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MSRA- my cards > O&G/ Sexual Health > Flashcards

O&G/ Sexual Health Flashcards

1
Q

What are the risk factors that require higher doses of Folic Acid in pregnancy?

A

BMI >30, Sickle cell, thallesemia, coeliac, hx of neural tube defect/ anti epileptic meds

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2
Q

Management of chickenpox (varicella) exposure in less than 20 weeks

A

Check immunoglobulins and if non immune start on IV varicella zoster immunoglobulin

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3
Q

Mangement of chickenpox (varicella) EXPOSURE if over 20 weeks

A

Check immunoglobulins and if non immune start on IV varicella zoster immunoglobulin OR acyclovir 7 to 14 days post exposure

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4
Q

What phase of the mensutrual cycle is Progesterone highest?

A

Luteal phase- secreted from corpus luteum

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5
Q

What drug is first line for infertility in PCOS?

A

Clomifene (Metformin used in combination if increased BMI)

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6
Q

What is the first line tx for Gonorrhoea?

A

IM Ceftriaxone

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7
Q

What type of bacteria is a Gonorrhoea (eg what would be seen in microscopy??)

A

Gram neg diplocci

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8
Q

First line treatment of chalymdia? (Uncomplicated)

A

Doxycycline 7 day course.

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9
Q

When should test of cure be performed for Chylamidia infections?

A

After 5 weeks in pregnant woman. TOC is not routinely in men or non pregnant females

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10
Q

Whooping cough (Pertussis) vaccine- when is it given during pregnancy?

A

between 16-32 weeks

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11
Q

TOPs can be carried out until what gestation in the UK Abortion Act?

A

23+6

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12
Q

When would you refer to colposcopy in a patient with HPV pos cervical smear but normal cytology?

A

at 24 months. eg if initial smear was HPV pos, then 12 month FU was still HPV pos and then 3rd smear at 24 months also pos.

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13
Q

What is the emergency contraception up to 5 days?

A

Ella one- Uliprisate up to 120 hours

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14
Q

What is the emergency contraception up to 3 days?

A

Levongesterol (1.5mg) progesterone

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15
Q

Treatment of premature ovarian failure

A

Combined HRT until aged 51

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16
Q

How long does the COCP need to be stopped prior to surgery?

A

4 weeks!

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17
Q

Chancres are due to which organism?

A

Haemophilus ducreyi.

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18
Q

Screening for downs syndrome- what is offered?

A

Combined test (nuchal and bloods) between 11- 13+6

Triple or quadruple screening 15-20

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19
Q

What fetal abnormalities would be seen in Varicella (chickenpox) infection intrapartum?

A

Scarring of the skin, limb hypoplasia, microcephaly and eye defects

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20
Q

What drugs are inducers of the PY450 system? and why is this relevant?

A

Carbamazapine, Phenytoin, Rifamicin, St Johns work and therefore they will reduce the efficacy of the COCP.

SICKFACES

St John’s Wort
isonidiazid
carbamazepine
Ketconazole
Fluconazole
Alchohol
Chloramphenicol
Erythromycin
Smoking

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21
Q

What age and regime is used for cervical ca screening in UK?

A

Aged 25-64.
25-50 every 3 years
50-65 every 5 years

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22
Q

When to start infertility testing? How many months of trying to concieve

A

12 months if under 35
6 months if over 35

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23
Q

Management of fibroadenoma?

A

Depends on size! 3cm or above= surgery
under 3cm= reassurance and monitoring

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24
Q

Management of GDM

A

If fasting BM >7 = Insulin
If fasting BM under 7= trial of diet+lifestyle.

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25
Q

Trichomonas is treated with?

A

Oral metronidazole

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26
Q

What are the risk factors for breast cancer?

A

HRT, early menarche, late menopause and COCP

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27
Q

Is Aspirin allowed in breastfeeding?

A

NO!

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28
Q

What are the rules around COCP and breastfeeding

A

UKMEC 2 between 6 weeks and 6 months

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29
Q

GDM. What fasting glucose on the OGTT should insulin be started?

A

If fasting glucose is over 7 = start Insulin

Or if fasting 6-6.9 but with complications such as macrosomia = consider Insulin

30
Q

Secondary dysmenorrhagia management in GP

A

Refer to Gynae

31
Q

How many days from starting the POP is it effective?

A

2 days

32
Q

What age does cervical screening go to 5 yearly?

A

50-65 years old - 5 yearly screening

33
Q

What is the treatment if a pregnant woman HAS chickenpox eg presents with the rash?

A

Aciclovir if over 20 weeks and Aciclovir can be considered if less than 20 weeks

34
Q

Presentation of Lymphogranuloma venereum

A

Stage 1: painless genital ulcer
Stage 2: Painful lymphadenopathy

35
Q

What are some contraindications to POP?

A

Acute porphyria/ current breast ca.

36
Q

What are the features of congenital rubella syndrome?

A

Cataracts, cardiac lesions, splenomegaly, cerebral palsy

37
Q

How do you define Perinatal Mortality Rate?

A

Number of stillbirths and early neonatal deaths (7 days) by number of livebirths and stillbirths PER 1000

38
Q

What is HELLP syndrome?

A

Haemolysis
Elevated liver enzymes
Low platelets

Diagnostic criteria need raised LFTs (twice upper limit of normal) and low platelets

39
Q

What are the risk factors for endometrial ca.

A

Nulliparious
High BMI
Unopposed oestrogen PCOS HRT
Tamoxifen

40
Q

What are the neonatal effects of maternal toxoplasmosis infection?

A

CNS and eyes!
Neonatal seizures, hydrocephalus, chorioretinitis, cerebral calcification, cataracts

41
Q

When can the copper IUD be fitted as emergency contraception?

A

5 days or 120 hours of USPI OR within 5 days of the earliest estimated date of ovulation.

Copper IUD should be offered to everyone first line!

42
Q

When can Ullipristate vs Levongestrol be used for emergency contraception?

A

Levongestrol - 72 hours
Ullipristate- 5 days/ 120 hours (shouldn’t be used in severe Asthma)

43
Q

Risk factors for HE?

A

Non smokers, twin pregnancies, molar pregnancies, eating disorders, N+v outside of pregnancy.

44
Q

PID Antibiotics?

A

Ceftriaxone 1 g as a single intramuscular (IM) dose, doxycycline 100 mg twice daily
metronidazole 400 mg twice daily for 14 days.

45
Q

Gonorrhoea in a man- presentation and Abx?

A

Discharge and dysuria
Mx: IM Cef + Azithromycin

46
Q

Chlamydia in a man- presentation and Abx?

A

Itchiness and urethritis but no discharge
Mx: Azithromycin

47
Q

Management of Pre menstrual tension

A
  1. Lifestyle
  2. COCP
  3. SSRI if severe and can be discontinued when pregnant
48
Q

When can a copper IUD be fitted?

A

Within 5 days after the first UPSI in a cycle
OR
within 5 days of the earliest estimated date of ovulation.

49
Q

What are some of the contraindications to copper IUD?

A

Unexplained bleeding
Current chlaymida/ gonorrhoea
Post TOP/ Post postpartum sepsis
Cervical CA
Molar pregnancies
PID

50
Q

Treatment of Gonorrhoea? and how would it be prescribed under the microscope?

A

IM CEF!!!
Gram neg diplococci

51
Q

What do these terms mean?
Azoospermia
Oligospermia
Hypospermia
Tetartospermia
Asthenzoospermia

A

Azoospermia- no sperm
Oligospermia- reduced sperm
Hypospermia- reduced semen volume
Tetartospermia- poor sperm morphology
Asthenzoospermia - reduced sperm motility

52
Q

Treatment of epidiymo-orchitis?

A

IM Cef (STAT) + Doxy for 10-14 days

53
Q

What would a high FSH indicate in the investigations of secondary amenorrhoea?

A

Primary Ovarian Failure

54
Q

Placental abruption presents with which examination finding?

A

Tender woody uterus
Pain
PV bleeding

55
Q

Which rash spares the umbilicus in pregnancy?

A

Polymorphic eruption of pregnancy

56
Q

What are the missed pill rules for POP?

A

Missed pill occurs if >3 hours late.
If this happens- take next pill and extra precautions for 48 HOURS!
EC only required if UPSI occurred between missed pill and 48 hour window

57
Q

What are the TORCH infections?

A

Toxoplasmosis
Other (syphillis)
Rubella
Cytomegalovirsus
H erpes simplex

58
Q

What gestation does ECV take place?

A

Nulliparous 36/40
Multiparous 37/40

59
Q

What gestation is routine anti D given?

A

28 weeks and 34 weeks

60
Q

What gestation is presentation palpated for

A

36 weeks

61
Q

Indications for high dose folic acid (5)

A

Sickle cell/ Thalassemia
Diabetes
Epileptic medication
BMI >30
Fhx of neural tube defects

62
Q

What drugs for medical TOP?

A

Mifepristone
Followed by Misoprostol 48 hours later

63
Q

Missed pill rules COCP

A

1 pill- fine - take next one and carry on
2 pills- 7 days extra precautions.
If at beginning of pack will need EC

64
Q

How to start COCP

A

If between D1-D5 quick start and no additional contraception required
If after D5 of period need 7 additional condom days!

65
Q

Lipid modification drugs in pregnancy?

A

All lipid modification drugs are contraindicated in pregnancy.
And should stop 3 months prior to pregnancy

66
Q

Risk factors for endometrial ca

A

Obesity
Nulliparity
Late menopause
Tamoxifen

67
Q

Treatment of listeria infection in pregnancy

A

Amoxicillin

68
Q

Treatment of Toxoplasmosis in pregnancy

A

Spiramycin

69
Q

What is a UK MEC 4 (unacceptable risk) for progesterone implant and injectables?

A

Current breast ca (within 5 years)

70
Q

What are the causes of painless genital ulcer (3)

A
  1. Syphillis
  2. Chancroid (haemophyllis ducreyi)
  3. Lymphogranuloma venereum (chlaymidia trichomatosis)

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