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Finals > Obstetrics and Gynaecology > Flashcards

Obstetrics and Gynaecology Flashcards

1
Q

what does bishops score assess

A

induction: dilation, effacement, station, cervical position

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2
Q

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

A

28 weeks and after a sensitising event (72h)

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3
Q

management of detrusor over activity

A

bladder training
oxybutynin
mirabegron

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4
Q

management of stress incontinence

A

pessary, colposuspension, tension free vaginal tape

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5
Q

diagnosis of PCOS

A

> 12 small follicles in an enlarged ovary +

hirsutism, oligomenorrhea, high testosterone

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6
Q

investigations in PCOS

A 
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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7
Q

diagnosis of GDM

A

> 5.6 random glucose

>7.8 OGTT - 24-28 weeks

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8
Q

management of GDM

A

lifestyle
metformin / glibenclamide
insulin if >7

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9
Q

risk factors for breast ca

A

lots of oestrogen:

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

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10
Q

risk factors for ovarian cancer

A

lots of oestrogen:

nulliparity, early menarche and late menopause

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11
Q

risk factors for endometrial cancer

A

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

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12
Q

risk factors for cervical cancer

A

HPV 16 + 18

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13
Q

types of ovarian cancer

A

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

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14
Q

investigations in ovarian cancer

A

risk of malignancy index:
CA125
menopausal status
USS

CT

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15
Q

hormone drugs used in treatment of breast cancer

A

tamoxifen - ER +ve

trastuzumab - HER2 +ve

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16
Q

investigation in endometrial cancer

A

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

17
Q

cervical cancer screening

A

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

18
Q

management of grade 1-3 CIN

A

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

19
Q

presentation and complications of endometriosis

A

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

20
Q

management of endometriosis

A

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

diagnostic laparoscopy and diathermy

21
Q

causes of primary amennhorreah

A

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

22
Q

causes of secondary ammennhorreah

A

(ie none for 6 months)

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

23
Q

when to check LH and FSH, progesterone

A

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

progesterone: day 21

24
Q

investigations in subfertility

A

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

25
Q

presentation in PID

A

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

26
Q

management of PID

A

likely chlamydia / gonorrhoea

IM ceftriaxone and oral doxycycline

27
Q

open os with retained products?

A

incomplete miscarriage

28
Q

open os with empty uterus

A

inevitable miscarriage

29
Q

closed os and large uterus with yolk sac

A

threatened miscarriage

30
Q

management of miscarriage

A

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

surgical

31
Q

presentation and investigations in gestational trophoblastic disease?

A

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

32
Q

investigations in ectopic pregnancy

A

beta hCG - 48 hours apart (plateaus)

TVUSS - no yolk sac

33
Q

management of ectopic

A

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

34
Q

management of hypertension in pregnancy

A

labetalol and hydralazine

35
Q

management of eclampsia

A

magnesium sulphate

36
Q

management of pre eclampsia

A

methyl dopa

37
Q

what is HELLP syndrome

A

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

38
Q

what is done at booking

A 
chlamydia
FBC
blood group and rhesus status
RBC antibodies
SCD / thalassemia
Hep B, HIV, rubella, syphilis
urine dip
39
Q

screening for downs syndrome

A

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)

Finals (18 decks)

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