OB GYN

Question 1

Risk factors for endometrial Cancer

Answer 1

Unopposed hyperestrogenism

Nulliparity
Early menarche
Late menopause
Obesity/Metabolic Syndrome
HRT
Oestrogen CPs
PCOS
Lynch syndrome(CRC and endometrial Ca)

Question 2

4 Ts of PostPartum Hemorrhage

Answer 2

Tone: Uterine Atony
Tissue: Retained POCs
Trauma: Tears or injury
Thrombin: Coagulopathy

Question 3

3 Ps of arrested labour

Answer 3

Power: Uterus eg difficult labor
Passage: Pelvis( Shape, past fractures, teratoma)
Passenger: LGA, abnormal presentation

Question 4

Mnemonic for menstrual disturbances

Answer 4

FIGO classification: PALM COEIN

PALM(structural)

Polyp
Adenomyosis
Leiomyoma
Malignancy/Endometrial Hyperplasia

COEIN(systemic)

Coagulopathy
Ovulatory dysfunction
Endocrine
Iatrogenic/Infection
Not otherwise classified

Question 5

Risk factors for PPROM/PROM

Answer 5

Chorioamnionitis
Trauma
UTI
Lower genital tract infection/Bacterial Vaginosis/Vaginal discharge
Polyhydramnios
Invasive procedures eg amniocentesis

Question 6

Risk factors for chorioamnionitis

Answer 6

DM or GDM
Chronic steroid use
GBS positive

Question 7

Risk factors for cervical cancer

Answer 7

Multiple sexual partners
Early onset of sexual activity
Immunocompromise(HIV,post transplantation)
Smoking
Past STDs

Question 8

Sign of shoulder dystocia

Answer 8

Turtle necking sign and head bobbing

Question 9

Causes of recurrent miscarriages

Answer 9

Placental insufficiency:
A. Thrombophilias(Antiphospholipid syndrome, Protein C+S deficiency, anti thrombin 3 deficiency
B. DM
C. Thyroid abnormalities

2. Uterine abnormalities(Mullerian abnormalities/structural abnormality of uterus, Submucosal fibroids, endometrial polyps, Asherman syndrome)

3.Chromosomal abnormalities (Unbalanced parental karyotype

Question 10

Methods of monitoring fetal well being

Answer 10

Ultrasound for Fetal Heart
CTG
Aminiotic fluid index of 5-25
Doppler

Question 11

Folate doses for normal and high risk pregnancy

Answer 11

Normal: 400mg pre conception
High risk: 5g

Question 12

Risk factors for stillbirth

Answer 12

1. GDM and Pre Gestational DM
2. Thrombophilias: (APS,Protein C+S deficiency, antithrombin 3 deficiency)
3. Hypertensive disorders: (Pre eclampsia,PIH, chronic HTN, CKD)
4. Inter current illness eg infection ESP listeria
5. Trauma/placental abruption (Falls, RTA, Domestic abuse)

Question 13

Indications for Crash C section

Answer 13

Cord prolapse
Uterine rupture
Unresolving Fetal bradycardia
Massive placental abruption
Maternal collapse

Question 14

Lambda and T sign of Ultrasound

Answer 14

Lambda:dichorionic pregnancy
T: monochorionic pregnancy

Question 15

Options for Screening for chromosomal abnormalities

Answer 15

First Trimester Screening(11-13wk): Maternal age, b-HCG, PAPP-A, Nuchal Translucency, Nasal bone

Non invasive Prenatal testing: free fetal DNA

Invasive: Chorionic Villi Sampling(14weeks>),Amniocentesis(>14weeks), fetal blood sampling

Question 16

Cutoff for endometrial thickness(ET) to investigate(UNLESS RECURRENT AUB)

Answer 16

> 5mm on ultrasound