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Misc. Notes Year 3 > Repro Misc. > Flashcards

Repro Misc. Flashcards

1
Q

What are the two primitive genital tracts called

A

Mesonephric/ Wolffian

Paramesonephric/ Mullerian

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2
Q

Which two chemicals do fetal testes release and what does this cause

A

Testosterone and Mullerian Inhibiting Factor

Causes the Mullerian tract to degenerate

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3
Q

What is metrorrhagia

A

Bleeding between periods

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4
Q

Define Polymenorrhoea

A

Bleeding < 21-day interval

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5
Q

Define Oligomenorrhoea

A

Bleeding > 35-day interval

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6
Q

What endometrial thickness on transvaginal ultrasound is indicative of a need for biopsy

A

Premenopausal - >16mm

Postmenopausal - >4mm

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7
Q

Name a normal bacterial flora in the vagina

A

Lactobacillus

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8
Q

What do Lactobacillus produce in the vagina

A

produce lactic acid and hydrogen peroxide

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9
Q

Which organism causes vaginal thrush

A

Candida Albicans

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10
Q

How is vaginal thrush diagnosed

A

Swab + culture

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11
Q

Clue cells on microscopy indicate which disease

A

Bacterial vaginosis

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12
Q

How is vaginal thrush treated

A

Topical Clotrimazole

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13
Q

How is bacterial vaginosis treated

A

Oral Metronidazole

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14
Q

How is bacterial prostatitis diagnosed and treated

A

Diagnosed by first pass urine sample

Treated with ciprofloxacin for 28 days

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15
Q

How are chlamydia and gonorrhoea diagnosed

A

NAAT/ swab

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16
Q

How is gonorrhoea treated

A

IM Ceftriaxone 500mg

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17
Q

How is chlamydia treated

A

100mg Doxycycline bd 7 days

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18
Q

What is another name for gestational trophoblastic disease

A

Molar pregnancy

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19
Q

What is the main difference between a miscarriage and a molar pregnancy

A

The embryo is viable in miscarriage

The embryo is abnormal in a molar pregnancy

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20
Q

What is a buzzword for a partial molar pregnancy

A

Grape-like clusters

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21
Q

Which type of molar pregnancy involves 1 or 2 sperm fertilising an egg with no DNA

A

Complete mole

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22
Q

Describe the genetic material in a partial mole

A

1 sperm ( reduplicating DNA material) or 2 sperms fertilising an egg, resulting in triploidy

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23
Q

A woody hard uterus suggests which pathology

A

Placental abruption

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24
Q

What is the classical presentation of Placenta Praevia and what should you do next

A

Recurrent painless bleeding > 24 weeks
Ultrasound
*do not perform PV exam

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25
Q

What is Placenta Accreta and what is a major risk factor

A

The placenta invades the myometrium

previous C-section is a risk factor

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26
Q

How is Pearl Index calculated

A

[Number of accidental pregnancies x 1200] / total months of exposure

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27
Q

Which three forms must be filled out after an abortion and which one requires 2 doctors to sign it

A

HSA1, HSA2, HSA4
HSA1 requires 2 doctors
HSA2 completed within 24hours
HSA4 sent to CMO in 7 days

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28
Q

What is the limit for social termination of pregnancy

A

23weeks 6 days

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29
Q

What is the Tayside medical termination of pregnancy limit

A

18 weeks 6 days

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30
Q

What is the Tayside surgical termination of pregnancy limit

A

12 weeks

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31
Q

What is the lamda sign on ultrasound a buzzword for

A

Strongly suggests a dichorionic (each twin has its own placenta) twin pregnancy

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32
Q

Which sign may be seen on ultrasound to suggest a monochorionic pregnancy

A

T- sign

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33
Q

Name 2 ways in which Hypertension in pregnancy is diagnosed

A

> 140/ 90 on 2 ocassions

> 160/ 110 once

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34
Q

What are the three 1st line drugs for hypertension during pregnancy

A

Methyldopa
Nifedipine
Labetalol

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35
Q

When might methyldopa be contra-indicated

A

Depression

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36
Q

Name two drugs which are 2nd line for hypertension during pregnancy

A

Hydralazine

Doxazocin

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37
Q

What should be given to those women at risk of pre-eclampsia

A

75mg Aspirin from 12 weeks gestation till birth

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38
Q

Which system is used to grade vaginal prolapses and which structure does it use as a reference

A

POP-Q system

Hymen used as a reference point

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39
Q

How long should a baby be exclusively breastfed

A

6 months

40
Q

How and when should mastitis be treated

A

If poor attachment, flucloxacillin 1g qd

41
Q

Define hydrops fetalis and give an example

A

Accumulation of fluid in at least 2 fetal compartments

e.g ascites and pleural effusion

42
Q

What are the two types of ultrasound scan and which one requires the bladder to be full

A

Trans-abdominal –> bladder full

Trans-vaginal

43
Q

Lynchy syndrome predisposes to which 2 reproductive tumours

A

Ovarian mainly

also endometrial

44
Q

Which tumour marker is raised in up to 80% of ovarian tumours

A

CA 125

45
Q

Which tumour marker is tested to exclude metastases from a primary GI tumour

A

Carcinoembryonic antigen (CEA)

46
Q

What is the vertex of the fetal skull

A

Area of fetal skull outlined by anterior & posterior fontanelles & parietal eminences

47
Q

What are the two layers of the endometrium

A

Stratum Functionalis

Stratum Basalis

48
Q

Which pathology is being described by “sub-epithelial lymphoid follicles present in the cervix”

A

Follicular Cervicitis

49
Q

How does follicular cervicitis typically present and what are the consequences of this

A

Usually asymptomatic

Can lead to infertility due to silent fallopian tube damage

50
Q

What do

sudden unilateral pelvic pain + free fluid in pelvic cavity suggest

A

Ruptured ovarian cyst

51
Q

What are the guidelines with regards to breech position of a fetus

A

If breech before 36 weeks –> watch and wait

Offer External Cephalic Version if breech at 36 weeks

52
Q

What is a mnemonic for the fetal cardinal movements

A 
Don't --> Descent and engagement
Forget --> Flexion
I --> Internal rotation
Enjoy --> Extension
Really --> Restitution 
Expensive --> External Rotation 
Equipment --> Expulsion
53
Q

What are Mefenamic acid and Tranexamic acid and which condition can they be given for

A

Mefenamic acid - NSAID
Tranexamic acid - Anti-fibrinolytic
Given for Menorrhagia

54
Q

What drugs are used for rapid tranquillisation

A

if a history of cardiac disease/ no previous typical anti-psychotics –> Lorazepam 1-2mg

If significant typical antipsychotic use –> Lorazepam ± Haloperidol

55
Q

What 3 things are included in the diagnostic criteria for Hyperemesis Gravidarum

A

5% pre-pregnancy weight loss
Dehydration
Electrolyte imbalance

56
Q

What is the best measure of ovulation and when should this be measured

A

Progesterone level

Should be measured 7 days post ovulation (day 21 in a 28-day cycle)

57
Q

Which ovarian tumour can be associated with atypical endometrial hyperplasia

A

Granulosa Cell tumours

they can secrete estrogen

58
Q

After which week gestation would you suspect gestational related hypertension rather than pre-existing hypertension

A

20 weeks

59
Q

What differentiates gestational hypertension from pre-eclampsia

A

No proteinuria

60
Q

How does Tamoxifen act in the body

A

Anti-estrogen in breast tissue

Pro-estrogen in uterus

61
Q

With regards to surgery, when should the COCP be stopped and restarted

A

Stopped 4 weeks prior

Can be restarted 2 weeks after

62
Q

Which contraceptive method is associated with a delay in return to normal fertility

A

Progesterone injection

up to 1-year delay

63
Q

What is the definitive management for placenta accreta

A

Hysterectomy with placenta left in situ

64
Q

What is the medical management of a missed miscarriage

A

Vaginal misoprostol

65
Q

Which drugs can be given to shrink fibroid size before surgery

A

GnRH agonists e.g leuprolide

66
Q

Which 3 contraceptive methods are unaffected by enzyme inducing drugs e.g. carbamazepine

A

IUS
IUD
Progesterone only pill

67
Q

How can you test for premature ovarian failure

A

FSH levels

high in menopausal patients

68
Q

What is adenomyosis and how is it diagnosed

A

Endometrial tissue in the myometrium

Diagnosed via MRI

69
Q

What are 2 management options for adenomyosis

A

GnRH agonists

Hysterectomy

70
Q

What is the Rokitansky protuberance

A

The inner lining of a mature cystic teratoma

71
Q

Which three things can cause increased nuchal translucency

A

Down’s syndrome
Congenital heart defects
Congenital abdominal wall defects

72
Q

Which two conditions should you suspect with cervical excitation

A

Pelvic Inflammatory Disease

Ectopic Pregnancy

73
Q

When does the IUD become effective as contraception if it isn’t started on the 1st day of a period

A

instantly as it is non-hormonal

74
Q

When does the progesterone only pill become effective as contraception if it isn’t started on the 1st day of a period

A

in 2 days time

75
Q

When do the IUS and COCP become effective as contraception if it isn’t started on the 1st day of a period

A

in 7 days time

76
Q

With regards to Down Syndrome screening, when are Nuchal translucency, BHcG and PAPP-A checked

A

10-14 weeks

combined test

77
Q

What is the quadruple test

A

AFP, Unconjugated Estriol lowered
BHcG, Inhibin A raised

14-20 weeks, to screen for Down’s syndrome

78
Q

When would you be required to give a double dose of the levonorgestrel emergency contraceptive

A

If BMI >26 or if weight >70kg §

79
Q

What is the mnemonic used for CTG reading

A

DR C BraVADO

80
Q

Name 4 maternal illnesses which would render a pregnancy as high risk

A

Epilepsy
Gestational diabetes
Asthma
Hypertension

81
Q

What is a normal duration and frequency of uterine contractions

A

10-45 seconds

3-4 per 10minutes

82
Q

How is the baseline fetal heart rate measured on CTG

A

The average heart rate of the fetus over a 10min window

83
Q

What is a normal fetal heart rate

A

110-160bpm

84
Q

Name 4 causes of fetal tachycardia

A

Fetal/Maternal Anaemia
Hypoxia
Chorioamnionitis
Hyperthyroidism

85
Q

Define fetal bradycardia on a CTG

A

HR <110 for 3 or more mins

86
Q

Name 4 causes of fetal bradycardia

A

Cord prolapse
Cord compression
Maternal seizure
Rapid fetal descent

87
Q

What does variability refer to with regards to a CTG

A

Refers to the variation of the fetal HR from one beat to the next

88
Q

How is variability calculated with regards to a CTG

A

Observing how much the peaks and troughs deviate from the baseline rate

89
Q

What are reassuring, non-reassuring and abnormal values for variability on a CTG

A

Reassuring 5-25bpm
Non-reassuring <5bpm for 30mins OR >25bpm for 15mins
Abnormal -
<5 for 50mins OR >25 for 25mins OR sinusoidal

90
Q

What does sinusoidal variability on CTG indicate

A

Severe hypoxia/haemorrhage/anaemia

91
Q

What are some causes of decreased CTG variability

A

Fetus sleeping

Fetal hypoxia –> acidosis

92
Q

Define accelerations on a CTG

A

An abrupt increase in the fetal baseline rate of >15bpm for >15 seconds

93
Q

What does the presence of accelerations on a CTG indicate

A

A healthy fetus –> reassuring sign

94
Q

Define decelerations on a CTG

A

An abrupt decrease in the fetal baseline rate of >15bpm for >15 seconds

95
Q

What are the 3 types of decelerations seen on CTG and what do each of them indicate

A

Early –> physiological due to increased ICP and increased vagal tone
Variable –> often indicate oligohydramnios
Late –> Begin at peak of the contraction and recover after it has ended –> indicates hypoxia + acidosis

Misc. Notes Year 3 (25 decks)

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