pastest

Question 1

atrophic vaginitis

Answer 1

oestrogen deficiency causes this
bladder and urethral atrophy = dysuria, urinary frequency, increased susceptibility to urinary infection

Question 2

Uterus reaches umbilical by?

Answer 2

week 20

Question 3

PPH
management?

Answer 3

Uterine massage and oxytocin infusion

large bore cannulae
send bloods for urgent tests
IV fluids

1)massage, oxytocin Infusion
2)more oxytocin/ergometrine/carboprost
3)intrauterine balloon / surgical intervention

Question 4

High BP and uterine atony what can you not do?

Answer 4

ergometrine infusion
- vasoconstricts and increases bp more
contrainidcated in women w htn

Question 5

vulvodynia?

Answer 5

unexplained pain
chronic

Question 6

lichen sclerosis
symptoms

Answer 6

itching
burning

associated

Question 7

PCOS and diabetes

Answer 7

all women screened

impaired glucose tolerance is defined as a fasting <7.00 with a two hour ogtt >7.8 but less than 11.1

Question 8

impaired glucose tolerance

Answer 8

Fasting <7.00
with a two hour OGTT >7.8 but less than 11.1

Question 9

Molar pregnancy

Answer 9

HTN
excessive stimulation of ovarian follicles with hCG = simultaneous growth, enlargement and luteinisation of multiple ovarian follicles

Question 10

Luteoma of pregnancy?

Answer 10

benign solid ovarian tumour
hirsutism and virilisation

Question 11

prolapse staging

Answer 11

4- maximum descent
3-protrusion of cervix and uterus outside of vagina
2-descent of cervix to level of introitus
1- no prolapse (failure of cervix to reach interoitus

Question 12

what is meningomyelocele

Answer 12

NTD associated with valproic acid

Question 13

should nipple shields be used?

Answer 13

no can worsen symptoms and exacerbate incorrect positioning

Question 14

Patient with 3cm fibroids, dysmenorrhoea and menorrhagia
PMH: UC
how to manage?

Answer 14

medically with mefenamic acid/ tranexamic acid

surgically you can do myomectomy but only if indicated with size, not responsive to medication

uterien artery embolization if they don’t want surgergy

ulipristal can have restricted use

Question 15

women with no identified pathology, fibroid 2.5cm and menstrual paina nd hevay bleeding what is first line?

Answer 15

LNG_IUS

2) tranexamix acid, mefanamic acid , hormonal treatment

Question 16

when should specialist care be taken in menorrhagia?

Answer 16

fibroid >3cm

Question 17

Infertility initial ix?

women
men

Answer 17

mid luteal phase progesterone
serum gonadotrophins
TFTs
prolactin
screen for chlamydia

semen analysis
screen for chlamydia

Question 18

mx of infertility?

Answer 18

medical - clomifene
surgical - laproscopy for ablation of endometriosis and surgical correction for epidydmal blockage for obstructive azoospermia

assisted reproduction: intrauterine insemination, IVF, intracytoplasmic sperm injection

Question 19

what is the earliest diagnostic test for Down’s?

Answer 19

CVS
11 weeks

Question 20

what would TVuss show for endometriosis?

Answer 20

ovarian endometriomas / involvement of structure such as the uterosacral ligament

Question 21

hydatidiform mole is a tumour of?

how many types?

Answer 21

trophoblastic villi
2 types
partial, complete

partial is worse

can become invasive and then become a choriocarcinoma

Question 22

what risks are associated with having diabetes and being pregnant
for foetus?

Answer 22

increased miscarriage rate, congenital birth defect, macrosomia, birth injuries, higher perinatal mortality risks

Question 23

first line meds for UTI in pregnancy?

Answer 23

nitrofurantoin (but avoided near term)
cefalexin

Question 24

what UTI med is not given in first term pregnancy UTI?

Answer 24

trimethoprim

Question 25

gestational diabetes risk in second pregnancy?

Answer 25

early OGTT and then again at 24-28 week

Question 26

Gestational diabetes lab

Answer 26

It is diagnosed with fasting plasma glucose > 5.6 mmol/l or 2-hour plasma glucose > 7.8 mmol/l after OGTT

Question 27

how to differentiate fungal infection of nipple and thrush and bacterial infection?

Answer 27

Fungal: Bilateral, white patch on baby’s mouth
> oral thrush

topical miconazole 2% cream applied to the affected nipples

infant treated with?
nystatin oral suspension

Question 28

Gestational diabetes
how is mother followed up after birth?

Answer 28

GP performs fasting plasma glucose at 6-13 weeks

Question 29

results of fasting glucose

Answer 29

<6mmol/l low probability of diabetes
6.0-6.9- high risk

> 7mmol/l likely to have diabetes

Question 30

PCOS treatment for hirsutism and androgenic effects

Answer 30

Co-cyprindiol
marketted as dianette

cryoprotenone acetate acts as an anti androgen

Question 31

how to investigate Prolactinoma in the first instant

Answer 31

exclusion of hypothyroidism
chronic renal failure
and pregnancy

1- TFTs

Question 32

First stage of labour
cervical dilation arte?

Answer 32

1 cm per hour
1.5-2cm per hour

Question 33

PCOS mx - hirsutism

Answer 33

oral combined pill

Question 34

low birth weight infants - feeding WHO recommends?

Answer 34

exclusively breastfed for 6 months

should commence as soon as possible

donor human milk can be used

<1500 then daily vit d, calcium, phosphorus

Question 35

Rotterdam criteria for PCOS

Answer 35

oligo
menstrual irregulariy
hyperandrogenism

Question 36

polycystic ovaries on USS

Answer 36

12 follicles in 1 2-9mm
7 in the other
eleavted testosterne and Lh:FSH

Question 37

miscarriage recurrence risk

Answer 37

1 miscarriage : 85%
2: 75%
3: 60