obstetrics

Question 1

when is gestational diabetes screened for

Answer 1

after 24 weeks

Question 2

test and diagnostic values for gestational diabetes

Answer 2

• OGTT
• Fasting >5.6 = GDM
• 2hrs postprandial > 7.8 = GDM

Question 3

treatment options for GDM

Answer 3

1. diet and exercise if <7mmol/l fasting
2. initiate insulin ± metformin immediately if fasting glucose >7mmol/l

Question 4

1st line Mx for baby with breech presentation + when

Answer 4

external cephalic version offered as early as week 36

Question 5

MC site of ectopic pregnancy

Answer 5

fallopian tube:
ampulla> isthmus> fimbria

Question 6

which factor is most likely contributing to the polyhydramnios?
Other causes

Answer 6

maternal diabetes»>
other causes are chromosomal abnormalities foetal renal issues, foetal anaemia

Question 7

how might oligohydramnios present

Answer 7

abnormally prominent foetal parts on abdominal palpation

Question 8

complication of oligohydramnios

Answer 8

foetal pulmonary hypoplasia

Question 9

main RF for oligohydramnios

Answer 9

smoking

Question 10

GBS microscopic morphology

Answer 10

gram +ve cocci

Question 11

define a complete molar pregnancy and what is seen on USS

Answer 11

• sperm fertilises an egg with no DNA
• shows up as snowstorm sign on USS

Question 12

define a partial molar pregnancy and what is seen on USS

Answer 12

• 2 sperm cells fertilise an egg with DNA
• USS shows foetal tissue in the uterus

Question 13

postpartum contraceptive advice

Answer 13

• no contraception is needed for 21 days postpartum.
• lactational amenorrhoea can only be used up to 6 months postpartum and if mum is exclusively breastfeeding and remains amenorrhoeic

Question 14

name an absolute contraindication for vaginal birth after C-section

Answer 14

a classic c-section - vertical scar.

Question 15

signs of hypokalaemia on ECG

Answer 15

U waves,
small or absent T waves,
prolonged QT and PR intervals along with
ST depression.

Question 16

what HRT regimen should you give perimenopausal women

Answer 16

Monthly cyclical hormone-replacement therapy where oestrogen is taken daily, and a progestogen is given for the last 10–14 days of each cycle as this mimics premenopausal menstrual cycle with a withdrawal bleed

Question 17

what HRT regimen should you give postmenopausal women

Answer 17

Continuous combined HRT is a treatment regimen whereby oestrogen and progestogen are both taken daily

Question 18

1st line Mx of menorrhagia

Answer 18

mirena coil
if wanting to get pregnant - TXA

Question 19

what is a nabothian cyst

Answer 19

Nabothian cysts are normal cervical findings in women [especially women that have had kids], appearing as small, amber mucous-filled cysts around the cervical os, resulting from epithelial transition areas that secrete and trap mucous.

Question 20

lichen sclerosis 1st Line Tx

Answer 20

clobetasol 0.05% - potent topical steroid