Obs and gynae quesmed Flashcards
What is most sensitive test for pre-eclamsia?
-Urine protein:creatinine ratio (PCR)
-A PCR >30mg/mmol
When to repeat smear test if HPV + but no dyskaryosis?
12 months (if HPV still + then repeat at 24 months, if positive at 24 months colposcopy)
What are the two main associations of obstetric cholestasis?
-Fetal death
-Maternal haemorrhage
When should you plan to deliver baby in mother with obstetric cholestasis?
37-38 weeks
What is the action of clomifene and what re the side effects?
-Selective oestrogen receptor modulator
-Side effects include ovarian hyperstimulation syndrome
Post menopausal bleeding in women is what until proven otherwise?
Endometrial cancer
What are the most common causes of post menopausal bleeding?
-Atrophic vaginitis (inflammation and thinning)
-Endometrial atrophy
-Cervical/endometrial polyps
-Endomterial hypertrophy
What is the HRT of choice in a women with regular periods?
Monthly, cyclical HRT
What is the HRT of choice in a women with irregular periods?
3 monthly, cyclical HRT
What is the HRT of choice in post-menopausal women ?
Continuous combined HRT
What can VWD disease cause?
-Menorrhagia (heavy periods)
-Will have prolonged APTT
What is first line to induce labour?
Prostaglandin pessary
What does PCOS do to risk of endometrial and ovarian cancer?
Increases the risk by 2-3 times
What symptoms can risperidone cause?
-Reduced libido, galactorrhoae and amenorrhoea
What is the treatment for lichen sclerosus?
-Topical corticosteroids (potent steroids such as dermovate) to reduce inflammation and itching
-Avoid soaps
-Emollients to relieve dryness and soothe itching
Describe first degree perineal tear
Tear limited to the superficial perineal skin or vaginal mucosa only
-Heal quickly, no muscle involvement and heal quickly superficial
Describe second degree perineal tear
Tear extends to perineal muscles and fascia, but the anal sphincter is intact (episiotomy is anatomically classified as second degree)
Describe third degree perineal tear
3a: less than 50% of the thickness of the external anal sphincter is torn
3b: more than 50% of the thickness of the external anal sphincter is torn, but the internal anal sphincter is intact
3c: external and internal anal sphincters are torn, but anal mucosa is intact
Describe fourth degree perineal tear
Perineal skin, muscle, anal sphincter and anal mucosa are torn
What can cause an enlarged, irregular and firm non tender uterus?
Fibroids
When does uterus return to non-pregnant size?
4 week post party
When is the anomaly scan performed?
18-20 + 6 weeks
What can you give women prior to fibroid surgery to mange bleeding?
Goserelin
What is the triad of hyperemesis gravidarum?
weight loss, dehydration and electrolyte disturbance
A key finding is ketonuria