Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

REVISION > OBS&GYNAE > Flashcards

OBS&GYNAE Flashcards

1
Q

At what gestation would a referral to the maternal foetal medicine unit for no foetal movements be done?

A

24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Whats the most common adverse effect of the progesterone-only pill?

A

Irregular vaginal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If Bishop score <=6, what should be done to induce labour?

A

vaginal prostaglandins or oral misoprostol

mechanical methods such as a balloon catheter can be considered if the woman is at higher risk of hyperstimulation or has had a previous caesarean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If bishop score >6 what should be done to induce labour?

A

Amniotomy and IV oxytocin infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

After pregnancy, when can the contraceptive implant be safely inserted?

A

Any time!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common risk following a surgical termination of pregnancy?

A

Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does cholestasis of pregnancy present differently yo acute fatty liver of pregnancy?

A

AFL of pregnancy - malaise, fever, n&v, abdo pain, jaundice, ALT very elevated (very non-specific)
Cholestasis - severe pruritus often in palms and soles and raised bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How should you manage a woman in labour when there is foetal bradycardia <80bpm?

A

Rule of 3 mins for foetal bradycardia:
3 minutes - call for help
6 minutes - move to theatre
9 minutes - prepare for delivery
12 minutes - deliver the baby as cat 1 c-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What should always be done at any sensitising event after 20/40 in a woman who is rhesus D negative?

A

A kleihauer test after giving anti-D to determine if additional anti-D is required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of gestational diabetes if fasting glucose level is >=7.0mmol/l?

A

Immediate insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When do baby blues start and when does PND start?

A

Baby blues are typically seen 3-7 days following birth
PND usually starts within 1 month and peaks at 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Risk factors for placenta praevia

A

multiparity
multiple pregnancy
previous caesarean section - Embryos implant in scar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does placenta praevia present?

A

Shock in proportion to visible loss
Lie and presentation may be abnormal

(No pain or tender uterus and foeta;l heart good)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is grade 1 placenta praevia?

A

I - placenta reaches lower segment but not the internal os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is grade 2 placenta praevia?

A

II - placenta reaches internal os but doesn’t cover it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is grade 3 placenta praevia?

A

placenta covers the internal os before dilation but not when dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is grade 4 placenta praevia?

A

IV (‘major’) - placenta completely covers the internal os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

First line investigations for PMB?

A

TVUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What UKMEC category is having positive antiphospholipid antibodies e.g. SLE/

A

4 - i.e. There is an unacceptably high clinical risk and she cannot use the pill anymore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the risk of chickenpox in pregnancy for the mother?

A

5 times greater risk of pneumonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are features of foetal varicella syndrome?

A

Skin scarring
Eye defects e.g. microphthalmia
Limb hypoplasia
Microcephaly
Learning disabilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Management if 2 COCP pills are missed in week 1 and they had unprotected sex during this week or the pill-free interval?

A

Consider emergency contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Risk factors for ectopic pregnancy?

A

Any damage to tubes e.g. PID, surgery
Previous ectopic
Endometriosis
IUCD
POP
IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What % of IVF pregnancies are ectopic?

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What drug class is leuprolide?

A

GnRH agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What can be used to screen for depression in the peurperal period?

A

The Edinburgh Postnatal Depression Scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When does puerperal psychosis typically start?

A

2-3 weeks following birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most effective form of contraception?

A

Implantable contraceptive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Moa of mifepristone in termination of pregnancy?

A

acts as an anti-progestogen that primes the uterus to enhance its responsiveness to misoprostol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Moa of misoprostol in termination of pregnancy?

A

A prostaglandin analogue

Misoprostol binds to smooth muscle cells in the uterine lining to increase the strength and frequency of contractions as well as reduce cervical tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is placenta accreta?

A

the attachment of the placenta chorionic villi attach to the myometrium, rather than being restricted within the decidua basalis

32
Q

What is the complication of placenta accreta?

A

Postpartum haemorrhage

33
Q

How does placental abruption present?

A

Shock out of keeping with visible loss
Pain with a tender and tense uterus
Foetal heart absent or distressed
Coagulation problems

34
Q

Indications for referring a woman to hospital with hyperemesis gravidarum?

A

Continued nausea and vomiting and is unable to keep down liquids or oral antiemetics
Continued nausea and vomiting with ketonuria and/or weight loss (greater than 5% of body weight), despite treatment with oral antiemetics
A confirmed or suspected comorbidity (for example she is unable to tolerate oral antibiotics for a urinary tract infection)

35
Q

What is yhe criteria for lactational amenorrhoea?

A

Amenhorrhoic
A bay <6 months
Breastfeeding exclusively

36
Q

When are OGTT done?

A

As soon as possible after booking
At 24-28 weeks if first test is normal or if any risk factors

37
Q

What condition causes a raised AFP?

A

Neural tube defects
Abdominal wall defects
Multiple pregnancies

38
Q

What condition causes a low AFP?

A

Down’s syndrome
Trisomy 18
Maternal DM

39
Q

Indications for induction of labour?

A

prolonged pregnancy
prelabour premature rupture of the membranes
maternal medical problems e.g. DM >38 weeks, pre-eclampsia, obstetric cholestasis
intrauterine fetal death

40
Q

Interpretation of bishop score?

A

a score of < 5 indicates that labour is unlikely to start without induction
a score of ≥ 8 indicates that the cervix is ripe, or ‘favourable’ - there is a high chance of spontaneous labour, or response to interventions made to induce labour

41
Q

How long should metoclopramide be used for for hyperemesis gravidarum and why?

A

No more than 5 days due to risk of extrapyramidal side efefcts

42
Q

Risk factors for endometrial cancer?

A

Excess oestrogen
Metabolic syndrome
Tamoxifen
HNPCC

43
Q

A 31-year-old woman complains of intermittent pain in the left iliac fossa for the past 3 months. The pain is often worse during intercourse. She also reports urinary frequency and feeling bloated. There is no dysuria or change in her menstrual bleeding

A

Ovarian cyst - can cause abdominal swelling na pressure effects on bladder

44
Q

After giving birth when do women require contraception?

A

After day 21

45
Q

What is a threatened miscarriage?

A

Painless vaginal bleeding occurring before 24/40
Bleeding is often less than menstruation and cervical os is closed

46
Q

What is a missed miscarriage?

A

Aka a delayed miscarriage

a gestational sac which contains a dead fetus before 20/40 without the symptoms of expulsion
mother may have painless, light vaginal bleeding / discharge and the symptoms of pregnancy disappear
cervical os is closed

47
Q

What is an anembryonic pregnancy?

A

When the gestational sac is >25mm and no embryonic/foetal parts can be seen

48
Q

What is an inevitable miscarriage?

A

heavy bleeding with clots and pain
cervical os is open

49
Q

What is an incomplete miscarriage?

A

not all products of conception have been expelled
pain and vaginal bleeding
cervical os is open

50
Q

Outline the scanning for placenta praevia after its first recognised at the 20 week scan?

A

Rescan at 32/40. If present and grade 1/2 then rescan every 2 weeks
Final USS at 36-37/40 to determine method of delivery (if grade 1 vaginal, any higher than elective c-section)

51
Q

Moa of ursodeoxycholic acid?

A

This inhibits the absorption of cholesterol in the intestine and secretion of cholesterol into bile = decreasing biliary cholesterol saturation and promoting bile acid secretion

52
Q

What % of pregnant women get obstetric cholestasis?
Which ethnicities is it more common in?

A

1% of pregnant women
Women of Indian-Asian or Pakistani-Asian origin

53
Q

When does obstetric cholestasis usually develop and why?

A

Usually after 28/40/third trimester due to the increased oestrogen and progesterone levels

54
Q

Outline the pathophysiology of obstetric cholestasis?

A

Outflow of bile acid flow is reduced causing them to build up in the blood and this causes pruritis

55
Q

What is the risk of obstetric cholestasis?

A

Increased risk of premature birth
May increase the chance of stillbirth if severe

56
Q

What is a partial hydatidiform mole?

A

When 1 ovum with 23 chromosomes is fertilised by 2 sperm, each with 23 chromosomes = triploid cell
A foetus will be present but abnormal

57
Q

What is a complete hydatidiform mole?

A

When 1 empty ovum without any chromosomes is fertilised by 1 sperm which duplicates, (or less commonly by 2 sperm) leading to 46 chromosomes of paternal origin alone = no foetus!

58
Q

Are complete and partial molar pregnancies benign?

A

Yes but they can become malignant
Complete molar pregnancies have a 15% chance of developing to gestational trophoblastic neoplasia

59
Q

What are the 3 types of invasive gestational trophoblastic disease?

A

Choriocarcinoma
Placental site trophoblastic tumour
Epitheloid trophoblastic tumour

60
Q

What is a choriocarcinoma?

A

A type of gestational trophoblastic disease - a maliganncy of the trophoblastic cells of the placenta
Commonly co-exists with molar pregnancies
Characteristically metastases to the lungs

61
Q

USS findings for a complete hydatidiform mole?

A

A snow stop appearance of mixed echogenicity

62
Q

When can you start the COCP after levonorgestrel emergency contraception?

A

Immediately

63
Q

When should folic acid be taken as antenatal care?

A

Folic acid 400mcg OD 3 months before conception up to 12 weeks gestation

64
Q

What is the Hb cut off for anaemia in the first trimester of pregnancy?

A

<110g/L

65
Q

What is the Hb cut off for anaemia in the second and third trimester of pregnancy?

A

<105g/L

66
Q

What is the Hb cut off for anaemia in the postpartum?

A

<100g/L

67
Q

What are the requirements for an instrumental delivery? (Remember using FORCEPS mnemonic)

A

Fully dilated cervix
OA position
Ruptured membranes
Cephalic
Engaged presenting part
Pain relief
Sphincter bladder empty

68
Q

What should be the next important investigation if you find a baby has a SFH of 25cm at 30/40?

A

US to confirm foetal size

69
Q

When should magnesium sulphate be given in eclampsia?

A

Give once a decision to deliver has been made and continue for 24 hours after last seizure of delivery

70
Q

What should be monitored during giving magnesium sulphate for eclampsia?

A

Urine output
Reflexes
RR (respiratory depression can occur)
O2 sats

71
Q

Which women should take aspiring 75-150mg daily from 12 weeks gestation until birth?

A

Those with >=1 high risk factor for pre-eclampsia OR
>=2 moderate risk factors

72
Q

What are high risk factors for pre-eclampsia?

A

hypertensive disease in a previous pregnancy
chronic hypertension
CKS
autoimmune disease, such as SLE or APS
T1 or T2DM

73
Q

What are moderate risk factors for pre-eclampsia?

A

First pregnancy
Aged 40 or older
Pregnancy interval of >10 years
BMI of 35 or more
FHx of pre-eclampsia
Multiple pregnancy

74
Q

What is the first line investigation for PROM? Second line?

A

Sterile speculum to look for pooling of amniotic fluid in posterior vaginal vault
Vaginal fluid tests for PAMG-1 or insulin-like growth factor binding protein-1 if no amniotic fluid is demonstrated on speculum,

75
Q

What is the risk of expulsion of the IUD and IUS?

A

1 in 20
Most likely to occur in the first 3 months

REVISION (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions