Obs and gynae Flashcards
Which vaccines are offered to all pregnant women?
Influenza and pertussis
What investigation is required after a medically managed miscarriage?
pregnancy test after 3 weeks
What’s the management of hyperemesis gravidarum?
fluid resuscitation with 0.9% saline +/- IV pabrinex to avoid Wernicke’s encephalopathy
Side effect of anostrozole (Aromatase inhibitors)
Osteoporosis
If low-lying placenta is found at the 20-week scan, when do we re-scan?
At 32 weeks to assess
Symptom triad of vasa praevia
Rupture of membranes followed by painless vaginal bleeding and fetal bradycardia
Risk factor for surfactant deficient lung disease in the newborn?
Maternal diabetes mellitus
Which medication is used to manage gestational hypertension in asthmatics?
Nifedipine
What is seen on bloods in premature ovarian failure?
High FSH, High LH, low oestrodiol
How long should women take HRT for in premature ovarian failure?
Until, at least, the age of 50
Which medication is used in PCOS to treat infertility?
Clomifene
What is seen on USS in ovarian torsion?
Whirlpool sign
What is seen on USS in fibroids?
Hypoechoic masses
When should external cephalic version offered in breech lie?
36 weeks
Female modifiable risk factors for infertility
- Previous or current STI
- Obesity
- Low body weight
- Smoking
- Stress
- Exposure to occupational or environmental hazards
- NSAID use
- Chemotherapy
- Antidepressants
- Antipsychotics
- Marijuana or cocaine use
Why does ovarian hyperstimulation syndrome lead to SOB?
1) Hyperstimulated ovaries release vasoactive mediators
2) Increased capillary permeability causes fluid shift from intravascular compartment to third space compartments
3) SOB due to pleural effusion
Which SSRIs can be used in breastfeeding women
Sertraline or paroxetine ONLY
Thrush treatment (vaginal candiadasis) in non-pregnant women
One dose of oral fluconazole
Thrush treatment (vaginal candiadasis) in pregnant women
clotrimazole 500 mg intravaginal pessary as a single dose
Where does ovarian cancer typically metastasise to?
Para-aortic lymph nodes
Pre-eclampsia symptoms
Headache, blurred vision, N+V, brisk reflexes, oedema, epigastric pain
Pre-eclampsia risk factors
Increased maternal age, nulliparity
Urine dipstick result in pre-eclampsia
Proteinuria
Which patient group is labetolol contraindicated in for pre-eclampsia?
Asthmatics
Complication of pre-eclampsia / eclampsia
HELLP syndrome (haemolysis, Elevated liver enzymes, Low platelets)
Copper coil side effects
(Short term) spotting or cramping after insertion / heavier periods / more painful periods / infection / it can fall out
Investigation of choice in post-menopausal bleeding (2 stages)
TVUS (if endometrial thickening) => pipelle biopsy
Treatment of stage 1 endometrial cancer
Total abdominal hysterectomy with bilateral salpingo-oophorectomy
Protective factors for endometrial cancer
COCP / Mirena / Increased pregnancy / Cigarette smoking
Risk factors this woman has for endometrial cancer
Increased age / early menarche / late menopause / nulliparity / T2DM
What is the aim of the cervical cancer screening programme?
Screen for HPV
Screen for abnormal cells indicative of pre-invasive (dyskaryosis) disease ‘cervical intraepithelial neoplasia’
How regularly are routine smears conducted?
Every 3 years in 25-49 year olds
Every 5 years in 50-64 year olds
Aside from HPV, list risk factors for the development of cervical cancer
- Multiple sexual partners
- Younger age at first intercourse
- Non-attendance at smears
- Immunosuppression
- Oral contraceptives
- Higher parity
- Tobacco use
- Deprivation
Aspects of the APGAR score
Appearance / body colour
Pulse rate
Grimace / reflex irritability Activity / muscle tone Respiratory effort
Urgent management in placental abruption (A-E)
- Get senior help / 2222 / emergency bleep obstetrics
- A:Protect airway
- B: 15L of 100% oxygen through a non-rebreather mask
- C:
- Insert two large bore (14G) cannulas
- Take bloods: group + save, FBC, clotting screen, U&E, LFT
- Activate major haemorrhage protocol
- Give warmed fluids
- Consider TXA
- D: Monitor patient’s GCS
Complications of gestational diabetes
- Macrosomia / Shoulder dystocia / Obstructed/delayed labour
- Organomegaly (particularly cardiomegaly)
- Polycythaemia
- Polyhydramnios
- Preterm delivery
- Neonatal hypoglycaemia
- Transient tachypnoea of the newborn
Criteria used in the diagnosis of PCOS
Rotterdam