Pastest Repro Flashcards
What happens to serum T4 levels in pregnancy
Increase up till week 12 gestation
What should be done to medication dose with regards to Hypothyroidism in pregnancy
Increase Levothyroxine by 25mg
A thin red vulva and spotting is suggesting of which disease
Atrophic Vaginitis
How is Atrophic Vaginitis typically treated
Local estrogen cream
Post-coital spotting suggests a problem with which area
cervix
What group of girls are more prone to developing cervical ectropion
Those on the COCP - due to effects of estrogen
Define Polyhydramnios and give 5 causes
>2-3L of fluid Diabetes Rhesus disease GI obstruction Increased fetal urine output Poor fetal swallowing
What are the first, second and 3rd line treatments for stress incontinence
1st –> Lifestyle changes (lower caffeine, alcohol and weight)
2nd –> at least 3 months of pelvic floor exercises
3rd –> Duloxetine
If a woman has a past medical history of diabetes then when should be screened during gestation
OGTT at booking appointment
If a woman has a first degree relative with diabetes then when should be screened during gestation
OGTT at 24-28weeks
A woman presenting with depression, irritability and emotional liability during her Luteal phase suggests what condition and how could this be treated
Pre-Menstrual Syndrome
SSRI
How is PID treated in the outpatient setting
IM Ceftriaxone and 14 days of Doxycycline + Metronidazole
Define primary and secondary PPH
Primary - within first 24 hours of delivery
Secondary - 24 hours to 6 weeks postpartum
What is first line for PPH
IV syntocinon
What is the second line management for PPH and how does it work
Ergometrine
Alpha, Serotonin and Dopamine agonist
When is ergometrine contra-indicated
High blood pressure
Define proteinuria
> 300mg/24hours
How is chickenpox immunity tested in pregnancy and what are the solutions
IgM = recent or current infection
IgG = Immunity
If not immune give varicella immunoglobulin
If the bishop score is <5 or >9, what action should be taken
<5 –> Vaginal prostaglandin
>9 –> wait
Define Oligohydramnios and give 5 causes
<500ml at 32-36 weeks PROM Renal Agenesis IUGR Post-term Pre-eclampsia
What are the blood pressure cutoffs for the COCP being contraindicated
> 160 systolic
>95 diastolic
If an ectopic pregnancy with the presence of a fetal heartbeat is found, what is the appropriate management
Surgical
Which triad of symptoms is common to both Endometriosis and PID and how can they be differentiated
Dysmenorrhoea, Dyspareunia & Subfertility
PID –> cervical excitation
Endometriosis –> pain associated with menstruation
An offensive yellow-green discharge and a strawberry cervix suggests which pathology
Trichomonas vaginalis
What is the treatment for Trichomonas vaginalis
oral Metronidazole
Sub-epithelial reactive lymphoid follicles is a description of which disease
Follicular cervicitis
Name 5 risk factors for breech presentation
Fibroid Placenta Praevia Poly/Oligohydramnios Fetal abnormality Pre-term
What is the triad of symptoms which suggest vasa praevia
PROM
Painless Vaginal Bleeding
Fetal Bradycardia
What is a Kleihauer test used for
Detection of fetal cells in maternal circulation
used for any potential sensitization event past 20 weeks
How does a molar pregnancy change thyroid concentration
Increased bHCG, Increased Thyroxine, Low TSH
What is the protocol if a cervical smear is due during pregnancy
Re-schedule to at least 12 weeks postpartum
What are the 3 main questions to answer when considering hormone replacement therapy
Is there a uterus present?
Peri/Post-menopausal?
Systemic or Local HRT needed?
How is post-menopausal defined
12 months since last menstrual period
Who should be offered cyclical/ continuous HRT
Continous –> Post-menopausal
Cyclical –> Peri-menopausal
When can systemic estrogen-only HRT be offered
If complete hysterectomy
When is contraception no longer needed with regards to menopause
if < 50 –> not until at least 2 years since LMP
if > 50 –> not until at least 1 year since LMP
What is given for infection prophylaxis in PROM
Erythromycin
What is given for Group B strep Prophylaxis
Benzylpenicillin
When should the fundus be palpable at the level of the umbilicus
20 weeks
When should the fundus be palpable at the level of the xiphisternum
36 weeks
With regards to the combined contraceptive patch, what should be done if one is missed
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
Name 4 risk factors for cord prolapse
Prematurity
Multiparity
Polyhydramnios
Placenta praevia
How is cord prolapse managed
Elevate presenting fetal part and put woman on knees and elbows
What is Asherman’s Syndrome
Intra-Uterine adhesions after invasive procedure
Unilateral breast pain and erythema in a wedge shape distribution suggests what
Lactational Mastitis
