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OBG Flashcards

1
Q

What is the term for the discharge of blood and mucus from the cervix signaling impending labor?

A

Bloody show

Bloody show is often a sign that labor is approaching as the cervix begins to efface and dilate.

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2
Q

What is the term for a miscarriage that has not yet been recognized or treated?

A

Missed (delayed) miscarriage

In this type of miscarriage, the embryo or fetus has died but the body has not expelled the pregnancy tissue.

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3
Q

What is the term for a miscarriage that is inevitable due to cervical dilation and contractions?

A

Inevitable miscarriage

This type of miscarriage usually involves significant bleeding and cramping, indicating that the pregnancy cannot continue.

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4
Q

A 25-year-old woman at 25 weeks gestation presents with constant lower abdominal pain and a small amount of vaginal bleeding. What is the most likely diagnosis?

A

Placental abruption

Placental abruption occurs when the placenta detaches from the uterus, which can lead to bleeding and potential complications for both mother and baby.

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5
Q

A 31-year-old woman presents with painless vaginal bleeding at 15 weeks gestation. She has not yet had any antenatal care despite suffering from severe vomiting. What is the most likely diagnosis?

A

Hydatidiform mole

A hydatidiform mole is a type of gestational trophoblastic disease that can cause abnormal growth of placental tissue.

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6
Q

A 19-year-old woman presents with a two-day history of central lower abdominal pain and one-day history of vaginal bleeding. Her cervix is tender to touch. What is the most likely diagnosis?

A

Ectopic pregnancy

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often leading to pain and bleeding.

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7
Q
A
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8
Q

What is a threatened miscarriage?

A

Painless vaginal bleeding typically around 6-9 weeks

A threatened miscarriage indicates that a pregnancy may be at risk but has not yet ended.

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9
Q

What characterizes a missed (delayed) miscarriage?

A

Light vaginal bleeding and symptoms of pregnancy disappear

This type of miscarriage occurs when the fetus has died but is not expelled from the uterus.

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10
Q

Define inevitable miscarriage.

A

Complete or incomplete depending on whether all fetal and placental tissue has been expelled

An inevitable miscarriage indicates that the pregnancy will end, with varying degrees of tissue expulsion.

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11
Q

What are the symptoms of an incomplete miscarriage?

A

Heavy bleeding and crampy, lower abdominal pain

Incomplete miscarriage means some but not all fetal tissue has been expelled.

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12
Q

What distinguishes a complete miscarriage from an incomplete miscarriage?

A

Complete miscarriage has little bleeding

In a complete miscarriage, all fetal and placental tissue has been expelled, leading to minimal bleeding.

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13
Q

What is a common symptom of ectopic pregnancy?

A

Typically history of 6-8 weeks amenorrhoea with lower abdominal pain (usually unilateral) initially and vaginal bleeding later

Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often causing severe pain.

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14
Q

Describe the presentation of a hydatidiform mole.

A

Bleeding in first or early second trimester associated with exaggerated symptoms of pregnancy e.g. hyperemesis

A hydatidiform mole is an abnormal pregnancy where tissue that normally becomes the placenta develops into a mass.

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15
Q

What are the symptoms of placental abruption?

A

Constant lower abdominal pain, tender, tense uterus, fetal heart may be distressed

Placental abruption is a serious condition where the placenta separates from the uterus before delivery.

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16
Q

What is placental praevia?

A

Vaginal bleeding, no pain; non-tender uterus but lie and presentation may be abnormal

Placental praevia occurs when the placenta covers the cervix, leading to bleeding in late pregnancy.

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17
Q

What is a characteristic sign of vasa praevia?

A

Rupture of membranes followed immediately by vaginal bleeding; fetal bradycardia is classically seen

Vasa praevia is a condition where fetal blood vessels cross or run near the internal cervical os.

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18
Q

True or False: Vaginal examination should be performed in primary care for suspected antepartum haemorrhage.

A

False

Vaginal examination is contraindicated as it may exacerbate bleeding in conditions like placenta praevia.

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19
Q

Infertility in PCOS First line

A

Clomiphene

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20
Q

Infertility in PCOS First line

A

Clomiphene

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21
Q

PCOS- acne and hirsuitism

A

COCP

2nd- eflornithine
Spiro, flutamide, finasteride

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22
Q

Pregnant women not immune to rubella

A

MMR post natally

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23
Q

What is the time until effective for an IUD?

A

Instant

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24
Q

What is the time until effective for a progestogen-only pill (POP)?

A

2 days

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25
Q

What is the time until effective for combined oral contraceptives (COC), injection, implant, and IUS?

A

7 days

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26
Q

If a combined oral contraceptive pill (COCP) is started after the fifth day of the menstrual cycle, how long until it provides reliable contraception?

A

7 days

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27
Q

True or False: The COCP provides immediate contraceptive protection if started after day 5 of the menstrual cycle.

A

False

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28
Q

What additional contraceptive measures should be used if the COCP is started after the fifth day of the menstrual cycle?

A

Additional contraceptive measures should be used for the first seven days.

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29
Q

What does the COCP need time to do before providing effective contraception?

A

Suppress ovulation and thicken cervical mucus

30
Q

What is the recommended time to start contraception after giving birth?

A

After day 21 postpartum

Women require contraception after giving birth to prevent unintended pregnancies.

31
Q

When can postpartum women start the Progestogen-only pill (POP)?

A

At any time postpartum

Both breastfeeding and non-breastfeeding women can start the POP at any time.

32
Q

What additional contraception should be used after starting the POP?

A

For the first 2 days after starting POP

This is necessary to ensure effectiveness.

33
Q

What risk is associated with using COCP within the first 21 days postpartum?

A

Increased venous thromboembolism risk

This is due to the postpartum physiological changes in the body.

34
Q

How long after childbirth can an intrauterine device (IUD) be inserted?

A

Within 48 hours or after 4 weeks

This provides flexibility for postpartum contraception.

35
Q

What is the effectiveness of the Lactational Amenorrhea Method (LAM) under specific conditions?

A

98% effective

Conditions include full breastfeeding, amenorrhea, and being less than 6 months postpartum.

36
Q

Eclampsia mx

A

MgSO4

37
Q

What is the diagnosis for a 28-year-old woman who has not had a period for 9 months and has fluid leaking from her nipples?

A

Prolactinoma

Prolactinoma is a type of tumor that produces prolactin, leading to symptoms like amenorrhea and galactorrhea.

38
Q

What is the diagnosis for a 26-year-old woman who has not had a period since giving birth and experienced a large postpartum hemorrhage?

A

Sheehan’s syndrome

Sheehan’s syndrome describes hypopituitarism caused by ischemic necrosis due to blood loss and hypovolaemic shock.

39
Q

What are some features of Sheehan’s syndrome?

A
  • agalactorrhoea
  • amenorrhoea
  • symptoms of hypothyroidism
  • symptoms of hypoadrenalism

These symptoms arise due to the failure of the pituitary gland to produce hormones following severe blood loss.

40
Q

What diagnosis is indicated for a 25-year-old woman who has not had a period 5 months after dilation and curettage for a miscarriage?

A

Asherman’s syndrome

Asherman’s syndrome refers to intrauterine adhesions that can prevent the endometrium from responding to estrogen.

41
Q

What causes Asherman’s syndrome?

A

Dilation and curettage (D&C) procedures

Intrauterine adhesions often occur after surgical procedures like D&C, which can lead to complications in menstruation.

42
Q

What is a risk associated with breastfeeding mothers?

A

The risk of HIV transmission

HIV can be transmitted through breast milk, posing a risk to the infant.

43
Q

Which antibiotics are safe for breastfeeding mothers?

A
  • penicillins
  • cephalosporins
  • trimethoprim

These antibiotics are generally considered safe for breastfeeding.

44
Q

What endocrine drug should be given cautiously to breastfeeding mothers?

A

Glucocorticoids (avoid high doses)

High doses of glucocorticoids may pose risks to the infant.

45
Q

List two epilepsy medications that can be given to breastfeeding mothers.

A
  • sodium valproate
  • carbamazepine

These medications are considered safe to use while breastfeeding.

46
Q

Which asthma medications are safe for breastfeeding mothers?

A
  • salbutamol
  • theophyllines

These asthma treatments are safe for breastfeeding.

47
Q

What types of psychiatric drugs are safe for breastfeeding mothers?

A
  • tricyclic antidepressants
  • antipsychotics

These psychiatric medications can be prescribed to breastfeeding mothers.

48
Q

Name two antihypertensive medications safe for breastfeeding.

A
  • beta-blockers
  • hydralazine

These medications are safe for breastfeeding mothers with hypertension.

49
Q

Which anticoagulants are safe for breastfeeding mothers?

A
  • warfarin
  • heparin

These anticoagulants can be used during breastfeeding.

50
Q

What is a safe cardiac medication for breastfeeding mothers?

A

Digoxin

Digoxin is considered safe for breastfeeding.

51
Q

Which antibiotics should be avoided by breastfeeding mothers?

A
  • ciprofloxacin
  • tetracycline
  • chloramphenicol
  • sulphonamides

These antibiotics can pose risks to breastfeeding infants.

52
Q

Name two psychiatric drugs that should be avoided by breastfeeding mothers.

A
  • lithium
  • benzodiazepines

These psychiatric medications can adversely affect breastfeeding infants.

53
Q

Which common medication should be avoided during breastfeeding?

A

Aspirin

Aspirin is not recommended for breastfeeding mothers.

54
Q

What is a medication that should be avoided in breastfeeding related to thyroid treatment?

A

Carbimazole

Carbimazole can have adverse effects on breastfeeding infants.

55
Q

Which medication used for cancer treatment should be avoided in breastfeeding mothers?

A

Methotrexate

Methotrexate is contraindicated due to its effects on the infant.

56
Q

Name a class of medications that should be avoided by breastfeeding mothers due to their potential toxicity.

A

Cytotoxic drugs

Cytotoxic drugs can be harmful to breastfeeding infants.

57
Q

Which drug used for heart rhythm issues should be avoided in breastfeeding mothers?

A

Amiodarone

Amiodarone can be harmful to breastfeeding infants.

58
Q

True or False: Clozapine should be avoided in breastfeeding mothers.

A

True

Clozapine poses significant risks to breastfeeding infants.

59
Q

Allergic to latex- male contraception

A

Polyurethane condom

60
Q

What are common features that may be detected during cervical cancer screening?

A

Abnormal vaginal bleeding, vaginal discharge

Abnormal vaginal bleeding includes postcoital, intermenstrual, or postmenopausal bleeding.

61
Q

Which human papillomavirus (HPV) serotypes are most important in the development of cervical cancer?

A

HPV serotypes 16, 18, and 33

These serotypes are particularly associated with cervical cancer risk.

62
Q

List some risk factors for cervical cancer aside from HPV.

A
  • Smoking
  • Human immunodeficiency virus
  • Early first intercourse
  • Many sexual partners
  • High parity
  • Lower socioeconomic status
  • Combined oral contraceptive pill

The association between combined oral contraceptive use and cervical cancer risk is sometimes debated.

63
Q

True or False: HPV is the only factor contributing to cervical cancer development.

A

False

While HPV is the most significant factor, other risk factors also contribute to cervical cancer.

64
Q

What is a key feature of Candida infection?

A

‘Cottage cheese’ discharge

Candida infections often present with a thick, white discharge resembling cottage cheese.

65
Q

What symptom is associated with Trichomonas vaginalis?

A

Offensive, yellow/green, frothy discharge

This type of discharge is characteristic of Trichomonas vaginalis infections.

66
Q

What is a common symptom of Bacterial vaginosis?

A

Offensive, thin, white/grey, ‘fishy’ discharge

The fishy odor is often more pronounced after intercourse or during menstruation.

67
Q

What symptom is indicative of vulvitis?

A

Itch

Vulvitis can cause significant itching and irritation in the vulvar area.

68
Q

What is a characteristic sign of Trichomonas vaginalis infection?

A

Strawberry cervix

The term ‘strawberry cervix’ refers to the appearance of the cervix due to inflammation.

69
Q

What type of discharge is commonly associated with vulvovaginitis?

A

Offensive, yellow/green, frothy discharge

This discharge is typical in cases of vulvovaginitis, particularly from infections like Trichomonas.

70
Q

Fill in the blank: A common feature of Candida infection is _______.

A

‘Cottage cheese’ discharge

71
Q

True or False: Bacterial vaginosis is characterized by a ‘cottage cheese’ discharge.

A

False

Bacterial vaginosis is characterized by a ‘fishy’ discharge, not ‘cottage cheese’ discharge.

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