Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1MSRA - Learning Points > O+G > Flashcards

O+G Flashcards

1
Q

Which SSRIs can be used in breastfeeding?

A

Sertraline and Paroxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mx of Post-partum haemorrhage

A

1st - press on uterus
2nd - IV Oxytocin
3rd - Intrauterine Balloon Tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you treat genital warts?

A

Topical podophyllum if there is more than one and not keratinised

If single and keratinised -> cryotherapy (freeze it off)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When do you investigate a couple’s inability to conceive and how?

A

After 12 months of regular sex

Male - semen analaysis
Female - Mid-luteal serum progesterone (i.e. day 21 of a regular 28 day cycle). This confirms ovulation.

Exception for earlier investigation is if surgical or STI history or abnormal genital exam.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the treatment for eclampsia?

A

IV Magnesium Sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you need to monitor when giving Mag Sulph for eclampsia?

A

RR, SpO2, reflexes
(can cause respiratory depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the difference between pre-existing HTN, gestational HTN and pre-eclampsia?

A

HTN is >140/90

Pre-existing = before 20 weeks gestation

Gestational/Pregnancy-induced = after 20 weeks, but no proteinuria, no oedema

Pre-eclampsia = after 20 weeks, with proteinuria and oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If not given on 1st day of cycle, in how many days do the following contraceptives become effective in?

A

Copper IUD = immediately

POP = 2 days

Everything else = 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Criteria for expectant management of ectopic pregnancy?

A

No symptoms
No fetal heartbeat
B-HCG 1500 or less, and falling

i.e. needs to be dying/dead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indication for surgical management of ectopic pregnancy?

A

Either
>35mm
Foetal heartbeat present
Rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you medically manage ectopic pregnancy?

A

Methotrexate + misoprostal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Medical management of miscarriage?

A

Mifepristone + misoprostal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which blood thinner is CONTRAINDICATED in breastfeeding (but not pregnancy)?

A

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2nd line Mx of endometriosis?

A

COCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

1st line Mx of menorrhagia?

A

if wanting contraceptive -> Mirena IUS

If wants to be fertile -> NSAID (mefanamic acid) or TXA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does Rhesus disease of newborn work?

A

Rh D -ve mothers
If foetus Rh D +ve

Any event which causes fetal cells -> maternal blood (termed fetomaternal haemorrhage), will cause irreversible RH D sensitisation of the mother. This means if future babies are RH D +Ve, there will be haemolysis.

We can prevent this with giving Rh D -ve mums routine anti-D immunoglobulin at 28 and 34 weeks.

If MFH event occurs, give anti-D immediately to prevent sensitisation and do Kleihauer test to check extent of MFH.

NB// anti-D immunoglobulin acts as prophylaxis only. Once sensitisation occurs, it is irreversible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which herbal remedy is an enzyme inducer and therefore may reduce COCP effectiveness?

A

St John’s Wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

1st line medication for HTN in pregnancy, regardless of cause?

A

Oral Labetolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

2nd line medication for HTN in pregnancy, regardless of cause?

(e.g. if patient asthmatic)

A

Nifedipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How are reflexes affected in pre-eclampsia?

A

Remember there is neurological hyper sensitisation (e.g. potential seizures if eclampsia develops)

Therefore, hyperreflexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How long do you need to continue contraception for if going through menopause?

A

<50yrs
For 24 months since last period

> 50yrs
For 12 months since last period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Does COCP increase or reduce BMD?
Why?

A

Increase

COCP contains oestrogen and progesterone.

Former reduces osteoclast activity and bone resoprtion

Latter helps maintain bone.

23
Q

Which contraceptive method reduces BMD? Why?

A

Depot injection

Methoxyprogrestin reduces oestrogen levels.

24
Q

Risks of smoking with pregnancy?

A

miscarriage
preterm labour
stillbirth
IUGR

25
Q

Which STIs/Vaginal infections cause raised pH?

A

The ones that end in vaginosis/vaginalis

(BV, TV)

26
Q

How to manage exposure to chickenpox in pregnancy?

A

1) check maternal IgG if immunity unsure

If non-immune, give aciclovir…
(If >20 weeks, give the aciclovir 7-14 days post exposure for better results)

27
Q

Tx If pregnant women gets chickenpox in pregnancy? Why is it important to treat?

A

Aciclovir

increased risk of pneumonitis to mother

Increase risk of fetal problems

28
Q

NOTE: in summary, labour can either be

  • Prelabour premature rupture of membranes (PPROM)
    -ROM at right time, but prolonged labour
    -ROM at right time, and labour normal
    -Late (and requiring induction of labour)
A
29
Q

What are the indications for induction of labour?

A

Essentially either 3rd trimester complications, fat baby or late

  • Obstetric cholestasis
  • Pre-eclampsia
  • Intrauterine death
  • Diabetic mother, 38 weeks
  • 42 weeks (note, they have a membrane sweep at 41)
30
Q

How do you decide how to induce labour?

A

Bishop score
<5 - labour not going to happen without induction

8 or more - labour should spontaneously happen

If 6 or less - opt for vaginal or oral prostaglandins

If >6, IV oxytocin or cervical balloon dilation

31
Q

What are the risks of inducing labour with prostaglandins? Why is it an issue? How would you manage this complication?

A

Uterine hyperstimulation syndrome

Excessive contraction disrupts blood flow to foetus, causing hypoxia

Also increases risk of the uterus rupturing

Manage by Tocolysis - beta agonists used e.g terbutaline

32
Q

What timeframe would absence of fetal movements worry you? What would you do to investigate?

A

24 weeks - refer to fetal medicine unit

Handheld doppler to check fetal heartbeat. If present, CTG 20mins
If absent, USS

33
Q

When would you expect to notice fetal movements and how should they evolve over time?

A

notice around 18-20 weeks, should steadily increase until 32 weeks then plateau in intensity

34
Q

Indications for higher dose 5mg OD folic acid in pregnancy?

A

previous personal, family or fetal history NTD

Diabetes
Coeliac disease
Obesity

35
Q

Are antiepileptics safe in pregnancy and breastfeeding?

A

Sodium valproate should not be used unless absolutely necessary (NTD)

Other drugs can be used and also safe in breastfeeding.

36
Q

Which trimester of pregnancy is nitrofurantoin contraindicated in?

A

3rd

37
Q

What advice would you give regarding statins during pregnancy

A

Contraindicated!

38
Q

What is the average age of menopause?

A

51

39
Q

When does progesterone need to given as part of HRT and why is this crucial?

A

If the woman has a uterus.
Otherwise increased risk of endometrial cancer with oestrogen only (causes proliferation of the lining)

40
Q

Can the mirena coil serve as the progesterone arm of HRT?

A

YES (for up to 4 years, then replace coil)

41
Q

If patient on long term steroids, how do you decide if needs bisphosphonates?

A

If >65, everyone on long term steroids (>3 months) should have bisphosphonates - no need for DEXA

If <65, DEXA first and if osteopenic, need bisphosphonates

42
Q

When do you start bisphosponates without a DEXA?

A

1) if >65 and on long term steroids
2) If >75 and had fragility fracture

43
Q

What is an alternative to HRT to manage vasomotor menopausal symptoms?

A

SSRIs
Sertraline
Venlafaxine

44
Q

What are the 4 situations where bisphosphonates may be indicated

A

Previous fragility fracture (backward)
FRAX score high (forward)
Long term steroids (moment)
DEXA revealed osteoporosis (scan)

45
Q

Which risks of HRT should you discuss with patients?

A

Increase risk of
endometrial cancer
DVT (only with oral)
breast cancer
IHD, stroke

46
Q

What is premature ovarian insufficiency?

A

menopause before 40

high LH, FSH, low oestradiol

47
Q

Mx of POI?

A

Must have HRT until 51, to prevent osteoporosis

48
Q

Different types of miscarriage?

A

Complete - prior to 20 weeks gestation, foetus dead inside

Threatened - bit of blood, os closed

Inevitable - bleeding and os open

Incomplete - os open, retained products

49
Q

How to minimise HIV vertical transmission

A

1) Mum ART prior to birth
2) C-section
3) Neonate gets ART - zidovudine if mum viral load <50, otherwise full triple ART
4) NO BREASTFEEDING

50
Q

How to treat chickenpox in pregnancy? Why is it important?

A

aciclovir if presenting within 24hrs of rash onset

Because x5 increase risk of pneumonitis

51
Q

Side effects of ‘mini pill’ (POP)?

A

Most common = irregular vaginal bleeding

52
Q

Biggest risk factor for umbilical cord prolapse?

A

Artificial Rupture of Membranes

53
Q

Management of umbilical cord prolapse?

A

Obstetric emergency!

-keep cord warm and moist
-woman on all 4s whilst preparing for C-section

54
Q
A

1MSRA - Learning Points (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions