obs and gynae Flashcards

1
Q

when do you start contraception after taking levonorgestrel emergency pill

A

can start it immediately after

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2
Q

up to what week in pregnancy is considered a miscarriage

A

up to 24 weeks

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3
Q

what marks the end of the first stage of labour

A

cervix dilated to 10cm

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4
Q

what is the most common cause of postpartum pyrexia

A

endometritis

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5
Q

first line menorrhagia

A

IUS

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6
Q

tx of baby losing >10% weight in first week of life

A

refer to midwife led breastfeeding clinic

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7
Q

fluids given in hyperemesis gravidarum?

A

saline + potassium as hypokalaemia is common

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8
Q

rf for perineal tears

A

primigravida
large babies
precipitant labour
shoulder dystocia
forceps delivery

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9
Q

which form of HRT does not increase the risk of VTE

A

transdermal HRT

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10
Q

most common cause of early onset neonatal sepsis

A

group B strep

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11
Q

what consideration is important before prescribing metocloperamide for hyperemesis gravidartum

A

avoid use for more than 5 days as risk of acute dystonia
ie extrapyramidal side effects

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12
Q

HB cut off for post partum females

A

<100g/L

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13
Q

first line medical mx of infertility in PCOS

A

clomifene

metformin is second line !!

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14
Q

combined test for downs syndrome

A

nuchal transparency
beta HCG
PAPPA

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15
Q

quadruple test for downs syndrome

A

AFP
unconjugated oestriol
human chorionic gonadotrophin
inhibin A

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16
Q

moderate RF for pre-eclampsia

A

first pregnancy
age 40 years or older
pregnancy interval of more than 10 years
body mass index (BMI) of 35 kg/m² or more at first visit
family history of pre-eclampsia
multiple pregnancy

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17
Q

high RF for pre-eclampsia

A

hypertensive disease in a previous pregnancy
chronic kidney disease
autoimmune disease, such as systemic lupus erythematosus or antiphospholipid syndrome
type 1 or type 2 diabetes
chronic hypertension

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18
Q

when should a pregnant lady be prescribed aspirin for pre-eclampsia risk reduction

A

if >1 high risk factors
>2 moderate RF

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19
Q

in labour, when can an external cephalic version be attempted?

A

if the amniotic sac hasnt ruptured and isnt in active labour (>4cm dilated)

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20
Q

most common cause of vulval itching?

A

contact dermatitis

21
Q

admission criteria for hyperemesis G?

A

Failure of oral antiemetics to control symptoms, ketonuria and weight loss (>5% of pre pregnancy body weight)

22
Q

mx of pregnant woman with previous VTE hx

A

LMWH throughout pregnancy until 6 weeks postnatal

23
Q

how many days barrier contraception needed when switching from POP to COCP

A

7 days

24
Q

side effect of GNRH agonist

A

loss of bone mineral density
hot flashes
vaginal dryness

25
Q

thresholds for OGTT and fasting glucose in gestational diabetes

A

fasting >5.6
OGTT >7.8

26
Q

routine recall for smear for diff age groups?

A

Age 25–49 years — screening every 3 years
Age 50–64 years — screening every 5 years

27
Q

treatment for premenstrual syndrome

A

drospirenone-containing COC taken continuously

28
Q

abx for PPROM

A

10 days erythromycin

29
Q

management for magnesium sulphate induced respiratory depression

A

calcium gluconate

30
Q

which cancer is at higher risk when prescribing a progesterone and oestrogen HRT

A

Breast

31
Q

if not started on first day of period, ho long does it take the diff types of contraceptive to be effective?

A

instant: IUD

2 days: POP

7 days: COC, injection, implant, IUS

32
Q

most common type of ovarian cancer

A

serous carcinoma

33
Q

blood glucose targets gestational diabetes

A

FBG <5.3
OGTT <6.4

if not met with diet/exercise - start insulin

34
Q

flying and pregnancy?

A

dont if:
- >37 weeks, singleton, uncomplicated
>32 weeks twin preg

if longer than 4 hours = compression stockings advisable

if VTE risk -> LMWH may be needed

35
Q

non-hormonal treatment for menorrhagia

A

Painless menorrhagia - Tranexamic acid

PainFul menorrhagia - MeFenamic acid

36
Q

placental abruption <36 weeks with no signs of fetal distress -> MX?

A

admit and admin steroids
no tocolysis
threshold to deliver will depend on gestation

37
Q

placental abruption >36 weeks -> MX?

A

if distress = c section
no distress = vaginal delivery

38
Q

contraceptive patch advise

A

Contraceptive patch regime: wear one patch a week for three weeks and do not wear a patch on week four

for first 3 weeks wear every day then can be changed weekly

if delayed change more than 48 hours in 1st or 2nd week then change immediately, use barrier contraception 7 days, if UPSI in last 5 days = emergency

39
Q

placenta percreta

A

the chorionic villi invade through the perimetrium

40
Q

BP target for hypertension in pregnancy

A

135/85

41
Q

results for trisomy testing

A

Low alpha fetoprotein (AFP)
Low oestriol
High human chorionic gonadotrophin beta-subunit (-HCG)
Low pregnancy-associated plasma protein A (PAPP-A)
Thickened nuchal translucency
high inhibin A

42
Q

what is sheehans syndrome

A

postpartum hypopituitarism
- ischaemic necrosis of the pituitary gland following PPH
symptoms
- lack of menstruation and lactation
- hypothyroidism

43
Q

why do fibroids grow in pregnancy

A

due to increased oestrogen levels which drives its growth

44
Q

how to estimate a mid-luteal date for progesterone testing

A

7 days before end of regular cycle

45
Q

indications of CTG tracing during delivery

A

suspected chorioamnionitis or sepsis, or a temperature of 38°C or above

severe hypertension 160/110 mmHg or above
oxytocin use

the presence of significant meconium

fresh vaginal bleeding that develops in labour - this was a new point added to the guidelines in 2014

46
Q

which contraception shoudl be used in caution with asthma

A

ulipristal -> ella one

47
Q

what week is earliest ECV can be offered

A

36 weeks

48
Q

Rokitansky protuberance on abdominal US indicates what pathology?

A
49
Q
A