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MSRA > O&G > Flashcards

O&G Flashcards

1
Q

emergency contraception <72 hours after UPSI

A

levonogestrel

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2
Q

fetal varicella syndrome triad

A

1) eye defects
2) limb Hypoplasia
3) microcephaly`

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3
Q

pregnant lady comes with chicken pox rash- what to do

A

start treatment of aciclovir, too late to check IG/give IG

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4
Q

pregnant lady -contact with chicken pox, hx of chicken pox - what to do

A

check her IGg levels, if low needs top up

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5
Q

emergency contraception <5 days >72 hours

A

IUcopper D- not mirena

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6
Q

other benefits of COCP for young women

A

1) treats acne

2) treats irregular periods

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7
Q

only useful contraceptive for HIV

A

condoms

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8
Q

what virus causes warts on vulva and perineum in young women

A

HPV 6 and HPV 11

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9
Q

high risk(PMHx DM, past history of large baby, >4.5kg BW, Fhx of GDM) of Gestational diabetes- what screening(

A

Glucose tolerance test at 20-28 weeks gestation

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10
Q

missed miscarriage key finding

A

1) no bleeding , sometimes brown discharge

2) no fetal heart activity

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11
Q

missed miscarriage management

A
  • watch and wait
  • misoprostol
  • ERCP
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12
Q

complete miscarriage definition

any treatment

A
  • bleeding and complete passage of sac and placenta

- no need for D&C

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13
Q

Threatened miscarriage

A
  • vaginal bleeding and cramping
  • cervix closed
  • watch and wait
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14
Q

incomplete miscarriage

A
  • extremely heavy bleeding and cramps.

- USS showed products of conception

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15
Q

inevitable miscarriage

A
  • increasing bleeding and cramps
  • rupture of membranes
  • CERVICAL OS IS OPEN- key difference between threatened
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16
Q

70 year old with recurrent UTI and urgency- biopsy showed atrophic vaginitis(thinning of skin around urethra can cause this) treatment

A

oestradiol cream

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17
Q

why cant you give warfarin to pregnant women

A

it is teratogenic- crosses into fetus

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18
Q

why is pyelonephritis more common in pregnant women

A

pregnancy causes dilation of ureters and calyces

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19
Q

symphysis pubis dysfunction key management

A

explain and reassure it will go away after birth.

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20
Q

dichorionic pregnancy- need to look out for maternal anaemia-what ix

A

FBC- at 20-24 weeks to assess need for iron supplementation

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21
Q

folic acid 5mg vs 400mcg

A

5mg- high risk- epileptics.

400mcg-normal

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22
Q

lymphomagranulomavenereum

  • organism
  • stages
  • symptoms
A
  • chlamydia trachomatis
  • step 1- painless genital ulcer
  • step 2-10 days to 6months later- lymphadenitis(painful lymphadenopathy), proctocolitis(painful defecation) and cervicitis(non-offensive vaginal discharge)
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23
Q

features of severe eclampsia(4)

A
  • severe headache
  • visual disturbances
  • epigastric pain
  • hyper-reflexia/clonus
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24
Q

type of discharge with vaginal candidiasis

A

thick paste like cheesy discharge

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25
Q

contraindications for progesterone only pill(2)

A

1) active liver disease

2) active breast cancer

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26
Q

features of congenital rubella(quite a few)- brain size

  • heart
  • brain function
  • liver and spleen
A
  • microcephaly- NOT hydrocephalus
  • cataracts
  • cardiac lesions
  • cerebral palsy
  • thrombocytopenia
  • jaundice, hepatomegaly and cerebral calcification
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27
Q

number of ulcers for syphillis

A

one single painless chancre- key way to differentiate from herpes

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28
Q

painless vaginal bleeding >28 weeks

A

placenta praevia

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29
Q

painful bleeding with shock

A

placental abruption

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30
Q

exaggerated pregnancy symptoms(severe hyperemesis) + large for dates _+ snowstorm appearance on USS

A

molar pregnancy/hydatidiform mole

31
Q

septic pelvic thrombophlebitis

A
  • pain and fever post-partum period
  • not respond to initial abx
  • responds to heparin + abx
  • needs CT/MRI for diagnosis
32
Q

when is anti d given to rhesus negative mothers(3)

A
  • at 28 weeks
  • at 32 weeks
  • after circulation contact-amniocentesis, miscarriage/ectopic pregnancy
33
Q

key things to do for HIV positive pregnancies to reduce transmission

A
  • advise not to breastfeed
  • <50copies/ml viral load can have a vaginal delivery. all others should have a c-section after 39 weeks
  • should start anti-retroviral therapy
34
Q
  • large pelvic mass that causes urinary urgency
  • vaginal bleeding and discharge
  • taking tamoxifen
A
  • uterine leiomyosarcoma(malignant growth of myometrium muscle)
  • key way to differentiate endometrial CA- endo Ca does not have a mass presentation
35
Q

CTG - pathological trace, Fetal blood sampling - ph- >7.10- foetal distress and hypoxia. plan

A

immediate delivery- c section if cervix is not fully dilated

36
Q

baby with purulent discharge and lid swelling B/L

A

gonorrhoea

37
Q

things to avoid for pregnant women with regards to the following:

1) toxoplasmosis
2) listeria

A

1) toxo- avoid changing cat litter

2) listeria- avoid soft cheese, pate, unpasteurised milk

38
Q

why is meconium released in utero? what to do?

A
  • sign of fetal distress
  • deliver the baby- induction with continuous CTG
  • if CTG is abnormal will need c-section
39
Q

what to do about a breech pregnancy with regards to delivery

A
  • offer an elective c -section at 39-40

- offer emergency if in labour

40
Q

assisted delivery vs c-section- when to push for c-section

A

when cervix is not dilated to 10

41
Q

what to do if not delivering after term

A
  • membrane sweep and book for induction in maternity unit
42
Q

uk peri natal mortality rate definition

A

the number of still births and early neonatal deaths per 1000 live births and still births

43
Q

neonatal mortality rate

A

total number of neonatal deaths per 100 live births

44
Q

PCOS biochemical markers(fsh/LH ratio)

A

LH:FSH ratio high( more cysts giving out LH)

menopause will have more LH

45
Q

what is the commonest cause of maternal death in the uk

A

PE

46
Q

first-line rx for menorrhagia who is trying to get pregnant

A

tranexamic acid

47
Q

first line treatment for dysmenorrhea associated with menorrhagia

A

mefenamic acid

48
Q

RF for PMS

A
  • hysterectomy with ovary conservation

- POP contraception

49
Q

management of pms

A
  • lifestyle changes

- COCP

50
Q

what type of HRT still produces a monthly bleed

A

continuous oestrogen and cyclical progesterone

51
Q

antibiotic class that is safe to give in pregnancy

A
  • penicillins

- cephalosporins

52
Q

HIV, prolonged rupture of membranes, retained products of conception, obesity, diabetes, manual removal of the placenta, extremes of productive age are risk factors for what post -partum.

A

Endometritis

53
Q

endometritis is 10 times more common after?

A

C-section

54
Q

symptoms of endometritis

A

fever, tachycardia, abdo pain, vaginal discharge and post partum haemorrhage accompanied by general malaise

55
Q

Primary Post partum Haemorrhage

  • when
  • most common cause
A

upto 24 hours after delivery

Uterine atony

56
Q

Secondary Post-partum Haemorrhage

  • when
  • most common cause and key investigation
A
  • 24 hours-12 weeks post partum
  • retained placental tissue
  • USS
57
Q

prophylaxis for preclampsia(reduces occurence, reduces perinatal mortality, reduces IUGR)
when to start

A

Aspirin(from 12 weeks)

58
Q

supplementation for pregnancy normal patient

A

folic acid 400mcg and Vit D 10mcg

59
Q

CTG- worrying signs

A

late deceleration- foetal distress(asphyxia/placental insufficiency)
Variable deceleration-cord compression
baseline bradycardia(HR<100)-increased fetal vagal tone, maternal beta blockeir use
Baseline tachycardia(HR>160)- maternal pyrexia, chorioamnionitis

60
Q

unique signs of ovarian hyperstimulation syndrom

A

jaundice, ascites, anuria

severe- thromboemoblism, acute respiratory distress syndrome

61
Q

baby blues management

A

reassurance

62
Q

other complications of pre-eclampsia(extra-gynae)

A

intracerebral haemorrhage,

pulmonary oedema

63
Q

after 20 weeks, symphysis-fundal height in cm= gestation in weeks

A

same gestation in weeks

64
Q

grop b strep other name

A

streptococcus agalactiae

65
Q

biggest issue with smoking in pregnancy

A

increased risk of pre-term labour

66
Q

simple cyst follow up- premenopausal

A

repeat USS in 8-12 weeks

67
Q

postmenopausal women - cysts

A

needs referral to gynaecology for assessment as a physiological cyst is unlikely

68
Q

treatment of breastmilk related candida

A
  • continue breastfeeding

- topical miconazole cream to nipple and oral mucosa of infant

69
Q

commonest ovarian cyst

A

follicular cyst

70
Q

hyperemesis gravidarum triad

A

1) 5% pre-pregnancy weight loss
2) dehydration
3) electrolyte imbalance

71
Q

key issue with unopposed oestrogen

A

endometrial cancer

72
Q

antenatal cytomegalovirus infection

A

cerebral calcification, microcephaly, sensorineural deafness.

73
Q

parvovirus B19 antenatal infection

A

hydrops fetalis

MSRA (14 decks)

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