Past Papers Flashcards
What investigations must you do for PCB
Pregnancy test Triple swab (exclude STI)
ONLY do cervical smear if due / overdue for screen
When do you do cervical smear if presenting for PCB
ONLY if due /overdue for screen
How do you manage cervical ectropion at GP
should resolve spontaneously if stop COCP / following pregnancy
Review 10-12 weeks
if persistent refer to gynae
How do you manage PCB if normal cervix and negative infection screen
Review in 6 weeks - if still present, refer to gynae
what women do you do Kleinhauer’s test in after abdo trauma in pregnancy?
all women
as it indicates degree of foetomaternal haemorrhage
What ix can you do for abdo trauma
CTG (foetal wellbeing), TAUSS (abruption), Kleihauer
What is Grava and Para?
Gravida = n times woman has been pregnant (regardless of outcomes) Para = n pregnancies that have reached gestation of 24 or more (dead or alive) -
what is a grand multipara
Given birth to 5 or more foetus beyond 24 weeks
what do you do if someone on colposcopy has CIN1
HPV swab in community in 12 months
What must you do from GP practice if adult woman comes in with FGM
Refer / self refer to gynae
Specialist needs to determine whether de-infib is indicated and if there are any complications of FGM
Also offer referral to:
- psychological services
- HIV, Hep B, C, sex health screen
WHEN WOULD YOU DO DE INFIB OF FGM
Only if appropriate
- sx of complications
- pregnant
what incidences do you need to do a cervical smear after a hysterectomy?
- subtotal hysterectomy (as cervix is left)
- no up to date smear > do vault smear 6m later
- if prior positive CIN as reason for hysterectomy > do smear at 6m, 18m after operation
what signs do you see on USS for twins?
DCDA: lambda (thick membrane separating)
MC: T sign (thin membrane separating)
How do you diagnose PMS
- symptom diary over 2 cycles
- GnRH analogues if symptom diary is inconclusive
What is the ratio of LH: FSH in PCOS
LH:FSH = 2:1
or even 3:1
what happens to protein level in urine in pregnancy
it doubles what is normal
so it is notmal to have 1+ on urine dip
How would you broadly change antiepileptics in woman planning to get pregnanct?
change valproate to carbamazepine / lamotrigine (which do not seem to affect neurodevelopment)
use lowest effective dose
give 5mg folic acid
what do you do if you suspect PTL in woman who is 30+
Cervical length on TVUSS
- if >15, unlikely
- if <15mm, likely
Use foetal fibronectin only if TVUSS not available
do not use both cervical length and foetal fibronectin for assessment
What must you do postnatally if on antiepileptic drugs during pregnancy
breastfeed to weane the baby off the drug
as small quantities will cross over to breastmilk
what medication should you give rtoutinely prior to a CS
- PPI e.g. omeprazole to reduce gastric volume and acidity
- metoclopramide
- intrapartum antibiotics single dose (cefuroxime, metronidazole)
beyond what gestation is medical management recommended over expectant?
beyond 13 weeks
what are the two different types of endometrial cancer? explain
T1: ENDOMETRIOID
- adenocarcinoma
- arises from endometrial hyperplasia
T2: High grade SEROUS, CLEAR CELL
- arises from atrophic endometrium
which SSRI has increased risk of congenital malformation
Paroxetine
what’s the most useful test for PCOS
high free androgen index (testosterone/sex hormone binding globulin)