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O&G Flashcards

1
Q

Placenta contains large and small villi with scalloped outlines and trophoblastic hyperplasia

A

Hydatidiform Mole

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2
Q

Virus causing vulval warts

A

HHV6 and 11

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3
Q

Score used to assess favourability of cervix

A

Bishop’s Score

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4
Q

How long should active 1st stage last?

A

1cm/hr in nullips, 2cm/hr in multips

16hrs max

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5
Q

How is delay in active 1st stage defined as?

A

<2cm in 4hrs

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6
Q

How is delay in active 2nd stage defined as?

A

2hrs in nullip, 1hr in multips

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7
Q

What is main risk factor for preterm delivery?

A

Infection (GBS, BV, chlamydia)

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8
Q

The cervical length which increases preterm risk

A

Cervical lenght <25mm

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9
Q

Shoulder tip pain in ectopic

A

Intraperitoneal blood loss (phrenic nerve supplies supraclavicular)

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10
Q

Transvaginal US shows pseudosac

A

Ectopic Pregnancy

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11
Q

Support group for ectopic patients

A

Ectopic Pregnancy Trust

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12
Q

“Snow-storm” appearance on US

A

Molar Pregnancy

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13
Q

Pathophysiology of pre-eclampsia

A

Incomplete trophoblast invasion of spiral arteries in placenta –> no vasodilation in spiral arteries –> placenta not perfused well

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14
Q

2 urine-based investigations for pre-eclampsia

A
  1. ++ protein on dip

2. Urine PCR >30

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15
Q

When should pre-eclampsia deliver?

A

By 36 weeks

-use oxytocin instead of ergometrine in 3rd stage

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16
Q

Diagnosis of GDM (fasting and 2hr post-GTT)

A

Fasting >5.6 mmol/L

Post-GTT >7.8 mmol/L

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17
Q

Leading cause of maternal death in UK

A

Heart disease

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18
Q

Pregnant woman with excessive thirst, epigastric pain and jaundice

A

Acute Fatty Liver

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19
Q

Cause of Acute Fatty Liver

A

LCHAD deficiency –> can’t metabolise fatty acids –> fatty acid build-up in liver

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20
Q

Itchy without rash, worse on palms and soles

Itch increases in evenings

A

Obstetric Cholestasis (oestrogen prevents bile acid uptake by liver cells)

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21
Q

Treatment of thrombosis in pregnancy

A

Enoxaparin (LMWH)

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22
Q

US:
Lamda Sign

T Sign

A

Lamda Sign = dichorionic (thick dividing membrane as it meets the placentas)

T Sign = monochorionic (thin dividing membrane)

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23
Q

Blueberry muffin rash in newborn

A

Congenital Rubella Syndrome

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24
Q

Urticarial rash on tummy, which spares the umbilicus

A

Polymorphic Eruption of Pregnancy

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25
Q

Bullous eruption on urticaria, involves umbilicus

A

Pemphigoid Gestationis

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26
Q

“Woody” uterus

A

(Severe) Placental Abruption (woody as bleeding stimulates myometrial contractions)

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27
Q

Pregnant woman has sudden increase in abdominal size

A

Polyhydramnios in Twin-Twin Transfusion Syndrome

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28
Q

Twin-Twin Transfusion Syndrome only affects which type of twins?

A

MCDA (shared placenta means shared vasculature)

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29
Q

Fused epiphyses in baby = side effect if this drug is used in pregnancy

A

Warfarin

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30
Q

Tense uterus and can’t feel foetal parts

A

Polyhydramnios

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31
Q

What drug class can cause closure of ductus arteriosus?

A

NSAIDs

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32
Q

When do you give anti-D to Rh-ve women?

A

1500IU at 28 weeks
OR
Within 72hrs of sensitising events

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33
Q

Kleihauer Test

A

Checks number of foetal cells in mum’s circulation –> detects fetomaternal haemorrhage

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34
Q

Waiter’s Tip deformity in baby

A

Erb’s Palsy after shoulder dystocia (excess traction on neck damages brachial plexus)

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35
Q

Management of shoulder dystocia

A
  1. McRoberts Manoeuvre = max flexion of mum to give baby more room
  2. Episiotomy and Wood’s Screw Manoeuvre = pressure behind posterior shoulder –> baby rotates 180
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36
Q

Liquor looks like pea soup

A

Undiluted meconium in amniotic fluid

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37
Q

Definition of foetal hypoxia

A

Foetal scalp pH <7.20

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38
Q

Features of foetal distress on CTG

A
  • Late decelerations
  • HR > 160
  • Reduced baseline variability
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39
Q

Pelvic bone pain worse on movement/end of day

A

Pelvic Girdle Pain

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40
Q

After C-section: heavy vaginal bleeding, boggy poorly contracted uterus

A

Retained Products

  • can happen if not all products removed during C-section
  • Offensive lochia = products infected
  • Management: EUA to remove the products
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41
Q

Uterus too large for dates + hyperthyroid symptoms

A

Molar Pregnancy

-hCG looks similar to TSH!

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42
Q

Schiller’s Test

A

Lugol iodine applied –> normal cervix dark brown, cervical cancer not stained

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43
Q

Definitions of oligomenorrhoae and amenorrhoae

A

Oligomenorrhoea: <6 periods in 1 year
Amenorrhoea: no periods in 6 months

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44
Q

Investigation in subfertility which confirms ovulation

A

Day 21 progesterone >30 (ovulation leaves behind corpus luteum, which makes progesterone)

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45
Q

PCOS criteria

A

(i) Polycystic ovaries on US
(ii) Irregular periods >35 days apart
(iii) Hyperandrogenism (clinical = acne/hair; biochem = raised testosterone)

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46
Q

Free Androgen Index calculation

A

(Total Testosterone/SHBG) x 100

= shows active cholesterol

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47
Q

When would you do blood tests in menopausal woman?

A
  • Under 45yrs
  • Over 45yrs with atypical symptoms

–>check increased FSH on 2 samples, 4-6 weeks apart

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48
Q

When would you give:

  1. Monthly cyclical HRT
  2. Continuous HRT
A
  1. Perimenopause (LMP within 1yr)

2. Postmenopause (LMP after 1yr)

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49
Q

HRT benefits

A
  • Decreases fragility fractures

- Improves muscle strength

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50
Q

HRT risks

A
  • Oestrogen only: endometrial cancer
  • Combined: breast cancer
  • Oral: VTE
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51
Q

1st-line investigation in postmenopausal bleeding

A

Transvaginal US –> measure endometrial thickness:
<4mm and only 1 bleeding ep: do nothing!
>4mm/many bleeding eps: endometrial biopsy +/- hysteroscopy

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52
Q

Types of endometrial cancer

A

Type 1 = mucinous and secretory adenocarcinoma

  • Oestrogen-dependent – arises from hyperplasia
  • Low grade –> doesn’t invade past uterus

Type 2 = serous and clear cell carcinoma

  • Oestrogen-independent – arise from atrophic endometrium
  • High grade –> invades more
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53
Q

Transvaginal US shows “skip lesions”

A

Asherman’s Syndrome = intrauterine adhesions

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54
Q
  • Cyclical pelvic pain
  • Period pains before periods start
  • Deep dyspareunia (“on deep penetration”)
  • Pain on passing stool during periods
A

Endometriosis

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55
Q

Transvaginal US shows “venetian blind appearance”

A

Adenomyosis

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56
Q

Transvaginal US shows chocolate cyst and “ground glass” bloos

A

Endometriosis

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57
Q

What is squamocolumnar junction (SCJ)?

A

Columnar epithelium of endocervix meets squamous epithelium of ectocervix

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58
Q

High-risk HPV strains

A

16 and 18

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59
Q

Follow-up after treat CIN

A

Repeat smear and HPV test after 6 months
o Normal? Return to normal smears
o Abnormal? Colposcopy

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60
Q

Cervix bleeds on contact

A

Cervical cancer (UNLESS smears are normal = ectropion)

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61
Q

Cancer types in cervical cancer

A

90% squamous cell. 10% adenocarcinomas (BAD)

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62
Q

Surgical treatment of cervical cancer

A

Radical (Wertheim’s) hysterectomy

  • Pelvic nodes
  • Uterus
  • Parametrium
  • Upper 1/3 vagina
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63
Q

What is a Krukenberg tumour?

A

Met on ovary, coming from GI primary

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64
Q

Risk of Malignancy Index calculation

A

Ultrasound Score x Menopause Status x CA125

  • US score = one point for every US feature (max 5)
  • Menopause status = 3 points if post-menopausal
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65
Q

Gynae cause of colicky abdo pain and vomiting

A

Ovarian cyst torsion – causes infarction of ovary and tubes

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66
Q

Vaginal discharge that is cyclical with period

A

Physiological discharge (increases with oestrogen)

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67
Q

Amsel Criteria for bacterial vaginosis

A
  1. Thin white discharge
  2. Clue cells on microscopy
  3. Vaginal pH >4.5
  4. Fishy odour after adding 10% KOH to the discharge (on a microscope slide)
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68
Q

Cause of bacterial vaginosis

A

Gardnerella vaginalis (loss of commensal lactobacilli + increased anaerobes)

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69
Q
  • Multiorgan failure + hypotension

- Desquamation

A

Toxic Shock Syndrome
= when keep tampon for a long time
–>Staph aureus/ Group A Strep releases toxins (superantigens) –> cytokines

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70
Q

Which STI causes arthritis, urethritis, conjunctivitis (Sexually Acquired Reactive Arthritis)

A

Chlamydia Trachomatis

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71
Q

Most common bacterial STI

A

Chlamydia Trachomatis

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72
Q

STI which is Gram -ve diplococcus

A

Neisseria Gonorrhoeae

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73
Q

Treatment of Neisseria Gonorrhoeae

A

IM ceftriaxone + PO azithromycin

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74
Q

Treatment of Chlamydia Trachomatis

A

Azithromycin 1g single dose

Or, doxycycline for 7 days

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75
Q

Most common viral STI

A

Genital warts (HPV)

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76
Q

Which types of HPV cause genital warts?

A

HPV 6 and 11

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77
Q

Solitary painless ulcer (on penis glans, tongue etc)

A

Syphilis

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78
Q

Which bacterium causes Syphilis?

A

Treponema Pallidum

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79
Q

Lots of warts at sites of skin friction in genitals

A

Condylomata lata = secondary syphillis

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80
Q

Treatment of Syphilis

A

IM penicillin

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81
Q

Strawberry cervix and frothy discharge

A

Trichomonas Vaginalis = flagellate protozoan

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82
Q

Bilateral lower abdo pain and deep dyspareunia

A

PID

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83
Q

Most common cause of pruritus vulvae (itchy vulva)

A

Contact dermatitis

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84
Q

Pruritus vulvae: really bad itch, worse at night

A

Lichen Simplex = eczematous plaque (due to repeated rubbing/scratching)

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85
Q

Pruritus vulvae: parchment skin + figure-of-eight distribution around vulva

A

Lichen Sclerosus (autoimmune = vulva epithelium loses collagen)

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86
Q

Vaginal pus cells on wet-mount smear

A

PID

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87
Q

Treatment of PID

A

IM ceftriaxone –> PO doxycycline + PO metronidazole

+screen partners for STI and treat them!

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88
Q

Difference between Urinary Stress Incontience and Overactive Bladder

A

Urinary Stress Incontinence = leaking during cough, WITHOUT detrusor contraction
Overactive Bladder = involuntary detrusor contraction after cough –> leak after cough

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89
Q

Dragging sensation in vagina

A

Urogenital Prolapse

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90
Q

Examination specific for urogenital prolapse

A

Sims’ Speculum: can see anterior and posterior vaginal walls

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91
Q

What does COCP contain?

A

Ethinyl oestrogen + progestogen

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92
Q

How does COCP work?

A

o -ve feedback on gonadotrophins –> suppresses ovulation
o Thickens cervical mucus
o Thin endometrium = more hostile

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93
Q

Pregnant even though have Mirena- what should you think about?

A

Ectopic!

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94
Q

What should you warn women about re. Mirena?

A

Reduces menstrual blood loss –> may become amenorrhoeic

Causes irregular light bleeding

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95
Q

What should you warn women about re. depot progesterone?

A

Can have prolonged amenorrhoea after stop depot … warn potential mums about this!

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96
Q

Sharp, shooting breast pain - esp when breastfeeding

A

Mastitis

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97
Q

Deep burning breast pain

A

Ductal infection

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98
Q

Bladder still palpable after urination

A

Urinary Overflow Incontinence (retention, due to bladder outlet obstruction)

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99
Q

Sharp unilateral pain immediately following intercourse or strenuous exercise

A

Ruptured ovarian cyst (see free fluid on US)

100
Q

Most common cause of post-coital bleeding

A

Cervical ectropion

101
Q

Chignon vs cranial abrasion

A

Chignon = birth trauma on skull after ventouse

Cranial abrasion = after instrumental/C-section

102
Q

Ectopic pregnancy: foetal heartbeat present but minor symptoms and haemodynamically stable

A

Surgical (foetal heartbeat = emergency due to rupture risk!)

103
Q

Tender RIF –> when palpate LIF, there is more pain in the RIF than LIF

A

Rosvig’s Sign in appendicitis

104
Q

Most common cause of PID in UK

A

Chlamydia trachomatis

105
Q

US shows intrauterine sac with no fetal pole

A

Missed miscarriage

106
Q

PCOS increases risk of which cancer?

A

Endometrial (oligo/amenorrhoea in the presence of pre-menopausal levels of oestrogen)

107
Q

Ovarian tumour causing ascites and pleural effusion

A

Fibroma (benign) –> causes Meigs’ Syndrome

108
Q

Most common benign ovarian tumour in women <30yrs

A

Dermoid Cyst

109
Q

Most common ovarian malignant cancer

A

Serous Adenocarcinoma

110
Q

Large ovarian malignancy cancer (can become massive)

A

Mucinous Cystadenoma

111
Q

Sudden collapse (low BP, high HR) after ROM

A

Amniotic Fluid Embolism

112
Q

Lack of postpartum milk production and amenorrhoea following delivery

A

Sheehan Syndrome = PPH causes ischaemia of pituitary

113
Q

Best LARC for young people

A

Progestogen-Only Subdermal Implant (Nexplanon = 40mm rod containing etonogestrel)

114
Q

Commonest ovarian cyst

A

Follicular Cyst –> regresses after a few menstrual cycles

115
Q

“Redness around cervical os”

A

Cervical ectropion = larger area of columnar epithelium being on ectocervix

  • COCP
  • Pregnancy!
116
Q

Itchy, sore ulcer on vulva - does not respond to steroids

A

Vulval Carcinoma

  • VIN = white plaque
  • HSV = small vesicles
117
Q

Ovarian cancer type which causes endometrial hyperplasia

A

Granulosa cell tumour

118
Q

Treatment for endometrial hyperplasia

A

Simple hyperplasia with no atypia: progestogens (IUS) –> 3-6monthly hysteroscopy + biopsy

Atypia: hysterectomy

119
Q

Fibroid complication that occurs during pregnancy

A

Red degeneration

120
Q

Which cancer drug increases risk of endometrial hyperplasia?

A

Tamoxifen = oestrogen antagonist in breast, agonist in endometrium!

121
Q

“Whirlpool sign” on US

A

Ovarian Torsion (whirlpool = twisty = torsion)

122
Q

When is mid-luteal progesterone?

A

Cycle length - 7 days

should be high (>30) as ovulation leaves behind corpus luteum, which makes progesterone…

123
Q

Disease which is an absolute contraindication for any hormonal therapy

A

Current breast cancer

124
Q

Riskiest form of breech

A

Footling = feet first –> 15% risk of cord prolapse

125
Q

What med suppresses lactation, and how does it work?

A

Cabergoline - dopamine receptor agonist –> inhibits prolactin

126
Q

Biggest risk factor for cord prolapse

A

ARM - because the baby is not yet engaged in the pelvis when the membrane is ruptured, so cord compressed if suspended below the baby

127
Q

If need to monitor LMWH in pregnancy, what do you use to monitor it?

A

Anti-Xa Activity (use APTT to monitor unfractionated)

128
Q

Painless lump in woman who has just stopped breastfeeding

A

Galactocele (obstruction of lactoferous duct) –> clinical diagnosis

129
Q

Which contraceptives should not be used >50yrs?

A

COCP and Depo-Provera (decreases BMD)

130
Q

Contraceptives used with enzyme-inducing drugs

A

Copper IUD
Progesterone injection (Depo-provera)
Mirena IUS

131
Q

Absolute contraindication for copper IUD

132
Q

Chick presents >5 days after UPSI - is it too late to give UPSI?

A

Not necessarily - can give copper IUD within 5 days after earliest ovulation date (start of next period - 14 days)

133
Q

Endometrial/ovary cancer, who also had bowel cancer at young age

134
Q

Ovarian cysts that ruptures to cause pseudomyxoma peritonei

A

Mucinous cystadenoma

135
Q

Where is most common site for ectopic rupture

A

Ampulla (middle region of Fallopian Tube)

136
Q

Most common site for lymphatic spread in ovarian cancer

A

Para-aortic lymph nodes

137
Q

Erythematous cervix with pinpoint areas of exudation

A

= Strawberry Cervix in Trichomonas vaginalis!

–> oral metronidazole

138
Q

Most common site in the tube for an ectopic pregnancy

A

Ampulla (70% ectopics)

–> then isthmus, then fimbriae

139
Q

Ovarian cyst containing Rokitansky’s protuberance

A

Teratoma (dermoid cyst)

-project from wall to centre of cyst

140
Q

Ovarian cyst that forms in early pregnancy (is completely normal)

A

Corpus luteum

141
Q

Main side effect of Progesterone Only Pill

A

Irregular vaginal bleeding

142
Q

What secretes hCG?

A

Syncytiotrophoblast

143
Q

Function of hCG

A

Prevent the disintegration of the corpus luteum, so it continues to make progesterone

144
Q

Definition of anaemia in pregnancy

A

Hb <11 –> give oral iron

145
Q

Fitz-Hugh–Curtis syndrome

A

PID –> liver adhesions

146
Q

Early Decelerations on CTG

A

Benign, head compression – starts with onset of contraction and ends when contraction ends

147
Q

Late Decelerations on CTG

A

Foetal distress – starts after contraction and ends >30 secs after end of contraction
–>foetal blood sampling –> C-Section if pH <7.2

148
Q

Variable Decelerations on CTG

A

= independent of contractions = cord compression

149
Q

Solitary painless, self-healing ulcer on penis –> unilateral lymphadenopathy

A

Lymphogranuloma venerum (chlamydia)

150
Q

Argyll-Robertson pupils

A

Neurosyphillis (pupils that accommodate but don’t constrict)

151
Q

Oestradiol functions

A
  • Endometrium proliferation
  • Production of thin cervical mucus
  • Maintains eggs in ovary
152
Q

Progesterone functions

A
  • Induces secretory changes in endometrium
  • Thickens cervical mucus
  • Decreases uterine contractility and inhibits breast milk (so progesterone drops before labour)
153
Q

Pelvic pain in pregnancy, which radiates to upper thighs/perineum– worse on walking

A

Symphysis Pubic Dysfunction (common)

154
Q

Cephalic presentation– feel Y-shaped dip anteriorly, and diamond posteriorly

A

Occipito-anterior = 95% and preferred

  • Y-shaped: posterior fontanelle
  • Diamond-shaped: anterior fontanelle
155
Q

Longitudinal lie, with irregular contours of uterus

A

Occipito-posterior (irregular contours = legs!)

156
Q

Drug which increases risk of necrotizing enterocolitis

A

Co-amoxiclav

157
Q

Ovarian tumour causing Meigs’ Syndrome

A

Fibroma (Meigs = ascites and transudative pleural effusion

158
Q

Ovarian tumours that secrete AFP

A

Yolk sac tumour and malignant teratoma

159
Q

Ovarian tumours causing precocious puberty/endometrial hyperplasia

A

Granulosa cell tumour

Thecoma (both are sex cord tumours)

160
Q

Ovarian tumour that secretes androgens

A

Sertoli-Leydig Cell tumour (sex cord tumour)

161
Q

Baby born with sensorineural deafness, cataracts and heart defect – what infection in pregnancy?

162
Q

Mother ate dodgy cheese –> baby has much increased risk of stillbirth

163
Q

Infection in mum causing fetal hydrops

A

Parvovirus B19 (haemolytic anaemia)

164
Q

Most common cause of gynae cancer death in UK

A

Ovarian Cancer

165
Q

Most common gynae cancer in UK

A

Endometrial Cancer

166
Q

Diabetes increases risk of risk gynae cancer?

A

Endometrial Cancer

167
Q

Drug used in Overactive Bladder if anticholinergics cannot be used

A

Mirabegron = B3 adrenoceptor agoinst –> relaxes detrusor muscle

168
Q

Painkiller causing premature closure of ductus arteriosus (if used in late pregnancy)

A

Ibuprofen = 2nd line after paracetamol

169
Q

Main oestrogen secreted by ovaries

A

17β-estradiol

170
Q

Adipose makes this type of oestrogen

171
Q

Oestrogen precursor

A

Androstenedione

172
Q

Painful genital ulcers –> phimosis and supppuration of inguinal lymph nodes (abscesses)

A

Chancroid = haemophilus ducreyi

–>culture on chocolate agar

173
Q

STI with RUQ pain

A

Fitz-Hugh-Curtis Syndrome, due to ascending chlamydia infection

174
Q

Painless genital ulcer –> systemic symptoms (fever, headache, skin rash)

A

Secondary Syphilis

175
Q

Cause of genital warts (including specific subtypes)

A

HPV 6 and 11

176
Q

Measurement of gestational age after 1st trimester

A

Head Circumference

177
Q

What is Biophysical Profile?

A

Looks at foetal breathing movements, body movements, tone… = measure foetal neuro status

178
Q

STI which is an obligate intracellular organism (can only replicate inside host cell)

A

Chlamydia trachomatis

179
Q

Infection with “cobblestone” cervix

A

Chlamydia trachomatis

180
Q

What position does head enter pelvis?

A

Occipito-transverse (looking sideways)

181
Q

How does head change position as it moves through pelvis?

A

Internal rotation (90degrees to OA) and flexion (flexed head = smallest diameter)

182
Q

Surge of this hormone initiates ovulation

183
Q

Type of prolapse causing urinary problems

A

Cystocele = bladder descends through anterior vaginal wall

184
Q

Type of prolapse causing pooing problems

A

Rectocele = rectum protrudes into lower vaginal wall

185
Q

Term pregnancy – heartbeat heard above umbilicus

A

Breech (also don’t feel definite presenting part, and feel ballotable part in fundus)

186
Q

Most common endometrial cancer

A

Adenocarcinoma

187
Q

Dull red papule –> single, painless well-demarcated ucler

A

Syphillis (ulcer = “chancre”)

188
Q

Placenta accreta vs increta vs percreta?

A
  • Accreta: invades into superficial myometrium, does not invade through the muscle itself
  • Increta: myometrium only
  • Percreta: beyond myometrium (outside of uterus)
189
Q

Inevitable vs Incomplete miscarriage

A 
Inevitable = vaginal bleeding (foetus may still be alive)
Incomplete = pass foetal parts
190
Q

Tumour marker for Granulosa Cell tumour

A

Serum inhibin

191
Q

Class of ovarian tumour seen in young women

A

Germ Cell Tumour

192
Q

Most common ovarian malignancy in young women

A

Dysgerminoma

193
Q

Ovarian tumour with increased AFP

A

Yolk Sac Tumour

194
Q

Supports of the uterus

A
  • Transverse cervical ligaments
  • Uterosacral ligaments
  • Round ligament
195
Q

2 important side effects of NSAIDs in pregnancy

A
  • Renal agenesis

- Premature closure of ductus arteriosus

196
Q

First site of mets in molar pregnancy

197
Q

Dizziness/LOC when pregnant woman lies supine (“at night”)

A

Aortocarval Compression (compression of abdominal aorta and inferior vena cava)

198
Q

Sudden-onset shock and cyanosis in labour (at height of a contraction)

A

Amniotic Fluid Embolism

199
Q

Painkiller contraindicated in breastfeeding

200
Q

Newborn with hypoplastic finger nails – what meds cause this?

A

Carbamazepine and phenytoin

201
Q

Treatment of trichomonas

A

Metronidazole for 7 days

202
Q

Treatment of BV

A

Metronidazole

203
Q

Treatment of Toxic Shock

A

IV clindamycin and vancomycin

204
Q

When can IUS be inserted post-partum?

A

Within 48hrs or after 4 weeks (risk of uterine perforation)

205
Q

When can COCP be used post-partum?

A

After 21 days if not breastfeeding

After 6 weeks if breastfeeding

206
Q

Criteria for the cysts in PCOS

A

At least 12 in one ovary, 2-9mm

207
Q

Foetal HR dropping steadily, but mum fine

A

Insertio velamentosa = umbilical vessels attached to membrane, not placenta –> bleeding from vessels compromises the foetus

208
Q

How do prolactinoma cause amenorrhoea?

A

High prolactin inhibits GnRH on anterior pituitary

209
Q

What hormone is in Depo-Provera?

A

Medroxyprogesterone acetate 150mg

210
Q

Which antihypertensive drug class causes oligohydramnios?

A

ACEi (reduces renal perfusion)

211
Q

Dyspareunia and menstrual pain –> ovarian cyst

A

Endometriosis (cyst = chocolate cyst! = endometrial ovarian deposit)

212
Q

Mechanism of action for transexamic acid

A

Prevents plasminogen to plasmin –> fibrin cannot be degraded

213
Q

Definition of low-lying placenta

A
  • Placental edge <20mm from internal os

- >16 weeks

214
Q

Erb’s Palsy caused by trauma to which nerves roots?

215
Q

Nerves affected in Erb’s Palsy

A 
Musculocutaneous = C5, 6 (and 7)
Radial = C5, 6 (7, 8, T1)
Axillary = C5, 6
216
Q

Newborn with claw hand

A

Klumpke’s Palsy = C8, T1

217
Q

When should PID be hospitalised?

218
Q

Laparoscopy shows thickened uterosacral ligament

A

Endometriosis

219
Q

Mechanism of mifepristone

A

Binds to progesterone receptors in endometrium –> degeneration of endometrium and ripens cervix

220
Q

Mechanism of misoprostol

A

Prostaglandin E1 analogue = stimulates contractions

221
Q

Mechanism of ectropion

A

Visible part of cervix goes from squamous to columnar (as cervical canal is columnar)

222
Q

Frothy vaginal discharge, with musty smell

A

Trichomonas vaginalis

223
Q

Treatment of DVT in pregnancy

A

LMWH until 6 weeks post-partum (3 months minimum)

224
Q

Normal histo appearance of endometrium

A

Pseudostratified columnar with tubular glands

225
Q

Most common cause of DIC in pregnancy

A

Placental abruption

226
Q

Condition causing “streak ovaries” (underdeveloped)

A

Turner Syndrome

227
Q

Cardio changes in pregnancy

A

CO 40% increase
Systemic Vascular Resistance 50% decrease
BP- small decrease in 2nd trimester

228
Q

Resp changes in pregnancy

A

Tidal volume 40% increase –> increased Minute Ventilation (feel SOB)
FRC decreases

229
Q

Definition of polyhydramnios

A

Amniotic Fluid Index > 25cm

230
Q

Definition of oligohydramnios

A

Amniotic Fluid Index < 5cm

231
Q

Endometrial cancer first metastasises to …

A

Para-aortic lymph nodes

232
Q

Low-grade dyskariosis and +ve HPV

A

Colposcopy in 6 weeks (2 weeks if moderate dyskariosis)

233
Q

Management of delay in 1st stage of labour

A

ARM if membranes intact

–> reassess 2hrs later – syntocinon if necessary

234
Q

Optimal contraction frequency in 1st stage of labour

A

4-5 every 10mins

235
Q

Down’s results in Combined Test

A

Low PAPP-A

High NT and hCG

236
Q

Down’s results in Quadruple Test

A

Low AFP and oestriol

High inhibin and hCG

237
Q

Oestrogen which increases most during pregnancy

238
Q

Pregnant woman with low-grade pansystolic murmur over precordium (4th ICS midaxillary line)

A

Flow murmur = normal!

239
Q

Newborn with nasal hypoplasia, vertebral calcinosis and brachydactyly (shortening of fingers and toes)

240
Q

Treatment of PE

A

Enoxaparin

241
Q

Young obese pregnant with headache + raised ICP, but no evidence of raised ICP/hydrocephalus

A

Idiopathic Intracranial Hypertension

242
Q

Pregnancy rash on trunk/upper limbs, spares abdomen

A

Prurigo gestationis

243
Q

Urinary incontinence, with urine leaking through vagina

A

Vesico-vagina fistula

244
Q

Diagnosis of vesico-vaginal fistula

A

Inject methylene blue into bladder –> use speculum to see blue dye in vagina

245
Q

Congenital infection causing chorioretinitis, microcephaly and convulsions

A

Toxoplasmosis

246
Q

Bony landmarks of pelvic outlet

A

Bottom of pubic symphysis
Left and right ischial tuberosities
Tip of coccyx

247
Q

Important indications for transdermal HRT

A
  • Family history VTE
  • BMI >30
  • Variable blood pressure
  • Liver enzyme-inducing drugs

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