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OBS and gynae > obs and gynae > Flashcards

obs and gynae Flashcards

1
Q

first line management for urge incontinence

A

oxybutynin, anti-muscarinic agent on smooth muscle

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2
Q

management for urge in continence if first line is contraindcated

A

mirabegron- is a potent and selective agonist of beta-3 adrenergic receptors

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3
Q

management for stress incontinence

A

duloxetine

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4
Q

pt with a previous history of caesarean and pelvic inflammatory disease presents with delayed third stage of labour what is the diagnosis

A

hysterectomy in situ

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5
Q

difference between cholestasis of pregnancy and acute fatty liver

A

acute fatty liver is generalised symptoms and jaundice while cholestasis during pregnancy presents with severe pruritis

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6
Q

difference between IUS and IUD

A

IUD makes periods heavier, IUS makes them lighter and you can use them in people with hypertension

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7
Q

what do you use for those in a low mood before menstruation but improves after menstruation

A

new COCP

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8
Q

first and second line for premenstrual syndrome

A

1) new COCP 2) SSRI

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9
Q

first line treatment for suspected VTE/DVT in pregnancy

A

LMWH

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10
Q

what should pregnant patients with suspected VTE/DVT be tested for when under 50kg or over 90kg

A

anti-xa activity and platelet count

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11
Q

What is the UKMEC 1 and 5

A

no restriction to use the COCP and unacceptable to use the COCP

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12
Q

protocol if you see female genital mutilation

A

call the police

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13
Q

When do you need to take aspirin during pregnancy

A

12 weeks till delivery if you have 2 moderate risk factros or 1 high risk of preeclampsia

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14
Q

what does smelly discharge indicate

A

STI

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15
Q

all patients with secondary dysmenorrhea should….

A

referred to gynaecology

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16
Q

does PPH look at birth of the baby or the placenta

A

baby

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17
Q

after how many weeks would you give an immediate ultrasound if there is no fetal heartbeat or reduced movements

A

28/30

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18
Q

In which two disorders would you find cervical excitation

A

PID and ectopic pregnancy

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19
Q

What is vaginal bleeding, a firm fixed uterus and maternal shock a sign of

A

placental abruption

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20
Q

Which of the following have to be stopped during pregnancy: metformin, glicazide

A

glicazide

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21
Q

Which cancers is COCP a risk factor for

A

breast and cervical

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22
Q

Which cancer is COCP protective against

A

endometrial and ovarian

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23
Q

what is the difference between primary and secondary dysmenorrhea

A

primary is with menustration and secondary is before

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24
Q

pain gets better after period

A

endometriosis

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25
Q

first line investigation for endometriosis

A

laproscopic

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26
Q

What are the risk factor for post partum haemorrhage

A

multiparous, parity over 4, placental abruption, placental pravia, ecclampsia, macrosomia

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27
Q

What is the most common cause of PPH and how is it seen

A

uterine atophy and high soft uterus

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28
Q

what is the mechanical management of PPH

A

rubbing the uterus and catheterisation

29
Q

What is the medical management of PPH

A

ergoteramine, oxytocin, crabtoperol and tranzexamic acid

30
Q

What is the surgical management for PPH

A

intrauterine balloon tamponade, hysterectomy and uterine artery ligation

31
Q

what is secondary post partum haemorrhage

A

500ml of blood loss from 24 hours - 12 weeks postpartum

32
Q

What are the two most common causes of secondary post partum haemorrhage

A

infection like endometriosis and retained tissue

33
Q

string of pearls on ultrasound

A

PCOS

34
Q

role of clomiphene

A

stimulant of FSH

35
Q

which contraception should you not use in high risk of breast cancer, uncontrolled hypertension and migrane without aura

A

COCP

36
Q

which contraception can we not use in people with PID or wilsons disease and only use after a screenign or chylamydia and gonorrhoea

A

mirena

37
Q

what does FSH over 10 suggest

A

reduced ovarian follicles

38
Q

what does FSH over 40 suggest

A

premature ovarian failure

39
Q

which contraceptive method acts immediately

A

IUD

40
Q

which contraception works after 2 days

A

progesterone only pill

41
Q

which contraception works after a week

A

injection, implant, combined oral contraceptive and IUS

42
Q

management in pregnany women with VTE prophylaxis

A

take LWMH until 6 weeks postnatally

43
Q

treatment for epileptics during pregnancy

A

lamotrigine

44
Q

treatment for nausea and vomiting during pregnancy

A

promethazine

45
Q

first line treatment for endometriosis

A

NSAID’s and if this doesnt work give COCP

46
Q

appendicits pain is unlikely to be of sudden onset

A
47
Q

bishops score

A

Cervical position Posterior Intermediate Anterior -
Cervical consistency Firm Intermediate Soft -
Cervical effacement 0-30% 40-50% 60-70% 80%
Cervical dilation <1 cm 1-2 cm 3-4 cm >5 cm
Fetal station -3 -2 -1, 0 +1,+2

Interpretation
a score of < 5 indicates that labour is unlikely to start without induction
a score of ≥ 8 indicates that the cervix is ripe, or ‘favourable’ - there is a high chance of spontaneous labour, or response to interventions made to induce labour

48
Q

first HPV test is high risk but negative and second test is negative

A

normal recall

49
Q

first HPV is high risk but negative and second test is that same

A

repeat smear in 12 months

50
Q

first HPV is high risk but negative and second test is that same

A

repeat smear in 12 months

51
Q

first line management for gestational diabetes

A

metformin

52
Q

fasting glucose is still more than 5.6mmol/L on metformin

A

start insulin

53
Q

which day on the cycle can an IUD be inserted

A

any day during the cycle

54
Q

what to do in a rhesus negative women who is pregnant

A

one dose anti D immunoglobulin followed by a Kleihauer test

55
Q

meig’s syndrome

A

benign ovarian syndrome, pleural effusion and ascietes

56
Q

why should metoclopromide not be used for more than 5 days

A

its can lead to increased upper muscle tone or extrapyramidal side effects

57
Q

medical management for ectopic pregnancy

A

oral methotrexate

58
Q

first line treatment for left over products of conception

A

vaginal misopristol and second line is surgical vaccum

59
Q

A cut-off of —g/Lshould be used in the postpartum period to determine if iron supplementation should be taken

A

100

60
Q

fetal head is not engaged and high

A

placental praevia

61
Q

maternal and fetal tachycardia and maternal pyrexia

A

chorioamnionitis

62
Q

what are the risk factors for endometrial and cervical cancer

A

endometrial: polycystic ovarian syndrome
cervical: parity

63
Q

how does placenta accreta

A

a woman who has had two previous caesarean sections develops massive bleeding shortly after giving birth
a 30-year-old woman develops a massive post-partum haemorrhage. An emergency hysterectomy is performed. Pathological examination demonstrates that the placenta is attached to the myometrium

64
Q

painless vaginal bleeding

A

placental praevia

65
Q

risk caused by tamoxifen

A

endometrial cancer

66
Q

ectopic pregnancy bhcg levels

A

more than 1500 is ectopic pregnancy

67
Q

fibroids less than 3cm, not distorting the cavity

A

less than 3cm medical management like COCP, IUS and mirena, and more than 3cm is a myomectomy

68
Q

characteristics cervical ectropion

A

endocervix(columnar part) is exposed outside, excess discharge that is not purulent, can result in post-coital bleeding, increased in those who use COCP and are pregnant,

OBS and gynae (17 decks)

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