O&G Flashcards
Obstetric examination
Antenatal
Gynae examination
PVSpeculum
Explain cervical smear
Refer
CTG interpretation
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Stages of labour
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Explain to a 18y at 12w who wants a TOP and whether she has the right or not
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Explain the different options of a TOP
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Contraception for less than 16 and Fraser guidelines
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Types of contraception and safety/efficacy
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Miscarriage… Types… Management
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Ectopic pregnancy… Diagnosed… Management
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Hyperemesis gravidarum… Management
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Pregnant in contact with vzv or appearance of rash…
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Management of pet and talking to mom
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Small pregnancy… Options… Management… Reassurance
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Down’s screeningDown’s diagnosisExplaining to mom resultsManagement of downs child
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Neural tube defect… Diagnosis, reassurance, management
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APH: placental abruption - previa
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Preterm labour
Z
Reduced foetal movements
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PROM/PPROM
Z
Post-term pregnancy
Z
Malpresentation
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Mode of delivery counselling, VBAC
Z
Maternal gbs infection
Z
Hypertension, pregnancy-induced HTN, PET and HELLP
Z
Diabetes and GDM
Z
Other medical cdts/medications in pregnancy (epilepsy, PE)
Z
HIV and counselling on methods of delivery, advice on conception
A
PPH
Z
Baby blues
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Postpartum depression/mania
Z
Contraception post-partum
Z
Postpartum pyrexia and infection
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VTE
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Primary amenorrhea
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Secondary amenorrhea
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Oligomenorrhea
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Menorrhagia
Z
Dysmenorrhea
C
IMB/PCB
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Premature menopause
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PMB
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Menopausal symptoms, complications and HRT
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Urinary incontinence (stress/urge)
Z
Prolapse
Z
Vaginal discharge
Physiological, ectropion, neoplasia, std, candidiasis, foreign body, PID
Pelvic pain
Superficial/deepCyclical/non-cyclicalGynae (endometriosis, adenomyosis, PID, ovarian cyst torsion/accident, chronic pelvic pain, adhesions from previous pelvic surgery)Non-gynae (interstitial cystitis, constipation, IBD, bony mets, psychological)
Subfertilify
Anovulatory (pcos, turner, hyperprloactinemia)Tubal problem (previous PID, previous ectopic, endometriosis)Male factorUnexplained (eg endometriosis)Investigations and managementMiscarriageIvf and counselling
Contraception
Condom, OCP, pop, implant, IUD iusMorning after pillSterilisationTopPost-partum contraceptionIndications CI, benefits, SE, efficacy,
Postnatal depression
Z
Postnatal psychosis
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Pregnant woman with alcohol abuseDescribe features and long term sequelae of fetal alcohol syndrome
Mental and physical defectsCNS damage (brain): cognitive memory attentionGrowth deficiencyPredisposition to mental health problems
Teenage girl wanting contraceptive
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Teenage girl wanting top
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F1 in a&e, see 33 y woman presenting with lower abdo painFocused history 6 minSummarise and present differentials: 2 minExamination 4 minExaminer questions: 3 minSupra public and rif pain. Started as discomfort 3 days ago, now severe. LMP was 7 weeks ago. Some abnormal light bleeding over past week. Stopped the OCP 2 y ago to conceive and used it for 10 yWith current partner for 4 years… Has 1 previous partner (got chlamydia from him). Appendicectomy as a child.Main differentials?InvestigationsYou return to see the patient and find her drowsy, BP 80/50 and is tachycardic. How to manage this caseMain sites for ectopic pregnancies? Risk factorCounsel the woman regarding impact on her fertility and future pregnancies
Points to considerCore gynae historyExplore pain and any other symptoms: patient stable?Using a contraceptiveSpecifically : PID, previous surgery, assisted conception, previous ectopic, smoking, endometriosisInvestigations and management: know the different approaches for different types of miscarriages and ectopics, remember to start with simple test (urine beta HCG) before blood tests or imaging, be able to confidently state manGement of an unstable patient in such a situationDo not forget other causes of lower abdo pain and ask questions in the history to exclude these (gastro, appendicitis, ovarian cyst torsion…)Alongside nil by mouth, two large bore cannulae, bloods (know what to take and why), fluids, senior help, call theatres to prepare… Mention rhesus status and anti-d (know dose, when to give it)
GP surgeryAsked to see 2 month old with mother for 8 week checkFocused history and discuss any issues raised: 12 minExaminer questions : 3 minMom feels exhausted. No energy. Worthless, very low, tearful, difficulty to get out of bed,utility for feeling this way. Wishes her baby didn’t come along because things were fine before. Added weight not lost. Unattractive. No contact with husband. Working two jobs. Supportive but irritated by her behaviour when comes home. Close family away. No harmful thoughts.
Main differentialBaby blues vs pn depressionAwtiological factors in this caseHow to assess her mental state: Edinburg postnatal depression scaleHow to manage this case
F1 on labour ward35 primip with painful contractionsFocused history: 5 minRelevant examination: 2 minInvestigations and management plan with examiner: 5mimInterpret ctg: 3 minJanet is 32 wUn eventful pregnancy so farPelvic discomfort Small amount of dark pv bloodFeeling a little woozyQuestionsMain differentialsOn abdo examination of a patient with an abruption, how to describe the uterus (woody hard)On obs, tachycardic and low BP. ManagementInterpret ctg (late decelerations)
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See 19y woman, booked an emergency appointment regarding contraceptionFocused history: 6minRelevant examination (2min)Management option with pt (5min)Brief questioning (2min)Very anxiousUnprotected sex with her bf best friendUsually uses widrawal method, not used this timeSex 2 days ago. Day 15 of a 5/28 cycleBeen with bf for 3 monthsMultiple partners in the past1 previous TOPTroubled by vaginal discharge, not smelly, white in colourQuestions:Perform ve and take swabsAdvise on options for emergency contraception and offer counselling regarding her current method, risk and alternatives5 infections she’s at riskSwabsTeat chlamydiaLong term complications of chlamydia
Health promotion is key hereDiagnose and appropriately treat the patientRecognise and advise lifestyle changesOptions of using condom,,,
See 34y primagravidaAttending antenatal clinic regarding abnormalities in her routine screeningThorough history (7min)Advise as necessary (4 min)Questioning with examiner (4min)24 w pregnantFirst pregnancySugar in her urineMain differential?How to further investigate?Glucose screen involve? How is it different from glucose tolerance test?Management?Foetal and maternal complications of GDMRf for GDMAdvise pt of what GDM is and how to initially manage her care
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Cervical smear
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BP bleed. Post menopausal but with delusions of pregnancy
Do Mse
15y old wanting top
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Pv discharge in older lady with msSTI, PID, abdo exam (station 2 years running)
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Missed miscarriage + speculum
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Pet
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Secondary amenorrhea
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Contraception in hypertensive obese woman
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VBAC counselling
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Early pregnancy pv bleed and counselling
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Emergency contraceptiom
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Recurrent miscarriage and antiphospholipid syndrome
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Small for gestational age. Young smoker
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HIV and pregnancy
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Down’s syndrome screening
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Sterilisation in a young woman
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PE in pregnancy (confused a lot of people)
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Ectopic pregnancy
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Chickenpox in a child whose mother is pregnant with another child
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Girl with learning difficulties asking for contraception, exploration of ethico-legal issues
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