Questions Flashcards
where is CIN most likely to arise
the transformation zone at the squamo-columnar junction
how long is the female urethra
4cm
at what stage of pregnancy does the uterus rise out of the pelvis
12 weeks
describe some of the physiological changes that occur during pregnancy
an increase in plasma volume by 50% resulting a physiological anaemia.
Blood pressure decreases from second trimester due to vasodilatation.
Glomerular filtration increases to cope with the additional load of the fetus, resulting in a decrease in creatinine and urea levels.
Due to increase 30-45% increase in cardiac output, systolic ejection murmurs are common.
Thromboembolism increase in pregnancy due to the thrombophilic state resulting from haemostatic and fibrinolytic changes
how long does the vagina measure
8cm
where does the pudendal nerve pass in relation to the ischail spine
The pudendal nerve passes behind and below the ischial spine
where does the ovarian artery arise
the aorta
in preeclampsia what is defined as significant proteinuria
more than 300mg/L
a small for gestational age baby is one which has an abdominal cicumferance below which centile
10th
what factors increase the risk of endometrial cancer
PCOS
diabetes
obesity
what weight is defines as macrosomia
birthweight more than 4 kg regardless of gestational age
what incontinence medication should not be used in frail elderly people
oxybutinin
use tolteridine instead
what is adenomyosis
endometrial tissue within the myometrium
how is adenomysosis diagnosed
MRI pelvis
what is the combined test for down’s syndrome and when in pregnancy is it done
nuchal translucecny on ultrasound scan + bHCG and PAPP-A
recommended at 10-14 weeks
in down’s syndrome PAPP-A is low and bHCG is high
what is the quadruple test for down;s syndrome and when is it done in pregnancy
Alfa-fetoprotein (AFP), unconjugated oestriol, beta-hCG and inhibin A.
In pregnancies with Down Syndrome, AFP and unconjugated oestriol are low and beta-hCG and inhibin A are raised.
done if combined test window missed - weeks 14-20
what changes on a CTG would be termed pre terminal and thus require emergency caesarian
terminal bradycardia - HR below 100 for more than 10 minutes
terminal decelerations - HR drops and does not recover within 3 minutes
who gets anti D give prophylactially in pregnancy at at what gestations
given to Rh neg mothers what have not been senstitised ad 28-34 weeks
how should you managed a pregnant woman who comes into contact with chicken pox and is unsure if they have had it before
check varicella IgM and IgG if IgG neg it suggests never having had it
give varicella immunoglobulin if there is doubt about immunity
do not give vaccine as it is live attenuated and there is a small risk of causing chicken pox
how do you manage a women who has a high vaginal swab postivie for GBS during pregnancy
do not need to treat immediately
give IV benzylpenicillin during delivery “intrapartum”
how long should magnesium sulphate be continue in pre eclampsia
either 24 hours after delivery or 24 hours after last seizure
what drugs are safe in breastfeeding
antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin
what drugs are contraindicated in breastfeeding
Lithium Aspirin Methotrexate Benzos Amioderone Sulphonylureas Tetracyclines 4Cs- Carbimazole, Ciprofloxacin, Chloramphenicol, Cytotoxics
Rokitansky’s protuberance.
Dermoid cyst/teratoma
what does a positive fetal fibronectin (fFN) test indicated
that preterm labour is likely (not definite)
what makes up the risk malignancy index in ovarian cancer
USS, Ca125 and menopausal status
what should babies born to mothers acutely or chronically infected with hep B during pregnancy
hep B vaccine at birth , one month and 6 months
if mother is antigen positive then also hep b immuniglobulin at birth
woman who does not want to take HRT - what can you give her for the vasomotor symptoms of menopause
SSRI
give causes of polyhydramnios
multiples fetal anomolies diabetes hydrops fetalis idiopathic
give causes of oligohydramnios
premature rupture of membranes fetal renal problems e.g. renal agenesis intrauterine growth restriction post-term gestation pre-eclampsia
at what cut off should a woman recieve oral iron therapy in pregnancy
HB less than 11 at booking or 10.5 at 28 weeks
contraindications to breastfeeding
HIV
galactosaemia
what medications are avoided in breast feeding
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides psychiatric drugs: lithium, benzodiazepines, cloazapine aspirin carbimazole methotrexate sulphonylureas cytotoxic drugs amiodarone
what medications are okay in breastfeeding
antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin
first line treatment of post natal depression in a woman with no previous history of depression
psychological intervention (CBT)
SSRI or TCA if not improving with CBT or if CBT refused
chlamydia +perihepatic adhesions
fitz hugh curtis
scissoring of legs
cerebral palsy
A 6-year-old girl presents with a one week history of febrile illness with sore throat and headache. One day prior to hospital admission, the patient awoke with pain and swelling in the right ankle. On examination, she has a warm swollen right ankle and a systolic heart murmur, consistent with mitral regurgitation.
rheumatic fever - group A step ie step pyoogenes
