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MSRA > Ob/Gyn > Flashcards

Ob/Gyn Flashcards

1
Q

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!

A

Compress the uterus and catheterise her

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2
Q

A woman pregnant with her second child has gestational diabetes during her first pregnancy which resolved after delivery. When should she have an OGTT?

A

As soon as possible after booking

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3
Q

35F with breast cancer previously in COCP. What is the most appropriate form of contraception?

A

Copper IUD

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4
Q

50F who’s last smear 12 months ago was +ve for HPV. Next smear is negative for HPV. When should she be invited back?

A

5 years time - routine recall
50-65 every 5 years

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5
Q

4 week post-natal woman with no antenatal complications. Currently exclusively breastfeeding. Presents with UTI. What is the most appropriate management?

A

Trimethoprim

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6
Q

Treatment for BV and criteria for diagnosis?

A

PO Metronidazole
Thin, white homogenous discharge, clue cells, stipples vaginal epithelial cells, pH>4.5 and positive whiff test

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7
Q

Treatment for Trichomonas vaginalis?

A

PO Metronidazole
Offensive, ‘musty’ frothy, green vaginal discharge (2% have a strawberry cervix)

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8
Q

Treatment for gonorrhoea?

A

IM Ceftriaxone

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9
Q

What should patients with diabetes start at 12 weeks gestation?

A

Aspirin 75mg to reduce the risk of pre-eclampsia

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10
Q

What are the target levels for BMS for pregnant women with gestational diabetes?

A

Fasting: 5.3mmol/L
AND
1 hour postprandial: 7.8mmol/L or
2 hours postprandial: 6.4 mmol/L

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11
Q

25 week gestation with fasting plasma glucose of 6.8mmol/L. What intervention should be offered?

A

Trial of diet and exercise for 1-2 weeks

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12
Q

24 year old has abdo USS showing a 4am simple ovarian cyst on left ovary. What is the most appropriate action?

A

Repeat USS in 12 weeks. If the cyst persists after 12 weeks then referral should be considered

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13
Q

What is the mode of action of the Progesterone-only pill? (excluding desogestrel)

A

Thickens cervical mucus

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14
Q

What is the mode of action of the injectable contraceptive (medroxyprogesterone acetate)?

A

Inhibits ovulation

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15
Q

When during pregnancy do you need VZIG after contact with chickenpox?

A

<20 weeks

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16
Q

What is HELLP?

A

Haemolysis, Elevated Liver enzymes, Low Platelets

17
Q

What form of contraception is contraindicated <6 weeks after delivery, if breastfeeding?

A

COCP

18
Q

What is the management for PPH in sequence?

A

Bimanual uterine compression to manually stimulate contraction
IV Oxytocin +/- Ergometrine
IM Carboprost
Intramyometrial Carboprost
Rectal Misoprostol
Surgical intervention such as balloon tamponade

19
Q

What are the signs seen in babies of varicella zoster infection in pregnancy?

A

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

20
Q

What signs are seen in a baby with congenital rubella syndrome?

A

Classic triad: sensorineural deafness, eye abnormalities and congenital heart disease

21
Q

What is the main mechanism of action of Nexplanon? (etonogestrel contraceptive implant)

A

Inhibition of ovulation

22
Q

How soon after giving birth do you require contraception?

A

21 days

23
Q

What is first-line treatment for urge incontinence?

A

Bladder retraining

24
Q

What is first-line treatment for stress incontinence?

A

Pelvic floor muscle training

25
Q

30F with brown vaginal discharge, 10 weeks pregnant. USS shows empty foetal sac?

A

Missed miscarriage

26
Q

15 week pregnant with heavy vaginal bleeding with clots. Cervical os is open?

A

Inevitable miscarriage

27
Q

What causes warty lesions on the vulva and perineum?

A

HPV 6 and 11

28
Q

35F with dichorionic twin pregnancy. What additional monitoring will she need?

A

FBC at 20-24 weeks

29
Q

IVDU with painful groin lymphadenopathy, non-offensive vaginal discharge and painful defecation. Painless genital ulcer 4 months ago which self resolved. Otherwise well?

A

Lymphogranulomavenereum

30
Q

35F with lethargy, sweats, generalised aches and pains and a faint maculopapular rash all over. Normal bloods?

A

HIV

31
Q

Treatment for PID?

A

IM Ceftriaxone STAT plus 14/7 Doxycycline and Metronidazole

32
Q

When is the baby tested for HIV if born to a HIV positive mother?

A

DNA PCR at 48 hours, 6 weeks and 12 weeks
Antibody test at 18 months

33
Q

What anti-hypertensives are safe to use in pregnancy?

A

Hydralazine and lobetalol

MSRA (16 decks)

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