PasTest - Obs + Gnae

Question 1

Causes of IUGR

Answer 1

Insufficent nutrition - placental problems / heart disease / pre-eclampsia / eclampsia

Foetal risk factors - Congenital & chromosomal abnormalities / CMV / TORCH

Maternal risk factors - Poor nutrition / Smoking / High BP / Uncontrolled BP

Question 2

GnRH causes secretion of?

Answer 2

LH and FSH from the pituitary gland

Question 3

Continuous pain before and after the first day of menstration

Answer 3

Endometriosis

Question 4

Irregular periods, coarse dark hair

Answer 4

PCOS

Insulin resistance, excessive androgen production via the ovaries

Bilateral enlarged cysts in the ovaries on USS

LH high, FSH normal

Management - reduce weight and therefore insulin resistence

COP - regulate cycles & combat hairsuitism

Question 5

Risk factors for ectopic pregnancy

Answer 5

Previous ectopic

PID

Progesterone only pill

Question 6

Postmenopausal Bleeding

Answer 6

Endometrial Cancer

Question 7

Postcoital Bleeding (spotting)

Answer 7

Cervical polyp and cervical cancer

(women using the COP are more prone to polyps and cervical erosion)

Question 8

Fever, clots, reduced GCS, tampon use

Answer 8

Toxic shock syndrome

Question 9

Open OS, lower abdo-pain, heavy periods

Answer 9

Inveitable abortion

Question 10

Menorrhagia, bulky uterus

Answer 10

Uterine Fibroids

Question 11

Light vaginal bleeding, no abdo pain, closed cervical OS

Answer 11

Threatened Abortion

Question 12

30/52 constant abdo pain, irritable uterus, small abruption. Painful

Answer 12

Antepartum Haemorrhage

Question 13

Late period, clots

Answer 13

Spontaneous Abortion

Question 14

COC, intermentrual and post-coital bleeding

Answer 14

Cervical Ectropion

Question 15

Watery vaginal discharge, tachycardia, flushed, wide-pulse pressure

Answer 15

Septicaemia

Question 16

Collapse, hard uterus, no signs of labour

Answer 16

Placental Abruption

Question 17

Collapse, hard uterus, no signs of labour

Answer 17

Placental Abruption

Question 18

Women collapses during active labour

Answer 18

Amniotic fluid embolism

Question 19

Primary postpartum haemorrhage

Answer 19

<24 hours after delivery

Question 20

Secondary postpartum haemorrhage

Answer 20

>24 hours - 6 weeks. Caused by endometriosis (increased temperature, fowl discharge)

Question 21

22 year old. Atifical rupture of the membranes. Heavy vaginal bleeding with associated abnormal CTG changes. Soft, non-tender uterus

Answer 21

Vasa Preva (foetal blood vessles run in close proximity to the external os)

Question 22

16 weeks amenorrhoea. Severe N&V. Uterine size of 24 weeks. No uterine sac on USS.

Answer 22

Molar pregnancy

gestational trophoblastic disease. Bunch of cells that cannot form a viable pregnancy.

Question 23

30 y.o. post-coital bleeding at 22 weeks gestation

Answer 23

Cervical ectropion

Columnar epithelium preotrudes through the external OS

Question 24

18 y.o. Forcepts, 4.3kg baby 1 hour ago. Had Syntocinon. 100BPM, BP = 90/45. Uetus is palpable but feels boggy. She is lying in a pool of blood.

Answer 24

Uterine Atony

A long labour and use of syntocinon and a large baby predispose to poor uterine contractions and therefore contractions are poor after birth and post-partum haemorrhage occurs.