OnG

Question 1

Criteria of Pre-eclampsia
- how many weeks
- BP (how many times)
- Urine

Answer 1

> 20 weeks
BP >/= 140/90 on 3 occasions, >4 hour
Proteinuria: urine PCR >30 or
>/= 0.3g/24hr

Question 2

Pre-eclampsia Mx
- BP
- Seizure (what to check, reversal)
- if baby <34 week

Answer 2

• (> 150/100) Labetelol/ Nifidipine
• MgSO4 : check areflexia ,
  Ca gluconate 10ml 10 min
• steroid to mature lung

Question 3

Eclampsia Immediate Mx (3)

Answer 3

1. ABCDE
2. IV labetelol ASAP
3. MgSO4
   IV 4g in 20min, then 1g/hr for 24hr
   IM 10g

Question 4

Oligohydramnios vs Polyhydramnios
- Amniotic fluid index
- amount in ml
- Cx

Answer 4

• <5 ; >25
• <500
• Pulmonary hypoplasia; Cord prolapse/ malposition/ abruptio

Question 5

Macrosomnia baby weight?
Low body weight?
SGA?

Answer 5

4.5 kg above
< 2.5 kg
<10th percentile

Question 6

IUGR check what? (3)

Answer 6

• Infection (CMV, toxoplasmosis, syphilis)
• Umbilical artery Doppler (uteroplacental insufficiency)
• Karyotype

Question 7

Post-partum Haemorrhage : Cause (4)

Answer 7

Uterine atony
Laceration
Retained placenta
Thrombocytosis

Question 8

Mx of PPH d/t uterine atony (3 Med, 2 non-Med)

Answer 8

Uterine massage
Syntometrine
Hemabate IM 250mg (after placenta delivery; max 3, each 15min apart)
Trenaxamic acid (stop bleeding)

Manual/ Buckley balloon

Question 9

Contraindication of vaginal delivery (5)

Answer 9

• malpresentation
• placenta previa major
• previous C sec
• Cephalopelvic disproportion (macrosomnia)
• prolonged 2nd stage of Labour (primi >12hr; multi >8hrs)

Question 10

FGR vs SGA
What parameters and < percentile?

Answer 10

FGR Estimated fetal weight
SGA Body weight

< 10th percentile

Question 11

Diagnosis GDM cutoffs?
Fasting & 2hr PP

Answer 11

Fasting: 5.1
2hr PP: 7.8

Question 12

Target maintenance level GDM?
Fasting and 2hr PP

Answer 12

Fasting 5.3
2hr PP 6.7

Question 13

2 medications for GDM mum?

Answer 13

Metformin, low dose Aspirin (12wk- birth)

Question 14

When do we start insulin for pregnant mothers? (2)

Answer 14

• 1st screening FBG>/= 7
• Metformin fails to reduce

Question 15

LGA possible causes? (5)

Answer 15

• wrong date
• Fibroid
• Polyhydramnios
• Macrosomnia
• Multiple pregnancy

Question 16

SGA possible causes? (5)

Answer 16

• wrong date
• oligohydramnios
• IUGR/ death
• Head engaged
• Malposition

Question 17

Infective screening for mum? (4)

Answer 17

Hep B
Hep C
HIV
Syphilis

Question 18

Leiomyoma/ Fibroids common presentations? (3)

Answer 18

Menorrhagia
Compressive symptoms
+- dysmenorrhea

Question 19

Adenomyosis common symptoms? (4)

Answer 19

Globular uterus
Dyspareunia
Dysmenorrhea
Menorrhagia

Question 20

Symptoms of Gynae cancer:
Post coital bleed=
Post menopausal bleed =

Answer 20

• cervical cancer
• endometrial cancer

Question 21

What is Endometriosis, symptoms ?

Answer 21

Invasion of endometrial lining out of uterus
Dysmenorrhea, dyspareunia, adnexal mass
(X Menorrhagia)

Question 22

Pharmacological Tx for endometriosis?
Symptoms, Pain

Answer 22

Visanne (dienogest)
Mirena IUD (levonorgestrel)
Mefenamic acid (ponstan)

Question 23

Criteria for PCOS (3)
Name & criteria

Answer 23

Rotterdam Criteria
- Oligo/amenorrhea (<8/yr)
- U/S: polycystic >/= 12
- Hyperandrogenism (Testos> 5nmol/L)

Question 24

Which hormone elevated in PCOS?

Answer 24

LH (LH: FSH >/= 3:1)
Testosterone
Estrogen

Question 25

Colposcopy diagnostic for what cancer?
What is used?

Answer 25

Cervical cancer
Acetic acid -> white = abnormal

Question 26

Tumor marker:

CA- 125
CA 19-9
AFP
CEA

Answer 26

CA- 125: Ovarian CA (serous)
CA 19-9: GI, biliary, ovary(mucinous)
AFP: Liver CA, Teratoma
CEA: Breast, ColoR

Question 27

COCP and risk of cancer?
(Breast, ovarian, endometrial)

Answer 27

Increase: Breast Cancer
Reduce: Endometrial, ovarian cancer

Question 28

Pre-eclampsia symptoms to ask? (4)

Answer 28

• Headache
• Blurry vision
• Abdominal pain
• N/V

Question 29

When can we do GBS swab ?

Answer 29

36-37 week