Obstetrics and Gynaecology Flashcards by Eleanor Shaw

what does bishops score assess

induction: dilation, effacement, station, cervical position

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when do you give anti D if mother is rhesus negative?

28 weeks and after a sensitising event (72h)

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management of detrusor over activity

bladder training
oxybutynin
mirabegron

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management of stress incontinence

pessary, colposuspension, tension free vaginal tape

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diagnosis of PCOS

> 12 small follicles in an enlarged ovary +

hirsutism, oligomenorrhea, high testosterone

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investigations in PCOS

LH and FSH on days 2-5
prolactin
testosterone
TFTs
TVUSS
BMs
cholesterol

cortisol - rule out cushings
17 hydroxyprogesterone - rule out CAH
DHEAs

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diagnosis of GDM

> 5.6 random glucose

>7.8 OGTT - 24-28 weeks

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management of GDM

lifestyle
metformin / glibenclamide
insulin if >7

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risk factors for breast ca

lots of oestrogen:

nulliparity, early menarche, late menopause, combined HRT, not breast feeding, obesity

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risk factors for ovarian cancer

lots of oestrogen:

nulliparity, early menarche and late menopause

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risk factors for endometrial cancer

HRT (oestrogen), nulliparity, early menarche, lat menopause, PCOS, diabetes

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risk factors for cervical cancer

HPV 16 + 18

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types of ovarian cancer

serous adenocarcinoma
thecoma - sex cell
teratoma/dermoid - germ cell

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investigations in ovarian cancer

risk of malignancy index:
CA125
menopausal status
USS

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hormone drugs used in treatment of breast cancer

tamoxifen - ER +ve

trastuzumab - HER2 +ve

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investigation in endometrial cancer

TVUSS (should be under 4mm thick)
pipelle biopsy
hysteroscopy
FIGO staging

cervical cancer screening

liquid based cytology every 3 years from age 25-49 and 5 years from 50-64

management of grade 1-3 CIN

1: repeat smear in 1 year
2: colposcopy +/- LETZ
3: LETZ

presentation and complications of endometriosis

subfertility, dysmenorrhea, deep dyspareunia (bleeding from elsewhere)
fibrosis, adhesions, chocolate cysts, frozen pelvis

management of endometriosis

trial hormones for 3-6 months: COCP, POP, mirena, goserelin

diagnostic laparoscopy and diathermy

causes of primary amennhorreah

imperforate hymen, X0, hyperprolactinaemia, hypothalamic, CAH, kallmans

causes of secondary ammennhorreah

(ie none for 6 months)

pregnancy, premature ovarian failure, adhesions, high prolactin, Sheehans, PCOS, cushings

when to check LH and FSH, progesterone

LH and FSH: days 2-5 (should be low)

progesterone: day 21

investigations in subfertility

STI screen
hormones: Lh and FSH, progesterone, prolactin, TFTs
sperm count (>4 million) morphology and motility
hysterosalpingogram with methylene blue

presentation in PID

abdo pain, bleeding, discharge, pareunia, cervical excitation and adnexal tenderness

management of PID

likely chlamydia / gonorrhoea | IM ceftriaxone and oral doxycycline

open os with retained products?

incomplete miscarriage

open os with empty uterus

inevitable miscarriage

closed os and large uterus with yolk sac

threatened miscarriage

management of miscarriage

expectant: wait 2 weeks and see if will resolve (threatened) or pass naturally medical: misoprostol PV / PO mifepristone surgical

presentation and investigations in gestational trophoblastic disease?

PV bleeding, morning sickness very high beta HCG TVUSS - snowstorm appearance

investigations in ectopic pregnancy

beta hCG - 48 hours apart (plateaus) | TVUSS - no yolk sac

management of ectopic

methotrexate if small, low hCG and patient well laparoscopy anti D

management of hypertension in pregnancy

labetalol and hydralazine

management of eclampsia

magnesium sulphate

management of pre eclampsia

methyl dopa

what is HELLP syndrome

assoc with htn and eclampsia haemolysis, elevated liver enzymes, low platelets can cause DIC, pulmonary oedema and renal failure

what is done at booking

``` chlamydia FBC blood group and rhesus status RBC antibodies SCD / thalassemia Hep B, HIV, rubella, syphilis urine dip ```

screening for downs syndrome

combined test 11-14 weeks PAPP-a (low), beta hCG (high) nuchal translucency quadruple at 14-20 weeks: b hCG and inhibin A (high) oestriol and AFP (low)