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Obs and Gynae > Obs and Gynae pretest > Flashcards

Obs and Gynae pretest Flashcards

1
Q

What level is the epidural needle inserted into?

A

Inserted between L3/L4 (as below spinal cord, which ends at L1/L2)

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2
Q

What level does the spinal cord end at?

A

L1/L2

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3
Q

Which space is the spinal anaesthetic inserted into?

A

The subarachnoid space

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4
Q

What should you give a woman prior to an epidural and why?

A

Should give 500ml-1000ml crystalloid fluid as epidural will lower her blood pressure

(hypotension because of vasodilation)

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5
Q

To provide relief for pain caused by uterine contractions, which levels must you block?

A

Must block levels T10-S4
T10-T12 -sympathetic nerves
L1 - ilioinguinal nerve
S2,S3,S4 - pudendal nerve

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6
Q

Lymphatic drainage of fundus of uterus

A

Para-aortic nodes

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7
Q

Lymphatic drainage of cervix

A

Internal and external iliac nodes

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8
Q

Lymphatic drainage of bladder

A

Internal and external iliac nodes

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9
Q

Lymphatic drainage of ovary

A

Para-aortic nodes

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10
Q

Lymphatic drainage of labia minora?

A

Superficial inguinal nodes

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11
Q

Which drug is given to a woman with eclampsia to treat seizures and prevent further seizures?

A

Magnesium sulphate

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12
Q

How should you check liver function in pre-eclampsia?

A

Serum ALT

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13
Q

How should you check renal function in pre-eclampsia?

A

Serum urate

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14
Q

How should you check haematological system in pre-eclampsia?

A

Check platelet count

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15
Q

How should you check neurology in pre-eclampsia?

A

Patellar reflexes

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16
Q

How should you check placental sufficiency in pre-eclampsia?

A

Umbilical artery doppler

17
Q

How long is the female urethra?

A

4cm

18
Q

Lymphatic drainage of ovaries?

A

Para-aortic nodes

19
Q

When does the uterus rise from the pelvis in pregnancy?

A

Rises out of pelvis at 12 weeks

20
Q

Is the posterior fornix of the vagina related to the peritoneal cavity (pouch of douglas)?

A

Yes, vaginal injury damaging the posterior fornix will open the peritoneal cavity and facilitate spread of infection to the cavity

21
Q

Most common HPV causing cervical cancer?

A

HPV 16 and 18

22
Q

Where does cervical intraepithelial neoplasia usually occur?

A

CIN usually occurs in the transformation zone at the squamo-columnar junction

23
Q

Which percentage of ovarian cancers are genetic and which genes are associated?

A

Around 5% of cases are genetic

Associated with BRCA1 and BRCA2

24
Q

How may ovarian cancer present?

A

Usually presents with non-specific symptoms such as abdominal pain, dyspepsia and weight loss.
MAY ALSO present initially as leg pain and swelling as a result of DVT

25
Q

Ovarian cancer survival

A

Most people die 3-5 years after diagnosis

26
Q

Does the pudendal nerve pass in front or behind the ischial spine?

A

Behind

27
Q

How big is the vagina?

A

About 8cm

28
Q

Which vessel does the ovarian artery arise from?

A

Arises from the aorta

29
Q

At ovulation, is the ovum extruded into the peritoneal cavity?

A

Yes - as the ovum is extruded into the peritoneal cavity, it is possible to develop an intra-peritoneal ectopic pregnancy

30
Q

Does plasma volume increase during pregnancy?

A

Yes, plasma volume increases by about 50% during pregnancy (this means blood becomes diluted so physiological anaemia)

31
Q

When does blood pressure decrease in pregnancy?

A

Blood pressure decreases in second trimester due to vasodilation

32
Q

What happens to glomerular filtration during pregnancy?

A

Glomerular filtration increases to cope with the additional load of the fetus - this results in a decrease in creatinine and urea levels

33
Q

Are systolic murmurs common in pregnancy?

A

yes - there is about a 35-40% increase in cardiac output during pregnancy, so systolic murmurs are common

34
Q

By how much is your risk of thromboembolism increased in pregnancy?

A

Increased by about 10%

Obs and Gynae (8 decks)

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