Pass Medicine practice MCQ info Flashcards by serena patel

what is hellp syndrome associate with

what is it a sign of

pre eclampsia

- sign of elevate liver enzymes

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what are the cancer risk of the COCP

The COCP increases the risk of breast and cervical cancer but decreases the risk of ovarian and endometrial cancer

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2 Complications associated with a transverse lie:

pre-term rupture of the membranes

cord prolapse

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cervical cytology result that reports mild (low-grade) dyskaryosis

what is the follow up if HPV found and if not found

lab results for HPV
referred to colposcopy if HPV found

if not found, returned to routine screening

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what hormone is used to test for ovulation

Day 21 progesterone

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what is erbs palsy?

damage to brachial plexus during delivery

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what movement cant baby with erbs palsy do?

Abduct the arm from the shoulder.
Rotate the arm externally from the shoulder.
Supinate the forearm.
This results in the classic ‘porter’s tip’ or ‘waiter’s tip’ appearance

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sign of erbs palsy

arm flexed medially

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maternal RF for erbs palsy 3

macrosomnia -> BIG fetus from maternal diabetes
increased BMI
gestational diabetes

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what is shoulder dystocia

obstructed labour whereby after the delivery of the head, the shoulders fail to deliver

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Roles of E&P in HRT

E for symptomatic relief

P to protect against E adverse effects

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HCG

detected on the 8th-day post-fertilisation
secreted by the chorion and maintains the corpus luteum’s secretion of oestrogen and progesterone until the placenta takes over this role

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oestrogren in pregnancy and labour

stimulates the growth of the myometrium needed for strong uterine musculature during labour.

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sign for molar pregnancy

large-for-dates uterus

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Fitz-Hugh-Curtis syndrome (adhesions of liver to peritoneum) is associated with what?

pelvic inflammatory disease

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first drug of choice for hypertension in pregnant woman

Labetalol

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what 2 drugs should you not give for hypertension in pregnant woman

Ramipril and candesartan

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when to start pregnant woman on LMWH

with 3 risk factors should be started on LMWH from 28 weeks – 6 weeks postnatal.

With > 3 RFs should begin LMWH immediately – 6 weeks postnatal
Risk factors for thromboprophylaxis include:
Age > 35
Body mass index > 30
Parity > 3
Smoker
Gross varicose veins
Current pre-eclampsia
Immobility
Family history of unprovoked VTE
Low risk thrombophilia
Multiple pregnancy
IVF pregnancy

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bloating and cramps in over 50 year old woman…what to suspect?

raise suspicion of ovarian cancer.

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what to test in over 50 with abdo pain and bloating

CA-125

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most common cause of secondary ammenhorea

dysfunction of the hypothalamic-pituitary-ovarian (HPO) axis

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what is a choriocarcinoma

cancer the grows in woman’s womb

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first cause of primary ammenhorrea

late onset of puberty is responsible

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features of turners

short stature

webbed neck

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when can you test for gestational diabetes?

28 weeks

how do you test for gestational diabetes?

OGTT

what can gestational diabetes cause? 6

``` macrosomia, polyhydramnios, shoulder dystocia, congenital heart abnormalities, neural tube defects and neonatal hypoglycaemia. ```

what is chronic pelvic pain, deep dyspareunia, dysuria, and odorous green vaginal discharge a sign of?

gonorrhea

most common cause of PPH

uterine atony >500 ml

how long does it take for POP to be effective?

48 hours

what should blood test for menopause show?

high FSH and LH | low oestrogen

what is rhesus disease associated with?

hydrops fetalis

reason for anemia in pregnancy

increase in plasma volume disproportionate to the increase in haemoglobin --> diluted

quantitative pregnancy test looks for what hormone?

HcG

how to avoid HIV transmission from mother to baby - 3

1. retroantiviral 2. c section 3. no breast feeding

what manoeuvre helps with shoulder dystocia

McRoberts' manoeuvre

what is Vasa praevia

when the blood vessels of the fetus cross or run near to the internal opening of the uterus, beneath the baby

vasa praevia signs

fresh PV bleeding immediately following membrane rupture, and fetal heart rate abnormalities.

at risk of preeclampsia if

hypertensive disease during previous pregnancies chronic kidney disease autoimmune disorders such as SLE or antiphospholipid syndrome type 1 or 2 diabetes mellitus

BP in pregnancy

blood pressure usually falls in the first trimester (particularly the diastolic), and continues to fall until 20-24 weeks after this time the blood pressure usually increases to pre-pregnancy levels by term

what do you use to stop hypertension from developing in pregnany woman

aspirin

dexamethason

gives to reduce resp distress in infants after PROM

lochia

vaginal discharge containing blood mucous and uterine tissue which may continue for 6 weeks after childbirth.

cottage cheese discharge

thrush

bacterial vaginosis

grey white discharge

mesenteric ischemia symptoms

severe, central and worse after eating, with associated diarrhoea

dysphagia that has always had an issue with solids and liquids is what

achlasia

when should the baby change position?

30 weeks

what does raised AFP levels mean?

Omphalocele fetal abdominal wall defect

what AB to give GBS +ve mother

penicillin

placental abruption RF

high maternal age multibirths trauma

placenta abrupriton symptoms

continuous abdominal pain shock the uterus may be in spasm and feel firm or 'woody' the fetus may be hard to feel the fetal heart may be hard to auscultate

Chorioamnionitis

women with preterm-PROM with a triad of maternal pyrexia, maternal tachycardia, and fetal tachycardia uterine tenderness foul discharge

what can cause CTG deaceleration variability?

cord compression

target BP for preggo women

< 150 / 80-100 mmHg.

when is a preggo woman hypertensive?

after 20 weeks

downs test results

Low alpha fetoprotein (AFP) Low oestriol High human chorionic gonadotrophin beta-subunit (-HCG) Low pregnancy-associated plasma protein A (PAPP-A) Thickened nuchal translucency

when to screen for downs? combined test

11-13 weeks

triple test

16 weeks

vasa praevia

rupture of membranes followed by painless vaginal bleeding and fetal bradycardia

most common place for ectopic pregnancy?

ampulla

common cause of secondary amenorrhoea in atheltic woman

hypothalamic hypogonadism

whirpool sign on USS can mean...?

ovarian torsion

mild suprapubic pain at 10 weeks gestation

misccariage

Cervical excitation

PID | ectopic pregnancy

post menopoausal bleeding think...

endometrial cance

endometrial cancer RF

obesity nulliparity early menarche late menopause

Sheehan's syndrome is ?

postpartum hypopituitarism

fibroid treatment

tranexamic acid, NSAIDs or progesterones as they are used in menorrhagia, but surgery is usually required for troublesome fibroids.

Meigs' syndrome

acites pleural effusion ovarian tumour - fibroids

Premature ovarian failure

no periods for a year preceded by irregular menstrual cycles. hot flushes, vaginal dryness, vaginal atrophy, sleep disturbance, and irritability.

PCOS has

oligomenhhoria

smear when pregnant

don't | wait until 12 weeks after birth

stress incontinence

do pelvic floor muscle retraining

ovarian torsion

common in women of reproductive age illiac fossa pain N&V

pre menopausal cyst

<5, repeate USS in 8-12 weeks

post menopausal cysts

suspcisous | refer to gynae

PCOS and IVF can cause

ovarian hyperstimulation

ovarian cancer signs

``` Abdominal distension/bloating Feeling full (early satiety) or loss of appetite Pelvic or abdominal pain. Increased urinary urgency or frequency ```

inevitable misscarriage

heavy bleeding | clots

GnRH

reduces uterus size before surgery

pregnant women comes into contact with chicken pox

if never had it | immunize up to 10 days after exposure

meds you cant have when breast feeding

``` antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides psychiatric drugs: lithium, benzodiazepines aspirin carbimazole methotrexate sulphonylureas cytotoxic drugs amiodarone ```

bishops score

a score of < 5 indicates that labour is unlikely to start without induction a score of > 9 indicates that labour will most likely commence spontaneously

ovarian cancer RF

HRT obesity early menarche