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MSRA > Reproductive medicine > Flashcards

Reproductive medicine Flashcards

1
Q

50-year-old on cyclical HRT complaining of irregular vag bleeding 1st line Ix?

A

Trans vaginal US

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2
Q

When endometrial biopsy if post-menopausal bleeding

A

> 5mm thick on US

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3
Q

palpable abdo mass in 55-year-old 1st line Ix?

A

trans abdo US

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4
Q

55 on warfarin with irregular vaginal bleeding 1st line Ix?

A

Trans vag US
- need to assess endometrial thickness

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5
Q

When secondary care if unable to conceive

A

after 12 months

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6
Q

1 off Bleeding in 3rd trimester with suspected placenta previa management and Ix? Which IX never? When would you give betamethasone

A

Admit to hospital for elective CS
Can do speculum exam - NEVER digital as risk of catastrophic haemorrhage
Betamethasone if <34weeks

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7
Q

Diabetic mums what happens to babies other than macrosomia

A

Sacral agenesis
[Cardiac defects and cleft palate]

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8
Q

Maternal valproate ->

A

Cleft palate
Learning impairment
Spinal abnomralities

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9
Q

Edwards syndrome mneumonic

A

EDWARDS
Eighteen - trisomy 18
Digital overlapping [when fist closed]
Wide head, Webbing of toes
Absent intellect - learning difficulties
Rocker bottom feet
Diseased heart
Small jaw

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10
Q

Pelvic radiation complication

A

Cancer, obstruction, fractures

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11
Q

Lifetime risk of breast Ca in women

A

1 in 8

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12
Q

Young with a non-tender mobile smooth breast lump has

A

Fibroadenoma

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13
Q

When can breast lumps get a routine referral

A

<30 with no suspicious features

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14
Q

Which cheeses do you need to avoid when preg

A

Soft ones - risk of listeria

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15
Q

How much caffine safe in preg

A

200mg / day - about 2 cups

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16
Q

Which fish have too much mercury for preg people

A

Swordfish and shark

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17
Q

Vitamin supplement a no no for preg

A

Vit A

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18
Q

BV rx

A

Metronidazole

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19
Q

Cerical dyskaryosis on smear referral speeds

A

Low grade - 6 weeks
High grade - 2 weeks
[for colposcopy]

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20
Q

Post TAH with severe dyspareunia and perimenopausal syndrome Rx

A

Bilat oophorectomy

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21
Q

Bilat ovarian endometrialomas rx

A

GnRH analogue and surgery

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22
Q

Mild Sx of endometriosis in young person Rx

A

COCP

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23
Q

Severe endometrosis in old gubbed person Rx

A

Danazol or GnRH analouge

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24
Q

Hx suggestive of PID Ix

A

Swabs including chlamydia PCR [not just culture]

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25
Q

Hx suggestive of vag-urethra fistula Ix

A

Dye injected into bladder + swabs in vag

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26
Q

child with sore vagina and discharge Ix

A

Vaginoscopy
-Need to exclude foreign body, sexual abuse or infection

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27
Q

Downs screening in preg which are screening/diagnositic when are they done?

A

First trimester10-14
Chorionic venous sampling - Diagnostic
Nuchal translucency scan - Screening
Combined test - NT scan, PAPP-A, HCG - screening

Second 14-20weeks
Aminocenteiss - diagnosistic
Tripple / quad test

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28
Q

Key infection to screen in a well couple struggling to conceive

A

Chlamydia

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29
Q

Which Ca risk a tiny bit higher with COCP

A

Breast

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30
Q

Epilepsy which contraceptive pill

A

POP
Oestrogen reduces seiure threshold

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31
Q

How does Paget’s disease of breast present ? Ix?

A

Chronic eczema rash by nipple
Biopsy

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32
Q

Which Ca if nulliparous and early menarche?

A

Ovarian
Breast
endometrial

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33
Q

Which Ca linked to long-term oral contraceptive use and is squamous?

A

Cervical

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34
Q

When can you use oestrogen-only HRT

A

TAH - as risk of endometrial Ca
Or if on a progesterone contraceptive eg implant / mirena

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35
Q

Which infection causes gross fetal hydrops at 26weeks with anaemia

A

parvovirus b19

36
Q

Which infection causes interuterine death in 3rd trimester with green coloured amniotic fluid

A

listeria

37
Q

Which infection causes intracerebral calcification and ventriculomegaly

A

CMV

38
Q

Most common cause of overwhelming meningitis and neonatal death

A

Group B strep

39
Q

fibroid red degeneration in preg rx

A

Conservative
[Analgesia, rehydration and supportive measures]

40
Q

when post partum most common for VTE

A

5-10 days [up to 6 weeks]

41
Q

Lumpy breasts especially around periods

A

Diffuse cystic mastopathy

42
Q

Key Ix for fetal CMV

A

Aminocentesis

43
Q

Ix if fetal hydrops in preg

A

[US then confirmed with] cordocentesis

44
Q

Ix for fetal sickle cell

A

chorion villus sampling

45
Q

Post preg and restarted pill. Now non-offensive discharge and occasional spotting =

A

cervical ectropion

46
Q

What is climateric

A

Basically vasomotor and mood sx of menopause

47
Q

What is morning after pill

A

Levonogestrel

48
Q

pregnant woman in contact with chicken pox now has vesicular rash rx?

A

acyclovir

Has sx so too late to check antibody status / Ig

49
Q

Emergency contraception - when can pill be used up to ? what if after that?

A

72hrs

copper coil - up to 5 days after unprotected sex

50
Q

Pregnancy booking US shoes Gestational sack >25mm with no fetal pole =?

A

Missed misscarriage

Complete misscariage has no fetal products

51
Q

1st line rx symphysis pubis dysfunction in 3rd trimester ? 2nd?

A

Advice and reassurance

Can use paracetamol
Obstetric physiotherapist or TENS machine

52
Q

Extra Ix for women with twin pregnancy

A

FBC at 20-24 weeks

53
Q

When do you use fornightly US scans in preg

A

Monochorionic twins

54
Q

Painless ulcer which resolved and now painful pelvic lymphadenopathy

A

lymphogranuloma venereum

[chlamydia]

55
Q

2 contra indications for progesterone only pill

A

Acute porphyria

Breast Ca

56
Q

PE in pregnancy with HD instability

A

unfractionated heparin

57
Q

Preg with BP 140/90 one off everything else fine plan?

A

Repeat next day

58
Q

Painless bleed after 28 weeks most likely

A

Previa

59
Q

US of preg -> snowstorm =? Usual presentation? Plan? Risk developing?

A

Hydatiform mole
Usually hyperemesis / large for dates

Uterine evacuation
->monitor hCG and if persistnetly raised then may be
Choriocarcinoma (gestational trophoblastic disease)

60
Q

10 days post delivery has abdo pain and fever. Abx -> no improvement. What is it? Rx?

A

Septic pelvic thrombophebitis

IV heparin

61
Q

Screen for downs? Dx?

A

Nuchal translucency 11-13 weeks

Amniocentesis / chorionic vilus sampling

62
Q

When is fetal anomaly scan done

A

20 weeks

63
Q

Maternal HIV reduce risk of transmission

A

Treat HIV
C section

64
Q

post menopausal vaginal bleeding and weight loss

A

Endometrial ca

65
Q

Post menopausal on tamoxifen with weight loss and PV bleeding. Large central pelvic mass with hard node in inguinal region

A

Uterine leiomyosarcoma

[Large mass key]

66
Q

3d old baby has bilat conjunctivitis ?

A

Gonorrhoea / chlamydia

67
Q

meconium stained liquor with premature rupture of membranes but normal CTG?

A

Induce labour
continuous monitoring

68
Q

No signs of labour at 40 + 2 plan?

A

Membrane sweep + book induction at 41-42 weeks

69
Q

Define Perinatal mortality rate?
Neonatal mortality rate?

A

Peri - Still births + neonatal (<7days) / 1000 live + still birth

Neo - neonatal deaths / 100 live births

70
Q

Conns rx

A

Aldosterone agonists eg spironolactone

Surgery

71
Q

Which hormon raised in PCOS

A

Testosterone
LH:FSH ratio raised

72
Q

painful vaginal bleeding and fetal distress at 39 weeks

A

Abruption

73
Q

Which contraception is contraindicated in women breastfeeding at <6weeks post partum

A

COCP

74
Q

Contraceptive contraindicated in symptomatic chlamydia

A

Intrauterine coil

75
Q

Hepatocellular carcinoma - which contraception contraindicated

A

COCP

76
Q

HRT if still have monthly bleeds?
If post-menopausal?
Which if hysterectomy / have mirena?

A

Monthly bleed - Continuous oestrogen and cyclical progesterone

Post menopause - Continuous combined

Hysterectomy - oestrogen only
[risk of endometrial cancer if still have uterus]

77
Q

UTI in preg

A

cefalexin

78
Q

When can you get a medical abortion? What is it?

A

up to 9 weeks usually, can go up to 20 weeks
mifepristone followed by prostaglandin

79
Q

1st line emergency contraception

A

copper coil

80
Q

What is ogilive syndrome

A

Large bowel pseudoobstruction following surgery of acute medical illness

81
Q

Depression
+ IBS / Chronic pain?
+ recent MI?
+ Bipolar on lithium?

A

+ IBS / Chronic pain - tricyclics eg amitriptyline
+ recent MI - Sertraline
+ Bipolar on lithium - citalopram

82
Q

Tamoxifen - which antidepressant contraindicated

A

Fluoxetine

TamoxiFen

83
Q

antiemetic in preg -> baby with structural heart defect and cleft palate

A

ondansetron
[low risk and used as second-line antiemetic for hyperemesis]

84
Q

hyperemesis antiemetic?

A

antihistamines
phenothiazines - eg levomepromazine

85
Q
A

MSRA (8 decks)

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