obs and Gyn Summary Q's Flashcards by Jonny Taylor

what MUST be offered if appropriate following any antepartum haemorhage?

Anti D (unless mother is known rhesus positive)

How well did you know this?

Not at all

Perfectly

cervical CA key facts

HPV (16/18) is main cause
examine with colposcope and acetic acid + biopsies if malig seen

If CIN –> LLETZ
If CA –> chemoradiation

How well did you know this?

Not at all

Perfectly

endometrial CA key facts

any post menopausal bleeding is suspicious

must sample ALL of uterine cavity when investigating

How well did you know this?

Not at all

Perfectly

ovarian Ca key facts

5 RF’s - nulliparity, early menarche, never used OCP, HRT, fam hx, infertility

3 CFs - abdo dist, weight loss, pain, bladder symp

T - surg and chemo

How well did you know this?

Not at all

Perfectly

GYn CA markers

Ca125 AFP BHcG

How well did you know this?

Not at all

Perfectly

a newly pregnant woman comes into clinic, what 3 things must you do during this, her first visit.

Educate - smoking and alcohol stop, control any chronic dis
Investigate - rhesus, rubella
Treat - give folate and stop any teratogens

How well did you know this?

Not at all

Perfectly

what is used to monitor progress of labour?

partogram

How well did you know this?

Not at all

Perfectly

what effects does oxytocin have?

decrease time of 3rd stage, decrease risk PPH // can increase risk MI

How well did you know this?

Not at all

Perfectly

contra-indications for giving oxytocin

pre eclampsia, hypertension, renal or liver impairment

How well did you know this?

Not at all

Perfectly

methods of induction

membrane sweep, vaginal PGE2, amniotomy and oxytocin

How well did you know this?

Not at all

Perfectly

pain relief options in labour?

entonox (NO2 and O2) 
opiates (diamorphine - not if delivery imminenet)
combined spinal nerve block
local (episiotomy)
GA (severe complications)

How well did you know this?

Not at all

Perfectly

when is anti D given during preg and to who?

28/34 weeks, 500Units given to rh -ve mothers and to babies of unknown status

How well did you know this?

Not at all

Perfectly

ECV key facts

must be >37 weeks
50% success
can revert
ci = PP, oligohyd, pre-eclampsia

How well did you know this?

Not at all

Perfectly

what can meconium stained liquor indicate, and what is management?

fetal distress

attach CTG, move to consultant ward
aspirate oropharynx, nasopharynx when delivered
risk of pneumonitis

How well did you know this?

Not at all

Perfectly

fetal distress - what does it indicate, Clinical signs and diag test/outcome

hypoxia leading to acidosis
HR goes up >160 / meconium liquor / reduced CTG variability

take blood sample and if pH low then acidotic = emerg section

How well did you know this?

Not at all

Perfectly

when would you perform an emergency c section

poor progress in labour, breech, abruption, prolapse, severe pre-eclampsia

How well did you know this?

Not at all

Perfectly

what is the danger of pre-term rupture of membranes?

premature labour, infection (chorioamniotis), fetal mortality

How well did you know this?

Not at all

Perfectly

APH defintion, causes and management

blood loss after 24 weeks
PP, Abruption, Vasa praevia
dont vag exam / ABCDE /

How well did you know this?

Not at all

Perfectly

PPH causes / management template

4 T’s // resus, investigate, control bleed, replace defecit

How well did you know this?

Not at all

Perfectly

main causes of maternal shock

concealed bleed abruption // sepsis / PE

How well did you know this?

Not at all

Perfectly

define pre-eclampsia

elevated BP, proteinuria and oedema in pregnancy

How well did you know this?

Not at all

Perfectly

major bleed at 20 weeks is known as…?

miscarriage

How well did you know this?

Not at all

Perfectly

3 tests for downs

nuchal translucency and free b hcg

CVS/ amnio , bloods???

How well did you know this?

Not at all

Perfectly

what is 4 ways of managing labour

monitoring baby every 2-4 hours - partogram
maternal monitoring (BP, HR, contractions)
give oxytocin
examine VG and Abdo

any mention of severe pre-eclampsia with deranged blood results is known as...

HELLP syndrome haemolysis elevated liver enzymes low platelets

managment of fibroids, both medical and surgical

GnRH analogue or surgical removal (hysterectomy)

3 major CF of menopause and treatment for each

autonomic - flushing etc -- clonidene oestrogen def - atrophic nipples etc -- oest irreg menstral cycles -- depends on heavy/light

lady walks in, vag symptoms, what do you do in clinic??

speculum and bimanual + high swab/endocervical swab if approp

DDx of dyspareunia

endometr/PID/STI/cerv ca, scarring

dysmenorrhea causes

endomet/ ?? / ??

PCOS triad + T

cyst on ovaries, menstral irreg, hyperandrogenic | lifstyle is most important, maybe metformin +/- OCP?? clomifene

PID triad , ivestigation and treatment

Pain, Infectious signs, Discharge // vaginal culture // treat with ABx's

diff swabs for diff diseases?

High vag - TV / Bact vag / candida endocerv - gon endocerv scrub - chlamydia

what must be screened for before starting ivf?

HIV, Hep B and C

what is common DDX for endometriosis?

IBS

common CF of endometriosis / I / T

pain (sex, periods, pooing) subfertility TV-US or gold standard is laparosopy T/ depends on trying to conceive or not YES = surg excision / ablation NO = stop cycles by OCP/IUD

what is endometriosis?

chronic oestrogen dependant condition which results in growth of endometrial tissue, outside of the endometrium. common sites: ovaries,bladder, rectum

first line treatment for Urge and Stress incontinence?

URGE - bladder retraining# | STRESS - pelvic floor muscle physio

what complication of gonorrhea are possible?

transfer to neonate eye infection throat infection

how to treat bact Vag, candida, gonorrhea, chlamydia

BV - metro candida - clotrimazole gonor - cefixime chlamydia - doxy

broad subfertility causes (5)

``` Male problem - low sperm, erectile dysfunction, motility idiopathic endometriosis tubal blockage no egg - pcos ```

big super painful lump on vulva

bartholin cyst, woman cant sit down, surgical drainage

diagnostic ovarian CA (4)

Ca125 up, histology, CT/US, ascites

OCP interactions: side effects of the pill

Int - anticonvulsnats, | SE: VTE risk, MI, Breast CA risk

when ??pre-eclampsia what investigations show mothers wellbeing?

HELLP tests! LFT's (enzymes) U+E's FBC (platelets)

assessing fetus wellbeing on US, what can be assessed (think acronym)

GLAD growth liquor activity doppler

DDx for girl with abdo pain, blood PV and no periods? | Treatment for each (3)

PID, ectopic, incomplete miscarriage | abx's, methotrexate, prostaglandins

incomplete miscarriage / ectopic

misoprostol or vaccum expulsion / methotrexate or surg (laparoscopy/salpingoscopy)

IUGR effects, both peri-natal and in adulthood (3)

Peri - N = hypoglyc / infection / jaundice / hypoxia | Adult = DM2, hypertension, thyroid, corornary artery dis

RF for PPH

PP, multi birth, pre eclamp, prev PPH, energ c sect

woman at 29 weeks with small painless vag bleed =

woman with very low BP at 34 weeks but no bleeding seen in extreme pain =

Abruption

risk factor for premature labour?

smoking, DM, multibirth, aph, polyhydramnios

what is normal fetal head presentation?

What year was term of preg act introduced and what were 4 guidelines?

1967 ok if;

methods of termination?

misoprostol + mifepristone - 15 weeks

increase risk of ectopic?

structural, prev ectopic, endometriosis, AntiPhos syn?, old IUD

Pro's and Cons of HRT (4 each)

``` Pro - decrease flushing decrease vag dryness etc decrease osteoporosis improve gen quality of life (sleep etc) ``` ``` Cons - increase risk endomet CA increase risk breast CA increase risk ovary CA increase risk VTE weight gain ```