Obs and Gynae

Question 1

what are the 3 oestrogens?

Answer 1

E1-oestrone
E2-oestrodiol
E3-oestriol

Question 2

what happens to the myometrium for implantation to be able to occur?

Answer 2

quiescence

Question 3

what could be a cause of pre-eclampsia that occurs very early on?

Answer 3

failed endovascular invasion of blastocyst

Question 4

what problem with implantation could cause PPH

Answer 4

morbid adherence-myometrial, could also cause poor placental separation

Question 5

what are the stages of partuition?

Answer 5

cervical dilatation and remodelling
foetal expulsion=myometrial contraction
placental delivery then haemostasis

Question 6

what is required for partuition to occur?

Answer 6

altered progesterone response
increased intracellular calcium
inflammatory mediators

Question 7

what is the underlying mechanism of contractions?

Answer 7

controlled immune response

Question 8

name tocolytic agents

Answer 8

nifedipine
atosiban
progesterone-in some ethnicities

Question 9

name some induction agents

Answer 9

syntocinon
alpha2 agonists-ergometrine
prostaglandin mimetics (carboprost and misoprostol)

Question 10

what is misoprostol used for

Answer 10

terminations and induction

Question 11

at what point do you need to inject KCl into the foetal heart to abort it?

Answer 11

22w

Question 12

what is the legal social cut off of abortion

Answer 12

23+6

Question 13

define the puerperic period

Answer 13

6w after birth

Question 14

what can you consider other than BUFALO in a pregnant woman?

Answer 14

delivery and VTE prophylaxis

Question 15

what is secondary post partum haemorrhage

Answer 15

bleeding from birth canal 24hrs-12w after delivery

Question 16

what causes PPH?

Answer 16

morbid adherence
retained products of conception
endometritis
subinvolution of the placental site
AV malformations
pseudoaneurysm

Question 17

what is the bishop score used for?

Answer 17

to assess whether or not a woman needs to be induced

Question 18

what are the consequences of being an older mother?

Answer 18

higher risk of chromosomal abnormalities
degree of placental insufficiency (leads to increased risk of stillbirth, so they induce), smaller children and higher risk of DM in child

Question 19

what are MCDA twins?

Answer 19

monochorionic monoamniotic twins, so they must be monozygotic

Question 20

what kind of twins can be dizygotic?

Answer 20

dichorionic diamniotic

if 2 placentas, has to be 2 amniotic sacs, they might also be from the same zygote though

Question 21

what kind of twins are at risk of twin twin transfusion syndrome?

Answer 21

monochorionic diamniotic
if in same sac then placenta delivers equal nutrients but if not then second twin becomes hypoxic and wastes but removing that twin would suck nutrients out of the surviving twin so that wouldn’t be useful anyway