pass med questions obgyn

Question 1

If a woman has an inadequate smear test result in what timeframe should they have a repeat smear?

Answer 1

repeat the test in 3 months
- inadequate means that the cells weren’t able to be visualised properly, no evidence that the transformation zone was properly sampled

Question 2

what is a smear test detecting

Answer 2

smear tests are done on a HPV first system.
If there is evidenced of HPV, then only after is a cytological exam performed

Question 3

if there are two consecutive inadequate smear samples then what is the next step?

Answer 3

carry out a colposcopy

Question 4

what are two common causes for hyperemesis gravidarium

Answer 4

this is usually due to high levels of BhcG, the body isn’t used to this hormone.
If it is a twin pregnancy or a molar pregnancy.

Question 5

which medication is often used to treat hyperemesis gravidarium

Answer 5

prochlormethazine

Question 6

why would you avoid using metoclopramide in HG

Answer 6

avoid using it for more than 5 days as it can cause acute dystonia

Question 7

what is the treatment for thrush in non-pregnant women

Answer 7

single dose of oral - fluconazole

Question 8

which part of the fallopian tube is an ectopic pregnancy more likely to rupture

Answer 8

isthmus as it is the most narrow part of the fallopian tube

Question 9

how would you manage a pregnant woman who is <6 weeks pregnant and presents with vaginal bleeding but no pain

Answer 9

• monitor expectantly and repeat pregnancy test in 7 days
  *if negative then this confirms a miscarriage
• if the test is positive or the symptoms continue to worsen then this is a urgent referral to EPAU

Question 10

if someone presents with premature ovarian insufficiency and they present with a raised FSH then what’s the next step

Answer 10

repeat a FSH test in 4-6 weeks and it should remain raised

Question 11

what is cervical excitation and when is it seen

Answer 11

• cervical excitation is also known as cervical motion tenderness, this when there is pain in the cervix when it is being moved in a pelvic exam
• it is often seen in PID and ectopic pregnancy

Question 12

what is the timeframe of a threatened miscarriage?

Answer 12

painless vaginal bleeding before 24 weeks
cervical os is closed

Question 13

When do you need to take a progesterone test

Answer 13

7 days before the next expected period

Question 14

progesterone in HRT increases the risk of what?

Answer 14

breast cancer

Question 15

how long should someone wait post partum for a smear test

Answer 15

12 weeks

Question 16

when would you prefer to do a laparoscopic salpingotomy vs salpingectomy

Answer 16

when there is a high risk of infertility in the woman, for example if they have PID, multiple adhesions

Question 17

what are some indications to immediately refer to EPAU

Answer 17

woman with a positive pregnancy test with:
- positive pregnancy test
- abdominal pain
- cervical motion tenderness

Question 18

when would surgical options in a miscarriage be necessary

Answer 18

• if there is evidence of haemorrhage or infection

Question 19

what is the treatment for PID

Answer 19

stat IM Ceftriaxone (gonorrhoea)
14 days oral doxy (chlamydia)
and metro (trichomonias)

Question 20

what is endometriosis a big risk factor for

Answer 20

ectopic pregnancy, the blastocyst has been implanted in other endometrial tissue

Question 21

which ovarian tumour is associated with endometrial hyperplasia

Answer 21

granulose cell tumours

Question 22

widely spaced nipples and primary amenorrhoea which are characteristics seen in

Answer 22

Turners syndrome Turner’s syndrome is caused by the presence of only one sex chromosome (X) or a deletion of the short arm of one of the X

Question 23

what is a diagnostic test for turners syndrome

Answer 23

increased FSH / LH levels

Question 24

High-risk human papillomavirus (hrHPV): POSITIVE.
Cytology: NEGATIVE.
what’s the next step

Answer 24

just continue with regular smear testing, only need to do colposcopy if the cytology comes back as abnormal

Question 25

at what age is premature menopause

Answer 25

40

Question 26

after 36 weeks of pregnancy a woman gets chicken pox what is the effect on the baby

Answer 26

This is the time when your baby is at greatest risk of getting chickenpox. If your baby is born within 7 days of your chickenpox rash appearing or you get chickenpox within the first week after birth, your baby may get severe chickenpox. He or she will be given VZIG and treated with an antiviral drug called aciclovir and monitored closely after birth.

This causes a risk of neonatal sepsis / disseminated infection
after 36 weeks baby is at a high chance of getting neonatal chickenpox

Question 27

infection of chicken pox between 28 and 36 weeks in the mum can cause what affect in the baby

Answer 27

it can cause the baby to be exposed to the virus, it will stay dormant in the body and reappear as shingles

Question 28

at first pregnancy will you likely feel baby move closer to 16 weeks or 20 weeks

Answer 28

closer to 20 weeks
if no movement by 24 weeks then this is bad

Question 29

menopause can cause which type of incontinence

Answer 29

stress
muscles are weakened

Question 30

69 year old woman has dramatic increase in urinary frequency, she has urgency, dysuria, and constantly wears a pad, she has been post menopausal for 20 years. She is not on HRT and urinalysis reveals blood and protein. Pelvic examination reveals there is a tender mass palpable anterior to the vagina what do you think this is and how would you manage it??

Answer 30

??

Question 31

18 year old who started periods art 12 has heavy menstrual bleeding for 7-8 days which are not painful since then. What do you think its could be and what would your investigation be.
her Hb is low and platelets would be low

Answer 31

clotting as her platelets are low and her periods have always been heavy and non painful.

its not always first line ti do thyroid tests unless they have signs of thyroid dysfunction usually hypothyroidism
its not first line to do ferritin either

Question 32

In pregnant woman if they have a UTI, what would your investigation be

Answer 32

MSU and urine dip, urine dip will show there is an infection and the MSU will show the culture and the antibiotics

Question 33

what UTI meds do you give to pregnant woman and when

Answer 33

nitrofurantoin during the first and second trimester as in the last it can cause heamolysis
trimethoprim can cause low folate in the first trimester so it is not safe to give.

Question 34

what is the most common cause for small for gestational age fetus

Answer 34

placental insufficiency

Question 35

when do you do fetal blood sampling

Answer 35

Diagnose blood disorders, like fetal anemia
Diagnose fetal infections, such as toxoplasmosis
Diagnose genetic or chromosome abnormalities
Check oxygen levels in the baby
Give certain medicines to the baby

Question 36

sagittal sinus thrombosis