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Exam > Reproduction medicine > Flashcards

Reproduction medicine Flashcards

1
Q

Rate of fetal anomalies is 2-5%

A

F (3-5%)

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2
Q

1/5 to 1/4 of women have miscarriage

A

T

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3
Q

1/10 of women develop pre-eclampsia

A

T

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4
Q

Full term (40 weeks gestation) is not inclusive of the 2 weeks after LMP

A

F (40 weeks gestation = 2 week post LMP + 38 weeks)

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5
Q

Very early preterm is 24-28 weeks & late preterm is 35-37 weeks

A

F (late preterm is 34-37 weeks)

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6
Q

It is common to feel excitement, tiredness and nausea in the 1st trimester

A

T

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7
Q

2nd trimester is from week 12-24

A

F (13-24)

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8
Q

During pregnancy, patient will have increased uterine blood flow (50mls/min to 500mls/min), constipation and higher risk of clotting.

A

T

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9
Q

In the 1st trimester, we need to do US scans ensure there is no physical deformity

A

F (anatomy scan is done in the 2nd trimester)

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10
Q

During the 3rd trimester, it is compulsory to have US scan to observe the placenta growth and location.

A

F (it is not compulsory)

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11
Q

Folic acid is best taken when the pregnancy test comes back positive.

A

F (neural tube is formed by 28 day, by then it may be too late.)

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12
Q

It is normal to gain >10kg during pregnancy especially if your BMI prior was >30

A

F (>30 BMI usually gain only 5-9kg)

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13
Q

For a smoker, switch to nicotine replacement therapy during pregnancy.

A

F (should quit, NRT is harmful)

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14
Q

Second to the baby, most weight gain is contributed to increase stores of fat, protein and other nutrients.

A

T (baby ~3.4kg, stores ~3.2kg)

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15
Q

The difference between DOMINO and ETH is the time difference required post delivery in hospital before heading home.

A

T (DOMINO - go home 6 hours postnatal while ETH - go home 1-2 days postnatal)

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16
Q

A moderate contraction last 30-60seconds.

A

T

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17
Q

The third stage of labour is the delivery of foetus only.

A

F (delivery of foetus to delivery of placenta)

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18
Q

The first vaccine is at 6 weeks.

A

F (8 week)

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19
Q

Puerperium is the period immediately after childbirth, when the womb is returning to its normal size, lasting approximately 8 weeks.

A

F (6 weeks)

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20
Q

Kegel exercise is recommended for woman postnatally.

A

T

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21
Q

After birth, the uterus shrinks from 1000g to a mere 350g by 6 weeks.

A

F (shrinks to 100-200g)

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22
Q

Immediately after delivery, uterus shrinks to level of umbilicus, then midway between umbilicus and symphysis by week 2 and finally to pelvis by week 4.

A

T

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23
Q

After birth, there will be constant volume of lochia up to 6 weeks.

A

F (lochia is reducing over 6 weeks)

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24
Q

Breast feeding acts as a contraceptive.

A

F (can still get pregnant)

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25
Q

Ovulation may return within 6-8 weeks in breastfeeding mothers.

A

F (in non-breastfeeding. breastfeeding preggos take longer time)

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26
Q

Oestrogen promotes lactation.

A

F (prolactin)

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27
Q

The AB in breast milk is only IgG

A

F (IgA and IgG)

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28
Q

Mother will produce colostrum for 48-72 hours

A

T

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29
Q

almost 50% of medicines taken during pregnancy is over the counter

A

T

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30
Q

Vitamins are not considered medication.

A

F

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31
Q

Thalidomide was marketed as an anti-emetic, anti-histamine and hypnotic. The critical period for exposure is 36-50 days menstrual age.

A

F (35-50)

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32
Q

25% of exposed children are affected

A

F (20%)

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33
Q

The mean age of diagnosis from DES syndrome is 18.9yo.

A

T

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34
Q

In females with DES syndrome, they have adenocarcinoma of ovaries, and structural genital tract anomalies

A

F (cancer is cervix/vagina, not ovaries)

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35
Q

Patients with hyperemesis gravidarum can be prescribe anti-psychotics.

A

T (anti-dopaminergic effect)

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36
Q

Anti-emetics are first line in treating morning sickness.

A

F (Give cariban. Only give anti-emetics if cariban doesn’t work)

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37
Q

Cariban is comprised of pyridoxine and doxylamine.

A

T (pyridoxine = Vitamin B6) (Doxylamine = histamine)

38
Q

Conservative treatment of reflux includes drinking milk, gasvicon and ranitidine.

A

F (ranitidine H2 blocker and omeprazole PPI are medicinal approach)

39
Q

Constipation in pregnant women should be treated with a stimulant, followed by a bulking agent.

A

F (do not give Senna!)

40
Q

You can give Ca2+ and Fe2+ supplement to alleviate leg cramps.

A

T

41
Q

In anaemic patients, give vitamin D and Ca2+

A

F (vitamin C helps iron absorption) (Ca2+ prevents iron from being absorbed)

42
Q

Iron tablets work almost immediately to manage anaemia.

A

F (takes few weeks to work)

43
Q

Iron infusion is the first choice for anaemia.

A

F (reserved for those with low iron stores and unable to tolerate PO iron)

44
Q

Labetalol is safe for pregnant women.

A

T

45
Q

What are the medication for epilepsy in a pregnant women?

A

Lamotrigine, Levetiracetam

46
Q

What medication for epilepsy should be avoided?

A

Phenytoin, sodium valproate - causes foetal defect

47
Q

In the ovarian cycle, how many primary follicles develop and on which day will there be a dominant follicle?

A

15-20

day 9

48
Q

FSH surge promotes ovulation

A

F (LH surge)

49
Q

What causes LH surge?

A

A rise in oestrogen in week prior to ovulation

50
Q

Basal body temperature falls during ovulation and rise during menstruation

A

F (opposite)

51
Q

What is the follicular and luteal phase?

A

Follicular phase = onset of menses till next LH surge

Luteal phase = LH surge till onset of next menses

52
Q

Follicular phase is variable but luteal phase is constant (12-16 days)

A

T

53
Q

Before ovulation, granulosa cells produce androgens and theca cells converts these androgens to oestradiol.

A

F (theca produce androgen, granulosa converts)

54
Q

What happens when there is no implantation

A

Decrease in progesterone due to corpus luteum regression. Increase thromboxane and endothelin results in vasoconstriction. Decrease blood flow results in ischaemia/apoptosis of endothelium and sloughing and rupturing of spiral arteries (menstruation).

55
Q

Ovaries and testes are formed from primordial germ cells that migrated from the yolk sac to gonadal ridge

A

T

56
Q

Primordial follicle in a primary oocyte halted at prophase 2, surrounded by a single layer of flatted granulosa cell

A

F (prophase 1)

57
Q

How many days does it take for spermatogenesis

A

70-75 days

58
Q

how many days does it take to transport the sperm from epididymis to ejaculatory duct?

A

10-21 days

59
Q

What are the layers a sperm has to penetrate?

A

corona radiate
zona pellucida
perivitelline space
vitelline membrane

60
Q

Most eggs are fertilized in the fallopian tube

A

T

61
Q

What are the 2 cell type of a fertilised eggs and what is their function

A
  1. inner cell mass “embryonic disc” - endoderm, mesoderm, ectoderm which will go on to form the baby
  2. Trophoblast - invades endometrium and form maternal venous sinuses to promote gas exchange, nutrient transfer, waste elimination
    also secretes hormones (HCG, oestrogen, progesterone)
62
Q

What are the 6 sites that an ectopic pregnancy can occur?

A 
ovarian
infundibular
ampullar
isthmic
transmural
cervical
63
Q

the umbilical cord contains 2 veins and 1 artery

A

F (1 vein and 2 arteries)

64
Q

The umbilical artery transport O2 and nutrients to the baby

A

F (transport CO2, waste etc, away from baby to placenta)

65
Q

what ages does girl and boys have puberty?

A

8-14 girls

9-14 boys

66
Q

What is the timing of puberty dependent on?

A
  1. genetics (50-80%)
  2. environment E.g. nutritional status (starved = later age)
  3. Leptin - regulates appetite and metabolism through hypothalamus
67
Q

What causes the formation of adrenarche?

A

rise in adrenal and androgens

68
Q

what are the stage in Marshal Tanner for both females and males?

A

too long…..

69
Q

After menarche, we only increase 6% of final height.

A

F (4%)

70
Q

Prepuberty, ovaries are what volume?

A

0.3-0.9cm3

71
Q

What volume of ovaries indicates puberty has begun?

A

> 1 cm3

72
Q

What volume are ovaries post-puberty?

A

4 cm3

73
Q

Delayed puberty can only be caused by hypogonadism.

A

F (hypergonadism can also cause delayed puberty)

74
Q

GH peaks at night.

A

T

75
Q

What effects does GH has on male sex organ?

A

delay of puberty
diminished Leydig cell function
Decrease response to gonadotrophins

76
Q

Precocious puberty is more common in males and usually benign.

A

F (less common, and mostly pathological)

77
Q

What does menarche, adrenarche, thelarche, pubarche mean?

A

menarche - first menses

adrenarche - androgen dependent body change
thelarche - reast development

pubarche - first sign of pubic hair

78
Q

Most follicles due to ovulation

A

F (from atresia, which accelerates with age, esp after 37)

79
Q

High pearl index = more safe (less accidental pregnancy)

A

F (pearl index = number of unintended pregnancies per 100 women per year)

80
Q

how does the COCP works?

A

it blocks FSH surge early in the cycle, hence no follicles become mature. Progesterone also makes cervical mucus more viscous)

81
Q

What are CI of COCP?

A 
Smoker (15 or more cigs/day for >35yrs)
<6 weeks postpartum (if breastfeeding)
>160/100bpm
IHD
Cirrhosis, liver failure
Diabetes w complication
Breast cancer
82
Q

Benefits of COCP?

A

reduce ovarian, endometrial and colonic cancer

reduce benign breast disease

83
Q

Chloasma will be reversed by stopping COCP

A

F (not always reversible)

84
Q

If I miss 2 pills in the 3rd week, what should I do?

A

do not have 7 day break, start new pack

85
Q

If I missed 3 pills, what should I do?

A

take emergency contraception

86
Q

What is the more common flora of genital tract

A

lactobacilli

87
Q

the normal vaginal pH is 3-5

A

F (3.5-4.6)

88
Q

How does lactobacilli protects female genitalia?

A

It metabolises glucose to lactic acid and create a vaginal pH of 3.5-4.6. It also produce hydrogen peroxide that is bactericidal.

89
Q

What are clue cells?

A

bacteria overwhelming vaginal epithelial cells till the point you cannot see the outline.

90
Q

What are features in trichomonas vaginalis?

A

tail behind the cell

Exam (3 decks)

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