Obstetrics And Gynaecology

Question 1

Name the risk factors for cervical cancer

Answer 1

1. HPV infection
2. Smoking
3. HIV
4. Early first intercourse, multiple sexual partners
5. High parity
6. Lower socioeconomic status
7. COCP

Question 2

COCP is protective against which cancers?

Answer 2

1.Ovarian
2.Endometrial
3. Colorectal

Question 3

COCP causes increase of which cancers?

Answer 3

1. Breast
2. Cervical

Question 4

25 year old
Came after an episode of unprotected intercourse.
Concerned about unwanted pregnancy
Last menstrual period was two weeks ago.

Most appropriate action?

Answer 4

Arrange for copper coil ( IUD ) insertion.
( The IUD is effective in preventing pregnancy for up to 5 days ( 120 hours ) following unprotected intercourse ( if not yet ovulated ) or up to five days following ovulation and acts to prevent fertilisation or implantation respectively. If there are concerns about the presence of STD, antibiotics can be given concurrently )

Question 5

Pregnant lady + pruritus without rash

Important diagnosis to rule out?

Answer 5

Obstetric cholestasis

It increases the risk of complications such as prematurity, passages of mechanism, postpartum haemorrhage, and possibly still birth.
LFT is the most importation test for check.

Another important differential is IDA, so FBC would be also relevant.

Question 6

State the risk factors for gestational diabetes.

Answer 6

BMI > 30kg/m2
Previous macroscopic baby weighing ≥4.5kg
Previous gestational diabetes
First-degree relative with diabetes
Family origin with a high prevalence of diabetes ( South Asian, black Caribbean, Middle eastern )

Question 7

Diagnostic thresholds for gestational diabetes

Answer 7

Fasting glucose ≥5.6mmol/L
2-hour glucose ≥7.8mmol/L

Question 8

Patient with breast cancer
Wants contraception

Answer 8

Copper IUD
Breast cancer is a contraindication to all hormonal forms of contraception.

Question 9

What is the first line treatment for menorrhagia in a patient who requires contraception?

Answer 9

Intrauterine ( IU ) system: Mirena is first line.

Question 10

What is the first line treatment for menorrhagia in a patient who requires contraception?

Answer 10

Intrauterine ( IU ) system: Mirena is first line.

Question 11

Treatment of bacterial vaginosis in pregnancy

Answer 11

Oral metronidazole

Question 12

Medication in the treatment of cognitive symptoms in vascular dementia.

Answer 12

Specifically for vascular dementia there is none currently. The treatment is to control the underlying comorbidites.

Question 13

State the potential problems that may arise from the insertion of a IUD.

Answer 13

1. Periods will tend to be longer, heavier and more painful.
2. Proportion of pregnancies that are ectopic is increased but the absolute number of ectopic pregnancies is reduced.