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Revision Week > Passmed OG > Flashcards

Passmed OG Flashcards

1
Q

First line treatment for urge incontinence?

A

Bladder retraining

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2
Q

First line treatment for stress incontinence?

A

Pelvic floor muscle training

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3
Q

What is used in medical management of a miscarriage?

A

Vaginal misoprostol

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4
Q

What is used in the medical management of an ectopic pregnancy?

A

IM methotrexate

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5
Q

Why would we give MGSO4 to pregnant ladies?

A

In eclampisa to prevent seizures

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6
Q

Symptoms of PMS?

A

Anxiety, stress, fatigue, mood swings, bloating and breast pain

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7
Q

Management of PMS?

A 
Mild = regular small complex carbohydrates 
Moderate = new COCP
Severe = SSRI (sertraline)
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8
Q

What are the stages of ovarian cancer?

A 
1 = confined to ovaries
2 = local spread within the pelvis
3 = spread beyond the pelvis to the abdomen
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9
Q

Presentation of ovarian cancer?

A 
Abdominal distention and bloating 
Abdominal and pelvic pain 
Urinary symptoms 
Early satiety 
Diarrhoea
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10
Q

Investigations for ovarian cancer?

A

CA125

US

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11
Q

Bishop score is inversely correlated with…

A

Labour duration

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12
Q

What does a bishop score of <6 suggest?

A

Cervical ripening is needed

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13
Q

What is the most common cause of early-onset severe infection in the neonatal period?

A

Group B streptococcus

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14
Q

Presentation of vulval carcinoma?

A

Lump or ulcer on labia majora, can be itching and irritation

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15
Q

Presentation of vulval intraepithelial neoplasia?

A

White or plaques

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16
Q

What does high beta hCG, low TSH and high thyroxine suggest?

A

Molar pregnancy

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17
Q

What is a complete hydatidiform mole?

A

Benign tumour of trophoblastic material.

Empty egg is fertilised by a single sperm, then duplicates its own DNA. All 46 chromosomes are of paternal origin

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18
Q

Presentation of molar pregnancy?

A

Bleeding in first or early second trimester
Exaggerated symptoms of pregnancy (hyperemesis)
Uterus large for dates
High hCG
Hypertension and hyperthyroidism

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19
Q

What is a partial mole?

A

A normal haploid egg fertilised by either
- 2 sperm
- 1 sperm with duplication of paternal chromosomes
DNA is both maternal and paternal but is triploid

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20
Q

When can expectant management be used in an ectopic pregnancy?

A

Unruptured embryo, <35mm, no heartbeat, asymptomatic, declining B-hCG

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21
Q

Can you prescribe contraception to a 13 year old?

A

NO - even if competent

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22
Q

What secretes hCG?

A

Syncytiotrophoblasts

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23
Q

Function of hCG?

A

Maintains production of progesterone by corpus luteum in early pregnancy

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24
Q

When can hCG be detected?

A

8 days after conception

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25
Q

When do hCG levels peak?

A

8-10 weeks gestation

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26
Q

What is a simple cyst?

A

Unilocular - more likely to be physiological or benign

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27
Q

What is a complex cyst?

A

Multilocular - more likely to be malignant

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28
Q

Management of a cyst in a post-menopausal woman?

A

REFER to gynaecology

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29
Q

What is the McRobert’s manoeuvre?

A

Patient supine with both hips fully flexed and abducted.

Used in shoulder dystocia

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30
Q

What methods of contraception are contraindicated in smokers?

A

all combined hormonal methods:

COCP, patch, vaginal ring

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31
Q

Risks for hyperemesis gravidarum?

A 
Multiple pregnancies
Trophoblastic disease
Hyperthyroidism 
Nulliaparity 
Obesity
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32
Q

Is smoking associated with hyperemesis?

A

Smoking is associated with a DECREASED incidence of hyperemesis

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33
Q

1st line treatment for hyperemesis gravidarum?

A

Antihistamines

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34
Q

What is the primary mode of action of the contraceptive implant?

A

Inhibition of ovulation

35
Q

What is the mode of action of the COCP?

A

Inhibits ovulation

36
Q

What is the mode of action of the POP?

A

Thickens cervical mucous

37
Q

What is the mode of action of the intrauterine contraceptive device?

A

Decreases sperm motility and survical

38
Q

What is the mode of action of the intrauterine system?

A

Prevents endometrial proliferation

39
Q

Name the 3 types of emergency contraception?

A

Levonorgestrel
Ulipristal
IUD

40
Q

What is the first line treatment for pre-eclampsia?

A

Labetalol

41
Q

What is the first line treatment for pre-eclampsia in a patient with asthma?

A

Nifedipine

labetalol is contraindicated in smokers

42
Q

What is a ‘white curdy discharge, pH <4.5’ likely to suggest?

A

Candidiasis

43
Q

Treatment for chlamydia?

A

Oral doxycycline

44
Q

Name the causes of infertility?

A

Male factor, unexplained, ovulation failure, tubal damage

45
Q

What would a ‘6-8 week amenorrhoea with lower abdominal pain and vaginal bleeding’?

A

Ectopic pregnancy

46
Q

What is a threatened miscarriage?

A

Painless vaginal bleeding occurring < 24 weeks. Cervical os is closed

47
Q

What is a missed/delayed miscarriage?

A

Gestational sac containing a dead foetus <20 weeks without symptoms of expulsion.

48
Q

What is an inevitable miscarriage?

A

Cervical os is open.

Heavy bleeding, clots and pain

49
Q

What is an incomplete miscarriage?

A

Not all products of conception have been expelled

50
Q

What is placental abruption?

A

Separation of a normally sited placenta from the uterine wall, resulting in maternal haemorrhage into the intervening space

51
Q

Features of placental abruption?

A

Constant pain
Tender, tense uterus
Normal lie and presentation
Foetal heart absent or distressed

52
Q

What is the 1st line investigation for post-menopausal bleeding?

A

TVUS

53
Q

Causes of postmenopausal bleeding?

A 
Vaginal atrophy
HRT 
Endometrial hyperplasia
Endometrial cancer
Cervical cancer 
Ovarian cancer 
Vaginal cancer
54
Q

What is vaginal atrophy?

A

Thinning, drying and inflammation of the vagina due to a reduction in oestrogen following the menopause

55
Q

At age 25-49 what is the timeframe for routine smears?

A

3 years

56
Q

At >50 what is the timeframe for routine smears?

A

Every 5 years

57
Q

What cardiovascular changes occur in pregnancy?

A

Increase SV, HR and CO

Diastolic BP reduced in early pregnancy, returns to normal at term

58
Q

What respiratory changes occur in pregnancy?

A

Pulmonary ventilation, tidal volume increase.
Fall in pCO2
BMR raised

59
Q

What is an amniotic fluid embolism?

A

Foetal cells/amniotic fluid enter the mothers bloodstream

60
Q

Presentation of amniotic fluid embolism?

A

During labour or post-partum

Chills, shivering, sweating, anxiety and coughing

61
Q

Is it safe to breastfeed while on anti-epileptics?

A

Yes

62
Q

Effect of sodium valporate during pregnancy?

A

Neural tube defects

63
Q

What is the least teratogenic of the anti-epileptics?

A

Carbamezepine

64
Q

Effect of phenytoin during pregnancy?

A

Cleft palate

65
Q

Which form of LARC is current breast cancer a contra-indication for?

A

Injectable progesterone contraceptives

66
Q

1st line investigation for endometriosis?

A

Laparoscopy

67
Q

Presentation of endometriosis?

A

Chronic pelvic pain
Dysmenorrhea
Deep dyspareunia
Urinary symptoms

68
Q

If a woman presents with a ‘heavy, dragging’ sensation, what does this suggest?

A

Urogenital prolapse

69
Q

What is placenta accreta?

A

Attachment of the placenta to the myometrium, due to a defective decidua basalis. As the placenta does not properly separate during labour there is a risk of post-partum haemorrhage

70
Q

What are the risk factors for placenta accreta?

A

Previous C section

Placenta praevia

71
Q

Can you use aspirin while breastfeeding?

A

NO.

It is associated with Reye’s syndrome which can cause liver and brain damage

72
Q

What drugs should be avoided in pregnancy?

A 
Antibiotics (ciprofoxaxin, tetracycline, chloramphenicol, sulphonamides)
Psyhciatric durgs (lithium, benzodiazepens)
Aspirin
Carbimazole
Methotrexate
Sulfonylureas
Cytotoxic drugs 
Amiodorone
Clozapine
73
Q

What is the 1st step after chicken pox exposure in pregnancy?

A

Check varicella antibodies

74
Q

What are the features of foetal varicella syndrome ?

A

Skin scarring, eye defects, limb hypoplasia, microcephaly and learning disablilities

75
Q

What should you do if the pregnant woman <20 weeks is exposed to chickenpox and is not immune?

A

Give varicella-zoster immunoglobulin

76
Q

What are the risk factors for endometrial cancer?

A 
Obesity 
Nulliparity 
Early menarche
Late menopause 
HRT
Diabetes mellitus
PCOS
HNPCC
77
Q

How does endometrial cancer present?

A

Postmenopausal bleeding
If in premenopausal = change intermenstrual bleeding
Possibly pain and discharge

78
Q

1st line investigation in endometrial cancer?

A

TVUS

Hysteroscopy with endometrial biopsy

79
Q

Treatment for endometrial cancer?

A

Total abdominal hysterectomy with bilateral salpingo-oophorectomy

80
Q

Name the 2 protective factors for endometrial cancers?

A

COCP

Smoking

81
Q

What is a cord prolapse?

A

Umbilical cord descending ahead of the presenting part of the foetus.

82
Q

Management of cord prolapse?

A

Presenting part of foetus may be pushed back into the uterus to avoid compression.
Tocolytics can be used.
If the cord is past the level of the introitus it cannot be pushed back, and a C section is performed.

83
Q

What blood markers are measured in Down Syndrome?

A

Beta-human chorionic gonadotrophin (beta-hCG) and pregnancy associated plasma protein A (PAPP-A)

84
Q

What test results show down-syndrome?

A

Increased HCG, decreased PAPP-A and thickened nuchal translucency

Revision Week (13 decks)

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