Obs and Gynae Continued Flashcards
what is the name of 3 HER2 receptor blocker medications?
trastuzumab
pretuzumab
Neratinib
what medications can be used in tripple negative breast cancer?
immunomodulators
what medications can be used in braca1 and 2 cancers?
PARP inhibitors
what is the first line management of cholestasis of pregnancy?
1 - emmolients and antihistamines
2- ursodeoxycholic acid
what are 4 risk factors for shoulder dystocia?
macrosomia
High maternal BMI
Diabetes
Prolonged labours
what is the 1st line management of shoulder dystocia?
McRoberts manoeuvre
what is the management of one missed COCP?
take missed pill even if have to take two in one day
no additional contraceptive needed
what is the management if 2+ OCPs are missed?
take yesterdays and todays dose then continue taking normally
Use condoms for 7 days
what is the management of unprotected sex on OCP with missed pills in week 1?
emergency contraception
what is the management of unprotected sex on OCP with missed pills in week 2?
no need for additional contraception
what is the management of unprotected sex on OCP with missed pills in week 3?
finish pills in current pack and start new pack immediately no need for pill free interval
where is the most common site of ectopic pregnancy?
ampulla of fallopian tubes
what are 4 risk factors for hyperemesis gravidum?
increased levels of beta-hCG - multiple pregnancies, trophoblastic disease
nulliparity
obesity
family or personal history of NVP
what is associated with decreased levels of hyperemesis gravidum?
smoking
what is the triad of hyperemesis gravidum?
5% pre-pregnancy weight loss
dehydration
electrolyte imbalance
what is the first line management of hyperemesis gravidum?
antihistamines: oral cyclizine or promethazine
phenothiazines: oral prochlorperazine or chlorpromazine
what is the second line management of hyperemsis gravidum?
oral ondasetron
oral metoclopramide or domperidone
what complication can ondansetron use in pregnancy cause?
cleft lip and palate
what are 4 complications of hyperemesis gravidum?
acute kidney injury
Wernicke’s encephalopathy
oesophagitis, Mallory-Weiss tear
venous thromboembolism
what are 7 features of fibroids?
asymptomatic
menorrhagia - may result in iron-deficiency anaemia
bulk-related symptoms
lower abdominal pain: cramping pains, often during menstruation
bloating
urinary symptoms, e.g. frequency, may occur with larger fibroids
subfertility
how are fibroids diagnosed?
TV USS
what is the management of menhorrhagia in fibroids?
levonorgestrel intrauterine system (LNG-IUS)
NSAIDs e.g. mefenamic acid
tranexamic acid
combined oral contraceptive pill
oral progestogen
injectable progestogen
what is the management to treat fibroids?
GnRH analogues
surgery - myomectomy, hysteroscopic endometrial ablation, hysterectomy, uterine artery embolisation
what can be a cause of thick green nipple discharge most common in postmenopausal smokers?
Mammary duct ectasia
what type of contraception can be used in trans men?
Progesterone only
non-hormonal
How long after UPSI can Levonorgestrel (Levonelle) be taken?
72 hours
How long after UPSI can Ulipristal (ella one) be taken?
120 hours
what patients should Ulipristal use be cautioned in?
Asthmatics
How long after taking Ulipristal do you need to wait to start hormonal contraception?
5 days
How long after UPSI can the copper IUD be fitted?
5 days
what is the most common ovarian cyst?
follicular cyst - due to non-rupture of the dominant follicle or failure of atresia in a non-dominant follicle
what is the most common benign ovarian tumour in women <30?
Dermoid cyst - torsion in more likely
what is amniotic fluid embolism?
when fetal cells/ amniotic fluid enters the mothers bloodstream and stimulates a reaction which results in cyanosis, hypotension, bronchospasms, tachycardia. arrhythmia and myocardial infarction.
what antibiotics should be avoided in breast feeding?
ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
what psychiatric drugs should be avoided in breast feeding?
lithium, benzodiazepines
What are 6 drugs that should be avoided in breast feeding?
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone
what medication can be used to suppress lactation?
cabergoline
what are 5 risk factors for breech presentation?
uterine malformations, fibroids
placenta praevia
polyhydramnios or oligohydramnios
fetal abnormality (e.g. CNS malformation, chromosomal disorders)
prematurity (due to increased incidence earlier in gestation)
when should external cephalic version (ECV) be offered in breech presentation?
37 weeks (can be 36 in primies)
what are 5 reasons for a Cat 1 section?
suspected uterine rupture
major placental abruption
cord prolapse
fetal hypoxia
persistent fetal bradycardia
how quick should a cat 1 section be?
within 30 mis
How quick should a cat 2 section be?
within 75 mins