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Ned's PassMed notes 2019/20 > Repro PassMed > Flashcards

Repro PassMed Flashcards

1
Q

how do you achieve down regulation in IVF

A

synthetic GnRh (buserelin)

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2
Q

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

A

HCG injection

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3
Q

what does the HCG injection in IVF treatment mimic

A

a spontaneous LH surge

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4
Q

in normal embryo development, when does the blastocyst develop

A

day 5

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5
Q

in normal embryo development, when does it start to implant

A

day 7

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6
Q

what luteal support is given after embryo transfer in IVF

A

progesterone pessaries for 2 weeks

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7
Q

what is the cause of variable decelerations on CTG

A

cord compression, perhaps secondary to cord prolapse

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8
Q

how do you prevent cord compression in a cord prolapse

A

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

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9
Q

an ectopic pregnancy occurring where has the greatest chance of rupture

A

isthmus

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10
Q

where do most ectopic pregnancies occur

A

ampulla

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11
Q

what is the most common site for fertilisation to occur

A

ampulla

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12
Q

what is the 1st line treatment for endometriosis

A

NSAIDs/paracetamol

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13
Q

what is the 2nd line treatment for endometriosis

A

COCP/POP

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14
Q

what is the 3rd line treatment for endometriosis

A

GnRH analogues

surgery

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15
Q

which ovarian tumour is associated with development of endometrial hyperplasia

A

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

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16
Q

what causes endometrial hyperplasia and how can you treat it

A

excess oestrogen

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

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17
Q

what should women at high risk of pre eclampsia take

A

aspirin 75mg from 12 weeks til birth of the baby

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18
Q

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

A

day 21 progesterone

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19
Q

most common cause of primary PPH

A

uterine atony

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20
Q

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

A

either:
mefenamic acid
or
tranexamic acid

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21
Q

what effect can administering steroids in diabetics have

A

can cause hyperglycaemia - need to monitor BGL closely

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22
Q

what is the role of tocolytic medication in pregnancy

A

they prevent preterm labour and immature birth by suppressing uterine contractions

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23
Q

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

A

total abdominal hysterectomy with bilateral salphingo-oophorectomy

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24
Q

which 2 STIs are treated using oral metronidazole

A 
bacterial vaginosis 
trichomonas vaginalis (frothy grene vaginal discharge)
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25
Q

what is the 1st line treatment for gonorrhoea

A

IM ceftriaxone

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26
Q

what is a red flag for puerperal psychosis

A

an abrupt change in mental state

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27
Q

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

A

misoprostol

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28
Q

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

A

trimethoprim

29
Q

why is trimethoprim contraindicated in the 1st trimester of pregnancy

A

it is a folate antagonist so is teratogenic

30
Q

describe a 1st degree perineal tear

A

tear within vaginal mucosa only

31
Q

describe a 2nd degree perineal tear

A

tear into subcut tissue

32
Q

describe a 3rd degree perineal tear

A

laceration extends into external anal sphincter

33
Q

describe a 4th degree perineal tear

A

laceration extends through external anal sphincter into rectal mucosa

34
Q

how do you differentiate between pre eclampsia and gestational hypertension

A

both occur from 20 weeks

pre eclampsia has sig proteinuria

gestational HT has no proteinuria

35
Q

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

A

Rh -ive mothers who are not sensitised

36
Q

name 3 signs of an amniotic fluid embolism

A

resp distress
hypoxia
hypotension

37
Q

how does red degeneration of a uterine fibroid occur

A

uterine fibroids are sensitive to oestrogen and can therefore grow during pregnancy

if growth outstrips the blood supply, they can undergo red degeneration

38
Q

name 3 signs of degeneration that usually occur

A

low grade fever, pain and vomiting

39
Q

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

A

calcium gluconate

40
Q

what should be given in an eclamptic seizure

A

magnesium sulphate

41
Q

1st line treatment for hyperemesis gravidarum

A

promethazine (antihistamine)
or
cyclizine

42
Q

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

A

nifedipine

NOT labetalol

43
Q

how is bacterial prostatitis diagnosed and treated

A 
dx = first pass urine sample 
tx= ciprofloxacin 28 days
44
Q

which 2 reproductive tumours does Lynch syndrome predispose to

A

mainly ovarian

endometrial

45
Q

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

A

CA125

46
Q

what do the guidelines say about babies in breech presentation

A

if breech before 36weeks - watch and wait

if breech >36weeks –> external cephalic version

47
Q

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

A

CEA

carcinoembryonic antigen

48
Q

3 things included in the diagnostic criteria of hyperemesis gravidarum

A

5% pre-pregnancy weight loss
electrolyte imbalance
dehydration

49
Q

how can you test for premature ovarial failure

A

FSH

should be high in menopausal women

50
Q

how does progesterone act on the uterus

A

it maintains the uterus in the pro-pregnancy state-

it will increase glandular secretions and increase the vascularity of the uterus

51
Q

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

A

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

52
Q

most common cause of post menopausal bleeding

A

atrophic vaginitis

53
Q

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

A

Nuchal thickness US

serum screening HCG and PAPP-A

54
Q

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

A

11-13+6

55
Q

what DS risk assessment is performed in the 2nd trimester

A

blood sampling for assay of HCG and AFP

56
Q

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

A

15-20 weeks

57
Q

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

A
  1. amniocentesis (>15 weeks)

2. chorionic villus sampling (>12 weeks)

58
Q

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

A

chorionic villus sampling

59
Q

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

A

metformin, either alone or alongside insulin

glixlazade is contraindicated

60
Q

what is the classic triad of vasa praevia

A

rupture of membranes followed by painless vaginal bleeding and fetal bradycardia

61
Q

what helps you differentiate vasa praevia form placenta praevia

A

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

62
Q

which adhesions are specific to Fitz-hugh-curtis syndrome

A

hepatic adhesions

FHC syndrome is a form of pelvic inflammatory disease

63
Q

when is premature ovarian failure and early menopause diagnosed

A

Premature ovarian failure = age <40

early menopause = age<45

64
Q

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

A

magnesium sulphate

65
Q

what should a pregnant woman with abdominal trauma have done ASAP

A

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

66
Q

what ovarian cyst causes pseudomyxoma peritonei if it ruptures

A

mucinous cystadenoma

67
Q

what is the most common type of epithelial cell tumour

A

serous cystadenoma

68
Q

what is the most common type of ovarian cyst

A

follicular cyst

Ned's PassMed notes 2019/20 (17 decks)

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