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Misc. Notes Year 3 > Pastest Repro > Flashcards

Pastest Repro Flashcards

1
Q

What happens to serum T4 levels in pregnancy

A

Increase up till week 12 gestation

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2
Q

What should be done to medication dose with regards to Hypothyroidism in pregnancy

A

Increase Levothyroxine by 25mg

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3
Q

A thin red vulva and spotting is suggesting of which disease

A

Atrophic Vaginitis

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4
Q

How is Atrophic Vaginitis typically treated

A

Local estrogen cream

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5
Q

Post-coital spotting suggests a problem with which area

A

cervix

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6
Q

What group of girls are more prone to developing cervical ectropion

A

Those on the COCP - due to effects of estrogen

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7
Q

Define Polyhydramnios and give 5 causes

A 
>2-3L of fluid 
Diabetes
Rhesus disease
GI obstruction
Increased fetal urine output
Poor fetal swallowing
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8
Q

What are the first, second and 3rd line treatments for stress incontinence

A

1st –> Lifestyle changes (lower caffeine, alcohol and weight)
2nd –> at least 3 months of pelvic floor exercises
3rd –> Duloxetine

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9
Q

If a woman has a past medical history of diabetes then when should be screened during gestation

A

OGTT at booking appointment

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10
Q

If a woman has a first degree relative with diabetes then when should be screened during gestation

A

OGTT at 24-28weeks

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11
Q

A woman presenting with depression, irritability and emotional liability during her Luteal phase suggests what condition and how could this be treated

A

Pre-Menstrual Syndrome

SSRI

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12
Q

How is PID treated in the outpatient setting

A

IM Ceftriaxone and 14 days of Doxycycline + Metronidazole

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13
Q

Define primary and secondary PPH

A

Primary - within first 24 hours of delivery

Secondary - 24 hours to 6 weeks postpartum

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14
Q

What is first line for PPH

A

IV syntocinon

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15
Q

What is the second line management for PPH and how does it work

A

Ergometrine

Alpha, Serotonin and Dopamine agonist

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16
Q

When is ergometrine contra-indicated

A

High blood pressure

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17
Q

Define proteinuria

A

> 300mg/24hours

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18
Q

How is chickenpox immunity tested in pregnancy and what are the solutions

A

IgM = recent or current infection
IgG = Immunity
If not immune give varicella immunoglobulin

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19
Q

If the bishop score is <5 or >9, what action should be taken

A

<5 –> Vaginal prostaglandin

>9 –> wait

20
Q

Define Oligohydramnios and give 5 causes

A 
<500ml at 32-36 weeks 
PROM
Renal Agenesis 
IUGR
Post-term 
Pre-eclampsia
21
Q

What are the blood pressure cutoffs for the COCP being contraindicated

A

> 160 systolic

>95 diastolic

22
Q

If an ectopic pregnancy with the presence of a fetal heartbeat is found, what is the appropriate management

A

Surgical

23
Q

Which triad of symptoms is common to both Endometriosis and PID and how can they be differentiated

A

Dysmenorrhoea, Dyspareunia & Subfertility
PID –> cervical excitation
Endometriosis –> pain associated with menstruation

24
Q

An offensive yellow-green discharge and a strawberry cervix suggests which pathology

A

Trichomonas vaginalis

25
Q

What is the treatment for Trichomonas vaginalis

A

oral Metronidazole

26
Q

Sub-epithelial reactive lymphoid follicles is a description of which disease

A

Follicular cervicitis

27
Q

Name 5 risk factors for breech presentation

A 
Fibroid 
Placenta Praevia
Poly/Oligohydramnios 
Fetal abnormality
Pre-term
28
Q

What is the triad of symptoms which suggest vasa praevia

A

PROM
Painless Vaginal Bleeding
Fetal Bradycardia

29
Q

What is a Kleihauer test used for

A

Detection of fetal cells in maternal circulation

used for any potential sensitization event past 20 weeks

30
Q

How does a molar pregnancy change thyroid concentration

A

Increased bHCG, Increased Thyroxine, Low TSH

31
Q

What is the protocol if a cervical smear is due during pregnancy

A

Re-schedule to at least 12 weeks postpartum

32
Q

What are the 3 main questions to answer when considering hormone replacement therapy

A

Is there a uterus present?
Peri/Post-menopausal?
Systemic or Local HRT needed?

33
Q

How is post-menopausal defined

A

12 months since last menstrual period

34
Q

Who should be offered cyclical/ continuous HRT

A

Continous –> Post-menopausal

Cyclical –> Peri-menopausal

35
Q

When can systemic estrogen-only HRT be offered

A

If complete hysterectomy

36
Q

When is contraception no longer needed with regards to menopause

A

if < 50 –> not until at least 2 years since LMP

if > 50 –> not until at least 1 year since LMP

37
Q

What is given for infection prophylaxis in PROM

A

Erythromycin

38
Q

What is given for Group B strep Prophylaxis

A

Benzylpenicillin

39
Q

When should the fundus be palpable at the level of the umbilicus

A

20 weeks

40
Q

When should the fundus be palpable at the level of the xiphisternum

A

36 weeks

41
Q

With regards to the combined contraceptive patch, what should be done if one is missed

A

If delay < 48hours –> new patch + no action
If delay > 48 hours –> new patch + condoms for 7 days

If the patch removal is delayed at the end of week 3
–> removed as soon as possible and the new patch applied on the usual cycle start day for the next cycle

If patch application is delayed at the end of a patch-free week, additional barrier contraception should be used for 7 days following any delay at the start of a new patch cycle

42
Q

Name 4 risk factors for cord prolapse

A

Prematurity
Multiparity
Polyhydramnios
Placenta praevia

43
Q

How is cord prolapse managed

A

Elevate presenting fetal part and put woman on knees and elbows

44
Q

What is Asherman’s Syndrome

A

Intra-Uterine adhesions after invasive procedure

45
Q

Unilateral breast pain and erythema in a wedge shape distribution suggests what

A

Lactational Mastitis

Misc. Notes Year 3 (25 decks)

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