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Obs and Gynae > Passmedicine > Flashcards

Passmedicine Flashcards

1
Q

Which chemotherapy drug increases the risk of which type of gynae cancer?

A

Tamoxifen increases the risk of endometrial cancer

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2
Q

Most common cause of post-coital bleeding

A

Cervical ectropion

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3
Q

Risks of hysterectomy surgery with antero-posterior repair

A

Enterocele and vaginal vault prolapse

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4
Q

What is Meigs syndrome?

A

OAP
Ovarian tumour (benign)
Ascites
Pleural effusion

-usually occurs in those over age 40

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5
Q

One of your patients has endometrial hyperplasia, which medication is associated with the development of this condition?

A

Tamoxifen

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6
Q

What is premature menopause?

A

Menopause that occurs in a woman below the age of 40

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7
Q

The most common type of ovarian epithelial tumour

A

Serous cystadenoma

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8
Q

If this ovarian tumour ruptures, it may cause pseudomyxoma peritonei

A

Mucinous cystadenoma

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9
Q

What inhibits FSH and LH?

A

Oestrogen

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10
Q

Which LFT might be raised in pregnancy?

A

ALP (because of placental ALP)

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11
Q

What might raise your CA-125?

A

Ovarian cancer
Endometriosis
Pelvic inflammatory disease
Raised at certain points of menstrual cycle

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12
Q

In terms of the bishop score, what level is 0 for fetal station

A

0 = level of ischial spines

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13
Q

When are people with rubella contagious?

A

From 7 days before rash, to 4 days after rash

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14
Q

What is port-partum haemorrhage?

A

A loss of 500mls or more

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15
Q

What is primary post-partum haemorrhage?

A

Haemorrhage that occurs within 24 hours

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16
Q

What is secondary post-partum haemorrhage?

A

Haemorrhage that occurs between 24 hours and 12 weeks

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17
Q

Most common cause or primary post-partum haemorrhage?

A

Uterine atony

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18
Q

Which antibiotic would you give a breastfeeding woman with a UTI?

A

Trimethoprim

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19
Q

When would you offer external cepahlic version? (ECV)

A

At 36 weeks

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20
Q

What might cause a macrocytic anaemia?

A

B12 or folate deficiency

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21
Q

What is the Kleihauer test?

A

Used to measure the amount of fetal RBCs present in the maternal circulation

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22
Q

When are oxytocin and vaginal prostaglandin contraindicated?

A

In foetal distress

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23
Q

Treatment for baby affected in rhesus

A

Transfusions, UV phototherapy

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24
Q

Why might you be more likely to have placenta praevia?

A

Caesarian sections, multiparity

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25
Q

Invesitgation if you suspect placenta praevia

A

Ultrasound

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26
Q

Management of placenta praevia with bleeding

A

Admit, treat shock, cross match
Caesarean section for grades III/IV
Vaginal delivery for grade I

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27
Q

First line treatment for gestational hypertension

A

Oral labetalol

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28
Q

When can gestational hypertension be diagnosed?

A

From 20 weeks

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29
Q

Which anti-epileptic medication can be used during pregnancy?

A

Lamotrigine

30
Q

The combined test

A

HCG and PAPP-A

31
Q

The triple test

A

HCG, AFP and oestriol

32
Q

Low and raised AFP

A

Raised AFP - neural tube defects

Low AFP - Down syndrome

33
Q

How often should fetal heart rate be checked in labour

A

Every 15 minutes

34
Q

How often should contractions be assessed in labour

A

Every 30 minutes

35
Q

How often should maternal pulse be checked during labour?

A

Every 60 minutes

36
Q

How often should maternal BP and temp be checked during labour?

A

Every 4 hours

37
Q

How often should maternal urine be checked during labour?

A

Every 4 hours (check for ketones and protein)

38
Q

How often should vaginal exam be performed during labour?

A

Should be offered every 4 hours to check for progression of labour

39
Q

Antibiotic of choice for premature rupture of membranes

A

Erythromycin

40
Q

Say a patient had PROM and a swab should group B strep, what antibiotics would you give?

A

Penicillin and clindamycin

41
Q

A mother has hep B, what should you give her baby?

A

Should be given a complete course of vaccination and hep B immunoglobulin

42
Q

Which women are screened for hep B?

A

All women

43
Q

Is it safe for a woman with hep B to breastfeed her baby?

A

yes

44
Q

Can hep B or HIV be transmitted during breast feeding?

A

Hep b - no

HIV - yes (avoid even if taking anti-virals as still risk of transmission)

45
Q

A 19 year old woman presents with a 2 day history of central lower abdominal pain and one day history of vaginal bleeding. Her last period was 8 weeks ago. On examination her cervix is tender to touch

A

Ectopic preganancy

46
Q

Which procedure commonly predisposes to Asherman’s syndrome?

A

Dilatation and curettage

47
Q

Initial definitive management for cord prolapse?

A

Place hand into vagina to elevate the presenting part

48
Q

How might cord prolapse present?

A

Variable decelerations

49
Q

When do the majority of cord prolapses occur?

A

At artificial rupture of the membranes

50
Q

Most common explanation for short episodes (<40 minutes) of decreased variability on CTG?

A

Baby is sleeping

start to worry if decelerations last longer than 40 minutes

51
Q

A pregnant lady comes into contact with someone with chicken pox, what should you do?

A

1) ask her if she has ever had chicken pox
2) if she doesn’t know, then check her antibodies
3) if she isn’t immune then give her varicella immunoglobulin (within 10 days of exposure)

52
Q

Risk factors for uterine atony?

A

Multiple pregnancy

Induction of labour

53
Q

When are women screened for anaemia?

A

At booking visit (done at 8-10 weeks)

and at 28 weeks

54
Q

What normally happens to blood pressure during pregnancy?

A

Falls in first half of pregnancy before rising to pre-pregnancy levels before term

55
Q

Diagnostic criteria for hyperemesis gravidarum?

A

5% pre-pregnancy weight loss AND dehydration AND electrolyte imbalance

56
Q

What is the direct Coombs test?

A

Investigation used to look for autoimmune haemolytic anaemia

57
Q

What is the indirect Coombs test?

A

Investigation used antenatally to detect antibodies in the maternal blood that can cross the placenta and result in haemolytic disease of the newborn

58
Q

How much folate should an epileptic planning to get pregnant take?

A

5mg per day

59
Q

A hepatitis B serology positive woman gives birth to a healthy baby girl. The mother is surface antigen positive. What treatment should be given to the baby?

A

Hap B vaccine and 0.5 millilitres of HBIG within 12 hours of birth, with a further vaccine at 1-2 months and a further vaccine at 6 months

60
Q

Deficiency of which vitamin causes Wernickes encephalopathy?

A

Vitamin B1

61
Q

Budd-chiari triad

A

Ascites
Liver enlargement
Abdominal pain

62
Q

Where is hCG secreted from?

A

Secreted by syncytiotrophoblasts

63
Q

What does HCG do?

A

Maintains the production of progesterone by the corpus luteum

(basically stops the corpus luteum from breaking down)

64
Q

When can HCG be detected in the maternal blood stream?

A

Can be detected in the maternal blood as early as 8 days after conception

65
Q

What happens to HCG levels during pregnancy?

A

hCG levels double approximately every 48 hours in the first few weeks of pregnancy. Levels peak at around 8-10 weeks gestation. Measurement of hCG levels form the basis of many pregnancy testing kits

66
Q

Active management of the third stage of labour involves what?

A

Uterotonic drugs
Deferred clamping and cutting of cord, over 1 minute after delivery but less then 5 minutes
Controlled cord traction after signs of placental separation

(also give oxytocin to reduce risk of post-partum haemorrhage)

67
Q

What is HELLP syndrome?

A

A severe form of pre-eclampsia

68
Q

When is the anomaly scan performed?

A

18-20+ 6 weeks

69
Q

Which diabetes medication is safe during breastfeeding?

A

Metformin

70
Q

What is lochia?

A

Vaginal discharge containing blood, mucous and uterine tissue, which may continue for 6 weeks after childbirth

71
Q

What should you give a pregnant lady with Factor V Leiden?

A

Low molecular weight heparin (LMWH) antenatally AND for 6 weeks postpartum

(i.e. during and after pregnancy)

Obs and Gynae (8 decks)

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