Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FINALS > OBGYN > Flashcards

OBGYN Flashcards

1
Q

Which pregnant woman should be treated for group B Strep

A

Offer Intrapartum antibiotic prophylaxis if:
- previous baby with GBS infection
- Carrier of GBS in a previous pregnancy & positive test result on swab for GBS
- Prelabour rupture of membranes & preterm baby / positive GBS carrier
- Preterm labour
- GBS positive term labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Management of primary dysmenorrhoea

A

1st: NSAIDs e.g. mefanamic acid
2nd: COCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of secondary dysmenorrhoea

A

Endometriosis
Adenomyoisis
PID
IUD (Copper)
Fibroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is tranexamic acid used for?

A

Heavy menstrual bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is mefenamic acid used for

A

Dysmenorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What contraceptive is proven to cause weight gain

A

Depo-provera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Correct position for woman with cord prolapse to be in while being prepared for surgery

A

On all fours, on knees and elbows
While someone pushes the presenting part of the foetus up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Criteria to diagnose a miscarriage

A

A confirmed miscarriage can be diagnosed on ultrasound if there is no cardiac activity and:
- The crown-rump length is greater than 7mm
OR
- The gestational sack is greater than 25mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Conditions that raise CA125

A

Ovarian cancer
But also:
- endometriosis
- Adenomyosis
- Pelvic infection
- Liver disease
- Pregnancy
- menstruation
- benign ovarian cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Risk and protective factors for endometrial cancer

A

RF: XS oestrogen
* Nulliparity
* Early menarche
* Late menopause
* Unopposed oestrogen (e.g. tamoxifen/oestrogen)

RF: Metabolic syndrome
* Obesity
* Diabetes
* PCOS

Protective = multiparity, COCP, smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk and protective factors for ovarian cancer

A

RF: Increased no. of ovulations
* Early menarche
* Late menopause
* Nuliparity

Genetic:
* FHx BRCA 1/2
* FHx HNPCC (Lynch)

Protective: anything that decreases number of ovulations
* COCP
* Lactation
* Pregancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pathology of endomedial cancer cells

A

90% = adenocarinoma (columnar endometrial glands)
- oestrogen dependent (oestrogen stimulates growth of endometrial cancer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is endometrial hyperplasia? What are the 2 different types?

A

Precancerous condition involving thickening of the endometrium
* Hyperplasia without atypia
* Atypical hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx of endometrial hyperplasia

A

IUS (mirena)
Continuous oral progestogens (e.g. levonorgestrel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Primary source of oestrogen in a postmenopausal woman

A

Adipose tissue
- Contains aromatase which is an enzyme that converts androgens to oestrogen
- Extra oestrogen is unopposed in women that are not ovulating (e.g. PCOS or post menopause) because there is no corpus luteum to produce progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Oestrogenic effects of tamoxifen

A

Anti-oestrogen on breat tissue
Oestrogenic effect on endometrium –> increasing risk of endometrial cancer

17
Q

Key symptoms of endometrial cancer

A

Post menopausal bleeding
/ discharge
- Post coital bleeding
- IMB
- Unsually heaving menstrual bleeding
- Anaemia

18
Q

Investigations for endometrial cancer

A
  1. TV USS - for endometrial thickness Normal = <4mm post-menopause
  2. endometrial biopsy - pipelle biopsy or hysteroscopic biposy
  3. hysterscopic biopsy - staging
  4. MRI/CXR = to assess spread
19
Q

Staging for endometrial cancer

A

International Federation of Gynaecology and Obstetrics (FIGO) staging system
Stage 1: Confined to the uterus
Stage 2: Invades the cervix
Stage 3: Invades the ovaries, fallopian tubes, vagina or lymph nodes
Stage 4: Invades bladder, rectum or beyond the pelvis

20
Q

Management of stage 1/2 endometrial cancer

A

total abdominal hysterectomy with bilateral salpingo-oophorectomy
+/- post-op radiotherapy

21
Q

Key symptoms of ovarian cancer

A

Suspect ovarian cancer in anyone >50 with IBS Sx
- New symptoms of IBS / change in bowel habit
- Abdominal bloating
- Early satiety
- Pelvic pain
- Urinary frequency or urgency
- Weight loss

22
Q

Risk of malignancy index for ovarian cancer

A

RMI estimates the risk of an ovarian mass being malignant, taking account of three things:

Menopausal status
Ultrasound findings
CA125 level

23
Q

Investigations for ovarian cancer

A
  1. CA 125 levels (>35 is significant)
  2. USS abdo/pelvis
  3. CT abdo pelvis
  4. Histology - CT guided biopsy or laparscopy
  5. Paracentesis (ascitic tap) can be used to test the ascitic fluid for cancer cells
24
Q

Tumour markers to test in a pt <40 with suspected ovarian cancer

A

Alpha fetoprotein
HCG

(Possibly a germ cell tumour)

25
Q

Timing of cervical cancer screening

A

hrHPV -ve tests:
* Every 3 years from 25-49 years
* Every 5 years from age 50-64 years

hrHPV +ve test:
- repeat in 12 months

26
Q

What is done next if hrHPV +ve

A
  1. Samples examined cytologically
  2. If cytology is abnormal –> colposcopy
  3. If cytology normal –> repeat test in 12 months
27
Q

Management of CIN II/III

A

Large loop excision of transformation zone (LLETZ)

28
Q

Treatment of Gonorrhoea

A

IM ceftriaxone 1g
then oral ciprofloxacin 500mg

29
Q

PALM COEIN

Causes of HMB

A

Polyps
Adenomyosis
Leiomyoema (fibroid)
Malignancy / hyperplasia
Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic -
Not yet classified

30
Q

Rotterdam criteria for PCOS

A
  1. Oligo-/An-ovulation
  2. Hyperandrogenism (hirsutism/acne)
  3. Polycycstic ovaries
31
Q

Common hormone abnormalities present in PCOS

A

XS leutenising hormone (LH) - produced by anterior pituitary gland in response to an increased GnRH pulse frequency –> ovarian production of androgens.

Insulin resistance - suppresses hepatic production of sex hormone binding globulin (SHBG), resulting in higher levels of free circulating androgens.

Increased testosterone
Decreased SHBG
FSH normal - disruption in FSH:LH ratio can disrupt ovulation
Low Progesterone

32
Q

Diagnostic criteria for “Polycycstic ovaries”

Not syndrome

A

> = 12 small folliciles in an enlarged ovary

33
Q

Management of PCOS

A
  1. Oligo/amenorrhoea
    - Induce bleeds COCP, POP
  2. Obesity
    - Aim for BMI under 30
    - Diet, exercise, lifestyle
    - Orlistat (severe cases)
  3. Infertility
    - Clomifene +/- metformin
  4. Hirsutism
    - Anti-androgen medications
    - Topical eflornithine
    - Cyproterone
    - Spironolactone
    - Finasteride
34
Q

Ix for amenorrhoea

A
  • Pregancy test
  • FSH/LH
  • TSH
  • Prolactin
  • Pelvic USS
35
Q

Tx of hyperemesis Gravidarum

A

Antiemetics - cyclizine or promethazine
Rehydrate - not with glucose as precipitates wernickes
Treat Complications

36
Q

Medications to induce ovulation

A

Letrozole (aromatase inhibitor)
Clomiphene citrate (SERM)

37
Q

How to test ovulation is occuring

A

Day 21 serum progestogen (peaks day 7 after ovulation has occured and luteal phase is constant)

38
Q

When is fetal cardiac activity observed on transvaginal USS

A

around 5.5 to 6 weeks gestation

FINALS (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions