O&G Flashcards
A 25 year old woman is 8 weeks pregnant. Her father has haemophilia A and she is worried that her baby may be affected.
Which of the following is the chance that the woman is a carrier for haemophilia A?
0, 1 in 1, 1 in 2, 1 in 4, 1 in 8
1 in 1
X-linked recessive = men don’t have other X chromosomes to protect them - father sufferer = daughter def carrier
N.B. Q is about MOTHER. If it was about her children, 50% sons affected, 50% daughters
A 35 year old woman is in the second stage of labour and requires a forceps extraction of the baby. A pudendal nerve block is performed.
Palpation of which structure allows correct placement of the local anaesthetic?
ischial spines, ischial tuberosity, ischipubic ramus, pubic symphesis, pubic tubercle
ischial spines
A 28 year old woman in the third trimester of pregnancy has back pain. She is advised that ibuprofen is contra-indicated.
Which potential complication can occur in the fetus with this medication?
AKI, closure of ductus arteriosus, liver failure, pre-term labour, reye’s syndrome
closure of ductus arteriosus
could also be oligohydromnios
A 40 year old primigravid woman is at 28 weeks’ gestation. She has epigastric tenderness and blurred vision.
Her BP is 160/110 mmHg. Reflexes are brisk with two beats of ankle clonus. Urine dipstick analysis shows protein 2+.
Which intravenous drug is the most appropriate immediate treatment?
diazepam, hydralazine, labetalol, magnesium sulphate, phenytoin
magnesium sulphate (IV)
N.B. labetalol as would be given orally first. Mag sulph is given to prevent seizures
women has severe pre-eclampsia
A 23 year old primigravida has been in labour for 12 hours. Her cervix was 4 cm dilated on arrival and is now 8 cm dilated. Her membranes were ruptured 8 hours earlier and she has been on a Syntocinon®infusion for 4 hours. The presentation is cephalic and the head is at the ischial spines. Her cardiotocograph is normal.
Which is the best way to describe her current status?
failure to progress in the 1st stage labour, failure to progress in the 2nd stage labour, malpresentation, normal labour, prolonged 3rd stage labour
failure to progress in 1st stage of labour
Normal labour would be: PRIMIP = 1/2cm every hour once labour is established
1st = 1-10cm
2nd = 10-delivery
3rd = delivery of baby-delivery of placenta
A 24 year old woman has a termination of pregnancy following the discovery of anencephaly on antenatal ultrasound. She would like to know what she can do to reduce the risk of this happening again in her next pregnancy.
Which dietary supplement, taken before conception, reduces the recurrence risk of anencephaly?
Calcium, folic acid, iron, vitamin C, vitamin D
Folic acid
A 23 year old Iranian woman attends the antenatal clinic at 14 weeks’ gestation.
Investigations:
Haemoglobin 120 g/L (115–150)
Mean cell volume 70 fL (80–96)
Ferritin 50 μg/L (12–200)
Which is the most likely diagnosis?
beta thalassemia trait, glucose 6 phosphate dehydrogenase deficiency, iron deficiency anaemia, rhesus haemolytic disease, sickle cell disease
Beta thalassemia trait
Asymptomatic, may cause mild anaemia
The nuchal translucency scan assesses the quantity of fluid collecting within the nape of the fetal neck.
What is the best description of this fluid?
amniotic, chorionic, lymph, plasma, urine
lymph
non-specific marker for chromosomal abnormalities eg. Down Syndrome
N.B. nuchal translucency is UNDER skin, hence why it is not amniotic fluid
An 18 year old woman presents with irregular uterine contractions at 29 weeks in her first pregnancy. She has had no bleeding and her baby is moving well currently. She stopped smoking when she found out she was pregnant at 6 weeks and is otherwise fit and healthy. Her vaginal assessment reveals an effaced and short cervix that is 2 cm dilated. She is diagnosed in preterm labour.
What is the most likely underlying factor in her pregnancy associated with her preterm labour?
1st pregnancy, idiopathic, previous smoking hx, undiagnosed UTI, young maternal age
idiopathic
Smoking stopped at 6 weeks, less likely to be having an impact now, if active smoking still this could have been an answer
A 24 year old woman attends for a routine antenatal visit at 36 weeks’ gestation, confirmed by an early scan. Her BP is 115/65 mmHg. The lie is longitudinal with a cephalic presentation. The symphyseal fundal height is 38 cm. Urinalysis: glucose negative, ketones negative, blood negative, protein 1+, nitrites negative, leucocytes negative.
Which is the most likely explanation for the clinical findings?
foetal duodenal atresia, foetal macrosomia, IUGR, normal pregnancy, pre-eclampsia
normal pregnancy
A 32 year old woman has menorrhagia, but her cycle is regular, with a length of 28 days.
An endometrial biopsy shows straight tubular glands, with mitotic figures in the epithelium and stroma. This is reported as consistent with the proliferative phase.
To which days of a 28 day menstrual cycle does this correspond?
1-5, 8-12, 14-18, 20-24, 25-28
8-12
endometrial cycle
1-5 menstruation
8-14 proliferative phase
14 ovulation
14-28 secretory phase - CHECK
A 32 year old woman requests a reliable method of contraception to improve her irregular periods and reduce her symptoms of premenstrual tension. She is a non smoker. Her BMI is 21.
Which is the most appropriate contraceptive choice?
COCP, long acting progesterone injection, progesterone coil, progesterone implant, progesterone only contraceptive pill
COCP
Wants to reduce pre menstrual tension (low mood, breast tenderness etc pre-period) - 1st line is COCP
A 56 year old woman presents to her GP with 6 months of amenorrhoea and severe hot flushes. She is requesting hormone replacement therapy (HRT).
The GP prescribes HRT containing both oestrogen and progestogen. Which cancer risk is most likely to be increased by this treatment?
breast, cervix, colon, endo, vagina
breast
progesterone part is risk of breast cancer
A 29 year old woman has had intermittent vaginal bleeding since a levonorgestrel-releasing intrauterine system (Mirena®coil) was inserted 6 weeks ago.
Which is the most appropriate investigation?
smear, colposcopy, high vaginal swab, no investigation, TVUSS
no investigation
Mirena coil can cause irregular bleeding/spotting for up to 6 weeks!
Re-assure / encourage not to remove
A 26 year old woman has an oophorectomy following detection of a 20
cm ovarian cyst on ultrasound scan. The cyst was reported as complex with solid areas. Serum CA125 was normal. On pathological examination, the cyst contains dirty fluid and fat, together with hair shafts mixed with greasy material.
Which is the most likely histological diagnosis?
mature cystic teratoma, mucinous cystadenocarcinoma, mucinous cystadenoma, serious cystadenocardinoma, serous cystadenoma
mature cystic teratoma
(can also be called dermoid cyst)
