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Finals - Systems Paper > Obstetrics/Gynaecology/Breast/Contraception > Flashcards

Obstetrics/Gynaecology/Breast/Contraception Flashcards

1
Q

Mechanism and risks COCP

A

Inhibits ovulation

Cervical and breast cancer, VTE

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2
Q

Mechanism and risks POP

A

Thickens cervical mucous

Breast cancer

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3
Q

Mechanism injectable and how often

A

Inhibits ovulation and thickens mucous

12w

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4
Q

Contraception most associated weight gain

A

Injectable

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5
Q

Mechanism implant and how long lasts

A

Inhibits ovulation and thickens mucous

3y

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6
Q

Irregular bleeding common contraception adverse

A

POP
Implant
IUS

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7
Q

COCP missed 2 pills

A

Condom 7d
Week 1 - emergency
Week 2 - none
Week 3 - skip pill free week

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8
Q

Emergency cannot use with asthma

A

Ullupristal

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9
Q

Most common breast cancer

A

Invasive ductal carcinoma

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10
Q

Breast cancer screening

A

Every 3y between 50 to 70

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11
Q

When do masectomy and when wide local excision

A

Masectomy - multifocal, or >4cm

Wide locatl - solitary and <4cm

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12
Q

Treatment for auxillary node clearance

A

If no lymphadenopathy - US then sentinal node biopsy if positive

If lymphadenopathy - auxillary node clearance

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13
Q

When is radiotherapy used breast cancer

A

If masectomy - T3 or above

If wide local - always

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14
Q

Hormonal therapy for oestrogen +ve receptors breast cancer

A

Premenopausal - tamoxifen

Postmenopausal - anastrazole (aromatase inhibitors)

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15
Q

Treatment for Her2 positive breast cancer

A

Trastuzumab (Herceptin)

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16
Q

Prognosis criteria for breast cancer

A

Nottingam prognostic index

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17
Q

Mastitis/abscess treatment

A

1) Continue breast feeding

2) Fluclox if systemicaly unwell

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18
Q

Treatment fibroadenoma

A

Conservative, unless >3cm then resection

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19
Q

Mechanism tamoxifen

A

Oestreogen receptor antagonist and partial agonist

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20
Q

Anastrozole mechanism

A

Reduced peripheral oestrogen synthesis

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21
Q

“Snowstorm appearance”

A

Breast implant rupture

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22
Q

“Halo sign”

A

Breast cyst

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23
Q

Diagnosis atrophic vaginitis

A

By exclusion

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24
Q

Treatment atrophic vaginitis

A

Lubricants and oestrogen creams

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25
Q

Most common ectopic location and most dangerous

A

Common - ampulla

Dangerous - isthmus

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26
Q

Diagnose ectopic

A

Transvaginal US

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27
Q

Ectopic treatment decide method

A

Expectant - asymptomatic and <35mm and hCG < 1000

Medical - little pain, hCG < 1500

Surgery - size > 35mm, rupture, pain, heatburn, hCG > 5000

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28
Q

Ectopic medical treatment

A

Methotrexate

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29
Q

Diagnose pelvic inflammatory disease

A

High vaginal swab and NAAT

HIV and syphilis tests

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30
Q

Treatment PID

A

IM ceftiaxone and oral deoxycycline and oral metronodazol

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31
Q

Identify Fits Hugh Curtis syndrome

A

PID and RUQ pain

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32
Q

Treatment urge incontinence

A

1) Antimuscurinics (oxybutynin) and bladder retraining

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33
Q

Treatment stress incontinence

A

1) Pelvic floor exercises
2) Surgery
2) Duloxetine

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34
Q

Cervical cancer screening

A

5 yearly from 25 to 64

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35
Q

Endometriosis diagnosis

A

Laparoscopy

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36
Q

Endometriosis treatment

A

1) NSAID - mefanemic acid
2) COPC
3) Referal - GnRH analogue or surgery

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37
Q

Fibroid diagonsis

A

Transvaginal US

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38
Q

Fibroids treatment

A

1) IUS - if no distortion
2) COCP and NSAID
3) GnRH to reduce size and myomectomy

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39
Q

Fibroid complication during pregnancy

A

Degeneration - pain and fever and vomiting

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40
Q

Menopause definition

A

If under 50 - 24m after last period

If over 50 - 12m after last period

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41
Q

Treatment menopause

A

1) Lifestyle
2) HRT - progesterone only if no uterus
3) SSRI/CBT

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42
Q

Commonest ovarian cyst

A

Follicular cyst - benign

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43
Q

Ovarian cyst contains hair/teeth

A

Dermoid cyst

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44
Q

Diagnosis ovarian cyst

A

US

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45
Q

Can be massive ovarian cyst

A

Mucinous cystadenoma

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46
Q

Staging for cervical cancer system

A

FIGO

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47
Q

Cervical cancer treatment

A

Hysterectomy and lymph node clearance

Cone biopsy if want to preserve fertility

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48
Q

Diagnose endometrial cancer

A

Transvaginal US

Hysteroscopy and biopsy

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49
Q

Risks ovarian cancer

A

Many ovulations

BRCA 1 and 2

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50
Q

Diagnosis ovarian cancer

A

CA125
US
CT scan establish and stage

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51
Q

FIGO staging ovarian cancer

A

1) Confined ovary
2) Outside ovary but in pelvis
3) Outside pelvis but in abdomen
4) Outside abdomen

52
Q

Most common ovarian tumour

A

Serous tumour

53
Q

“Signet ring”

A

Krukenberg tumour in ovary from GI tract

54
Q

Infertility diagnosis

A

Progesterone levels 7 days before next period

Semen analysis

55
Q

Termination of pregnancy method

A

<9w - mifepristane

>9w - surgery

56
Q

Definition miscarriage and still birth

A

Miscarriage <24w

Stillbirth >24w

57
Q

Treatment miscarriage

A

1) Expectant
2) Vaginal misoprostol
3) Surgery

58
Q

What is adenomyosis

A

Endometrial tissue within myometrium

59
Q

Identify adenomyosis

A

Large boggy uterus

Painful and heavy periods

60
Q

What is cervical ectropion

A

Elevated oestrogen levels cause larger areas columnar epithelium at ectocervix

61
Q

“Snow storm”

A

Complete hydaidiform mole

62
Q

Treatment dysmenorrhoea

A

1) NSAID - mefenamic acid

2) COCP

63
Q

“Whirlpool sign”

A

Ovarian torsion

64
Q

Diagnosis ovarian torsion

A

Laparoscopy, also for treatment

65
Q

What is Meigs syndrome

A

Benign ovarian cyst causing ascites and pleural effusion

66
Q

What is Sheehans syndrome

A

Postpartum pituitary infarction causing global hypopituiritism

67
Q

“Chocolate cyst”

A

Endiometriotic cyst

68
Q

How long pregnancy test positive after miscarriage

A

4w

69
Q

What is Asherman syndrome

A

Scar tissue in uterus following previous surgery causing amenorrhoea

70
Q

What is premature ovarian failure

A

<40y

71
Q

Diagnose VTE in pregnancy

A

1) Doppler US
2) Ventilation perfusion scan

Cannot use D dimer or wells score in pregnancy

72
Q

Treatment VTE in prengnacy

A

1) LMWH

73
Q

Treatment eclampsia

A

1) Magnesium sulphate

2) Calcium gluconate

74
Q

HELPP syndrome

A

Haemolysis, elevated liver enzymes and low platelets

75
Q

Treatment postpartum haemorrhage

A

1) IV syntocin or ergometrine
2) Intrauterine baloon tamponade, B lynch suture, uterine artery ligation
3) Hysterectomy

76
Q

“Woody uterus”

A

Placental abruption

77
Q

Diagnosis placental abruption

A

Clinical, US exclude placenal praevia

78
Q

Treatment placental abruption

A

<36w - steroids if no distress, caesarean if distress

> 36w - vaginal no distress, caesarean distress

79
Q

Treatment cord prolapse

A

Patient get on all 4s
Tocolytics reduce contractions
If cord past introitis minimal handling

80
Q

Postnatal depression assessment

A

Edinburgh postnatal depression scale

81
Q

Baby blues treatment

A

Reassurance and follow up

82
Q

Postnatal depression treatment

A

1) CBT

2) SSRI - sertraline or paroxetine

83
Q

Peurperal psychosis treatment

A

Admission together with baby

84
Q

Gestational diabetes diangosis

A

Oral glucose tolerance test:

  • fasting 5.6
  • 2h 7.8
85
Q

Treatment gestational diabetes

A

If fasting <7:

1) Diet and exercise
2) Metformin after 2w
3) Insulin

If fasting >7:
1) Insulin

86
Q

Gestational diabetes complications

A

Macrosomia

Polyhydramnios

87
Q

Epilepsy drug choice in pregnancy

A

Lamotrigine

88
Q

Identify pregnancy induced hypertension

A

20 weeks or later

No proteinuria, no oedema

89
Q

Identify pre-eclampsia

A

Pregnancy induced hypertension and proteinuria (>0.3g/24h)

90
Q

Pre-eclampsia prophylaxis

A

Aspirin 75mg from 12w to birth

91
Q

Hypertension treatment pregnancy

A

1) Labetolol

2) Nifedepine

92
Q

Obesity treatment in pregnancy

A

Folic acid 5mg from conception to 12w

Screening for gestational diabetes at 24 and 28w

93
Q

Levothyroxine in pregnancy

A

Increase by 30-50%

94
Q

Cut of for iron therapy in pregnancy

A

1st trimester - <110
2/3rd trimester - <105
Post partum <100

95
Q

Identify hypermesis gravidarum

A

Triad:

  • 5% pre pregnancy weight loss
  • dehydration
  • electrolyte imbalance
96
Q

Scoring system hypermesis gravidarum

A

PUQE

97
Q

Treatment hypermesis gravidarum

A

1) Oral cyclizine or promethazine
2) Ondansetron or metochlopramide

Admit if unable to keep things down, ketones

98
Q

Diagnosis placental praevia

A

Transvaginal US

99
Q

Treatment low lying placenta at 20w

A

1) Reasses at 34w and scan every 2

2) If still low at 37w then elective caecaerean

100
Q

Treatment bleeding placental praevia

A

1) Emergency caecrean if not able to stabilise

101
Q

Definition of premature labour

A

<37w

102
Q

Diagnosis preterm prelabour rupture of membranes

A

Speculum first then US

103
Q

Treatment preterm prelabour rupture of membranes

A

Oral erythromycin 10d
Corticosteroids
Consider delivery at 34w

104
Q

Diagnosis preterm labour in tact membranes

A

<30w - speculum

>30w - transvaginal US

105
Q

Treatment preterm labour in tract membranes

A

Tocylysis - nifedepine
Corticosteroids if <35w
IV magnesium sulphate if <34w

106
Q

Drug to suppress lactation

A

Dopamine agonist (eg cabergoline)

107
Q

What is vasa praevia

A

Foetal vessels are within foetal membrane and travel across internal cervical OS

108
Q

Stages of labour

A

1) Onset to cervix fully dilated
2) Full dilation to delivery foetus
3) Delivery foetus to delivery placenta

109
Q

When is anti-D prophylaxis given if needed routine

A

Week 28 and week 34

110
Q

When is presentation checked and external cephalic version offered if indicated

A

Week 36

111
Q

When is induction if late

A

Week 41

112
Q

When is anomaly scan

A

18-21w

113
Q

When is early scan confirm dates

A

10-14w

114
Q

When is booking visit

A

8-12w

115
Q

When is down syndrome screening

A

11-14w

116
Q

Increases AFP

A

Neural tube defect

Abdominal wall defect

117
Q

Decreases AFP

A

Down syndrome

Trisomy 18

118
Q

Breastfeeding contraindications

A 
Lithium, benzos
Methotrexate
Sulphonylureus
Asprin
Amiodarone
Some antibiotics

EPILEPSY DRUGS SAFE

119
Q

Breech presentation treatment

A

36w - offer external cephalic conversion

If fails - planned caesarean

120
Q

Down syndrome reslts

A

Increased HCG
Increased nuchal translucency
Decreased PAPP-A

121
Q

Treatment group B strep in pregnancy

A

Intrapartum antibiotics:

- benzylpenicillin

122
Q

Induction of labour scoring

A

Bishop score:

- >8 high chance

123
Q

Induce labour

A

Membrane sweep
Vaginal prostaglandin
Oxytoxin infusion

124
Q

Intrahepatic cholestasis of pregnancy treatment

A

Ursodeoxycholic acid

Induction at 37w

125
Q

When to refer if no movements felt

A

24w

Finals - Systems Paper (20 decks)

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