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Finals passmed > Sexual health/gynae/obs > Flashcards

Sexual health/gynae/obs Flashcards

1
Q

What is the recommended duration of treatment for PEP?

A

4 weeks

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2
Q

What should women with hypothyroidism do with their levothyroxine dose if they become pregnant?

A

Increase levothyroxine by up to 50%

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3
Q

What is the management of placental abruption in <36 weeks?

A

Admit and administer steroids if foetus is okay
C-section if signs of foetal distress or maternal instability

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4
Q

What is the management of placental abruption in >36 weeks?

A

foetal distress - c-section immediately
no distress - deliver vaginally

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5
Q

What risk factor is most associated with testicular cancer?

A

Infertility (think of undescended testes being infertile)

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6
Q

What is used for the medical management of an ectopic pregnancy?

A

methotrexate

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7
Q

When would you do expectant management of an ectopic pregnancy?

A
  • <35mm
  • unruptured
  • asymptomatic
  • no foetal heartbeat
  • hCG <1,000
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8
Q

What is the management of genital warts?

A

Cryotherapy or podophyllum

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9
Q

How does the COCP prevent pregnancy?

A

Inhibits ovulation

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10
Q

How does the desogestrel pill prevent pregnancy?

A

Inhibits ovulation and thickens cervical mucus

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11
Q

How does the IUD work?

A

prevents endometrial proliferation and thickens cervical mucus

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12
Q

What is the management of vaginal candidiasis?

A

oral fluconazole 150mg
or 500mg clotrimazole pessary if not (e.g. in pregnancy)

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13
Q

What are the first line treatments of heavy menstrual bleeding?

A

mefenamic acid 500mg or tranexamic acid 1g if wanting to conceive
Mirena coil if not wanting to conceive

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14
Q

What is klinefelter’s syndrome?

A

XXY
male external genitalia, tall, small testes, gynaecomastia

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15
Q

What are the hormonal levels found in klinefelters?

A

High LH and FSH and low testosterone

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16
Q

What are the features of androgen insensitivity syndrome?

A

Genetically male with female external genitalia

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17
Q

Which drugs reduce the efficacy of the COCP?

A

Carbemazepine, phenytoin, rifampicin, St John’s Wort, Alcohol, Smoking

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18
Q

What is the management of someone with a primary herpes infection in their 3rd trimester?

A

Oral aciclovir 400mg TDS, until delivery, elective caesarian

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19
Q

What is the management of a UTI in the first trimester?

A

7-day course of nitrofurantoin

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20
Q

What is the management of a UTI in the third trimester?

A

7 day course of trimethoprim

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21
Q

What type of hepatitis is common in pregnant women?

A

Hepatitis E

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22
Q

If a smear is HPV positive but normal cytology when do you retest?

A

In 12 months, then 12 months again if the same, then refer for colposcopy

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23
Q

Which STI causes painful ulcers?

A

Herpes Simplex Virus

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24
Q

Which STI causes painless ulcers?

A

Syphilis

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25
Q

How often is routine screening for cervical cancer?

A

Every 5 years

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26
Q

What is the management of BV?

A

Metronidazole
- if not, topical clindamycin

27
Q

Which infection has clue cells on microscopy?

A

Bacterial vaginosis

28
Q

What is the main side effect of the injectable contraceptive?

A

weight gain

29
Q

Which factors indicate an organic cause of erectile dysfunction?

A

gradual onset of symptoms, lack of tumescence, normal libido

30
Q

What investigations should you do for erectile dysfunction?

A

CV risk, free testosterone in morning (if low measure again plus FSH, LH and prolactin)

31
Q

What is the management of erectile dysfunction?

A
  • PDE-5 inhibitors (sildenafil)
  • vacuum erection devices
  • stop cycling
32
Q

What are the different categories of C section?

A
  • cat 1 - immediate threat to life of mum or baby (within 30 mins)
  • cat 2 - maternal or foetal compromise (within 75 mins)
  • cat 3 - delivery required, but mum and baby stable
  • cat 4 - elective
33
Q

Name a GnRH agonist

A

Goserelin - causes gynaecomastia

34
Q

What antibiotics do you use for a UTI in pregnancy?

A

Nitrofurantoin 1st line - but not near term
amoxicillin 2nd line
Trimethoprim - terataogenic not 1st term

35
Q

Which immunoglobulin is most present in breast milk?

A

IgA

36
Q

Which immunoglobulin can cross the placenta?

A

IgG

37
Q

What hepatitis antigens would show a previous hep B and hep C infection?

A

Anti-HBc (HB caught)
Anti-HCV (HC caught - no vaccine)

Anti-HBs (HB vaccine), HBsAg (active infection)

38
Q

How do you differentiate between endometriosis and fibroids?

A

Endo - more pain than bleeding, deep dyspareunia
Fibroids - more bleeding, frequent urination, can feel mass on examination

39
Q

What is the management of fibroids?

A

GnRH agonists, then surgical myomectomy, uterine artery embolisation

40
Q

How should induction be done for different bishop scores?

A

< 6 vaginal prostaglandins or oral misoprostol or balloon catheter
> 6 amniotomy and IV oxytocin infusion

41
Q

What doses of folic acid should be taken in pregnancy?

A

400mcg until 12th week
5mg until 12th week - if high risk, BMI > 30, coeliac, thalassaemia, diabetes, NTD pmh

42
Q

What is the management of cord prolapse?

A
  • presenting part pushed back into uterus
  • cord kept warm
  • patient asked to go on all fours
  • tocolytics to reduce contractions
  • fill bladder
  • C section is first line
43
Q

What is the time frame for taking the emergency contraceptive pills?

A

Levonogestrel - within 72hrs
Ulipristal (EllaOne) - within 120hrs

44
Q

What cardiac signs are normal in pregnant women?

A

third heart sound, peripheral oedema, ejection systolic murmur, forceful apex beat

45
Q

What are the common features of endometrial hyperplasia?

A

painless vaginal bleeding - intermenstrual, can be post menopause

46
Q

When can you start the COCP after having a baby?

A

21 days if not breastfeeding
6 weeks if breastfeeding

47
Q

How often is cervical cancer screening normally?

A

5 years

48
Q

What is the first line investigation for post-menopausal bleeding?

A

Transvaginal ultrasound - best at looking at endometrial thickness

49
Q

How does placenta previa typically present?

A

painless bleeding, no scan at 20weeks, foetus and mum not unwell.
Use transvaginal ultrasound to diagnose

50
Q

What is the management of varicella zoster in pregnant women?

A

if exposed: check IgG
give aciclovir (IgG shortage)
if develops chickenpox - see specialist and give antivirals

51
Q

What is the medical management of a primary PPH?

A

IV oxytocin, IV ergometrin, IM carboprost (except in asthmatics), sublingual misoprostol

52
Q

What is the first line surgical management of a primary PPH?

A

Intrauterine balloon tamponade

53
Q

Which antihypertensives should be stopped in pregnancy?

A

ACE inhibitors and ARBs

54
Q

When should 75mg aspirin be given as pre-eclampsia prophylaxis?

A

1 or more high risk RFs
- hypertension, diabetes, CKD, autoimmune, previous HTN in pregnancy
2 or more moderate - first pregnancy, over 40, multiple pregnancy, FH, BMI > 35

55
Q

What is the first-line management of intrahepatic cholestasis of pregnancy?

A

Ursodeoxycholic acid

56
Q

Which cancers does the COCP have an impact on?

A

Breast and cervical - increases risk
Ovarian and endometrial - decreases risk

57
Q

What is the management if there is reduced foetal movements? - less than 10 in 2 hrs.

A
  • handheld doppler for HR
  • if cannot find, ultrasound
  • if can find HR - CTG for 20 mins to assess foetus
58
Q

What are the three levels of placenta accreta?

A

Accreta - attach to myometrium
Increta - into myometrium
percreta - into perimetrium - most severe

59
Q

What drug is used for induction of labour?

A

Oxytocin (syntocin)

60
Q

What type of anticoagulant can be used in pregnancy?

A

LMWH

61
Q

What is the treatment of syphilis?

A

benzathine benzylpenicillin

62
Q

What are the features of pre-eclampsia?

A

BP > 140/90
1 of organ dysfunction or +ve proteins on urine dip

63
Q

What is the management of pre-eclampsia?

A

Oral labetalol
Nifedipine if asthmatic

Finals passmed (23 decks)

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