Ob/Gyn Flashcards
A woman delivers her baby and opts for a physiological third stage of labour. Shortly after she loses 700ml of blood. After an A-E approach that is the appropriate next step!
Compress the uterus and catheterise her
A woman pregnant with her second child has gestational diabetes during her first pregnancy which resolved after delivery. When should she have an OGTT?
As soon as possible after booking
35F with breast cancer previously in COCP. What is the most appropriate form of contraception?
Copper IUD
50F who’s last smear 12 months ago was +ve for HPV. Next smear is negative for HPV. When should she be invited back?
5 years time - routine recall
50-65 every 5 years
4 week post-natal woman with no antenatal complications. Currently exclusively breastfeeding. Presents with UTI. What is the most appropriate management?
Trimethoprim
Treatment for BV and criteria for diagnosis?
PO Metronidazole
Thin, white homogenous discharge, clue cells, stipples vaginal epithelial cells, pH>4.5 and positive whiff test
Treatment for Trichomonas vaginalis?
PO Metronidazole
Offensive, ‘musty’ frothy, green vaginal discharge (2% have a strawberry cervix)
Treatment for gonorrhoea?
IM Ceftriaxone
What should patients with diabetes start at 12 weeks gestation?
Aspirin 75mg to reduce the risk of pre-eclampsia
What are the target levels for BMS for pregnant women with gestational diabetes?
Fasting: 5.3mmol/L
AND
1 hour postprandial: 7.8mmol/L or
2 hours postprandial: 6.4 mmol/L
25 week gestation with fasting plasma glucose of 6.8mmol/L. What intervention should be offered?
Trial of diet and exercise for 1-2 weeks
24 year old has abdo USS showing a 4am simple ovarian cyst on left ovary. What is the most appropriate action?
Repeat USS in 12 weeks. If the cyst persists after 12 weeks then referral should be considered
What is the mode of action of the Progesterone-only pill? (excluding desogestrel)
Thickens cervical mucus
What is the mode of action of the injectable contraceptive (medroxyprogesterone acetate)?
Inhibits ovulation
When during pregnancy do you need VZIG after contact with chickenpox?
<20 weeks
What is HELLP?
Haemolysis, Elevated Liver enzymes, Low Platelets
What form of contraception is contraindicated <6 weeks after delivery, if breastfeeding?
COCP
What is the management for PPH in sequence?
Bimanual uterine compression to manually stimulate contraction
IV Oxytocin +/- Ergometrine
IM Carboprost
Intramyometrial Carboprost
Rectal Misoprostol
Surgical intervention such as balloon tamponade
What are the signs seen in babies of varicella zoster infection in pregnancy?
Scarring of skin, limb hypoplasia, microcephaly and eye defects.
What signs are seen in a baby with congenital rubella syndrome?
Classic triad: sensorineural deafness, eye abnormalities and congenital heart disease
What is the main mechanism of action of Nexplanon? (etonogestrel contraceptive implant)
Inhibition of ovulation
How soon after giving birth do you require contraception?
21 days
What is first-line treatment for urge incontinence?
Bladder retraining
What is first-line treatment for stress incontinence?
Pelvic floor muscle training
