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MC specialities > O&G > Flashcards

O&G Flashcards

1
Q

Gardasil. What does it protect against?

A

HPV types 6, 11, 16, 18

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2
Q

UTI in 1st trimester of pregnancy. What would be safest and most effective treament?

A

1st line
Nitrofurantoin (avoid at term) 100mg modified-release twice a day for 7 days if eGFR ≥45ml/minute.

As second-choice (no improvement in lower UTI symptoms on first-choice taken for at least 48 hours or when first-choice not suitable) consider prescribing:

Amoxicillin (only if culture results available and susceptible) 500mg three times a day for 7 days.
Cefalexin 500mg twice a day for 7 days.
For alternative second-choices discuss with local microbiologist.

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3
Q

Amenorrhea for 4 months. What test do you do?

A

BHCG

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4
Q

19 year old, abdo swelling, weight gain, irregular periods usually, can’t remember last period, denies being sexually active. What test do you do 1st?

A

Pregnancy test

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5
Q

Girl with cycstic ovaries on USS. What other symptom would be best indicator for her having PCOS?

Dysmenorrhea
Hirsutism
Obesity
Acne

A

Hirsutism

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6
Q

Woman with PCOS. Best medication to increase fertility

A

Clomiphene

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7
Q

Woman with signs of premature ovarian failure. What test would be best to confirm this diagnosis?

A

FSH

FSH >20 IU/L suggests POV

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8
Q

Man with azoospermia. Whats the most likely cause

Mumps hx
Hx of testicular torsion
Varicocele

A

Varicocele apparently

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9
Q 
Post menopausal woman with PV bleed. What ix do you do?
Laparotomy and hysteroscopy
Outpatient USS with endometrial biopsy
CT
MRI
A

Outpatient USS with endometrial biopsy

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10
Q

Asymptomatic woman, nulliparous, found to have 5.4 cm unilocular ovarian cyst on USS. no FHx. Management/IX?

USS guided cyst taspiration
Laparoscopic removal of cyst
Discharge and safety net
Rearrange USS in 3 mo and CA125 follow up

A

Apparently its rearrange USS in 3 mo and CA125 follow up

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11
Q

Lady with cyclic pain 1 week before periods start. Trying for a baby for 1 year. Whats the diagnosis?

A

Endometriosis

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12
Q 
Woman 8 weeks after normal vaginal delivery and 2nd degree tear. still bleeding and mild lower pelvic pain. Diagnosis?
Normal menstruation
PID
endometritis
Lochia
A

Endometritis

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13
Q

What is a 23 week USS useful for?

Nuchal thickness
Congenital heart disease identification
Predicting placenta position at term

A

Congenital heart disease identification

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14
Q

What causes increased urinary volume and frequency in first trimester?

Increased GFR
Pressure of uterus on bladder
glycosuria

A

Increased GFR

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15
Q

Effect of taking fluoxetine during pregnancy on baby?

A

Persistent pulmonary hypertension of the newborn

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16
Q 
Woman with Nexplanon. Most likely reason for wanting to change contraceptive? 
Weight gain
Acne
Mood swings
Irregular bleed
A

Irregular bleed

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17
Q

14 yo wants TOP, can’t/will not inform parents. What do you do?

A

Assess gillick/fraser competency and decide

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18
Q

Pregnant lady being domestically abused by husband and scared to go home. What do you do in GP?

Send her home and ask her to come back with husband
Give a leaflet about domestic abuse
Call and arrange emergency accomodation

A

Lol - give her a leaflet to show to her husband
no jokes
call and arrange emergency contraception

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19
Q

Woman with slow growing painless lesion on labia

A

?genital wart or bartolin cyst

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20
Q

Woman with tender lump inside vagina

A

?Vaginal cancer

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21
Q

Young woman, pain during sex, strawberry cervix on examination

A

Trichomonas vaginalis

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22
Q

Old woman complaining of superficial dyspaneuria

A

Atrophic vagina

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23
Q

Woman with cheesy white discharge

A

Candidiasis

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24
Q

Woman who has gone through menopause. Had hysterectomy. Wants HRT mainly to prevent osteoporosis and treat hot flushes. Doesn’t want tablets

A

Transdermal oestrogen (NICE guidelines no uterus give only oestrogen)

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25
Q

HRT: Swimmer wants to treat hot flushes, doesn’t want patch.

A

combined HRT (oestrogen + progesterone)

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26
Q

HRT: Woman with premature ovarian failure wants to have periods.

A

offer sex steroid replacement with a choice of HRT or a combined oral contraceptive (why does she want periods is she crazy?)

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27
Q

HRT: Woman who just wants to treat osteoporosis?

A

Bisphosphonates

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28
Q

Breast: lady with high WBC count, fever ,lump in breast

A

Abscess

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29
Q

Breast: General breast tenderness, left sided, breastfeeding

A

Mastitis

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30
Q

Breast: Small slow growing lesion on labia, pregnant lady

A

Genital wart (why was this in breast weird)

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31
Q

Breast: Small painful lump inside vagina of sexually active woman

A

?malignancy

32
Q

40 year old premature ovarian failure and wanted medication to deal with symptoms of menopause. What would you prescribe her?
Combined HRT or COCP?

A

COCP or HRT bad question cuz NICE says either

33
Q

Woman is pregnant and HIV negative at booking but partner is HIV positive. What do you do?
Start her on antiretrovirals
Retest her in 2 weeks
Nothing

A

Apparently nothing

34
Q 
What signifies onset of active labour?
ROM
Os is 4 cm
Woman can feel contractions
Regular contractions
A

Os is 4 cm

35
Q

Woman has cervical cancer, is a smoker, hasnt had a smear for 8 years. What is the most likely contributing factor?
HPV
smoking
Family history

A

HPV

36
Q

37 yo wants COCP. Which of the following is an absolute contraindication to the GP?

Smokes 20 cigs a day
Recent abnormal smear in last 6 months
breakthrough vaginal bleeding
Recent history of PID

A

Smoking

< 6 wks postpartum
smoker over the age of 35 (>15 cigarettes per day)
hypertension (systolic > 160mmHg or diastolic > 100mmHg)
current of past histroy of venous thromboembolism (VTE)
ischemic heart disease
history of cerebrovascular accident
complicated valvular heart disease (pulmonary hypertension, atrial fibrillation, histroy of subacute bacterial endocarditis)
migraine headache with focal neurological symptoms
breast cancer (current)
diabetes with retinopathy/nephropathy/neuropathy
severe cirrhosis
liver tumour (adenoma or hepatoma)

37
Q

Woman with white discharge and itch. What is the treatment?

Fluconazole
Azithromycin

A

Oral antifungal (oral fluconazole) + intravaginal or pessary antifungal (topical clotrimazole)

38
Q

Woman with itchy feet .What investigation?
Transaminases
Urine bilirubin
Serum bile acids

A

Serum bile acids

39
Q 
Couple seen in subfertility clinic and male and female investigations are given. Results show azoospermia. How should they be managed
IVF
Egg donation
Intrauterine insemination
Intracytoplasmic sperm injection
A

Intracytoplasmic sperm injection

40
Q

Ovarian cysts: Cyst contains hair and teeth

A

Teratoma

41
Q

Ovarian cysts: Ground glass appearance

A

Endometrioma

42
Q

Gyne cancer: post menopausal bleed

A

endometrial cancer

43
Q

Gyne cancer: 70 yo lady has spotting and says she uses some steroid cream for a rash down there

A

endometrial cancer until proven otherwise otherwise maybe vulval cancer?

44
Q

Gyne cancer: woman had some bleeding and curettage of endometrium had carcinomatous change ?

A

Endometrial cancer again?

45
Q

Gyne cancer: Lady is on tamoxifen. Which cancer does this increase the risk of

A

Endometrial cancer

46
Q

STI: green discharge

A

Trichomonas vaginalis

47
Q

STI: White discharge

A

Candidiasis

48
Q 
HIV with undetectable viral load. What is contraindicated in labour? 
Forceps
Ventouse
foetal blood sampling
C section
A

foetal blood sampling

49
Q 
Chicken pox in pregnancy what do you do?
Check igG antb
Check igM antb
Give varicella Ig
Give acyclovir
A

Check IgG antb

50
Q

Woman with BMI 40, abdo distension, urinary symptoms, bowel symptoms, weight loss. What could it be?
Ovarian cancer
Colorectal cancer
Endometrial cancer

A

Ovarian cancer

51
Q

72 yo with post menopausal bleed and endomethrial thickness >4mm on USS.

A

Endometrial cancer

52
Q

60 yo with post menopausal bleed and superficial dyspaneuria. Whats the most likely diagnosis

A

Atrophic vagitnitis MOST LIKELY lool

53
Q 
47 yo with 2 cm simple ovarian cyst on USS and 12 mm endometrium. What do next? 
Repeat USS
Ca 125 
Hysteroscopy
Pipelle biopsy
Reassure and discharge
A

Pipelle biopsy apparently
>10 mm in premenopausal
>4 mm in postmenopausal

54
Q

Woman with ROM, painless bleed. Whats the likely diagnosis?

A

Placenta previa

55
Q

Woman had implant inserted but shes getting it remvoed. Whats the most likely reason why

Weight gain
irregular bleed
hirsutism

A

Irregular bleed

56
Q

What cancer are you at increased risk of with HRT?

Ovarian
endometrial
cervical
bowel
breast
A

Breast

57
Q

cervical os opened in young woman early pregnancy. What is it?
Inevitable misscarrige
Threatened

A

Inevitable if bleeding

58
Q

Woman with pre eclampsia what is 1st line drug?

A

Labetalol

59
Q

Mother had ROM at 32 weeks. What do you give her?

A

IM dexamethasone

60
Q

Intermittent pain in a young woman not pregnant?

Ovarian torsion
primary dysmenorrhea
Endometriosis

A

Endometriosis

61
Q

17 yo wants Emergency contraception more than 5 days after sex?

A

Copper IUD

62
Q

Woman wsants contraception 6 hours after giving birth. what is good? (not giving any wasnt an option)

A

Progesterone pill

63
Q

post partum contraception in breastfeeding lady

A

None needed

64
Q

Babies head comes out and then goes back in. Whats the cause

A

Shoulder dystocia in turtle neck

65
Q

Woman had intrauterine growth and endometrial thickness

A

Fibroids

66
Q 
Pregnant woman with gram -ve bacilli in urine microscop. What do?
Watch and wait
give amoxicillin
urgent referal
some scans
A

I mean you give nitrofuratonin but not an option maybe they forgot

67
Q

Some girl with painful periods in first 2 days of period ever since menarche. she is heavy bleeder.

A

Primary dysmenorrhea

68
Q

BP 120/80, smokes 5/d, wants contraception

can you give cocp?

A

COCP (doesnt meet absolute contraindications)

69
Q

Abscess 2ry to mastitis how do you treat
Surgical excitison
aspirate and culture
ciprofloxacin

A

Ciprofloxacin

70
Q 
Pregnant lady in early pregnancy on sertraline for depression and anxiety what do?
stop sertraline
carry on
prescribe high dose folic acid
reduce sertraline dose
amitryptalline
A

Carry on sertraline

71
Q 
What do in woman in labour after 4 hrs of check and shes still 4 cm
Prostaglandins
cervical sweek
oxytocin
ergometrin 
ARM
A

Cervical sweep

72
Q

Foreign woman has come in pregnant. What vaccine shall she be offereD?

Hep A
hep B
Whooping cough

A

Hep b or whooping cough dumb question

73
Q

Woman with really heavy periods. Whats 1st line mx. Doesnt want to get pregnant.

A

IUS

74
Q

fOETUS WITH TRANSVERSE LIE, RECENT srom, ctg SHOWS FETAL DISTRESS

A

Cord prolapse

75
Q

HRT for menopasual woman with flushes. LMP 10months. What give?

A

Cyclical combined HRT

76
Q

Whats the MX for DVR risk iin prenant woman.

A

LMWH and Ted stockings

MC specialities (3 decks)

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