Obs + gynae Flashcards
What is a side effect of magnesium sulphate toxicity?
loss of deep tendon reflexes (1st symptom), respiratory depression, and cardiac arrest
What is the most common cause of postmenopausal bleeding?
Vaginal atrophy
What disease causes post-coital bleeding in pre-menopausal?
Cervical cancer
What is the most common cause of puritis vulvae (itching)?
Contact dermatitis
What is given for stress incontinence?
Duloxetine
What is given for urge incontinence?
Oxybutynin
What does COCP protect you against?
ovarian and endometrial cancer
What does COCP increase the risk of?
breast and cervical cancer
When can expectant management of an ectopic pregnancy be performed?
1) An unruptured embryo
2) <35mm in size
3) Have no heartbeat
4) Be asymptomatic
5) Have a B-hCG level of <1,000IU/L and declining
What are the symptoms of uterine fibroids?
Menorrhagia, anaemia, bulk-related symptoms e.g. bloating/urinary frequency
What is Ovarian hyperstimulation syndrome caused by?
Side effect of ovulation induction/ IVF
What are symptoms of Ovarian hyperstimulation syndrome ?
ascites, low blood pressure and tachycardia
What is lochia?
Bleeding that presents for the first 2 weeks following giving birth (vaginal or C-section birth).
How to treat lochia?
Reassure and discharge unless red flags:
- bad smell
- increase in blood loss/ is not stopping
- abnormal stats/ NEWs
What is given for severe nausea and vomiting in pregnancy?
- 1st line is Metoclopramide
- 2nd line is Ondansetron
What do you give for hirsutism and acne for PCOS?
COCP
What do you give for oligomenorrhoea for PCOS?
Levonorgestrel-releasing intrauterine system
A women suffered from an eclamptic seizure and was given magnesium sulfate. When do you stop the magnesium sulphate?
Magnesium treatment should continue for 24 hours after delivery or after last seizure (whatever comes last)
What is the initial management of a pregnant woman who reports reduced fetal movements?
handheld Doppler should be used to confirm fetal heartbeat as a first step
What is the gold standard investigation for endometriosis?
Laparoscopic visualisation of the pelvis
At what age can you NOT consent for sexual intercource?
younger than 13 (so 12 and below)
What are symptoms of cocaine abuse in pregnant women?
- placental abruption which causes hyperreflexia
- dilated pupils
What are symptoms of heroin abuse in pregnant women?
- does NOT cause placental abruption
- pinpoint pupils
What can cause placental abruption?
- Cocaine abuse
- pre-eclampsia
- HELLP syndrome
What bacterial will ause neonatal sepsis after prolonged premature rupture of membranes (PROM)?
Group B Streptococcus
When can’t Ulipristal be used?
in severe asthmatics
What are the C-section categories?
- immediate threat to the life of the mother or baby. Must be done in 30 min
- maternal or fetal compromise which is not immediately life-threatening. Must be dine in 75 min
- delivery is required, but mother and baby are stable
- elective caesarean
If you have a bishop score </= 6, what should be used to induce labour?
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
If you have a bishop score 7 or 8, what should be used to induce labour?
amniotomy and an intravenous oxytocin infusion
What bishop score indicates that labour will unlikely start without induction?
<5
What bishop score indicates that labour will be likely spontaneous?
> /= 8
When can you not give the COCP in breastfeeding women?
<6 weeks postpartum
When can a external cephalic version (ECV) be attempted?
36 weeks for primiparous women, and at 37 weeks for multiparous women
Can nearly all anti-epileptics be given to breast feeding women?
Yes
What are the blood results of a molar pregnancy?
Hugh beta hCG, low TSH, high thyroxine
What is given first line for hyperemesis gravidarum?
0.9% saline with potassium
When is lifestyle changes gone in gestational diabetes?
Fasting plasma glucose <7
When is insulin +/- metformin given in gestationa, diabetes?
Fasting glucose >7
