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year 3. > Repro Other > Flashcards

Repro Other Flashcards

1
Q

Ectopic pregnancy vs miscarriage symptoms

A

Ectopic: pain mainly, dull ache, sharp stabbing

Miscarriage: mainly bleeding rather than pain, experience period cramp pain

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2
Q

What needs to be assessed to gauge whether someone requires a scan for TOP
(7)

A
  • pain/ bleeding?
  • <16yrs
  • does patient want a scan
    -IUD/IUS in situ?
  • hx of PID/ chlamydia
  • hx of ectopic pregnancy
  • known tubal disease/previous sterillisation
  • unsure of LMP
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3
Q

what type of ovarian tumours are more common in women under 40

A

Germ cell tumours

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4
Q

what type of cancer are most endometrial carcinomas

A

adenocarcinomas

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5
Q

what is the inheritance of lynch syndrome and what kind of uterine cancer does it cause

A

autosomal dominant

endometrial carcinoma TYPE 2

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6
Q

ixfor tumours caused by lynch syndrome

A

immunohistochemistry staining of tumour for mismatch repair proteins

microsatellite instability (characteristic of defective mismatch pair)

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7
Q

TP53 mutation associated with which cancer

A

endometrial carcinoma type 2

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8
Q

type 1 or type 2 endometrial carcinoma: which is more agressive

A

Type 2, spreads along fallopian tube mucosa and peritoneal surfaces so can present with extrauterine disease

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9
Q

the presence of … gives carcinosarcoma the worst prognosis

A

rhabdomyosarcomatous

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10
Q

endometroid and mucinous adenocarcinoma are what type of endometrial cancer

A

type 1

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11
Q

type 2 endometrial cancer: what type of cancers

A

serous and clear cell carcinoma

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12
Q

what is the causative organism for syphilis
give type of organism too

A

treponema pallidum I - spirochete

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13
Q

which strains of hpv associated with cervical cancer

A

HPV 16 and 18

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14
Q

Which strains of HPV associated with genital warts

A

HPV 6 and 11

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15
Q

contraindications to HRT

A

hx of breast cancer/ endometrial cancer
CHD, TIA, stroke
active liver disease
unexplained vaginal bleeding

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16
Q

how does the combined oral contraceptive supress fertility.

A

progesterone & oestrogen together have a negative effect on HPG axis (negative feedback)
this prevents the LH surge from occurring= oocyte is not released (prevents ovulation)

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17
Q

type 1 vs type 2 vasa praevia

A

type 1:Type I when the vessel is connected to a velamentous umbilical cord
Type II when it connects the placenta with a succenturiate or accessory lobe.

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18
Q

cholestatic LFTS vs Hepatic

A

cholestatic: greater ratio of ALP:ALT

hepatic: higher ratio of ALT: ALP

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19
Q

what contraceptive is most associated with weight gain

A

injectable

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20
Q

Contraceptives - time until effective (if not first day period):IUD

A

instant

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21
Q

Contraceptives - time until effective (if not first day period): pop

A

2 days

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22
Q

what Contraceptives take 7 days to be effective (if not first day period)

A

coc, injection, implant, ius

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23
Q

when should methotrexate be stopped before conception in both dad / mum

A

both partners must stop 6 months before conception

24
Q

placenta increta vs placenta accreta vs placent perceta

A

abnormal placentation,

placenta accreta: chorionic villi attach to myometrium but do not deeply invade it

placenta increta: chorionic villi invade myometrium but not deep enough to reach perimetrium

(increta deeper)

perceta: invades perimetrium

25
Q

what is the role of oestrogen regarding menstrual cycle

A

thins cervical mucus
thickens endometrium (hyperplasia)

26
Q

what is the role of progesterone regarding the menstrual cycle

A

thickens cervical mucus
increases gland secretion
increases blood flow to uterus
thickens and maintains endometrium

27
Q

what does progesterone medication end in

A

strel

eg. levonogestrel

28
Q

COC: if 1 missed pill

A

take the last pill even if it means taking two pills in one day and then continue taking pills daily, one each day

no additional contraceptive protection needed

(it doesn’t matter when in the cycle)

29
Q

COC: if 2 or more missed pills in week one of cycle

A

take last missed pill & continue on as normal

condoms/no sex till taken 7 pills over7 days in a row

emergency contraception should be considered if she had unprotected sex in the pill-free interval or in week 1

30
Q

COC: if 2 or more missed pills in week 2 of cycle

A

take the last pill even if it means taking two pills in one day, leave any earlier missed pills and then continue taking pills daily, one each day

the women should use condoms or abstain from sex until she has taken pills for 7 days in a row. FSRH: ‘This advice may be overcautious in the second and third weeks, but the advice is a backup in the event that further pills are missed’

*no need for emergency contraception

31
Q

COC: if 2 or more missed pills in week 3 of cycle
what days are week three

A

days 15-21
start a new pack the next day; thus omitting the pill free interval

take the last pill even if it means taking two pills in one day, leave any earlier missed pills and then continue taking pills daily, one each day

the women should use condoms or abstain from sex until she has taken pills for 7 days in a row. FSRH: ‘This advice may be overcautious in the second and third weeks, but the advice is a backup in the event that further pills are missed’

32
Q

miscarriage types

A

threatened
inevitable
incomplete
complete
missed

33
Q

when can a miscarriage occur

A

<24 weeks

(otherwise its a stillbirth)

34
Q

when does gestational hypertension occur

A

> 20 weeks

35
Q

when in pregnancy timeline does hyperemesis gravidarum occur

A

before 20 weeks

36
Q

what age is a risk factor for infertility

A

> 35

37
Q

first degree tear (after labour) involves…

A

Tear limited to the superficial perineal skin or vaginal mucosa only

38
Q

second degree tear (labour) involves

A

Tear extends to perineal muscles and fascia, but the anal sphincter is intact (episiotomy is anatomically classified as second degree)

39
Q

third degree tear (labour)

A

3a: <50% of the thickness external anal sphincter is torn

3b: >50% of the thickness of the external anal sphincter is torn, but internal anal sphincter is intact

3c: external and internal anal sphincters are torn, but anal mucosa is intact

40
Q

4th degree tear (labour) involves

A

Perineal skin, muscle, anal sphincter and anal mucosa are torn

41
Q

what are some drugs that should be avoided during breastfeeding

A

some abx (not penicillins but)
psychiatric drugs: lithium, benzodiazepines,clozapine
aspirin
carbimazole
methotrexate
amiodarone

42
Q

what babies in utero are at higher risk of folic deficiency

A

them/partner has hx of Neural Tube Defects

mother taking antiepileptic drugs/ has coeliac/ has thalassemia trait

woman is obese (bmi >/=30)

43
Q

pregnant women are screened for anaemia at 8-10 weeks & 28 weeks. what are their haemoglobin cut offs for intervention

A

First trimester < 110 g/L
Second/third trimester < 105 g/L
Postpartum < 100 g/L

44
Q

what day does ovulation occur on

A

day 14 (for a 28 day cycle)
or
14 days before start of next cycle

45
Q

HRT and cancer

A

oestrogen only inc risk of endometrial cancer
adding progesterone mitigates that risk

oestrogen slightly inc risk of breast cancer. adding progesterone further inc risk of breast cancer (prog worse for breasts than oestrogen)

oestrogen only and hrt both slightly inc risk of ovarian cancer

46
Q

what cancer does the combined oral contraceptive pill increase the risk of

A

breast and cervical cancer

47
Q

what cancer is the combined oral contraceptive pill protective against

A

ovarian and endometrial cancer

48
Q

fundal height- when/ where palpate

A

20 weeks palpable at umbillicus

36 weeks palpable at xiphoid sternum

49
Q

risk factors for abruption

A

ABRUPTION:
A for Abruption previously;
B for Blood pressure (i.e. hypertension or pre-eclampsia);
R for Ruptured membranes, either premature or prolonged;
U for Uterine injury (i.e. trauma to the abdomen);
P for Polyhydramnios;
T for Twins or multiple gestation;
I for Infection in the uterus, especially chorioamnionitis;
O for Older age (i.e. aged over 35 years old);
N for Narcotic use (i.e. cocaine and amphetamines, as well as smoking)

50
Q

mcroberts manouevre position

A

(for shoulder dystocia)

supine with both hips fully felxed and abducted

51
Q

high risk factors for pre-eclampsia

A

hypertensive disease previous pregnancy
CKD
autoimmune disease eg. SLE or APP syndrome
t1 or t2 diabetes
chronic hypertension

52
Q

moderate risk factors pre-eclampsia

A

first pregnancy
age 40 years or older
pregnancy interval of more than 10 years
BMI 35 or more at first visit
FHx of pre-eclampsia
multiple pregnancy- as in twins

53
Q

When is miscarriage a potential diagnosis

A

Before 24 weeks !!!!!

54
Q

most common causative organism for pelvic inflammatory disease

A

chlamydia trochamitis

55
Q

what is diagnostic of a miscarriage on ultrasound

A

us showing no cardiac activity and crown-rump length is greater than 7mm or gestational sack is greater than 25mm

year 3. (32 decks)

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