Scarpa) 
Anterior rectus sheath 
Rectus Abdominis 
Parietal peritoneum, visceral peritoneum 
Uterus
30
Q

What tests can screen for aneuploidy

A

Combined test
Quadruple test
Integrated test
Harmony test

31
Q

Explain components of combined test

A

USS + bhCG + PAPP-A

32
Q

What will Down’s SYndorme results be for Combined test

A

increased nuchal transulucenty
high bhCG
low PAPP A

33
Q

What are components of quadruple test

A

AFP + bHCG + Inhibin A + unconj estriol

34
Q

WHen is quadruple test done

A

14-20 weeks

35
Q

What is integrated test

A

Quadruple + NT + PAPP A

36
Q

What is the triple test^

A

AFP + bHCG + unconj estriol

ABE

37
Q

When are triple/quadruple test performed

A

When combined screening for Down’s was missed

38
Q

When can you give whooping cough vaccine in preg

A

16-32 weeks

39
Q

Molar pregnancy sx

A

light PV bleed
large for dates uterus (should only be palpable after 12 weeks normally)
hyperemesis
hyperthyroidism

40
Q

How does a molar pregnancy cause hyperthyroidism

A

because high beta hCG > similar to TSH > stimulates T4 production > thyrotoxicosis

41
Q

List the four types of gestational trophoblastic disease

A

Partial mole
Complete mole
Choriocarcinoma
Invasive mole

42
Q

What is a partial mole

A

Ovum fertilised by 2 sperm. > 69 chromosomes.

May have some human limbs

43
Q

What is a complete mole

A

Ovum has NO chromosome
Fertilised by 1 or2 sperm
forms fluid filled sacs
46 XY, 46 YY, 46XX

44
Q

what is an invasive mole

A

mole invades myometrium

45
Q

what is a chorioacarcionomaa

A

a malignancy of trophoblastic cells that arises from molar pregnancy

46
Q

what is the danger with choriocarcinoma

A

that it could metastise haematogenously to the lungs

47
Q

How do you investigate GTD

A

urine bHCG
serum bHCG (HIGH)
TVUSS (snowstorm appearance)

(high T3)

48
Q

How do you manage GTD

A

URGENT REFERRAL FOR SPECIALIST CENTRE FOR EVACUARTION OF POC

+ histology for ,malignancy

49
Q

What should you do as followup for GTD

A

Monitor betaHCG - if it does not fall you many need to start chemo

contraception next 12m

50
Q

what are reasons for giving anti-D prior to 12 weeks gestation

A

MUTE

Molar pregnancy
Uterine bleedings (repeated, heavy, with abdominal pain)
TOP
Ectopic pregnancy (surgical Mx - NICE, all - RCOG)

51
Q

Who do you give aspirin 75mg to to prevent PET

A

women at high risk:

  • Prior HTN during pregnancy
  • chronic HTN
  • DM
  • AI disease (SLE, APS)
  • CKD

or women with 2 or more moderate risk factors:

  • primiparity, preg interval >10 years
  • advanced maternal age
  • BMI >35
  • FH PET
  • Multiple preg
52
Q

what are risks of ECV

A 
Placental abruption 
Premature ROM 
Cord accident 
Transplacental haemorrhage 
Foetal bradycardiA
53
Q

WHAT ARE CONTRAINDICATIONS FOR ECV

A

MATERNAL:

  • multiple gestation
  • APH in last 7 days
  • ROM
  • pre-eclampsia /HTN
  • plan to deliver by CS

FOETAL:

  • Foetal abnormality e.g. hydrocephalus
  • placenta previa
  • oligo/polyydramsnios
  • multiple gestation
54
Q

if at risk of VTE, how do you manage a pregnant woman

A

give LMWH prophylactic dose

55
Q

how many RF do you need to be started on VTE prophylaxis?

A

4+ RF: from first trimester

3RF; from second trimester

56
Q

what are RF for VTE prophylaxis

A 
NON_PREG RELATED
Obesity (BMI >30)
Age > 35 
SMoker 
Varicose veins 
immobility 
FH of VTE in first deg reltive 
Thrombophilia

PREG RELATED
Parity >=3
Multiple pregnancy
IVF/ART

Y5 Gynae & Obstetrics (34 decks)

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