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Phase 3A > Obs and gynae: revision session > Flashcards

Obs and gynae: revision session Flashcards

1
Q

APH definition

A

Bleeding from genital tract from 24 weeks to birth of baby

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2
Q

Minor APH

A

<50mls and stopped

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3
Q

Major APH

A

50-100mls

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4
Q

Massive APH

A

100mls + signs of shock

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5
Q

Causes of APH

A 
Cervical ectropian
Vaginal infection
Bleeding from placental edge
Placenta praevia
Abruption
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6
Q

Placenta praevia

A

When placenta is within 2.5cm of cervix

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7
Q

Management of APH

A 
ABCDE
IV access
Bloods, G and S
IV fluids
Blood transfusion
Delivery of baby
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8
Q

32 weeks, Post coital bleed

A

Cervical ectropian

Infection

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9
Q

6 weeks, PV bleeding, saw something jelly like, now bleeding stopped

A

Miscarriage

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10
Q

28 weeks, large volumes, woody hard uterus, drug missuse

A

Abruption

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11
Q

Painless PV bleeding, previous children

A

Placenta praevia

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12
Q

Menorrhagia

A

Regular, heavy menstrual bleeding. Excessive amount which interferes with quality of life.

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13
Q

Ix of menorrhagia

A 
Detailed history
Bimanual examination
Speculum
Blood test
TV USS
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14
Q

Bulky uterus

A

Adenomyosis

Fibroids

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15
Q

Menorrhagia

A

Fibroids
Endometriosis
Polyps
Endometrial hyperplasia

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16
Q

Which maternal non gynae diseases can cause menorrhagia

A 
Hypothryoidism
Coagulation problems
Diabetes
Liver/ kidney disease
Anticoagulant therapy
Copper IUD
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17
Q

Red flag symptoms for menorrhagia

A

Postcoital bleeding
IMB
Dyspareunia
Dysmenorrhoea

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18
Q

PCB

A

Cervical cancer

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19
Q

IMB

A

Cervical cancer or endometrial cancer

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20
Q

Dyspareunia

A

Cervical cancer

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21
Q

Irregular periods

A

PCOS

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22
Q

Pelvic pain and pressure symptosm

A

Prolapse or cancer

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23
Q

Vaginal discharge

A

PID

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24
Q

Menorrhagia first line

A

Levonorgesterel IUS- Mirena coil

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25
Q

Menorrhagia second line

A

Tranexamic acid
NSAIDS
COCP

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26
Q

Mirena benefits

A

Progesterone very local long term, mainly causes amenorrhoea

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27
Q

Why is tranexamic acid bad

A

VTE risk (avoid if fat and VTE risk already)

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28
Q

COCP cant be given to

A

Anyone with clot risks (high BMI, FHx)

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29
Q

Menorrhagia surgeries

A

Endometrial ablation
Uterine artery embolisation
Hysterectomy
Myomectomy

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30
Q

21 year old student, 3 months menorrhagia

A

Infection?
New contraception?
PCOS

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31
Q

What contraceptions can cause heavy bleeding

A

Copper coil, implant

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32
Q

Treatments for menorrhagia in young

A

Mirena coil
COCP
POP

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33
Q

45 year old lady
Heavy IMB
BMI 50
Flooding

A

Endometrial cancer
Fibroids
Endometriosis

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34
Q

Adenomyosis

A

Over growth of muscle of uterus

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35
Q

Treatment for endometrial cancer, fibroids, endometriosis

A

Surgery- ablation, hysterectomy, myomectomy

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36
Q

Whats a myomectomy for

A

Fibroids

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37
Q

Investigation for 45year old heavy bleeder (at risk for endometrial cancer)

A

Pipelle biopsy

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38
Q

Why does obesity risk factor for cancers

A

Fat cells produce oestrogen

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39
Q

Who gets endometrial

A

Menopause

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40
Q

Who gets ovarian cancer

A

50+

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41
Q

Who gets vulval cancer

A

70+

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42
Q

PCB in a young person

A

Cervical cancer

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43
Q

What causes cervical cancer

A

High risk HPV

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44
Q

Cervical cancer risk factors

A 
High risk HPV
early age intercourse
multiple sexual partners
STDs
Cigarette smoking
Multiparity
OCP uses
Previous cervical intraepithelia neoplasia
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45
Q

Precancer of cervical cancer

A

Cervical intraepithelial neoplasia

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46
Q

Who gets high risk HPV

A

16, 18, 31 and 33

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47
Q

What do smears check for

A

CIN 1, 2 and 3 not cancer

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48
Q

CIN treatment

49
Q

Stage 1 cervical cancer treatment

A

Radical trachylectomy

Hysterectomy

50
Q

Stage 2 cervical cancer treatment

A

Radiotherapy
Chemotherapy
Palliative care

51
Q

Endometrial cancer red flag

A

Postmenopausal bleeding

52
Q

Main risk factor for endometrial cancer

A

Unopposed oestrogen

53
Q

Risk factors for endometrial cancer

A 
Obesity
Diabetes
Nulliparity
Late menopause
Ovarian tumours
HRT
Pelvic irradiation
Tamoxifen
PCOS
54
Q

Treatment for endometrial cancer

A

Hysterectomy and pelvic lymph nodes
+radiotherapy
+progesterone therapy

55
Q

What is brachytherapy

A

Radiotherapy from the inside out

56
Q

What causes ovarian cancer

A

Ovulation and gene mutation (BRCA1 and 2)

57
Q

Factors affecting ovulation

A

Early menarche and late meopause= more

Breast feeding and parity= less

58
Q

Ovarian cancer presentation

A

50s, IBS symptoms
Urinary frequency
Bowel obstruction

59
Q

What cells do ovarian cancers normally come from

A

Epithelial

60
Q

Risk of ovarian cancer calculator

A 
Risk of malignancy index
Symptoms and age
CA125
Ultrasound score
Menopausal score
61
Q

Treatment for ovarian cancer

A

Hysterectomy or debulking
Chemo/ radio
Palliative care

62
Q

Vulval cancer causes

A

HPV and lichen sclerosis

63
Q

What is lichen sclerosis

A

Premalignant condition
Scaly white plaques on vulva
Older population

64
Q

Symptoms of vulval cancer

A 
Vulval itching
Non healing lesion
Vulval soreness
Persistent lump
Bleeding
Pain on passing urine
Past history of HPV or lichen sclerosis
65
Q

Vulval cancer treatment

A

Surgery
Chemotherapy
Radiotherapy

66
Q

Late pregnancy problems

A 
Symphysis pubis dysfunction
IUGR
Gestational diabetes
Anaemia
Reduced fetal movements
Preeclampsia
67
Q

Differential diagnosis in obstetrics

A 
Can just get migraines, tension headache etc
UTI
MSK pains
Diarrhoea and vomitting
Appendicitis
68
Q

28 year old lady, 24 weeks pregnant, abdo pain

A 
Appendicitis
Abruption
Miscarriage
Braxton hicks
Symphysis pubis dysfunction
69
Q

40 year old lady, 36 weeks pregnant

A

Preeclampsia
Migraine
Tension headache
Venous sinus thrombosis

70
Q

Stroke in pregnant woman and why

A

Venous sinus thrombosis, hypercoagulable when pregnant

71
Q

16 year old, 8 weeks with vomitting

A

Hyperemesis

Molar pregnancy

72
Q

Why do people get sick in hyperemesis and molar pregancy and twins

73
Q

Infertility definition

A

Inability to conceive after 2 years of regular unprotected sexual intercourse and in the absence of known reproductive pathology

74
Q

Pretesticular male infertility causes

A

Chemotherapy, hyperprolactinaemia

75
Q

How does hyperprolactinaemia cause low testosterone

A

Surpresses FSH

76
Q

Testicular causes of male infertility

A

Kleinfelters, trauma, infection, radiation

77
Q

Post testicular causes of male infertility

A

Obstruction, retrograde ejaculation, absence of vas deferens

78
Q

Causes of no eggs

A 
Tuners syndrome
Trauma
Toxins (chemo and radio)
Oophrectomy
Premature ovarian failure
79
Q

Turners syndrome

80
Q

What does the embryo inplant as

A

Blastocyst

81
Q

Anovulation causes

A

PCOS

increased androgens can cause hirsuitism and acne, weight gain

82
Q

Problems with implantation of blastocyst

A

Recurrent miscarriage
Antiphospholipid syndrome
Polyps, fibroids, Ashermans syndrome

83
Q

What is ashermans syndrome

A

Adhesions within the uterus

84
Q

Male factor infertility treatment

A

Sperm donation, stop steroids

85
Q

General fertility tips

A

Stop smoking, lose weight, good sleep, regular sex, stress reduction

86
Q

Anovulation treatment

A

Clomiphene, metformin, ovarian drilling

87
Q

Ovarian reserve treatment

88
Q

Tubal fertility treatment

A

Tubal cannulation

89
Q

Unexplained infertility treatment

90
Q

On which days are women most likely to conceive in a cycle

A

8-14 days (14 days from end)

91
Q

What number day is the first day someone bleeds

92
Q

Fetal complications of maternal smoking

A

Prematurity, respiratory disease, IUGR, cot death

93
Q

Fetal complications of maternal alcohol

A

Neurological damage, facial deformities, fetal growth retardation, spontaneous miscarriage

94
Q

What vitamin is in liver and vitamins and can cause foetal abnormalities

95
Q

Why shouldnt pregnant people take multivitamisn

96
Q

Foods to avoid in pregnancy

A 
Soft cheese (listeria)
Raw eggs (salmonella)
Liver (vitamin A)
Shellfish (
Tuna (mercury)
Caffeine
Alcohol
97
Q

Why should you avoid cat litter in pregnancy

A

Toxoplasmosis

98
Q

What is the normal dose of folic acid

99
Q

5mg of folic acid for

A

Family history of neural tube defect
Diabetes
Previous neural tube defect
Obese

100
Q

Which drugs should you avoid in pregnancy

A

Propanolol and NSAIDS (premature PDA closure)
Warfarin (foetal abnormalities)
Furosemide (renal development problems)

101
Q

What drug is defo safe in preganncy

A

Paracetamol

102
Q

Serum markers triple test for risk of downs syndrome

A

Alpha feto protein, beta HCG, Estriol

103
Q

When is the best time to do an ultrasound scan, for nuccal translucency

A

11-14 weeks- 12 week scan

104
Q

What do you look for on ultrasound scan for downs syndrome

A

Nuccal translucency

105
Q

Most appropriate time for amniocentesis

106
Q

Risk of miscarriage in amniocentesis

107
Q

Whats the most appropriate time for chorionic villous sampling

A

from 11 weeks as placenta needs to be big enough

108
Q

What is commonly seen on USS at 12 weeks

A

Anencephaly (no brain)

109
Q

When can you see oligohydramnios

110
Q

What can confuse looking at nuccal translucency

A

Cystic hydroma on the neck

111
Q

At every appointment what do you look at

A 
Blood pressure
Urine
Symphysis fundal height
Fetal heart beat
(not fetal position)
112
Q

Physiological changes in pregnancy

A

Fall in BP in early pregnancy
Increased maternal ventilation
Hypercoagulability
Increased GFR

113
Q

What hormone causes N and V

114
Q

Which serum makers increase in preganncy

A

T3, T4, thyroid binding globulin

AlkPhos

115
Q

Which serum markers go down in pregnancy

A

Protein and albumin

116
Q

Preeclampsia diagnosis

A

High blood pressure, protien in urine

Epigastric pain, facial swelling, headache

117
Q

Risk factors for preeclampsia

A 
Diabetes
Hypertension
Renal disease
Molar pregnancy
High BMI
118
Q

HELLP syndrome

A

High liver enzymes
High Us and Es
Low platelets

119
Q

Management for preeclampsia

Phase 3A (25 decks)

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