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Womens Flashcards

1
Q

cervical screening
a) negative HPV - return to routine testing
b) positive HPV - cytology abnormal -> colposcopy
positive HPV - cytology normal -> repeat in 12 months
B.i) HPV -ve -> return to routing testing
B.ii) HPV +ve -> repeat in 12 months
B.ii.1) HPV -ve -> return
B.ii.2) HPV +ve -> colposcopy

A

cervical screening
a) negative HPV - return to routine testing
b) positive HPV - cytology abnormal -> colposcopy
positive HPV - cytology normal -> repeat in 12 months
B.i) HPV -ve -> return to routing testing
B.ii) HPV +ve -> repeat in 12 months
B.ii.1) HPV -ve -> return
B.ii.2) HPV +ve -> colposcopy

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2
Q

cervical screening “inadequate”

A

repeat in 3 months
if still “inadequate” -> colposcopy

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3
Q

hyperemesis gravidum (most common 8-12 weeks) features (3)

A

weight loss, electrolyte imbalance, dehydration

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4
Q

hyperemesis gravidum Mx

A

1st - cyclizine/ promethazine
2nd - ondansetron/ metoclopramide

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5
Q

reasons for early referral for infertility (female) after 6 months trying

A

age >35
amenorrhea
prev STI
prev pelvic surgery
abnormal genital examination

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6
Q

reasons for early referral for infertility (male) after 6 months trying

A

genital surgery
prev STI
varicocele
significant systemic illness
abnormal genital examination

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7
Q

oligohydraminos (reduced amniotic fluid) causes (5)

A

premature rupture of membranes
renal agenesis
intrauterine growth retardation
post term gestation
pre eclampsia

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8
Q

indication for induction of labour (5)

A

prolonged pregnancy (2 weeks post predicted)
premature rupture of membrane
diabetic mother + >38 weeks
pre-eclampsia
rhesus incompatibility

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9
Q

bishop score interpretation (assess whether induction of labour is required)

A

<5 = needs induction
>7 = unlikely to need induction

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10
Q

methods of inducing pregnancy

A

1st - membrane sweep
2nd - vaginal prostaglandin (PGE2)
3rd - maternal oxytocin
4th - amniotomy/ cervical ripening balloon

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11
Q

complication of induction of labour

A

uterine hyperstimulation
Manage uterine hyperstimulation with tocolysis (terbutaline)

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12
Q

gestational diabetes OGTT diagnosis

A

fasting >5.6
2hr glucose >7.8

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13
Q

gestational diabetes Mx

A

1st - insulin

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14
Q

pre-existing diabetes in pregnancy Mx

A

stop oral hyperglycaemics (apart from metformin)
folic acid 5mg/day from pre-conception to 12 weeks

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15
Q

Rhesus negative pregnant women Mx

A

anti D at 28 and 34 weeks

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16
Q

placental abruption Fx

A

constant lower abdominal pain, tender tense uterus, normal lie/ presentation

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17
Q

placental praevia Fx

A

painless vaginal bleeding, non tender uterus, lie/ presentation may be abnormal

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18
Q

urge incontinence Mx

A

bladder retraining
antimuscarinics - oxybutynin, tolterodine, darifenacin
beta 3 agonist - mirabegron - for “frail old women”

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19
Q

stress incontinence Mx

A

pelvic floor training
surgery - mid-urethral tape
medical - duloxetine (SNRI)

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20
Q

pregnant women supplements

A

folic acid 400 mcg + vit D 10mcg per day

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21
Q

pregnant women nausea/ vomiting Mx

A

promethazine

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22
Q

secondary dysmenorrhea causes and Mx

A

causes - endometriosis, adenomyosis, pelvic inflammatory disease, copper coil, fibroids
Mx - gynae referral

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23
Q

Moderate contraindication for COCP (UKMEC 3)

A

> 35 yo + smoke <15/ day
BMI > 35
VTE family Hx
HTN
immobility e.g. wheel chair use
BRCA1/ BRCA2
current gallbladder disease

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24
Q

Complete contraindication for COPD (UKMEC 4)

A

> 35yo + smoke >15/day
migraine with aura
Hx VTE/ stroke/ IHD
breast feeding < 6 weeks post-partum
uncontrolled HTN
current breast cancer
major surgery with prolonged immobilisation
SLE, Antiphospholipid

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25
Hormone replacement therapy contraindications
Hx breast cancer Any oestrogen-sensitive cancer Undiagnosed vaginal bleeding Untreated endometrial hyperplasia
26
Hormone replacement therapy risks
VTE stroke (oestrogen HRT) IHD breast ca ovarian ca
27
Non HRT menopausal Mx
vasomotor (flushes, sweats) - fluoxetine, citalopram, venlafaxine
28
high risk groups for pre-eclampsia therefore require aspirin 75mg from week 12 to birth
HTN, CKD, autoimmune disease, diabetes
29
gestational diabetes Mx
oral labetolol
30
Contraceptives - time until effective (if not first day period): instant: 2 days: 7 days:
instant: IUD 2 days: POP 7 days: COC, injection, implant, IUS
31
congenital rubella syndrome Fx (triad)
sensorineural deafness eye abnormality congenital heart disease
32
copper coil moa
decreased sperm motility
33
progestogen only pill moa
mucus thickening
34
oligohydramnios (<500ml @32 weeks) causes
intrauterine growth retardation premature rupture of membranes renal agenesis post term gestation pre-eclampsia
35
mittleschmerz Fx
pelvic pain around ovulation, no PV bleed
36
chickenpox EXPOSURE in pregnancy (if non immune) <20 weeks >20 weeks
< 20 weeks - VZIG >20 weeks - VZIG or Aciclovir
37
chickenpox IN pregnancy Mx
Aciclovir (if >20 weeks, if <20weeks use with caution)
38
gestational diabetes diagnosis OGTT fasting Glu 2hr Glu
fasting glucose >5.6 2-hour glucose level >7.8 '5678'
39
primary dysmennhorea (painful menstruation) Mx
1st - NSAIDs - mefenamic acid, ibuprofen, naproxen 2nd - COCP (if not trying to conceive)
40
meigs syndrome Fx (3)
benign ovarian tumour (fibroma), ascites, pleural effusion
41
premature ovarian insufficiency Fx
menopausal Fx - hot flushes, sweats infertility secondary amenhorea raised FSH + LH low oestrodiol
42
placenta praecia Fx
pathological position of placenta in lower segment Fx - painless PV bleed, closed cervical os
43
drugs contraindicated in breast feeding
ciproflxocin, tetracycline, chloramphenicol lithium, benzo aspirin carbimazole amiodarone methotrexate sulfonylureas
44
polycystic ovarian syndrome blood resutls
high LH and androgens (testosterone, oestrodiol)
45
shoulder dystocia Mx
1st - McRobert's manouvre - flexion/ abduction of mother's hips
46
Down's screening dates
11 - 13+6 weeks
47
Anomaly scan dates
18 - 20+6 weeks
48
Reasons for surgical Mx of ectopic pregnancy (salpingectomy/ salpingotomy)
>35mm visible foetal heartbeat abdominal pain bHCG >5000
49
contraceptive patch missed patch Mx
delay >48 hrs - change patch immediately, use barrier method for 7 days
50
varicella foetal syndrome Fx
hypoplasia, microcephaly, dye defects
51
menorrhagia Mx
contraception not required - mefenamic acid/ transexamic acid contraception required - IUS (Mirena), COCP
52
group B strep in pregnancy Mx
prophylactic PO benpen - pyrexia during labour (>38), previous GBS Mx - IV benzylpenicillin intrapartum
53
post natal depression screening tool name
Edinburgh scale
54
Down's syndrome combined test results
raised HCG reduced PAPP-A thickened nucal translucency
55
endometriosis Mx
1st - NSAIDs, paracetamol 2nd - COCP
56
fibroids Mx
>3cm myomectomy (surgical removal) + GnRH for shinkage <3cm IUS (medical)
57
eclampsia Mx
IV magnesium sulphate
58
gestational diabetes Mx
1st - fasting glucose > 5.6 but <7.0 - lifestyle modification for 2 weeks 2nd add metformin 3rd add insulin IF fasting glucose > 7.0 - start insulin
59
risk of unopposed oestrogen (eg oestrogen only HRT)
endometrial Ca
60
reasons for expectant Mx of ectopic pregnancy
absence of symptoms 1) An unruptured embryo 2) <35mm in size 3) Have no heartbeat 4) Be asymptomatic 5) Have a B-hCG level of <1,000IU/L and declining
61
perineal tears first second third fourth
1st - superficial, no repair required 2nd - perineal but not anal sphincter, suture repair on ward 3rd - perineum and anal sphincter, surgical repair 4th - perineum, anal sphincter and rectal mucosa, surgical repair
62
Hyperthyroidism Mx in pregnancy
1st trimester (<12 weeks) - propylthiouracil 2nd trimester (>12 weeks) - Carbimazole
63
COCP Missed pill Mx
1 pill missed - take pill now, resume normal pill taking >1 pill missed - take pill now, resume normal pill taking, condoms next 7 days a) if in first 7 tablets of pack - need emergency contraception b) if last 7 tablets of pack - omit pill free interval
64
POP missed pill Mx
take missed pill condoms 2 days
65
Menopausal hot flushes Mx other than HRT
citalopram/ clonidine/ gabapentin
66
Physiological changes in pregnancy
raised prolactin raised plasma levels raised cardiac output (SV + HR) raised RR + tidal volume increase Hb falls (due to dilution) BP falls (normalised by term)
67
adenomyosis Fx
ectopic endometrial tissue within myometrium heavy, painful, irregular periods pre-menstrual pelvic pains
68
adenomyosis Ix
MRI confirmation on histology
69
adenomyosis Mx
tranexamic acid Hormonal contraception/ GnRH surgery - uterine artery embolisation/ hysterectomy
70
Sheehans syndrome
postpartum hypopituitiarisum due to blood loos/ hypovolaemia during childbirth Fx - failure to lactate, fatigue, amennhorrea
71
Asherman's syndrome (intrauterine adhesions) Fx
often post Dilation and Currette (D&C) procedure - dilated cervix to currette/ scrape uterus to remove retained products post pregnancy
72
Genital ulcers causes painful vs painless
painful - Chancroid (haemophilus ducreyi) painless - lymphogranuloma venereum (chlamydia), syphilis (treponema pallidum)
73
Syphilis (Treponema pallidum) Mx
Benzylpenecillin
74
Listeriosis causes Mx
causes - prepared meat (eg hot dogs, deli meat), dairy, unwashed veg, seafood Mx - Amoxicillin and Gentamicin
75
Menorrhagia Mx
1st - Mirena (IUS) 2nd - tranexamic acid/ NSAIDs/ COCP 3rd - norethisterone surgical - endometrial ablation (<10cm)/ uterine artery embolisation (>10cm)/ hysterectomy
76
Bishop score (PEDSS) - indicated the success rate of induction
position of cervix Effacement (length) dilatation softness (consistency) station of foetus
77
Female infertility check - mid luteal cycle progesterone
7 days prior to ovulation normally day 21 of 28 day cycle
78
Placental abruption Fx
tense tender uterus PV bleeding fetal distress

MSRA (17 decks)

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