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Finals > Obg (Passmed) > Flashcards

Obg (Passmed) Flashcards

1
Q

Pregnant women: with a BP above 160/110 immediate next step? (query: Pre-eclampsia

A

Admit to hospital and observe
- arrange same day admission

  • after this: start patient of medication: Labetalol, if asthmatic= use Nifedipine
  • definitive step: delivery of baby
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2
Q

Most common site of ectopic pregnancy?

A

Ampulla of the fallopian tubes
- However: most dangerous if in isthmus area

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3
Q

Vitamin B12 deficiency most specific test to get diagnosis?

A

Intrinsic Factor Antibodies
NB: also predisposes you to Gastric cancer

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4
Q

1st step in management for Post-partum Haemorrhage (PPH)?

A

After ABC approach, palpate uterus (uterine massage)
- assess what could be the potential cause first? uterine atony: risk factors= Induction of labour, multiple pregnancy (twins for example)

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5
Q

Ectopic Pregnancy management:

A

Need surgery: - Salpingectomy(removal of one or both fallopian tubes) IF mass is more than 35mm, and a visible heart beat is present on Transvaginal Ultrasound.
- only go for Salpingotomoy surgery if fallopian tubes need to be saved for eg. infertility issues.

  • Investigation of choice and to confirm diagnosis: Transvaginal Ultrasound
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6
Q

Gestational Diabetes: Blood glucose targets and management=

A
  • Fasting: 5.3 mmol/L: anything above= start insulin
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7
Q

Endometriosis: (gold-standard diagnostic test)?

A
  • Laparoscopy (is diagnostic) however 1st line is often: Transvaginal Ultrasound
    NB Presents with:
  • Dysmenorrhoea a few days before period, deep dyspareunia, subfertility

Mx: 1st line) NSAIDS/paracetamol for symptomatic relief
2nd line) COCP/progestogen

Secondary treatments:
- GnRH analogues: induces a pseudomenopause due to low oestrogen levels.

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8
Q

Medical termination of pregnancy: (Abortion) medical mx-

A
  • Oral Mifepristone and vaginal Misoprostol
  • first take MiFepristone and then take Prostaglandins eg. Misoprostol.
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9
Q

Management for: Pregnant woman with previous VTE history?

A

Start Low molecular weight heparin (eg. Dalteparin): throughout pregnancy and until 6 weeks postnatal.
NB: DOACs and Warfarin should be AVOIDED in pregnancy.

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10
Q

Atrophic Vaginitis: Mx+Adjunct treatment

A
  • 1st line) Oestrogen Cream
  • Lubricants and Moisturisers=useful as adjuncts
  • Condition causes vaginal dryness, dyspareunia and occasional spotting
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11
Q

In case of unknown pregnancy location: bHCG levels more than 1500 indicates?

A

Ectopic Pregnancy
- examination findings: Abdominal tenderness, cervical excitation, adnexal mass

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12
Q

Characteristic features of Endometriosis?

A

Deep pelvic pain, dysmenorrhoea, dyspareunia and sub-fertility, could also present with a fixed, retroverted uterus + young age around 30yrs old

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13
Q

Fibroid presentation:

A
  • Common pelvic tumour in women
  • Px: abnormal uterine bleeding, pelvic pressure and pain+reproductive dysfunction
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14
Q

Cancers associated with: Tamoxifen (given for oestrogen positive breast cancer)

A

Endometrial Cancer:
- Classical symptom= Postmenopausal bleeding
- Be suspicious in all women over 55 years
Inv:
- 1st line investigation: Trans-Vaginal Ultrasound
- Hysteroscopy with endometrial biopsy
Mx: main treatment= of Endometrial cancer= surgery

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15
Q

Diagnosing criteria for Gestational Diabetes?

A
  • Fasting Glucose: more than 5.6 mmol/L, if more than 7= immediately start insulin
  • 2 hour Glucose: more than 7.8 mmol/L
    NB: remember by (5678 mnemonic)
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16
Q

Umbilical cord Prolapse mx:

A

1st Step: Correct position= ask mother to go on all 4’s (on knees and elbows)
2nd) Prepare for immediate c-section
- Tocolytics could be used to reduce uterine contractions
- Is a Obstetric emergency

17
Q

Stress Incontinence Mx:

A
  • Pelvic Floor Exercises
  • Duloxetine

NB: for Urge Incontinence
- Bladder retraining exercises
- Oxybutynin

18
Q

STI: Trichomonas Vaginalis

A
  • Presents with a strawberry/erythematous cervix, offensive/green frothy vaginal discharge

Mx: With Metronidazole (BV=Bacterial Vaginosis is also treated by this)

19
Q

Ovarian Cancer Risks:

A
  • Early Menarche as ovarian cancer is hormonal in nature
  • Family History
  • Late menopause
  • Nulliparity

Diagnosis: Laparotomy (surgical incision into abdominal cavity)

20
Q

Pregnant patients with T1 diabetes: how often monitor glucose levels?

A
  • DAILY: fasting, pre-meal, 1 hour post-meal and bedtime (need regular monitoring)
  • Diabetes medication: STOP Gliclazide
21
Q

PPH management: in order

A

1st: ABCDE approach
2nd: compress uterus and catheterise patient
3rd: then give IV oxytocin
Other meds to give=
- Ergometrine: unless history of hypertension
-Carboprost: unless history of asthma
1st line surgical option: Intrauterine Balloon Tamponade

22
Q

Medical Mx. for ectopic pregnancy?

A

Methotrexate

23
Q

Management for pregnant women with BP more than 160/110?

A

Admit into hospital and observe
- Labetalol/ if asthmatic: Nifedipine

24
Q

Management for woman at moderate/high risk of pre-eclampsia?

A

Start Aspirin 75-150mg daily from 12wks until birth

25
Q

Mx of chickenpox in preg?

A
  • if less than 20wks gestation= varicella zoster immunoglobulin
  • If more than 20 weeks gestation= Oral Aciclovir
26
Q

PPH definition: (Including blood volume)-

A
  • Blood loss of more than 500mL after delivery
27
Q

Pelvic inflammatory disease+RUQ pain diagnosis?

A

Perihepatitis (Fitz-Hugh Curtis Syndrome

28
Q

Which anaemia is associated with having lemon tinge to skin?

A
  • Pernicious (vit b12) Anaemia
29
Q

Gestational Diabetes diagnosis levels:

A
  • Fasting Glucose: more than 5.6 mmol/L
    -2 hour Glucose: more than 7.8 mmol/L

If fasting levels is more than 7: give Insulin

complications: Macrosomia

30
Q

Trichomonas Vaginalis (STI) Mx?

A
  • Oral Metronidazole
  • Presents with strawberry cervix, discharge: Green-yellow colour frothy
31
Q

what does PID(Pelvic Inflammatory Disease) increase the risk of?

A
  • Ectopic Pregnancy
32
Q

Pelvic Inflammatory disease presentation?

A
  • Dyspareunia
  • Bleeding in between periods
  • Lower abdominal tenderness
    -Vaginal discharge
33
Q

Mx. of ectopic: in presence of foetal heartbeat?

A

Need to do: Surgical Management!
- Salpingectomy

34
Q

Iron deficiency anaemia blood profile?

A

1) Transferrin: Low
2) Ferritin: Low
3) TIBC (total iron binding capacity): High

35
Q

If prescribing a SSRI+NSAID, then what else needs to be added?

A
  • PPI: Omeprazole
36
Q
A

Finals (38 decks)

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