Repro PassMed Flashcards
how do you achieve down regulation in IVF
synthetic GnRh (buserelin)
what is the next step in IVF treatment after the gonadotrophins have been given
HCG injection
what does the HCG injection in IVF treatment mimic
a spontaneous LH surge
in normal embryo development, when does the blastocyst develop
day 5
in normal embryo development, when does it start to implant
day 7
what luteal support is given after embryo transfer in IVF
progesterone pessaries for 2 weeks
what is the cause of variable decelerations on CTG
cord compression, perhaps secondary to cord prolapse
how do you prevent cord compression in a cord prolapse
elevate the presenting part either manually or by filling the urinary bladder
an ectopic pregnancy occurring where has the greatest chance of rupture
isthmus
where do most ectopic pregnancies occur
ampulla
what is the most common site for fertilisation to occur
ampulla
what is the 1st line treatment for endometriosis
NSAIDs/paracetamol
what is the 2nd line treatment for endometriosis
COCP/POP
what is the 3rd line treatment for endometriosis
GnRH analogues
surgery
which ovarian tumour is associated with development of endometrial hyperplasia
granulosa cell tumours (excess oestrogen release causes overstimulation of endometrium)
what causes endometrial hyperplasia and how can you treat it
excess oestrogen
high dose progesterone reduce oestrogen release (ie- the IUS)
what should women at high risk of pre eclampsia take
aspirin 75mg from 12 weeks til birth of the baby
what is the 1st line investigation in a women who has not concieved after 1 year of regular unprotected sexual intercourse
day 21 progesterone
most common cause of primary PPH
uterine atony
how do you treat heavy menstrual bleeding if the patient doesn’t require contraception (ie - not IUS tx)
either:
mefenamic acid
or
tranexamic acid
what effect can administering steroids in diabetics have
can cause hyperglycaemia - need to monitor BGL closely
what is the role of tocolytic medication in pregnancy
they prevent preterm labour and immature birth by suppressing uterine contractions
what is the 1st line treatment for stage I and II endometrial carcinoma
total abdominal hysterectomy with bilateral salphingo-oophorectomy
which 2 STIs are treated using oral metronidazole
bacterial vaginosis trichomonas vaginalis (frothy grene vaginal discharge)
what is the 1st line treatment for gonorrhoea
IM ceftriaxone
what is a red flag for puerperal psychosis
an abrupt change in mental state
in medical termination of pregnancy, which of the 2 drugs is a prostaglandin
misoprostol
which drug used to treat UTIs is contraindicated in 1st trimester of pregnancy
trimethoprim
why is trimethoprim contraindicated in the 1st trimester of pregnancy
it is a folate antagonist so is teratogenic
describe a 1st degree perineal tear
tear within vaginal mucosa only
describe a 2nd degree perineal tear
tear into subcut tissue
describe a 3rd degree perineal tear
laceration extends into external anal sphincter
describe a 4th degree perineal tear
laceration extends through external anal sphincter into rectal mucosa
how do you differentiate between pre eclampsia and gestational hypertension
both occur from 20 weeks
pre eclampsia has sig proteinuria
gestational HT has no proteinuria
which rhesus state would a mother be to require anti natal anti-D prophylaxis
Rh -ive mothers who are not sensitised
name 3 signs of an amniotic fluid embolism
resp distress
hypoxia
hypotension
how does red degeneration of a uterine fibroid occur
uterine fibroids are sensitive to oestrogen and can therefore grow during pregnancy
if growth outstrips the blood supply, they can undergo red degeneration
name 3 signs of degeneration that usually occur
low grade fever, pain and vomiting
what is the 1st line treatment for MgSO4 induced respiratory arrest
calcium gluconate
what should be given in an eclamptic seizure
magnesium sulphate
1st line treatment for hyperemesis gravidarum
promethazine (antihistamine)
or
cyclizine
what is 1st line pre eclampsia tx in a patient with asthma
nifedipine
NOT labetalol
how is bacterial prostatitis diagnosed and treated
dx = first pass urine sample tx= ciprofloxacin 28 days
which 2 reproductive tumours does Lynch syndrome predispose to
mainly ovarian
endometrial
which tumour marker is raised in up to 80% of ovarian tumours
CA125
what do the guidelines say about babies in breech presentation
if breech before 36weeks - watch and wait
if breech >36weeks –> external cephalic version
which tumour marker is tested to exclude metastases of a primary GI tumour
CEA
carcinoembryonic antigen
3 things included in the diagnostic criteria of hyperemesis gravidarum
5% pre-pregnancy weight loss
electrolyte imbalance
dehydration
how can you test for premature ovarial failure
FSH
should be high in menopausal women
how does progesterone act on the uterus
it maintains the uterus in the pro-pregnancy state-
it will increase glandular secretions and increase the vascularity of the uterus
if fertilisation occurs, which hormones keep the endometrium viable for implantation
BhCG produced by the embryo stimulates the corpus luteum to continue to secrete progesterone
most common cause of post menopausal bleeding
atrophic vaginitis
what downs syndrome risk assessment is done in the 1st trimester
Nuchal thickness US
serum screening HCG and PAPP-A
at how many weeks gestation is the combined US and serum screening for DS risk assessment performed
11-13+6
what DS risk assessment is performed in the 2nd trimester
blood sampling for assay of HCG and AFP
when is the DS risk assessment performed in there 2nd trimester
15-20 weeks
what are the 2 diagnostic tests for diagnosing DS and when are they performed
- amniocentesis (>15 weeks)
2. chorionic villus sampling (>12 weeks)
which of the 2 diagnostic tests for DS has the highest miscarriage rate
chorionic villus sampling
what is the treatment for a type 2 diabetic who is pregnant
metformin, either alone or alongside insulin
glixlazade is contraindicated
what is the classic triad of vasa praevia
rupture of membranes followed by painless vaginal bleeding and fetal bradycardia
what helps you differentiate vasa praevia form placenta praevia
vasa praevia is associated with rupture of membranes, placenta praviea is not
which adhesions are specific to Fitz-hugh-curtis syndrome
hepatic adhesions
FHC syndrome is a form of pelvic inflammatory disease
when is premature ovarian failure and early menopause diagnosed
Premature ovarian failure = age <40
early menopause = age<45
what is used to prevent seizures but also treat them acutely In eclampsia
magnesium sulphate
what should a pregnant woman with abdominal trauma have done ASAP
rhesus testing - need to prevent rhesus isoimmunization in rhesus -ive mothers if there is a bleed
what ovarian cyst causes pseudomyxoma peritonei if it ruptures
mucinous cystadenoma
what is the most common type of epithelial cell tumour
serous cystadenoma
what is the most common type of ovarian cyst
follicular cyst
