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MSRA > Womens > Flashcards

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
Q

Hormone replacement therapy contraindications

A

Hx breast cancer
Any oestrogen-sensitive cancer
Undiagnosed vaginal bleeding
Untreated endometrial hyperplasia

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26
Q

Hormone replacement therapy risks

A

VTE
stroke (oestrogen HRT)
IHD
breast ca
ovarian ca

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27
Q

Non HRT menopausal Mx

A

vasomotor (flushes, sweats) - fluoxetine, citalopram, venlafaxine

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28
Q

high risk groups for pre-eclampsia therefore require aspirin 75mg from week 12 to birth

A

HTN, CKD, autoimmune disease, diabetes

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29
Q

gestational diabetes Mx

A

oral labetolol

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30
Q

Contraceptives - time until effective (if not first day period):
instant:
2 days:
7 days:

A

instant: IUD
2 days: POP
7 days: COC, injection, implant, IUS

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31
Q

congenital rubella syndrome Fx (triad)

A

sensorineural deafness
eye abnormality
congenital heart disease

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32
Q

copper coil moa

A

decreased sperm motility

33
Q

progestogen only pill moa

A

mucus thickening

34
Q

oligohydramnios (<500ml @32 weeks) causes

A

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

35
Q

mittleschmerz Fx

A

pelvic pain around ovulation, no PV bleed

36
Q

chickenpox EXPOSURE in pregnancy (if non immune)
<20 weeks
>20 weeks

A

< 20 weeks - VZIG
>20 weeks - VZIG or Aciclovir

37
Q

chickenpox IN pregnancy Mx

A

Aciclovir (if >20 weeks, if <20weeks use with caution)

38
Q

gestational diabetes diagnosis OGTT
fasting Glu
2hr Glu

A

fasting glucose >5.6
2-hour glucose level >7.8
‘5678’

39
Q

primary dysmennhorea (painful menstruation) Mx

A

1st - NSAIDs - mefenamic acid, ibuprofen, naproxen
2nd - COCP (if not trying to conceive)

40
Q

meigs syndrome Fx (3)

A

benign ovarian tumour (fibroma), ascites, pleural effusion

41
Q

premature ovarian insufficiency Fx

A

menopausal Fx - hot flushes, sweats
infertility
secondary amenhorea
raised FSH + LH
low oestrodiol

42
Q

placenta praecia Fx

A

pathological position of placenta in lower segment
Fx - painless PV bleed, closed cervical os

43
Q

drugs contraindicated in breast feeding

A

ciproflxocin, tetracycline, chloramphenicol
lithium, benzo
aspirin
carbimazole
amiodarone
methotrexate
sulfonylureas

44
Q

polycystic ovarian syndrome blood resutls

A

high LH and androgens (testosterone, oestrodiol)

45
Q

shoulder dystocia Mx

A

1st - McRobert’s manouvre - flexion/ abduction of mother’s hips

46
Q

Down’s screening dates

A

11 - 13+6 weeks

47
Q

Anomaly scan dates

A

18 - 20+6 weeks

48
Q

Reasons for surgical Mx of ectopic pregnancy (salpingectomy/ salpingotomy)

A

> 35mm
visible foetal heartbeat
abdominal pain
bHCG >5000

49
Q

contraceptive patch missed patch Mx

A

delay >48 hrs - change patch immediately, use barrier method for 7 days

50
Q

varicella foetal syndrome Fx

A

hypoplasia, microcephaly, dye defects

51
Q

menorrhagia Mx

A

contraception not required - mefenamic acid/ transexamic acid
contraception required - IUS (Mirena), COCP

52
Q

group B strep in pregnancy Mx

A

prophylactic PO benpen - pyrexia during labour (>38), previous GBS
Mx - IV benzylpenicillin intrapartum

53
Q

post natal depression screening tool name

A

Edinburgh scale

54
Q

Down’s syndrome combined test results

A

raised HCG
reduced PAPP-A
thickened nucal translucency

55
Q

endometriosis Mx

A

1st - NSAIDs, paracetamol
2nd - COCP

56
Q

fibroids Mx

A

> 3cm myomectomy (surgical removal) + GnRH for shinkage
<3cm IUS (medical)

57
Q

eclampsia Mx

A

IV magnesium sulphate

58
Q

gestational diabetes Mx

A

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
Q

risk of unopposed oestrogen (eg oestrogen only HRT)

A

endometrial Ca

60
Q

reasons for expectant Mx of ectopic pregnancy

A

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
Q

perineal tears
first
second
third
fourth

A

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
Q

Hyperthyroidism Mx in pregnancy

A

1st trimester (<12 weeks) - propylthiouracil
2nd trimester (>12 weeks) - Carbimazole

63
Q

COCP Missed pill Mx

A

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
Q

POP missed pill Mx

A

take missed pill
condoms 2 days

65
Q

Menopausal hot flushes Mx other than HRT

A

citalopram/ clonidine/ gabapentin

66
Q

Physiological changes in pregnancy

A

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
Q

adenomyosis Fx

A

ectopic endometrial tissue within myometrium
heavy, painful, irregular periods
pre-menstrual pelvic pains

68
Q

adenomyosis Ix

A

MRI
confirmation on histology

69
Q

adenomyosis Mx

A

tranexamic acid
Hormonal contraception/ GnRH
surgery - uterine artery embolisation/ hysterectomy

70
Q

Sheehans syndrome

A

postpartum hypopituitiarisum due to blood loos/ hypovolaemia during childbirth
Fx - failure to lactate, fatigue, amennhorrea

71
Q

Asherman’s syndrome (intrauterine adhesions) Fx

A

often post Dilation and Currette (D&C) procedure - dilated cervix to currette/ scrape uterus to remove retained products post pregnancy

72
Q

Genital ulcers causes
painful vs painless

A

painful - Chancroid (haemophilus ducreyi)

painless - lymphogranuloma venereum (chlamydia), syphilis (treponema pallidum)

73
Q

Syphilis (Treponema pallidum) Mx

A

Benzylpenecillin

74
Q

Listeriosis
causes
Mx

A

causes - prepared meat (eg hot dogs, deli meat), dairy, unwashed veg, seafood
Mx - Amoxicillin and Gentamicin

75
Q

Menorrhagia Mx

A

1st - Mirena (IUS)
2nd - tranexamic acid/ NSAIDs/ COCP
3rd - norethisterone
surgical - endometrial ablation (<10cm)/ uterine artery embolisation (>10cm)/ hysterectomy

76
Q

Bishop score (PEDSS) - indicated the success rate of induction

A

position of cervix
Effacement (length)
dilatation
softness (consistency)
station of foetus

77
Q

Female infertility check - mid luteal cycle progesterone

A

7 days prior to ovulation
normally day 21 of 28 day cycle

78
Q

Placental abruption Fx

A

tense tender uterus
PV bleeding
fetal distress

MSRA (17 decks)

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