Obs and Gynae Flashcards
What blood result would indicate menopause?
FSH rise
How to know if a woman is ovulating?
day 21 progesterone
what does GnRH do?
stimulate FSH and LH secretion from the pituitary gland
2 indications for c section
terminal bradycardia (hr<100 for more than 10 minutes) terminal decelerations (heart rate drops and does not recover in 3 minutes)
diabetes medication contraindicated in pregnancy
gliclazide
prophylaxis of another pre eclampsia in women who have had it before?
75mg aspirin daily
fetal consequences of pre-eclampsia
pulmonary oedema IUGR prematurity oligohydramnios intracerebral haemorrhage
a raised alpha-feto-protein may indicate?
neural tube defects
abdominal wall defects
a lowered alpha fetoprotein may indicate?
Down’s syndrome
maternal diabetes mellitus
what causes sheehan syndrome?
blood loss, hypovolaemia after birth
what is sheehan syndrome?
postpartum hypopituitarism
signs of sheehan syndrome
amenorrhoea
galactorrhoea
hypothyroidism
treatment of pre eclampsia in asthmatics
Nifedipine
Antibiotic given in premature rupture of membranes?
erythromycin 10 days
what causes HELLP syndrome#?
pre-eclampsia/eclampsia
What is HELLP syndrome?
Haemolysis, elevated liver enzymes, low platelets
symptoms of HELLP syndrome
RUQ pain, vomiting, raised bp
treatment of pre eclampsia
labetolol
treatment of eclampsia
MgSO4, magnesium sulfate
what condition are chocolate cysts seen in?
endometriosis
treatment of pelvic inflammatory disease?
IM ceftriaxone + 14 days of metronidazole and doxycycline
what hormone does the corpus luteum produce?
progesterone
what causes physiological anaemia in pregnancy?
increased blood volume: 5-7.5L
first line treatment of infertility?
lifestyle advice: stop smoking, lose weight, stop drinking alcohol
what drug stimulates ovulation?
clomiphene cirrate
what hormone indicates ovulation is about to occur?
LH
What combination of rhesus is dangerous?
negative mother, positive baby (second pregnancy)
how long do you have to wait before inserting a copper IUD after birth?
4 weeks
when does pre-eclampsia set in?
after 20 weeks
hormone levels in PCOS?
high LH, low FSH
high androgen and oestradiol
medications indicated for PCOS
spironolactone, combined contraceptive pill
What medication is used to shrink fibroids? (drug and mechanism)
danazol, GnRH agonist
what conditions is lichen sclerosus associated with?
vitiligo
thyroid disease
What cancer may develop form lichen sclerosus?
squamous cell carcinoma
Protective factor for endometrial cancer?
contraceSptive pill
Symptom of endometrial cancer?
Post menopausal bleeding
intermenstrual bleeding
define stages of cervical cancer
- uterus and cervix only
- invasion into upper vagina
- invasion into lower vagina, or obstructing ureters
stage 4. invasion of bladder/rectum
risk factors for ovarian cancer?
more ovulations = more risk
- early menarche
- late menopause
- nulliparous
what is protective for ovarian cancer
pregnancy
lactation
COCP
women over 50 with abdominal/IBS symptoms should have what checked?
CA-125
snow storm on ultrasound indicates
hyaditiform mole/molar pregnancy
immobile uterus on examination?
endometriosis - adhesions
what is seen on laproscopy in endometriosis
red dots
powder burn spots
raised vesicles
how is adenomyosis diagnosed?
MRI
Treatment for hyperprolactinaemia
bromocriptine
what is the normal thickness of t/he endometrium
<4mm
first line treatment of urge incontinence?
bladder retraining
first line management of stress incontinence?
pelvic floor muscle training
serum bcg >1,500 indicates
pregnancy
medical management of urge incontinence if blasdder training fails?
muscarinic antagonist e.g. tolterodine, oxybutinin
where is the most common site of ectopic pregnancy?
ampulla
medical management of ectopic pregnancy
methotrexate
borderline dyskariosis + HPV positive?
colposcopy
borderline dyskariosis but HPV negative?
routine recall
what cancer may you get if you’ve had tamoxifen therapy?
endometrial cancer
treatment for vasomotor symptoms of menopause (e.g. sweating)?
SSRI e.g. fluoxetine
unopposed oestrogen is a risk for what cancer?
endometrial cancer
which strains of HPV lead to cervical cancer?
HPV 16 and 18
medication for painful periods
mefanamic acid
most common type of ovarian cancer?
serous carcinoma
what factors determine the Risk Malignancy Index?
US findings, menopausal status, CA125
which thrush treatment is contraindicated in pregnancy, which is preferred?
fluconazole is contraindicated, clotrimazole is preferred
hormone levels in premature ovarian failure?
FSH and LH both raised
Effect in elderly of oxybutinin?
increased risk of falls
HRT for women with a womb
cyclical combined HRT
HRT for women without a womb?
continuous oestrogen only HRT
definitive treatment of adenomyosis
hysterectomy
fixed retroverted uterus may indicate
endometriosis
medical management of miscarriage
vaginal misoprostol
what is placenta praevia?
when the placenta is implanted in the lower protion of the uterus
intermittent painless bleeding in pregnancy may indicate
placenta praevia
what is placental abruption?
when all or part of the placenta separates before delivery
Painful vaginal bleeding during pregnancy?
placental abruption
woody hard uterus indicates
placental abruption
what is placenta percreta?
placenta grows through the endometrial wall
causes of PPH?
Tone
Tissue
Trauma
Thrombin
what is given to manage the 3rd stage of labour if there is a risk of PPH?
syntometrin
rash, itching and raised bilirubin?
intrahepatic cholestasis of pregnancy
raised ALT, abdo pain and vomiting?
acute fatty liver of pregnancy
what would you see in chorioamnionitits?
preterm PROM
maternal pyrexia, maternal and fetal tachycardia
management of intrahepatic cholestasis of pregnancy?
delivery at 37 weeks to prevent stillbirth
management of maternal group B strep?
IV antibiotic prophylaxis
when are postnatal blues suspected to end?
After 10 days
screening for post antal depression
edinburgh depression test
treatment of hyperemisis gravidarum
0.9% saline
IV vitamin B and C (pabrinex)
