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MS4 - OnG > O&G lectures > Flashcards

O&G lectures Flashcards

1
Q

3 meds that should be avoided at (almost) all cost during pregnancy

A

Methoterexate Radioactive iodine (lithium)

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2
Q

Meds for medical termination of pregnancy (MTOP)

A

methotrexate

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3
Q

Factors affecting fertility

A

Reversible effect: hormones for menorrhagia Irreversible effect: chemotherapy and smoking

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4
Q

What are fibroids

A

smooth muscle tumours of the uterus

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5
Q

Sx of pelvic inflammatory disease (PID)

A

Gradual onset lower abdo pain Unwell Dyspareunia Abnormal vaginal discharge

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6
Q

What is this

A

Fitz-Hughs-Curtis

Rare complication of PID: adhesions between liver and diaphragm

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7
Q

Long term complications of PID

A

Adhesions

Infertility

Chronic pelvic pain

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8
Q

Treatment of PID patients

A

14 days of abx

Doxycycline + metronidazole

Or

Ofloxacin + metronidazole

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9
Q

Other considerations in management of PID

A

Treat partner + contact tracing

No intercourse whilst on abx

Full STIs screening (hep b,c HIV)

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10
Q

Cause of Ovarian hyperstimulation

A

Fertility treatment giving too much FSH causing hyperplasia of the ovaries

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11
Q

Sx of ovarian hyperstimulation

A

ascites

pain

thrombosis

pleural effusion

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12
Q

What is typical hx for miscarriage septic

A

prolonged heavy vaginal bleeding

3-5 days post miscarriage

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13
Q

What is this condition

How is it treated?

A

Bartholins cyst/abscess

Abx or

surgery and marsupialisation

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14
Q

location and function of bartholins glands

A

Posterior vulval wall at 4 and 8 o clock

Lubrication of intercourse

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15
Q

Which pathogen is bartholins abscess associated with

A

20% associated with Gonorrhoea

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16
Q

Marsupialisation

A

curring a slit into an abscess

suturing it in a way that can drain freely

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17
Q

Differential for abnormal menstrual bleeding (AUB)

A

PALM-COEIN

Polyps

Adenomyosis

Leiomyoma

Malignancy

Coagulopathy

Ovulatory dysfunction

Endometrial

Iatrogenic

Not yet classified (eg dysfunctional uterine bleeding: everything is normal but still bleeding)

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18
Q

Causes of vaginal bleed in 1 week old?

A

Oestrogen withdrawal

or

Rhabdomyosarcoma (vaginal cancer)

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19
Q

Medical management of heavy menstrual bleeding?

A
  1. tranexamic acid
  2. NSAIDS: mefenamic acid/ ibuprofen
  3. Iron
  4. Hormonal (IUS, COCP, etc)
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20
Q

What is this

What sx does it give?

A

Cerivical ectropion

Columnar epithelium of cervix replaces stratified squamous of the vagina

Very vascular, post coital bleeding

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21
Q

Organisms causing cervicitis

A

Chlamydia

Gonorrhoea

Trichomonas vaginalis

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22
Q

Organisms causing vaginitis

A

Gardnella vaginalis

Candida Albicans

Trichomoniasis Vaginalis

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23
Q

Abx for Chlamydia

A

doxycycline 100mg BD- 7 days (CI pregnancy)

Azithromycin 1gm PO- stat dose

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24
Q

Gonorrhoea Abx

A

Ceftriaxone 250mg IM- stat dose

Cefixime 400mg PO- stat dose

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25
Q

Causes of oligomenorrhoea

A

Thyroid

Pituitary

Exercise and diet

PCOS

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26
Q

Medical mangement of stress urinary incontinence

A

Duloxetine

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27
Q

Interventional procedures for stress urinary incontinence

A

Urethral bulking

Midurethral sling

Colpsuspension

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28
Q

Types of Pelvic organ prolapse

A

Anterior Vaginal wall: urethrocele, cystocele

Posterior vaginal wall: rectocele, cystocele

Apical vaginal (vault prolapse, post-hysterectomy)

Uterine (I-IV)

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29
Q

Overactive bladder medical mx

A

Antimuscarinics:

Tolterodine XL 4mg OD

Solifenacin 5mg - 10 OD

Trospium XL 60 mg OD

Mirabegron 50 mg PO OD

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30
Q

HPV vaccines

A

Cervarix

Gardasil (6,11,16,18)

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31
Q

Cervical cancer risk factors?

A

HPV

COCP

Smoking

Immunosuppression

low social class

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32
Q

What type of cancer is the majority of cervical

A

80% squamous, 20 adeno

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33
Q

Endometrium cancer risk factors

A

Unopposed E2

FHx: HNPCC

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34
Q

Conditions with increased Oestrogen (E2) exposure

A

Early menarche/ late menupause

Nulliparity

Obesity

HRT

PCOS

Tamoxifen

Liver cirrhosis

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35
Q

How obesity increases E2 exposure

A

adipose tissue produces E2

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36
Q

Presentation of endometrial cancer

A

post menopausal bleed

Abdnormal pre/peri menopausal bleed

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37
Q

Vulval cancer presentation

A

Long history of itch and irritation

Lump/ ulcers

bleeding / pain

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38
Q

Ovarian cancer presentation

A

Dyspepsia

Increased abdominal girth

Altered bowel habits

Anorexia

Cachexia

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39
Q

Trachelectomy

A

remove cervix

anastomise vagina and utrerus

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40
Q

Average life expectancy for an untreated HIV patient

A

10-12 yrs

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41
Q

Average life expectancy for a treated HIV patient

A

near normal 2-10 yrs less

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42
Q

When to test for HIV

A

at 4 weeks post exposure

if v high risk, also at 8 week post exposure

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43
Q

What is PEPSE

A

Post exposure prophylaxis after sexual exposure

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44
Q

When to take PEPSE

A

within 72 hours of exposure

HIV test 8-12 weeks post exposure

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45
Q

How long is a course of PEPSE

A

1 month

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46
Q

What drugs used in PEPSE

A

Truvada od

Raltegravir bd

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47
Q

PrEP

A

Pre-exposure prophylaxis for HIV

taken before sex

48
Q

Diagnosis of chlamydia

A

NAAT:

First catch urine in men

Vaginal or endocervical swab in women

49
Q

Rx of chlamydia

A

doxycycline 100 mg bd 7/7

or

azithromycin 1g

50
Q

Gonorrhoea diagnosis

A

NAAT:

First catch urine in men

High Vaginal or endocervical swab in women

51
Q

Gonorrhoea Rx?

A

Ceftriaxone 500 mg IM

AND
Azithromycin 1g PO

52
Q

Transmission of genital warts?

A

skin to skin

53
Q

Pathogen causing genital warts

A

HPV 6, 11

54
Q

Mx of genital warts

A

Podophyllotoxin (warticon)

Cryotherapy

Imiquimod (aldara- immune modulator)

55
Q

What causes lymphogranulumoa venereum

A

Chlamydia tracchmoatis serovars L1-3

Results in local destruction and lymphadenopathy

56
Q

What is this

A

Molluscum contageosum

Pink raised lesions on skin

57
Q

How is Molluscum contageosum transmitted

A

skin to skin

58
Q

What is this

A

genital warts

59
Q

What is this

A

genital Herpes

60
Q

What is this

A

scabies

61
Q

scabies transmission

A

skin to skin

62
Q

Scabies caused by

A

Mite sarcoptes scabiei

63
Q

What causes the itch in scabies

A

mite poo into skin capillaries causing hypersensitivity

64
Q

Managment of scabies

A

Topical : permethrin/ malathion

avoid contact with partners

wash clothes from last 4 days at 60 C

Itch mx: crotamiton cream

65
Q

Mx of pubic lice

A

Malathion (leave on for 2-12hrs)

Permethrim (rinse after 10 mins)

Phenothrin (wash off after 2hrs)

66
Q

oro-labial herpes causes

A

HSV1

67
Q

Genital herpes cause

A

HSV2

68
Q

Which HSV recurrs more frequently

A

HSV 1

(<1/yr vs 2-3 yr)

69
Q

Diagnosis of HSV

A

swab from lesion

70
Q

Rx for HSV

A

`Aciclovir for 5 days

  • either 400 mg TDS
  • or 200mg 5 times/day
71
Q

What is this

A

syphilis

72
Q

Dx of syphilis

A

Dark ground microscopy or serology

73
Q

Mx of syphilis

A

Benzathine penicillin or doxyccyline

74
Q

Window for DNA retrieval for adults and children after sexual assault

A

adults 7 days

children 3 days

75
Q

Clomiphene use?

A

Induce ovulation in anovulatory infertility

76
Q

Danazol use?

A

Treat endometriosis

77
Q

Rx of anovulatory infertility (PCOS)

A

Clomifene

Metformin

Ovarian diathermy

GnRH analogues

78
Q

Prevention of pre-eclampsia

A

Aspirin start at 12th week

(reduces the risk of pre-eclampsia development)

79
Q

Normal endometrial thickness

A

<4 mm

80
Q

Contraceptive needs post menopause

A

No need if:

<50 yo: 2 years of no periods

>50 yo: 1 year of no period

81
Q

Mech of action of copper coil

A

decrease sperm utility and survivlal

82
Q

IUS mech of action

A

prevents endometrial proliferation

thickens cervical mucous

83
Q

When to give anti-D

A

First dose at 28 wks

Second at 34 wks

84
Q

When should offer ECV

A

Prim: after 36 wks

Multip: after 37

Before may change spontaneously

85
Q

Which contraception to give post-menupause

A

IUS

Dont give COCP to older than 40 yo

86
Q

Sheehans syndrome

A

Pituitary grows during pregnancy

Sudden drop in BP post-partum causes necrosis

87
Q

Asherman’s syndrome

A

Scarring of the uterus (iatrogenic)

endometrium doesn’t respond to E2 as well

88
Q

Krukengberg tumours

A

GI tumour, mets to ovaries

Signet ring cells

89
Q

Meig’s syndrome

A

benign ovarian tumour

ascites

pleural effusion

spindle shaped fibroblast

90
Q

Insertio velamentosa

A

Umbilical cord vessels pass through amniotic membrane before entering placenta

91
Q

Haematometra

A

Blood collected inside uterus (due to imperforate hymen)

92
Q

Snowstorm USS

A

molar pregnancy

93
Q

Order of fetal distress ix

A

Doppler/CTG

Scalp electrode

FBS

Deliver

94
Q

Forceps vs Ventouse

A

Forceps- quicker, more damaging

Ventouse- when fetus not distressed and there is time

95
Q

Early vs Late syphillis

A

early <2yrs

late >2yrs

96
Q

Mx of early syphillis

A

Single dose Pen G/Benpen

97
Q

Mx of late syphillis

A

BenPen once wkly for 3 wks

98
Q

Secondary syphillis sx

A

Rash

Fever

Joint pain

Malaise

Condylomata lata

99
Q

Condylomata lata

A

Wart like lesion

100
Q

Gummatous syphillis

A

plaques in all solid organs

101
Q

Pre-mensutrual syndrome

A

AKA premenstural tension

headache

depression

102
Q

Depression post birth

A

Baby blues days

Puerperal depression/psychosis wks

Postnatal depression months

103
Q

Uterine prolapse degrees

A

1st: cervix above introitus

2nd degree: cervix at introitus

3rd degree: cervix below introitus

4th degree: cervix, uterus and vaginal prolapse

104
Q

Introitus

A

Vaginal opening that leads to the vaginal canal

105
Q

Chorionic villous sampling date

A

From 11 wks

106
Q

Amniocentesis date

A

From 15 wks

107
Q

Primary vs secondary dysmenorrhoea

A

Primary: pain before mensturation

Secondary: pain before and during menstruation

108
Q

Treatment dysmenorrhoea

A

COCP

Mefanemic acid

109
Q

PROM mx

A

Admit

Pen/Erythromycin for 10 days

Corticosteroids

Consider delivery after 34 wks

110
Q

RFs for neural tube defects

A

Obesity

NTD Hx/FHx

Sodium Valproate

Coeliac

Thalasaemia trait

111
Q

Strawberry cervix

A

trichomonas vaginallis infection

112
Q

Clue cells

A

Bacterial vaginitis

113
Q

Flagellated protozoa STI

A

Trichomonas vaginallis

114
Q

Gram -ive rods STI

A

chlamydia

115
Q

Gram -ive dipplococci STI

A

Gonorrhoea

MS4 - OnG (5 decks)

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