Repro PassMed

Question 1

how do you achieve down regulation in IVF

Answer 1

synthetic GnRh (buserelin)

Question 2

what is the next step in IVF treatment after the gonadotrophins have been given

Answer 2

HCG injection

Question 3

what does the HCG injection in IVF treatment mimic

Answer 3

a spontaneous LH surge

Question 4

in normal embryo development, when does the blastocyst develop

Answer 4

day 5

Question 5

in normal embryo development, when does it start to implant

Answer 5

day 7

Question 6

what luteal support is given after embryo transfer in IVF

Answer 6

progesterone pessaries for 2 weeks

Question 7

what is the cause of variable decelerations on CTG

Answer 7

cord compression, perhaps secondary to cord prolapse

Question 8

how do you prevent cord compression in a cord prolapse

Answer 8

elevate the presenting part either manually or by filling the urinary bladder

Question 9

an ectopic pregnancy occurring where has the greatest chance of rupture

Answer 9

isthmus

Question 10

where do most ectopic pregnancies occur

Answer 10

ampulla

Question 11

what is the most common site for fertilisation to occur

Answer 11

ampulla

Question 12

what is the 1st line treatment for endometriosis

Answer 12

NSAIDs/paracetamol

Question 13

what is the 2nd line treatment for endometriosis

Answer 13

COCP/POP

Question 14

what is the 3rd line treatment for endometriosis

Answer 14

GnRH analogues

surgery

Question 15

which ovarian tumour is associated with development of endometrial hyperplasia

Answer 15

granulosa cell tumours (excess oestrogen release causes overstimulation of endometrium)

Question 16

what causes endometrial hyperplasia and how can you treat it

Answer 16

excess oestrogen

high dose progesterone reduce oestrogen release (ie- the IUS)

Question 17

what should women at high risk of pre eclampsia take

Answer 17

aspirin 75mg from 12 weeks til birth of the baby

Question 18

what is the 1st line investigation in a women who has not concieved after 1 year of regular unprotected sexual intercourse

Answer 18

day 21 progesterone

Question 19

most common cause of primary PPH

Answer 19

uterine atony

Question 20

how do you treat heavy menstrual bleeding if the patient doesn’t require contraception (ie - not IUS tx)

Answer 20

either:
mefenamic acid
or
tranexamic acid

Question 21

what effect can administering steroids in diabetics have

Answer 21

can cause hyperglycaemia - need to monitor BGL closely

Question 22

what is the role of tocolytic medication in pregnancy

Answer 22

they prevent preterm labour and immature birth by suppressing uterine contractions

Question 23

what is the 1st line treatment for stage I and II endometrial carcinoma

Answer 23

total abdominal hysterectomy with bilateral salphingo-oophorectomy

Question 24

which 2 STIs are treated using oral metronidazole

Answer 24

bacterial vaginosis 
trichomonas vaginalis (frothy grene vaginal discharge)

Question 25

what is the 1st line treatment for gonorrhoea

Answer 25

IM ceftriaxone

Question 26

what is a red flag for puerperal psychosis

Answer 26

an abrupt change in mental state

Question 27

in medical termination of pregnancy, which of the 2 drugs is a prostaglandin

Answer 27

misoprostol

Question 28

which drug used to treat UTIs is contraindicated in 1st trimester of pregnancy

Answer 28

trimethoprim

Question 29

why is trimethoprim contraindicated in the 1st trimester of pregnancy

Answer 29

it is a folate antagonist so is teratogenic

Question 30

describe a 1st degree perineal tear

Answer 30

tear within vaginal mucosa only

Question 31

describe a 2nd degree perineal tear

Answer 31

tear into subcut tissue

Question 32

describe a 3rd degree perineal tear

Answer 32

laceration extends into external anal sphincter

Question 33

describe a 4th degree perineal tear

Answer 33

laceration extends through external anal sphincter into rectal mucosa

Question 34

how do you differentiate between pre eclampsia and gestational hypertension

Answer 34

both occur from 20 weeks pre eclampsia has sig proteinuria gestational HT has no proteinuria

Question 35

which rhesus state would a mother be to require anti natal anti-D prophylaxis

Answer 35

Rh -ive mothers who are not sensitised

Question 36

name 3 signs of an amniotic fluid embolism

Answer 36

resp distress hypoxia hypotension

Question 37

how does red degeneration of a uterine fibroid occur

Answer 37

uterine fibroids are sensitive to oestrogen and can therefore grow during pregnancy if growth outstrips the blood supply, they can undergo red degeneration

Question 38

name 3 signs of degeneration that usually occur

Answer 38

low grade fever, pain and vomiting

Question 39

what is the 1st line treatment for MgSO4 induced respiratory arrest

Answer 39

calcium gluconate

Question 40

what should be given in an eclamptic seizure

Answer 40

magnesium sulphate

Question 41

1st line treatment for hyperemesis gravidarum

Answer 41

promethazine (antihistamine) or cyclizine

Question 42

what is 1st line pre eclampsia tx in a patient with asthma

Answer 42

nifedipine | NOT labetalol

Question 43

how is bacterial prostatitis diagnosed and treated

Answer 43

``` dx = first pass urine sample tx= ciprofloxacin 28 days ```

Question 44

which 2 reproductive tumours does Lynch syndrome predispose to

Answer 44

mainly ovarian | endometrial

Question 45

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

Answer 45

CA125

Question 46

what do the guidelines say about babies in breech presentation

Answer 46

if breech before 36weeks - watch and wait | if breech >36weeks --> external cephalic version

Question 47

which tumour marker is tested to exclude metastases of a primary GI tumour

Answer 47

CEA | carcinoembryonic antigen

Question 48

3 things included in the diagnostic criteria of hyperemesis gravidarum

Answer 48

5% pre-pregnancy weight loss electrolyte imbalance dehydration

Question 49

how can you test for premature ovarial failure

Answer 49

FSH | should be high in menopausal women

Question 50

how does progesterone act on the uterus

Answer 50

it maintains the uterus in the pro-pregnancy state- | it will increase glandular secretions and increase the vascularity of the uterus

Question 51

if fertilisation occurs, which hormones keep the endometrium viable for implantation

Answer 51

BhCG produced by the embryo stimulates the corpus luteum to continue to secrete progesterone

Question 52

most common cause of post menopausal bleeding

Answer 52

atrophic vaginitis

Question 53

what downs syndrome risk assessment is done in the 1st trimester

Answer 53

Nuchal thickness US | serum screening HCG and PAPP-A

Question 54

at how many weeks gestation is the combined US and serum screening for DS risk assessment performed

Answer 54

11-13+6

Question 55

what DS risk assessment is performed in the 2nd trimester

Answer 55

blood sampling for assay of HCG and AFP

Question 56

when is the DS risk assessment performed in there 2nd trimester

Answer 56

15-20 weeks

Question 57

what are the 2 diagnostic tests for diagnosing DS and when are they performed

Answer 57

1. amniocentesis (>15 weeks) | 2. chorionic villus sampling (>12 weeks)

Question 58

which of the 2 diagnostic tests for DS has the highest miscarriage rate

Answer 58

chorionic villus sampling

Question 59

what is the treatment for a type 2 diabetic who is pregnant

Answer 59

metformin, either alone or alongside insulin glixlazade is contraindicated

Question 60

what is the classic triad of vasa praevia

Answer 60

rupture of membranes followed by painless vaginal bleeding and fetal bradycardia

Question 61

what helps you differentiate vasa praevia form placenta praevia

Answer 61

vasa praevia is associated with rupture of membranes, placenta praviea is not

Question 62

which adhesions are specific to Fitz-hugh-curtis syndrome

Answer 62

hepatic adhesions FHC syndrome is a form of pelvic inflammatory disease

Question 63

when is premature ovarian failure and early menopause diagnosed

Answer 63

Premature ovarian failure = age <40 early menopause = age<45

Question 64

what is used to prevent seizures but also treat them acutely In eclampsia

Answer 64

magnesium sulphate

Question 65

what should a pregnant woman with abdominal trauma have done ASAP

Answer 65

rhesus testing - need to prevent rhesus isoimmunization in rhesus -ive mothers if there is a bleed

Question 66

what ovarian cyst causes pseudomyxoma peritonei if it ruptures

Answer 66

mucinous cystadenoma

Question 67

what is the most common type of epithelial cell tumour

Answer 67

serous cystadenoma

Question 68

what is the most common type of ovarian cyst

Answer 68

follicular cyst