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Past-Test exam questions > O&G > Flashcards

O&G Flashcards

1
Q

30 y/o

  • increasingly painful periods
  • ibuprofen useless
  • worsened on intercourse
  • adnexal tenderness

diagnosis:

first line IX:

A

endometriosis

IX: transvaginal USS

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2
Q

turners syndrome is associated with what genotype:

A

45 XO

  • primary & secondary amenorrhoea due to premature ovarian failure
  • failure to develop secondary sexual characteristics
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3
Q

Fragile X syndrome is what type of disorder:

A

X-linked dominant

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4
Q

Which condition is associated with the following features:

  • narrow face
  • large ears
  • large testicles
  • significant mental retardation
  • developmental delay
  • men affected more
A

Fragile X syndrome

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5
Q

which hormone increases greater than the others during pregnancy:

  • LH
  • FSH
  • oestrone
  • oestradiol
  • oestriol
A

oestriol

  • increases 1000 fold
  • least potent of three oestrogens

oestrogen needed to control LH and FSH
- stimulate & control placental growth

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6
Q

classical marker of colorectal cancer

A

CEA

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7
Q

POP is associated with increased risk of ectopic pregnancy.

what other method of contraception is also associated with this:

A

depo-provera
- progesterone only injectable contraceptive

side effects

  • weight gain
  • irregular bleeding
  • amenorrhoea
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8
Q

most common type of vulval malignancy:

A

squamous cell carcinoma

  • peak age of incidence 60 years
  • vulval discomfort and itching
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9
Q

classical triad of pre-eclampsia

A

proteinuria

hypertension

oedema

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10
Q

recap symptoms of pre-eclampsia

A

frontal headache

blurring, flashing in vision

epigastric / upper abdo pain

vomiting

oedema : face hands and feet

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11
Q

what is HELLP

A
  • haemolysis
  • elevated liver enzymes
  • low platelet count
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12
Q

first line for pre-eclapmsia

A

labetalol

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13
Q

complications of pre-eclampsia

A

DR COG

D- disseminated intravascular coagulation –> HELLP

R- renal failure

C- cerebral haemorrhage

O- oligohydraminos

G- growth restriction (intrauterine growth restriction)

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14
Q

most common cause of bacterial vaginosis

A

gardnerella vaginalis

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15
Q

Pelvic inflammatory disease is usually due to:

A

chlamydia or gonorrhoea infection

signs

  • bilateral lower abdo pain
  • deep dyspareunia
  • abnormal bleeding or discharge
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16
Q

treatment for a patient with PID who is otherwise wel:

A

stat IM ceftriaxone

then 2 week course of doxycycline and metronidazole

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17
Q

treatment for patient with PID who has severe disease, including pyrexia >38c

A

IV therapy

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18
Q

54 y/o

pc: 3 day hx increased urinary frequency + urgency , urinary incontinence
pmh: T2DM, heavy drinker
obs: 104bpm, lower abdo discomfort , perineal sensation and anal tone are normal

likely cause of incontinence:

A

urinary tract infection

urge incontinence!
- overactive detrusor muscle

  • acute onset, mildly t.cardic, generalised lower abdo pain –> UTI most likely cause
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19
Q

high risk factors for pre-eclampsia

A
  • personal history of pre-eclampsia
  • essential HTN
  • T1DM / T2DM
  • CKD
  • AUTOIMMUNE: antiphospholipid syndrome and SLE
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20
Q

moderate risk factor for pre-eclampsia:

A

BMI > 35kg/m

FH of pre-eclampsia

> 40 in 1st -pregnancy

multiple pregnancy

interpregnancy interval of > 10 years

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21
Q

Fluoxetine has licensed use in treatment of:

A
  • hot flushes
  • severe menopausal symptoms
  • in patients with breast cancer

CONTRAINDICATED

  • if patient with history of breast cancer is receiving tamoxifen therapy
  • fluoxetine reduces efficacy of tamoxifen
22
Q

patient with hx breast cancer.

dh: tamoxifen therapy

low mood, sleep disturbance secondary to hot flush

best management:

A

cognitive behaviour therapy

accompanied by lifestyle modifications

  • regular exercise
  • weight loss if applicable
  • relaxation exercises
  • good sleep hygiene
23
Q

urinary incontinence differential diagnoses:

A

UTI

bladder carcinoma

24
Q

pharmalogical treatment of urge incontinence

A

antimuscarinics

- oxybutinin

25
Q

pharamological treatment in stress incontinence

A

duloxetine

  • SSRI
  • 2nd line when conservative measures fail
26
Q

duloxetine is contraindicated in patients with:

A

uncontrolled hypertension

27
Q

17 y/o female

  • primary amenorrhoea
  • phenotypically female
  • absent uterus

likely to have:

A

androgen insensitivity syndrome

karyotype of 46 XY

28
Q

first line treatment for lichen sclerosis:

A

high potency steroids such as clobestasol proprionate.

3 month trial of topical steroid then review.

29
Q

if patient with lichen sclerosis fails to respond to first line tx of high potency steroid, what might be given next?

A

topical calcineurin inhibitors such as tacrolimus

  • immunosuppressant
  • inhibits secretion of IL-2 (so T cell proliferation inhibited)
  • reduces inflammation
30
Q

first line tx for UTI in pregnancy

A

nitrofurantoin

safe to use in pregnancy, should be avoided near term, don’t use in breast feeding

note:

  • trimethoprim contraindicated.
  • interferes with folate metabolism in first trimester
31
Q

what causes microcytic anaemia:

A

iron deficiency anaemia

32
Q

what would give rise to macrocytic anaemia?

A
  • folic acid or b12 deficiency

- raised MCV

33
Q

in a fit and well 39 week pregnant lady, the following findings are consistent with:

  • low Hb
  • normal MCV
  • normal platelets
  • normal WCC
A

dilutional anaemia of pregnancy

  • disproportional rise in plasma volume for RBC are diluted out
34
Q

difference between urge and stress incontinence:

A

stress incontinence
- weakening or damage of pelvic floor muscles

urge incontinence

  • overactivity of detrusor muscle
  • anti-muscarinics: oxybutinin
35
Q

ectopic pregnancies most common in:

A

ampulla

HOWEVER
- rupture more likely in isthmus because its narrower

36
Q

what is placenta accreta?

A
  • placenta grows into the myometrium rather than in decidua
37
Q

40 y/o female

  • hot flushes
  • nausea
  • palpitations
  • sweatiness

which is a recognised cause of premature menopause:

a) addisons disease
b) PCOS
c) mutliparity
d) recurrent miscarriage
e) hyperthyroidism

A

addisons disease

associated with premature ovarian failure

38
Q

PCOS clinical presentation

A

PCOS PAL

P-polycystic ovaries on USS

C- cycles erratic

O- obesity and hirustism

S- subfertility

P- prolactin

A- androgens elevated

L - LH elevated

39
Q

3 weeks post partum, 31 y/o female requests contraception. breastfeeding.

which method is most practical?

A

progesterone implant

4-6 weeks

  • barrier method
  • POP
  • progesterone implant
  • copper coil, IUS

COCP contraindicated
- risk of thromboembolism

40
Q

sheehans syndrome is

A
  • ishcaemic necrosis of anterior pituitary
41
Q

difference between laparoscopic salpinectomy or laparocopic salingotomy

A

salpingectomy
- removal of fallopian tube

salpingotomy

  • removes only ectopic pregnancy
  • leaves fallopian tube in place
  • in attempt to preserve fertility
42
Q

what is recommended for patients as prophylaxis for pre-eclampsia

A

aspirin 75mg daily

43
Q

which is the earliest possible diagnostic test for downs syndrome?

A

11 weeks onwards
- Chorionic villus sampling for karyotyping

15 weeks onwards
- amniocentesis if baby high risk for downs

18-21 weeks
- anomaly scan

screening tests

  • nuchal translucency test
  • quadruple blood test (15-22 weeks)
44
Q

bacterial vaginosis treatment

A

metronidazole 400mg twice a day for week

45
Q

treatment of severe pre-eclampsia

proteinuria with ongoing headache

A

magnesium sulphate

46
Q

55 y/o obese post menopausal

  • voice deepened
  • severe hirsutism and clitoral enlargement
  • elevated testosterone
  • bilaterally enlarged, solid appearing ovaries
  • simple endometrial hyperplasia

likely diagnosis

A

ovarian stromal hyperthecosis

peripheral adipose tissue
- conversion of androgen to oestrogen

–> hyperoestrogenic state

—> endometrial hyperplasia

47
Q

most common cause of cervical cancer:

A

human papillomavirus

48
Q

which virus caused slapped cheek syndrome?

A

parovirus b19

commonly affects paeds

general malaise + erythematous rash on cheeks

49
Q

which hormone regulates development of male structures in womb

A

anti-mullerian hormone

suppresses development of female structures

50
Q

causes and risk factors of infertility

A

INFERTILE

Idiopathic

No ovulation, PCOS, menopause…

Fibroids

Endometriosis

Regular bleeding pattern disrupted - oligo/amenorrhoea

Tubal disease

Increasing age > 35

Large size

Excessive weight loss - anorexia nervosa

51
Q

first line management for prolactinoma:

A

dopamine receptor agonist
- cabergoline

if conservative management fails then surgical excision

Past-Test exam questions (7 decks)

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