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Year 4 Placements > Obs & Gynae > Flashcards

Obs & Gynae Flashcards

1
Q

What is the first line medication in pregnancy induced HTN?

A

Oral labetolol

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2
Q

Which medications may be used in a patient with pregnancy induced HTN who also has asthma?

A

Oral nifedipine/methyldopa/hydralazine

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3
Q

Those at risk of gestational diabetes should have what test conducted at what gestation?

A

OGTT at 24-28 weeks

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4
Q

What is the drug of choice for reversing magnesium sulphate induced respiratory depression?

A

Calcium gluconate

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5
Q

In an ongoing eclamptic seizure, what medication should be given, how much and over how long?

A

IV bolus magnesium sulphate over 10-15 minutes

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6
Q

What is the main risk factor for developing hyperemesis gravidarium?

A

Increased beta-hCG levels, via multiparity or trophoblastic disease (e.g. molar pregnancy)

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7
Q

Which type of pregnancy may increase the risk of developing hyperemesis gravidarum?

A

Molar or multiple

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8
Q

What immediate medication should be administered in cases of eclampsia?

A

Magnesium sulphate

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9
Q

When are the 2 doses of prophylactic anti-D given in rhesus negative pregnant women?

A

28 and 34 weeks

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10
Q

Name 4 potentially sensitising events in pregnancy for rhesus negative women

A

Any of:
Amniocentesis, chorionic villus sampling, vaginal bleeding > 12 weeks, ectopic, external cephalic version, IUD, evacuation of retained products of conception, molar pregnancy, antepartum haemorrhage, abdominal trauma

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11
Q

What is the standard dose of folic acid for pregnancy? How long should this be taken for?

A

400mcg daily, taken ideally before conception up until 12 weeks gestation

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12
Q

What is the dose of folic acid utilised in high risk pregnancies?

A

5mg per day, ideally from before conception up until 12 weeks gestation

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13
Q

What mode of labour should be offered to women with intrahepatic cholestasis of pregnancy and why?

A

Induction at 37-38 weeks, as intrahepatic cholestasis of pregnancy increases risk of stillbirth

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14
Q

Which LFT can be normally raised in pregnancy?

A

ALP

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15
Q

Which prophylactic antibiotic should be given for GBS and for how long?

A

Oral erythromycin for 10 days

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16
Q

At what gestation should external cephalic version be offered if baby is in breech presentation?

A

36 weeks

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17
Q

What is the most common risk factor for development of placenta accreta?

A

Previous C section

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18
Q

How long after a decision has been made to perform a:
1. Category 1 C section
2. Category 2 C section
Should they be carried out?

A
  1. 30 minutes
  2. 75 minutes
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19
Q

McRoberts manoeuvre is often used to treat what?

A

Shoulder dystocia

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20
Q

The Zavanelli manoeuvre involves what?

A

Replacement of head into canal and delivery via emergency C section, in cases of shoulder dystocia

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21
Q

Shoulder dystocia is associated with with maternal complication?

A

Gestational diabetes

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22
Q

A pregnant women with 4 or more risk factors for VTE should have what treatment initiated, until when?

A

LMWH immediately until 6 weeks post natal

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23
Q

A pregnant women with 3 risk factors for VTE should have what treatment initiated, until when?

A

LMWH from 28 weeks gestation to 6 weeks post natal

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24
Q

A history of VTE in a pregnant women indicates the need for what treatment until when?

A

LMWH immediately until 6 weeks post natal

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25
Q

Give 2 examples of LMWH

A

Dalteparin, enoxaparin

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26
Q

PPH is defined as blood loss over what?

A

500ml

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27
Q

Which PPH medication should be avoided in cases complicated by hypertension?

A

Ergometrine

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28
Q

Which PPH medication should be avoided in cases complicated by asthma?

A

Carboprost

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29
Q

What is first line treatment in PPH?

A

Oxytocin 5iu slow IV injection

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30
Q

Misoprostol is given for PPH via which route?

A

Sublingual

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31
Q

What is the most common cause of PPH?

A

Uterine atony
- NB uterus may be palpated high above umbilicus in cases of uterine atony

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32
Q

What is the brand name of oxytocin used for PPH?

A

Syntocinon

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33
Q

Terbutaline has what effect on the uterus?

A

Reduce contractions

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34
Q

Placental abruption is associated with use of which recreational drug?

A

Cocaine

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35
Q

How should we manage cases of placental abruption which are:
1. Complicated by foetal distress?
2. Under 36 weeks and no foetal distress
3. Over 36 weeks and no foetal distress?

A
  1. Cat 1 C
  2. Observe + steroids
  3. Vaginal delivery
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36
Q

Amenorrhoea is classed as failure to establish menstruation by what age, in girls with:
1. Secondary sexual characteristics
2. No secondary sexual characteristics

A
  1. 15
  2. 13
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37
Q

High or low levels of prolactin may cause secondary amenorrhoea?

A

High

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38
Q

How do NSAIDs work?

A

Inhibit prostaglandin production

39
Q

Which form of intrauterine device may cause dysmenorrhoea?

A

Copper

40
Q

What is the quantification of heavy menstrual bleeding?

A

Over 80ml per menses

41
Q

What are the most likely causes of an enlarged uterus which is:
1. Diffuse
2. Irregular

A
  1. Adenomyosis
  2. Fibroids
42
Q

What is the only effective treatment for fibroids causing problems in fertility?

A

Myomectomy

43
Q

Goserelin (Zoladex) is an example of what type of drug?

A

GnRH analogues

44
Q

What is first line for infertility in PCOS?

A

Clomiphene

45
Q

At what stage of life is adenomyosis most common?

A

When approaching menopause

46
Q

What is the first line medical treatment for PMS?

A

COCP +/- sertraline

47
Q

Raised LH/FSH in cases of primary amenorrhoea is suggestive of what as underlying cause?

A

Gonadal dysgenesis

48
Q

In secondary amenorrhoea, low levels of gonadotrophins are suggestive of what cause of the amenorrhoea?

A

Hypothalamic

49
Q

Primary amenorrhoea with features of cyclical pelvic pain and bloating is suggestive of what as the diagnosis?

A

Imperforate hymen

50
Q

What levels of markers may be seen in PCOS for:
1. LH:FSH ratio
2. Prolactin
3. SHBG

A
  1. Raised LH:FSH
  2. Normal to elevated prolactin
  3. Normal to low SHBG
51
Q

Which ratio may be elevated in PCOS patients?

A

LH:FSH

52
Q

How do GnRH analogues reduce fibroid size?

A

By decreasing oestrogen exposure

53
Q

What is considered first line contraceptive treatment for menorrhagia?

A

Mirena coil

54
Q

What is first line contraceptive treatment for endometriosis patients?

A

COCP

55
Q

Fill in the blank:
Bishop score of under __ indicates labour unlikely to start without induction

A

5

56
Q

How is dinoprostone administered? When is it used?

A

Vaginal pessary used in induction of labour

57
Q

Stage 1 of labour is divided into latent and active phase, determined by dilatation of how many cm?
1. Latent
2. Active

A
  1. 0-3cm
  2. 3-10cm
58
Q

Stage 3 of labour describes what?

A

From delivery of foetus to complete delivery of placenta and membranes

59
Q

Bleeding is classed as antepartum haemorrhage from how many weeks gestation?

A

24

60
Q

Surgical intervention for ectopic pregnancy is required in sizes over what?

A

35mm

61
Q

What age range is offered cervical screening in the UK?

A

25-64

62
Q

Beta hCG levels of over what indicate the need for surgical management of an ectopic?

A

5000IU/L

63
Q

Medical management of ectopic pregnancy is achieved via what?

A

Methotrexate

64
Q

What is the upper limit for termination of pregnancy gestation?

A

24 weeks

65
Q

We should give anti-D in patients having an abortion over how many weeks?

A

10

66
Q

Which agents are used for medical management of termination of pregnancy?

A

Mifepristone followed by misoprostol 48 hours later

67
Q

What is the first line treatment for BV?

A

Oral metronidazole for 5-7 days

68
Q

Clue cells on microscopy suggest what?

A

BV

69
Q

Bacterial vaginosis presents with what kind of pH?

A

Raised

70
Q

What treatment should be given to pregnant women who develop:
1. BV
2. Thrush

A
  1. BV - oral metronidazole 5-7 days (same as non pregnant)
  2. Topical clotrimazole 500mg pessary (oral C/I)
71
Q

What is the definitive treatment for ovarian torsion?

A

Laparoscopy

72
Q

What is the most common causative organism in BV?

A

Gardnerella

73
Q

What is the first line treatment in PID?

A

IM ceftriaxone stat + 14 days oral doxycycline + oral metronidazole

74
Q

Right upper quadrant pain in a patient with a history of PID suggests what complication has occurred?

A

Perihepatitis / Fitz-Hugh Curtis Syndrome

75
Q

Fill in the blank:
All women over the age of __ with PMB should be urgently referred for ultrasound to investigate for __

A

55
Endometrial cancer

76
Q

Cervical ectropion is most common in women taking what medication?

A

COCP

77
Q

Which rheumatological disorder can lead to recurrent miscarriages?

A

Antiphospholipid syndrome (APS)

78
Q

How should ovarian cysts that are 5-7cm be managed?

A

Annual TV USS

79
Q

How should ovarian cysts over 7cm be managed?

A

MRI with/without surgical intervention

80
Q

Which medication can help prevent formation of new ovarian cysts?

A

COCP

81
Q

Premature ovarian insufficiency occurs in women under what age?

A

40

82
Q

Which hormones are raised in premature ovarian failure?

A

FSH and LH

83
Q

Fill in the blank:
To diagnose premature ovarian failure, FSH levels must be above __ on 2 blood samples taken __ apart

A

30IU/L
4-6 weeks

84
Q

Which medication can be used for vasomotor symptoms in menopause?

A

Clonidine

85
Q

The combined oral contraceptive pill has a protective effect against which 2 reproductive cancers?

A

Endometrial and ovarian

86
Q

Normal endometrial thickness is defined as under how many mm?

A

4

87
Q

Which 3 types of HPV are the biggest risk for developing cervical cancer?

A

16, 18, 33

88
Q

Which 2 HPV subtypes are not associated with cancer? What are they associated with instead?

A

6 and 11, genital warts

89
Q

CA 19-9 is associated with what?

A

Pancreatic cancer

90
Q

What is the most common identifiable cause of postcoital bleeding?

A

Cervical ectropion

91
Q

PID most commonly increases the risk of what pregnancy complication?

A

Ectopic

92
Q

Anastrozole is an example of what type of medication?

A

Aromatase inhibitor

93
Q

Aromatase inhibitors decrease levels of what hormone?

A

Oestrogen

94
Q

Aromatase inhibitors are associated with what side effect?

A

Osteoporosis

Year 4 Placements (10 decks)

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