Obs And Gynae🧚🏼♀️ Flashcards
Why are GnRH agonists used preoperatively for uterine fibroids?
Reduce the size and vascularity of the fibroids
What agonists are used preoperatively for symptomatic uterine fibroids?
GnRH agonists
Dose of folic acid for BMI > 30
5mg
How soon should BMI>30 women start folic acid before pregnancy?
1 month before conception
How to confirm absence of sperm after vasectomy?
Semen analysis
When can the copper IUD be used for emergency contraception?
5 days after unprotected sex
Within 5 days of earliest expected ovulation
When is levonorgestrel effective emergency contraceptive?
Within 72 hours
At what BP should antihypertensives be started in gestational hypertension?
140/90
What is target BP for gestational hypertension?
< 135/85
Important side effect of methyldopa if continued post partum
Increased risk of depression
First line management in gestational diabetes?
Metformin
Positive side effect of COCP?
Potential improvement in skin
Suitable contraception for those with history of mild acne?
COCP
First line management for atrophic vaginitis
Topical oestrogen
When are Hb levels checked in pregnancy?
At booking, and 28 weeks
Smear test follow up for HPV positive, negative cytology smear
Repeat in 12 months
Gestational diabetes management when glucose >7
Immediate insulin
What does HELLP stand for
Haemolysis, elevated liver, low platelets
Risk factors for ovarian cancer (4)
Obesity
Nulliparity
Family history
Older Age
Protective factors against ovarian cancer (2)
Long term COCP use
Breastfeeding
When do we screen for gestational diabetes?
24-28 weeks
Misoprostol MOA
PGE analogue, causing uterine contractions and cervical softening
1st line treatment for PID
IM ceftriaxone 1g
Oral doxycycline 100mg BD AND
Oral metronidazole 400mg BD for 14 days
POP MOA
Thickening of cervical mucus
GnRH agonists cause which deficiency?
Oestrogen deficiency
Primary MOA of COCP
Suppression of ovulation through inhibiting gonadotropin release from HPO axis
Most common cause of PPH?
Uterine atony
1st line management of uterine atony
IV oxytocin
1st line management of uterine atony
IV oxytocin
Most likely cause of PPH in women with previous c sections?
Placenta accreta
Target Hb for pregnant women with iron deficiency in 3rd trimester
> 105 g/L
Immediate priority when there’s umbilical cord prolapse
Manually elevate presenting part
Effective non-hormonal treatment for vasomotor menopausal symptoms
SSRIs e.g. citalopram
How long after last ever period should women >50 use contraception for?
12 months
What cancer needs to be ruled out with postmenopausal bleeding?
Endometrial
Primary mechanism of progesterone-only injectable?
Inhibits ovulation
First line investigation for fibroids
TVUS
How long should you avoid breastfeeding for after taking LNG as emergency contraception?
8 hours
What to do if the POP is more than 12 hours late?
Take missed pill immediately, additional contraception for next 2 days
Initial investigation for DVT in pregnancy
Compression duplex US
Common side effect of the progesterone only injection?
Irregular bleeding
Weight gain
When can COCP be started after giving birth?
21 days after
Glucose result diagnosing gestational diabetes
Fasting >5.6
Absolute contraindication to COCP
Uncontrolled hypertension
<6 weeks post partum
Previous VTE
Protective factor against ovarian cancer
Breastfeeding
Factor that increases risk of cervical cancer
Early age at first sexual intercourse
No. of days required for the progesterone-only injection to be effective
7
Differentiate between vasa praevia and placenta praevia
Vasa praevia - happens after membrane rupture
Anticoagulants for antiphospholipid syndrome in pregnancy
Aspirin and LMWH
What age is ‘early menopause’
40-45
What age is ‘premature ovarian insufficiency’
< 40
3 functions of oestrogen
Anti inflammatory
Protection of small blood vessels
Bone health
Why is progesterone used in HRT?
For uterine protection
When would you not give progesterone as HRT?
If the lady doesn’t have a uterus
