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Y5 O&G > Passmed Key Concepts > Flashcards

Passmed Key Concepts Flashcards

1
Q

Which SSRI leads to QT elongation and torsades de pointes?

A

Citalopram

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2
Q

What is first-line treatment for menorrhagia?

A

Tranexamic acid

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3
Q

What is the definition of pre-eclampsia?

A

New-onset BP >140/90mmHg after 20w AND proteinuria/organ dysfunction

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4
Q

When can hormonal contraception be started again after using levonorgestrel for emergency contraception?

A

Immediately

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5
Q

How do you manage a pregnant woman with previous VTE history?

A

Prophylactic LMWH throughout pregnancy until 6 weeks postnatal

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6
Q

What does an older woman with a labial lump + inguinal lymphadenopathy suggest?

A

Vulval carcinoma

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7
Q

What should you do if you are presented with a case of FGM in someone under 18?

A

Report it to the police

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8
Q

How does ovarian cancer initially spread?

A

Locally into pelvic area

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9
Q

What advice should you give about contraception to patients assigned female at birth?

A

Can’t use any contraceptions with oestrogen in if they’re undergoing testosterone therapy as antagonises it

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10
Q

What does a complete hydatidiform mole (pregnancy) look like on ultrasound?

A

‘snow storm’ appearance on ultrasound scan

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11
Q

How are pregnant women >20w who present within 24 hrs of a rash appearing (chickenpox) treated?

A

Oral aciclovir

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12
Q

What sign is ovarian torsion associated with on ultrasound?

A

Whirlpool sign

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13
Q

For transgender males, does testosterone therapy provide protection against pregnancy and what effects can it have on the pregnancy if it doesn’t?

A

No it doesn’t

Teratogenic effects

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14
Q

What is an important risk factor for hyperemesis gravidarum?

A

Multiple pregnancy

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15
Q

What is the cervical screening timeline?

A 
25y - first invite
25-49 - every 3 years
50-64 - every 5 years
65+ not offered
delay 3 months post-partum unless missed previous or previous abnormal
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16
Q

What treatment is first-line for painful periods that are otherwise normal?

A

NSAIDs - inhibit prostaglandin synthesis (one of main causes of dysmenorrhoea pains)

17
Q

What is the symphysis-fundal height, where is it measured, and what should you do if it’s abnormal?

A

Measure to establish whether small for dates, should be 1-2cm from the gestational age in weeks e.g. 24 weeks should have a SFH of 22-26cm.
Measured from top of pubic bone to top of uterus in cm.
Get ultrasound to confirm if foetus is small for gestational age.

18
Q

What is the main investigation of suspected placenta praevia?

A

Transvaginal ultrasound

19
Q

What are 2 common long-term complications of vaginal hysterectomy with antero-posterior repair?

A

Enterocele

Vaginal vault prolapse

20
Q

Which emergency contraception should be used with caution in patients with severe asthma?

A

Ulipristal

21
Q

What is the first step after a woman presents concerned about reduced foetal movements?

A

Handheld Doppler to confirm foetal heartbeat

22
Q

How long does it take each contraceptive type to be effective after administration?

A

Instant - IUD
2 days - progesterone-only pill
7 days - combined oral contraceptive, injection, implant, IUS

23
Q

What is a major risk factor for cord prolapse?

A

Artificial rupture of membranes

24
Q

What is a potential complication of ovulation induction?

A

Ovarian hyperstimulation syndrome

25
Q

What is a typical presentation of ovarian hyperstimulation syndrome?

A

Acute presentation of hours-ago onset abdominal pain + bloating that has been increasing. On exam abdo tenderness + ascites. Hx of IVF treatment (ovulation induction)

26
Q

What is a major contraindication for injectable progesterone contraceptives?

A

Current breast cancer

27
Q

What scale is used to screen for postnatal depression?

A

The Edinburgh Scale

28
Q

How should you manage premenstrual syndrome?

A

SSRIs (fluoxetine) either continuously or during the luteal phase

29
Q

What is the first-line treatment for a <35mm ectopic pregnancy with no heartbeat?

A

Methotrexate (interferes with DNA synthesis and disrupts cell multiplication so pregnancy doesn’t develop)

30
Q

What is the definition of pregnancy-induced hypertension? (and what features does it lack that differs from pre-eclampsia?)

A

> 140/>90 mmHg after 20w

No proteinuria or oedema

31
Q

How do you manage pregnancy-induced hypertension?

A

Oral labetalol

32
Q

When must methotrexate be stopped for males AND females before conception?

A

At least 6 months in both men and women

33
Q

What is the management if at the time of diagnosis of gestational diabetes, the fasting glucose is >7mmol/L?

A

Insulin (with or without metformin) should be started immediately

34
Q

How is PPROM (preterm premature rupture of membranes) investigated and why?

A

Sterile speculum exam

Then, if no fluid in posterior vaginal vault, use US to assess for oligohydramnios

35
Q

How are perineal tears classified after birth?

A

1st degree - tear within vaginal mucosa only
2nd degree - tear into subcutaneous tissue (submucosa)
3rd degree - laceration extends into external anal sphincter
4th degree - laceration extends through external anal sphincter into rectal mucosa

36
Q

What is the key clinical feature of placenta praevia?

A

Painless bleeding after 24w

37
Q

How long are healthy couples expected to take to conceive and when would investigations be started?

A

Up to 1 year, investigations only started after 1 year of regular attempts to conceive

38
Q

What are 3 important causes of placental abruption and what are their distinguishing features?

A

Placental abruption - abdominal pain + vaginal bleeding

HELLP (Haemolysis, Elevated Liver enzymes, Low Platelets) syndrome - Anaemia or low platelets seen in blood results
Cocaine use - Dilated pupils + hyperreflexia
Pre-eclampsia - absence of the other 2 and fit of clinical scenario

Y5 O&G (20 decks)

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