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O&G Flashcards

1
Q

Hyperemesis gravidarum first line treatment?

A

Oral Antihistamines e.g. cyclizine, promethazine or prochlorperazine

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2
Q

Hyperemesis gravidarum 2nd line treatment?

A

Ondansetron (increased risk of cleft palate) and metoclopramide (no more than 5 days)

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3
Q

When would you admit someone for Hyperemesis gravidarum?

A
  • Continued nausea and vomiting and is unable to keep down liquids or oral antiemetics
  • Continued nausea and vomiting with ketonuria and/or weight loss (greater than 5% of body weight), despite treatment with oral antiemetics
  • A confirmed or suspected comorbidity (for example she is unable to tolerate oral antibiotics for a urinary tract infection)
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4
Q

First line for pre-eclampsia?

A

oral labetalol

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5
Q

First line for pre-eclampsia with asthma?

A

Nifedipine or hydralazine

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6
Q

Treatment for eclampsia which presents with seizure?

A

IV magnesium sulphate for 24 hours after last seizure / delivery

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7
Q

Management of PID?

A

oral ofloxacin + oral metronidazole (outpatient)
or
IM ceftriaxone + oral doxycycline + oral metronidazole (inpatient - risk of gonorrhoea)

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8
Q

Management of gestational diabetes with fasting glucose <7mmol/l?

A
  1. lifestyle modifications trial for 1-2 weeks
  2. add metformin if targets aren’t met
  3. add short-acting insulin if targets not met
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9
Q

Management of gestational diabetes with fasting glucose >7mmol/l?

A
  1. short-acting insulin
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10
Q

Pregnant woman with BP >/- 160/90?

A

admit for observation

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11
Q

management of nexplanon causing unscheduled bleeding?

A

3 month course of COCP

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12
Q

> 28 weeks gestation with reduced fetal movement?

A
  1. doppler for heartbeat
  2. if no HR then immediate USS
  3. if HR then CTG for 20 mins
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13
Q

Main drugs contraindicated in breast-feeding?

A
  • antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
  • psychiatric drugs: lithium, benzodiazepines
  • aspirin
  • carbimazole
  • methotrexate
  • sulfonylureas
  • cytotoxic drugs
  • amiodarone
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14
Q

prophylaxis for pre-eclampsia?

A

low dose aspirin

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15
Q

placenta praevia at 20 weeks?

A

rescan at 32 weeks - if still present then rescan every 2 weeks, if present at delivery may need a c-section.

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16
Q

treatment for stage 2-4 ovarian cancer?

A

surgical excision +/- chemotherapy

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17
Q

Management of premature ovarian insufficiency?

A

HRT or COCP until age of normal menopause (51y)

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18
Q

Gold standard investigation for endometriosis?

A

laparoscopy

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19
Q

management of endometriosis?

A
  1. NSAIDS/ paracetamol for symptomatic relief
  2. COCP or progestogens (e.g. medroxyprogesterone acetate)
  3. GnRH analogues
  4. surgery
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20
Q

PMS manegement?

A
  1. lifestyle
  2. COCP
  3. SSRI
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21
Q

Chlamydia management

A

Azithromycin (1dose) or doxycycline (7 days)

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22
Q

Gonorrhoea management?

A

IM cefriaxone 1g

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23
Q

Bacterial vaginosis management?

A

Metronidazole

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24
Q

TOP drugs?

A

Misoprostol + mifepristone

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25
Q

Induction of labour management?

A

bishop score (cervical position, consistency, effacement, dilation and fetal station)

Bishop score </=6 - vaginal prostaglandin or oral misoprostol

bishop score > 6 - amniotomy and IV oxytocin

26
Q

Medical management of miscarriage?

A

Misoprostol

27
Q

Prolactinoma first line?

A

Dopamine receptor agonist E.g. bromocriptine or cabergoline

28
Q

Drug of choice for epilepsy with pregnancy

A

Lamotrigine or carbamazepine

29
Q

Fibroids <3cm management

A

Progesterone IUS

30
Q

Folic acid dose before pregnancy (low risk)?

A

400mcg 12 weeks before pregnancy until 12 weeks gestation

31
Q

Folic acid dose if high risk?

32
Q

What are the two screening and two diagnostic tests for trisomy 21?

A
  1. Nuchal transparency test (+ blood hCG and PAPP-A)
  2. Quadruple blood test (AFP + hCG + inhibin A + unconjugated oestriol ) - between weeks 15 - 22.
  3. Chorionic villus sampling (karyotyping - from 11 weeks until 13 weeks)
  4. Amniocentesis ( from 15 weeks)
33
Q

When is the anomaly scan done and what does it check for?

A

Between 18 - 21 weeks
Checks for spina bifida + anencephaly

34
Q

What is sheehan syndrome?

A

A rare complication of PPH where there is a lack of oxygen in brain causing necrosis of the anterior pituitary causing hypopituatarism

35
Q

What is the most common symptom of Sheehan syndrome?

A

Failure to lactate due to low prolactin

36
Q

High risk of gestational diabetes investigation?

A

OGTT at 24-28 weeks

37
Q

fertility treatment for people with PCOS ?

A
  1. weight reduction
  2. clomifene
  3. metformin
38
Q

pregnant woman with autoimmune conditions should take what?

A

aspirin 75mg to try prevent pre-eclampsia

39
Q

choice of anti-depressant for breastfeeding woman?

A

sertraline or paroxetine

40
Q

Pregnant + OGTT +ve + fasting glucose <7mmol/l?

A
  1. trial of diet and exercise
  2. metformin
  3. insulin
41
Q

Pregnant + OGTT +ve + fasting glucose >7mmol/l?

A
  1. insulin - 1st line
  2. metformin
    + exercise/diet
42
Q

4 T’s of PPH?

A
  1. tone
  2. trauma
  3. tissue
  4. thrombin
43
Q

Suspected PE in pregnant woman with a confirmed DVT treatment?

A

Low molecular weight heparin then rule in/ out

44
Q

Woman with Pyrexia is >38 degrees during labour should get which antibiotic to prevent group B strep?

A

Benzylpenicillin

45
Q

syphilis management?

A

IM benzylpenicillin
or
doxycycline

46
Q

genital herpes investigation?

A

NAAT (nucleic acid amplification test)

47
Q

multiple, non-keratinised genital warts management?

A

topical podophylltoxin

48
Q

solitary, keratinised genital warts management?

A

cryotherapy

49
Q

Pre-eclampsia investigations?

A
  • FBC
  • LFT
  • Renal function- U&E’s (creatinine)
  • coagulation screen - consider
50
Q

Combined screening test results which would suggest down’s syndrome?

A

↑ HCG, ↓ PAPP-A, thickened nuchal translucency

51
Q

Complications of gonnorhoea?

A

urethral strictures,
epididymitis and salpingitis (hence may lead to infertility)

Disseminated gonococcal infection (DGI) - tenosynovitis
migratory polyarthritis, dermatitis

gonococcal arthritis

52
Q

Antiphospholipid syndrome in pregnancy management?

A

Aspirin + LMWH

53
Q

Gonorrhoea treatment if patient refuses IM treatment?

A

oral cefixime + oral azithromycin

54
Q

Thrush in pregnancy treatment?

A

clotrimazole pessary

55
Q

Thrush treatment?

A

Oral fluconazole

56
Q

What are the different degrees of perineal tears + treatment ?

A

1st - superficial damage (no surgical repair)

2nd - perineal muscle damage but not involving anal sphincter (suturing on ward)

3rd - perineal muscle damage + sphincter damage (repair in theatre)

4th - perineal muscle damage + sphincter + rectal mucosa damage (repair in theatre)

57
Q

Premature ovarian failure - LH/FSH patterns?

58
Q

management of premature preterm rupture of membranes?

A
  • admission
  • regular observations to ensure chorioamnionitis is not developing
  • oral erythromycin (10 days)
  • antenatal corticosteroids (dexamethasone) should be administered to reduce the risk of respiratory distress syndrome
  • delivery should be considered at 34 weeks of gestation
59
Q

Ovarian cancer investigations?

A
  1. CA125
  2. if raised then USS.
  3. consider CT.
60
Q

Normal nuchal thickness?

Finals (18 decks)

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