REPRO 4

Question 1

menopause should happen when
early
late
premature and causes

Answer 1

51
45
54
40 genetics, radio/chemo, cancer

Question 2

some symptoms of menopause

Answer 2

hot flushes and night sweats, mood changes, palpitations, insomnia, anxiety, difficulty concentrating, forgetfulness, decreased libido, dry vagina, atrophy of breasts and genitals, incontinance, UTIs, headaches, joint aches

Question 3

ix for menopause

Answer 3

can check LH/FSH level which will be high but not done regularly as can be high in depo, breastfeeding, SSRIs, prior to ovulation, stopping COCP

Question 4

complications of menopause

Answer 4

osteoporosis, increased risk of ischaemic heart disease

Question 5

contraception till how long after last period if aged over 50 and if under

Answer 5

> 50 12mmonths

<50 24 months

Question 6

PMB - when does it need to be investigation

Answer 6

after a year

Question 7

contraindications for HRT

Answer 7

past or current angina, MI, PE etc

Question 8

non HRT treatment - lifestyle - for menopause

Answer 8

diet, decrease weight, exercise, lifestyle, caffeine

Question 9

mennorhagia

Answer 9

MFA, TXR, preg, IUS, endom ablation, hysterectomy

Question 10

non HRT for vasomotor symptoms 5

Answer 10

fluoxetine 20mg OD
citalopram 20mg OD
velefaxine 37.5mg BD
clonidine - lots of SE
vaginal dryness - lubricant/moisturiser

Question 11

HRT for vasomotor symptoms

Answer 11

oral or transdermal combined

Question 12

HRT for no uterus

Answer 12

oral or transfermal oestrogen only

Question 13

premenopausal

Answer 13

steroid and HRT or COC

Question 14

HRT for mood

Answer 14

oraltrandmeral

Question 15

urogenital atrophy

Answer 15

topical oestrogen

Question 16

vaginal dryness

Answer 16

moisturise, lubricant, topical oestrgent

Question 17

sexual dysf

Answer 17

testosterone - off licence

Question 18

benefits of HRT

Answer 18

decreased risk of fragility fracture, decreased risk of bowel cancer, muscle strength and mass

Question 19

risks of HRT

Answer 19

VTE oral >trandermal
increased risk in breast cancer
CHD and stroke in oestrogen and progesterone combined

Question 20

prolapse risk factors

Answer 20

increased age, obesity, increased number of vaginal deliveries, increased abdominal pressure

Question 21

anterior aka

what is it

Answer 21

cystocele

bladder drops into anterior vagina

Question 22

middle aka

Answer 22

apical/enterocele

herniation of pouch of douglas into vagina

Question 23

posterior aka

Answer 23

rectocele

prolapse of rectum into posterior vagina walls

Question 24

uterine prolapse levels

Answer 24

in vagina
at interoitus
outside vagina
procidenta

Question 25

ix for prolapse

Answer 25

abd exam | biman exam - cough, speculum

Question 26

POPQ

Answer 26

``` 0 no prolapse 1 >1cm above hymen -ve 2 within 1cm -ve 3 1-2cm below +ve 4 exercion ```

Question 27

treatment of prolapse conservative and non

Answer 27

``` avoid heavy lifting lose weight vaginal oestrogen - if atrophy pessary -surgery ```

Question 28

risks of pessary

Answer 28

can fall out bleeding erosion -> fistula

Question 29

conception - what is started

Answer 29

FA 0.4mg daily for up to 3months into pregnancy | if BMI>30 5mg

Question 30

booking is when | what is checked

Answer 30

8-12 weeks scan blood group, FBC, syphilis, Hep B/C, HIV, VDRLA, haemoglobinopathies, rubella, random BG, urinalysis, BP

Question 31

anomaly scan

Answer 31

18-21w

Question 32

visits

Answer 32

monthly visits till 28 weeks fortnightly visits till 36w weekly visits from 36>

Question 33

growth scan when | what is checked and why

Answer 33

28 weeks abd circumferance IUGR femur length weight head circumference IUGR

Question 34

anti D

Answer 34

28 and 34 weeks or all at 28w

Question 35

vaccines offered to pregnant woman

Answer 35

pertussis from 16-32w | flu every year from oct-march

Question 36

assessment of fatal growth

Answer 36

fatal growth chart

Question 37

normal metal heart baseline variability acceleration? decelerations?

Answer 37

120-160 >5bpm accelerations present. no decel

Question 38

early decel happen when part of what why are they happening

Answer 38

same time as contraction normal labour head and orbital compressed during second stage

Question 39

variable decel - why variable why when are they pathological

Answer 39

variable in depth and timing to contraction umbilical cord compression pathological if deep and prolonged and other CTG features present

Question 40

late decel when why action

Answer 40

after contractions fetal hypoxia, fetal distress fetal blood sample. deliver

Question 41

biophysical USS - what is assessed and numbers

Answer 41

movement, tone, breathing , liquor vol | 8-10 satisfactory, 4-6 repeat, 0-2 deliver

Question 42

umbilical artery doppler

Answer 42

20-24 weeks | screening for PET