O+G

Question 1

In women going through menopause, contraception is needed until age ____

Answer 1

55

• 1 year if periods stop >50
• 2 years if periods stop <50

Question 2

FSH investigation for menopause is indicated when…

Answer 2

age <45

Question 3

FSH > ____ is indicative of POI/ menopause

Answer 3

30IU/L

Question 4

HRT and POI advise

Answer 4

Protective against osteoporosis

No excess risk up to age of natural menopause

Contraception still needed as spontaneous ovarian function can occur

IVF still possible with oocyte donation

Question 5

Absolute contraindications for COCP (UKMEC 4)

Answer 5

Pregnancy
- <6 weeks post-partum, breastfeeding

Co-morbidites/ cancer

• Migraine with aura
• Major surgery + Prolonged immobilisation
• Coagulopathy
• Current rbeast cancer, live tumours
• DM with kidney disease

CVD

• Cardiovascular conditions: AF, IHD, stroke, history of VTE, vascular disease
• SBP > 160, DBP >100

Social
- Smoking >15 cigarettes/ day

Question 6

Contraindications for COCP (UKMEC 3)

Answer 6

Cardiovascular

• Multiple CVD risk factors: smoking, DM, HTN, obesity, dyslipidaemia
• Controlled hypertension
• Systolic >140, DBP >90
• First degree relative <45 with VTE

Social factors
- Smoking/ stopped within 1 year.

Co-morbidities

• BMI >35
• Hx migraine with aura (>5 year)
• Immobility unrelated to surgery
• Unexplained vaginal bleeding
• Past breast cancer

Question 7

Non-pharmacological management for primary dysmenorrhoea

Answer 7

Hot water bottle

Yoga

Massage

TENS

Question 8

First line management of fibroids (<3cm)

Answer 8

IUS

Tranexamic aicd

Question 9

What contraception is best indicated for hirsutism in PCOS

Answer 9

Cyproterone acetate + ethinylestradiol

Question 10

First-line medication for postponing periods

Answer 10

Norethisterone 5mg TDS

• Taken 2-3days before event
• peroid starts after stopping

Question 11

Norethisterone is contraindicated in…

Answer 11

Previous/ current VTE

Has increased risk of DVT

Question 12

Risk factors for post-natal mental health disorders

Answer 12

Previous hx of mental health disorder

Previous trauma/ abuse

Poor health / complications in pregnancy/ birth

Stress

Difficult birth

Unsupportive environment during/ after birth

Question 13

Management options for post natal mental health disorders in GP

Answer 13

Medication

Specialist perinatal mental health team

Counselling

Self-guided help

Peer support groups

Question 14

Post natal depression is screed using ______ in GP

Answer 14

Edinburg Post natal depression scale (Health visitor)

Patient health questionnair 9 (PHQ9)

Whooley questions