Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3A GH > Womens > Flashcards

Womens Flashcards

1
Q

define normal birth

A 
spontaneous
vertex
37-42 weeks
mum + baby good condition
no instruments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

latent phase - what will woman see/feel? how long?

A

irregular contractions
bloody show (mucoid plug)
6hrs - 3days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

latent phase - whats happening to cervix?

A

effacing and thinning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

advice for women in latent phase

A

stay at home
paracetamol
eat and drink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe effacement

A

cervix moves forward, retraction of muscle fibres, cervix thins and opens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how would you feel a fully engaged baby on abdo palpation

A

feel 2 finger width of head above symphysis pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does ‘presentation’ refer to when assessing fetus?

A

anatomical part of fetus which presents through birth canal 1st e.g. breach/cephalic (vertex, brow, face)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does ‘lie’ refer to in fetal assessment?

A

relationship between uterus axis and fetal axis. e.g. longitudinal/transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does fetal ‘attitude’ refer to?

A

flexed/deflexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is engagement, in labour?

A

widest part of presenting part has passed through pelvic brim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the fetal ‘station’ and how is it measured?

A

relationship between lowest part of fetus and ischial spines. measured on vaginal exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what fetal station would you expect in a woman in 2nd stage

A

at least at the ischial spines (0)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what dilatation is expected at active phase?

A

at least 4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe contractions at active phase

A

stronger

every few mins (3-4 in 10 mins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

where is oxytocin released and what is its role in the active phase?

A

pituitary

keeps contractions going

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what reduces oxytocin levels and why?

A

anxious mother, ^adrenaline release inhibits oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the 3 Ps used to categorise a problem in labour?

A

power (of contractions)
passage (pelvis problem)
passenger (baby’s position)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does entonox contain and in what quantities

A

Nitrous oxide and oxygen 50:50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

non-pharmacological pain relief for labour

A 
in water
TENS
relaxation
hypnosis
SUPPORT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

fetal side effects of opiates for labour pain (pethidine, morphine)

A

respiratory depression
drowsy
decreased breast seeking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

maternal side effects of opiates in labour (pethidine, morphine)

A

drowsy
nausea/vom
LONGER LABOUR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

epidural consequences

1 maternal side effect

A 
longer labour
need more oxytocin
malposition
^instruments
incontinence (catheter)
decreased mobility
headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

in a normal labour, how often vaginal exams

A

every 4 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

fetal heart rate monitoring in high and low risk

A

low - intermittent

high - continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

1st stage of labour can be split into what 3 phases?

A

latent
active
transition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what will mother see/feel during transition phase of labour

A

spontaneous rupture of membranes with clear liquor
feel pressure (like want to poo)
contractions slow/stop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what can be seen in the 2nd stage of labour

A

head
bulging perineum
anal dilatation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

which fontanelle should you be able to feel on vaginal exam during labour, and which is a bad sign and why?

A

small post font good

larger ant font bad - deflexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what suture joins anterior and posterior fontanelles

A

sagittal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

describe left occiput anterior position

A

back of baby’s head towards pubic symphysis

baby’s back on mothers left side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

at how many hours after commencement of pushing would you diagnose delay in a primagravid and a multiparous

A

prima - 2 hrs

multi - 1 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

within how many hours of pushing would you expect birth (prima/multi)?

A

prima - within 3 hrs

multi - within 2 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

which shoulder is delivered first?

A

anterior/pubic symphysis side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

during delivery, when and why does internal rotation of the fetus occur?

A

head hits pelvic floor, rotates because the ant/posterior diameter of the pelvis is wider further down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

when the head is crowning, what is done when delivering in water vs air?

A

in air, support head and perineum

in water, dont touch head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

labour - what drug is given for active 3rd stage management and route

A

oxytocin IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

risk of physiological 3rd stage of labour

A

^blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is controlled cord traction

A

pull on cord and massage uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

why do we do delayed cord clamping

A

prevent neonatal anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

17 yr old. Lower abdo pain. Nausea. Ix?

A

pregnancy test
WCC/CRP
USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

17 yr old F. Right sided lower abdo pain. Differentials?

A

ectopic pregnancy
appendicitis
ovarian torsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

why does torsion cause pain?

A

ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

symptoms of threatened miscarriage

A

vaginal bleeding

occasionally abdo pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what does it mean for the pregnancy when the cervical os is open 1 finger width O/E

A

inevitable miscarriage

retained tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is a delayed miscarriage?

A

fetus has died but miscarriage has not occurred i.e. no vaginal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

best way to diagnose delayed miscarriage

A

USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

in the 1st few weeks of pregnancy, what should happen to serum bhCG levels over a 36-48 hr period?

A

double

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

which is better, transabdo or transvaginal scan at early gestation? and why?

A

transvaginal. closer to fetus, can pick up heartbeat earlier, don’t need full bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what might you see on an USS of a delayed miscarriage?

A

empty gestation sac

fetal pole with no heartbeat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what percentage of pregnancies with early vaginal bleeding remain viable?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

risk of surgical Tx of miscarriage

A

uterine perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

appropriate management of incomplete miscarriage

A

expectant management (watch and wait)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

treatment for delayed miscarriage, >12 weeks fetal size

A

mifepristone (antiprogestogen)

misoprostol (prostaglandin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

treatment for delayed miscarriage, <12 weeks fetal size

A

misoprostol (prostaglandin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

most common site of ectopic pregnancy

A

ampulla of fallopian tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what should you consider when an empty uterus is found on USS in a patient with positive pregnancy test?

A

ectopic pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

management of ectopic pregnancy

A

expectant
methotrexate
laparoscopy/laparotomy salpingotomy/salpingectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what is hyperemesis gravidarum?

A

excessive vomiting associated with weight loss, dehydration and ketosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

management of hyperemesis gravidarum

A

anti-emetics
fluids
nil by mouth
K+ and Na+ replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

anti-emetics for hyperemesis gravidarum?

A

metoclopramide

ondansetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

why is breast cancer incidence increasing?

A

living longer
obesity
screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

risk factors for breast cancer

A 
obesity
decreased exercise
alcohol
HRT
OCP
ADH (atypical ductal hyperplasia)
FH
early menarche, late menopause
older 1st pregancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

breast cancer symptoms

A 
nipple retraction
nipple discharge
painless lump
skin tethering
fracture
confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what is the triple assessment in breast cancer?

A
  1. clinical score
  2. imaging score (USS/mammo)
  3. biopsy score
    1 normal -> 5 cancer, aim for concordance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

in triple assessment, if clinical and imaging score is 5, and biopsy score is 1… what would you do?

A

re-biopsy. may have missed lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

how does cancer appear on mammogram?

A

white/dense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

if one breast appears different shape/smaller on mammogram, what might this suggest?

A

tethering (wont squash as well)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

when would MRI be used in breast imaging?

A

dense breast
screening in young women w/ e.g. BRCA
w/ contrast to see if lump is benign or malig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

in breast cancer if nodes are palpable clinically, what axilliary Tx is required?

A

full axillary clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

reasons for mastectomy

A

large cancer relative to breast size
tumour under/indrawing nipple
multifocal
patient choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

complication of axillary clearance

A

lymphoedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

axillary management if nodes are not palpable in breast cancer

A

sentinel lymph node biopsy

limited axillary clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

% of breast cancers that are ductal and typical presentation?

A

70%

hard lump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

% of breast cancers that are lobular and typical presentation

A

10%

soft, dont show well on mammogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

difference between stage and grade of breast cancer

A

stage is anatomical (tumour, nodes, mets)

grade - how they look down microscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

endocrine treatment for breast cancer are used in oestrogen or progesterone +ve disease. Give the commonly used endocrine therapy and another that is used only in post-menopausal women

A

tamoxifen [oestrogen receptor blocker]

aromatase inhib [peripheral oest synth]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

when would you use trastuzumab (Herceptin) in breast cancer Mx?

A

Her-2 positive cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

side effects/complications of tamoxifen

A

hot flushes, nausea, vaginal
bleeding (thromboses, endometrial
cancer rarely)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

side effects of aromatase inhib

A

hot flushes, reduced bone density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

why are bisphosphonates given in breast cancer?

A

prevent bone mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

methods of intermittent fetal auscultation used in community

A

Pinard stethoscope

Hand-held Doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

disadvantages of intermittent auscultation methods

A

diff to distinguish maternal and fetal heart

can’t pick-up variation and decelerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

adv of intermittent ausculation

A

cheap, non-invasive, home setting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what are the parameters you’re looking for on a CTG?

A 
Bra- baseline HR
Variability
Accelerations
Decelerations
Overall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

how would you classify a reassuring CTG

A

baseline 110-160bpm
variability <5bpm
accelerations
no/early decelerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

what are the 2 CTG transdusers detecting?

A

fetal HR

uterine contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

disadvantages of CTG

A

dec mobility

no improved outcome, ^intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

advantages of CTG

A

continuous

non-invasive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what are accelerations and decelerations on ctg?

A

rise/ fall in fetal HR by 10-15bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what are early decelerations/ why do they happen?

A

uterus contracts, blood supply to baby dec > fetal HR dec. uterus relaxes>HR^. physiological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

what are late decelerations on ctg?

A

fetal HR drop after uterine contraction, takes longer to recover. sinister

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

what are variable decelerations on ctg?

A

fetal HR drops with no relation to uterine contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

why could variation be <5bpm for up to 40 mins?

A

baby sleeping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

gold standard for fetal monitoring and why?

A

scalp ECG, not confused w/ maternal heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

disadvantages of scalp ECG for fetal heart monitoring

A 
invasive
can only be done when waters broken
X with maternal infection
scalp injury
only in labour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

adv and disadv of abdo fetal ECG

A

non-invasive, mother mobile
still being developed
signal hampered by ^amniotic fluid 28-32wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

side effects of entonox

A

maternal nausea and vom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

difference between spinal and epidural anaesthesia

A

epidural outside dura, spinal -intrathecal/ subarachnoid (continuous space with intracranial)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

how would you deliver opoids to a woman in labour (X2)

A
  1. single shot IM

2. patient controlled analgesic pump IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

side effects of single shot opoids

A

sedation
respiratory depression
seizure
N and V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

at what level does the spinal cord terminate?

A

L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

indications for epidural

A 
maternal request
pregancy induced HTN
pre-eclampsia
cardiac disease
multiple births
theatre likely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

contraindications for epidural

A

maternal refusal
local infection
LA allergy
(coagulopathy, systemic infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

effects of epidural other than analgesia

A

fever
breathlessness
headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

disadv of general anaethesia over regional for CS

A

partner cant be there
aspiration
failed intubation
seeing baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

disadv of regional anaesthesia

A

failure
discomfort
headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

what is menopause and when is it diagnosed?

A

cessation of menstruation. after 12 months amenorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

name of period leading up to menopause

A

perimenopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Sx of perimenopause

A 
irregular periods
hot flushes, night sweats
mood swings
dec sex drive
vaginal dryness
joint/muscle pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

health impacts of the menopause

A 
dyspareunia
^UTIs
prolapse
incontinence
dementia
heart disease
osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

what hormone causes endometriosis

A

oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

what is the most common site of endometriosis and why

A

pouch of douglas [betw rectum and uterus]

lowest anatomical part

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

how does endometriosis enter the abdo cavity

A

retrograde menstruation through fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

symptoms of endometriosis

A 
pain
infertility
nosebleed
cough blood
lump
dyspaerunia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

how does endometrium travel to other areas of body in endometriosis

A

blood stream
lymphatics
metaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

describe the pain experienced in endometriosis and why

A

fluctuating, worsening until period then improving after. Oestrogen fluctuates, thickens endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

what is a chocolate cyst?

A

ovary full of blood, seen in endometriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

why can endometriosis cause dyspareunia?

A

pouch of douglas irritated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

at what age would endometriosis typically present?

A

teens/early 20s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Tx options for endometriosis

A 
stop oest or give prog!
OCP
GnRH
POP
mirena
depo
oophorectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

what effect do oestrogen and progesterone have on endometrial lining

A

oest^, prog decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

what is triphasing with the OCP?

A

give back to back for 3 months without week off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

what doe giving GnRH effectively do to a woman?

A

make menopausal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

why can’t you give oestrogen alone without progesterone?

A

^^^endometrial growth > endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

what reason may you need to give endometriosis patient prog alone instead of OCP? and disdv of this

A

migraines

irregular bleeding/spotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

how do you diagnose endometriosis?

A

laparoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

whats a frozen pelvis

A

everything stuck togtehr in endometriopsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

surgical options in endometriosis

A

ablation
hysterectomy
oophorectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

theories for why endometriosis causes infertility

A

immune factors
tubal dysfunction
ovary dysfn
adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

what type of woman does adenomyosis typically present

A

older, multiparous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

sx of adenomyosis

A

cyclic pain
dyspareunia
dysmenorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

what are fibroids and hormonal cause of them

A

benign uterine tumours of myometrium

oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

tx for fibroids

A 
nothing if asymptomatic
COCP, Mirena
tranexamic acid
mefanamic acid/ ibuprofen
ulipristal acetate
GnRH
surgery[myomectomy/hysterectomy]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

sx of fibroids

A

depends where
bleeding, pain, miscarriage, infert
lump
anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

what is a endometrial polyp?

A

growth from endometrium as opposed to myometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

sx of endometrial polyp

A

miscarr, bleed, pain, infert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

what is battery?

A

failure to obtain informed consent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

What is autonomy

A

patients right to make decision, without Dr.s opinion influencing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

elements of full informed consent

A 
nature of procedure
alternatives
benefits/risks
assess Pt understanding
Pt acceptance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

can a woman refuse emergency CS for fetal distress?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

recommendations of fraser competence

A
  1. patient understanding
  2. encourage parental involvement
  3. likely to have sex anyway?
  4. physical\mental health suffer if no Tx?
  5. Pt’s best interests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

limit for termination of pregnancy and exeptions

A

<24 weeks
OR risk to pregnant woman’s life
child would be severe disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

risks of HRT

A

breast cancer
DVT/PE
stroke
MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

non hormonal Tx for hot flushes and mood. what type of drug?

A

clonidine, alpha blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

non-pharmaceutical Mx for menopause

A

CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

hormonal Tx for menopause

A

local [vaginal] oest

HRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

when to give HRT with oest and prog

A

if they have a uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

what type of HRT has ^breast cancer risk? combined/ just oest

A

combine oest and prog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

how would your HRT management differ is woman with implant/Mirena?

A

implant - give combined oest/prog

mirena - give only oest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

how does oestrogen ^clot risk? how would you combat this with a different method?

A

^clotting factor production by liver. transdermal patch instead of oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

why might you use transdermal HRT over other methods?

A

crohns
Pt with ^clot risk
patient choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

what is premature ovarian insufficiency?

A

menopause <40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

tx for prem ovarian insufficinecy

A

HRT
combined OCP
until age 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

how long are women fertile after menopause

A

if menopause <50 - 2yrs

menopause >50 - 1yr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

2 syndromes of incont + cause

A

overactive bladder [Involuntary bladder contractions]

stress incont [sphincter weakness]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

presentation of overactive bladder

A 
Urgency incont
Frequency
Nocturia
Nocturnal enuresis (bed wetting)
‘Key in the door’
‘Handwash’
sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

presentation of stress incont

A

Involuntary leakage: Cough, Laugh, Lifting, Exercise, Movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

initial simple assessment of incont

A

bladder diary/freq vol chart
MSU
questionnarie
residual [catheter/USS]

159
Q

frequency vol chart shows voiding 400-600ml 4 times a day with some leakage in between. What type of incont

A

stress

160
Q

freq. vol chart shows voiding 100-150ml 10X a day. what type incont

A

overactive bladder

161
Q

why do diabetics get ^incont

A

^UTIs
neuropathy/dec sensation bladder
polydipsia/polyuria

162
Q

what could microscopic haematuria on MSU suggest?

A

glomerulonephrits, infection, nephropathy, cancer

163
Q

how does urodynamics study measure detrusor pressure

A

bladder pressure [catheter] - abdo pressure [rectum]

164
Q

urodynamics, cough causes urine leak w/ no change in detrusor pressure. Dx?

A

stress incont

165
Q

urodynamics, wash hands, ^detrusor pressure. Dx?

A

overactive bladder

166
Q

medical/surgical Mx for stress incont

A

surgery [sling]

vag oest

167
Q

medical/surg Mx of overactive bladder

A 
oxybutynin
mirabegron
Botox
sacral nerve stimulation
augmentatioin cystoplasty
vag oest [vaginal atrophy]
168
Q

non pharma/invasive Mx of incont

A

physio/pelvic floor
lifestyle [caffeine, weight, smoking]
pads
Bladder training

169
Q

side effects of anticholinergics [oxybutynin]

A

Dry mouth, blurred vision, Drowsy, Constipation

170
Q

prolapse management

A

pessary

surgery

171
Q

define antepartum haemorhage

A

Bleeding from anywhere in genital tract >24 weeks

172
Q

causes of antepartum haemorrhage

A 
placenta praevia
placenta accreta
vasa praevia
abruption
infection 
unexplained
173
Q

when/how is Dx of placenta praevia made? &when would you re-check

A

20 week anomaly scan

re-check 32[major]/36[mild]

174
Q

what must be done is placenta remains <25mm from os

A

CS

175
Q

bleeding placenta praevia, <34 wks, what drugs may you want to give

A

steroids

176
Q

mx of placenta accreta

A

CS

177
Q

in vasa praevia who’s at most risk, mum or baby?

A

baby, no major maternal risk

178
Q

what is placental abruption?

A

Premature separation of placenta from uterine wall

179
Q

Woody-hard, tense uterus and maternal shock out of proportion with PV bleed

A

placental abruption with concealed haemorrhage

180
Q

risk factors for placental abruption

A 
Previous abruption
Hypertension
Multiple pregnancy
Trauma
iatrogenic [amniodrainage]
Infection
Smoking, drugs
181
Q

complications following antepartum haemorrhage

A 
Premature delivery
Acute tubular necrosis
DIC
PostPH
ARDS
Fetal hypoxia/death
182
Q

causes of post partum haemorrhage

A

Tissue - placenta complete?
Tone - uterus contracted?
Trauma - tears
Thrombin - clotting

183
Q

risk factors for PPH

A 
big baby
prima/^multigravid
multiple preg
precipitate/prolonged labour
pyrexia
instrumental delivery
shoulder dystocia
previous PPH
APH
184
Q

how do you prevent maternal post partum PE

A

LMW heparin, dose is weight dependent

185
Q

risk factors for postpartum maternal VTE

A 
previous VTE
thrombophilia
^age
^BMI
smoking
parity>4
mult preg
pre eclam
immobile
CS
systemic infection
186
Q

risk factors fro maternal sepsis

A

obesity, DM, immunosupp, anaemia, PROM, Hx groupB strep

187
Q

Sx/signs of sepsis [maternal post partum]

A

pyrexia, hypothermia, tachycardia, tachypnoea, hypoxia, hypoTN, oliguria, imp consciousness, failure to respond to Tx

188
Q

sepsis 6

A
  1. ABG + give O2
  2. cultures
  3. IV Abx
  4. fluids
  5. bloods [lactate, Hb, glucose]
  6. urine output
189
Q

Sx of severe pre-eclampsia

A 
RUQ pain
oedema
blurred vision/flashing
nausea/vom
headache
190
Q

Mx pre-eclampsia

A 
labetalol/nifedipine
magnesium sulphate
urine output/fluid restrict
CTG/USS
delivery
191
Q

seizures in pregnant woman is what until proven otherwise

A

eclampsia

192
Q

eclampsia seizure Mx

A

IV mag sulphate
treat HTN labetalol
deliver

193
Q

why does cord prolapse cause fetal mortality/morbidity

A

cord vasospasm > hypoxia

194
Q

risk factors for cord prolapse

A 
PROM
polyhydramnios
long umb cord
fetal malpresentation
multiparity
multi preg
195
Q

Mx of cord prolapse

A

trendelenburg
tocolytics
push baby off cord
CS

196
Q

what is shoulder dystocia?

A

failure of ant shoulder to pass under symphysis pubis after delivery of fetal head

197
Q

risk factors for shoulder dystocia

A 
big baby
DM
postmaturity
obesity
prolonged labour
instrumental delivery
198
Q

maternal and fetal complicaitons of shoulder dystocia

A

maternal: PPH, vaginal tear
fetal: hypoxia, fits, CP, brachial plexus injury

199
Q

WHO screening criteria

A 
important disease
latent stage
natural course known
test known
acceptable test
continuous testing
treatment accepted
facilities
who to treat agreed
cost
200
Q

what’s in infectious diseases screening on preg women

A

HIV, hep B, syphilis

201
Q

newborn blood spot screening diseases

A 
CF
congenital hypothyroidism
sickle cell
Phenylketonuria
MCADD
maplesyrup urine disease
IVA
GA1
homocystinuria
202
Q

what is down’s syndrome and main maternal risk factor

A

trisomy 21

^maternal age

203
Q

what is edwards syndrome, maternal risk factor and prognosis

A

trisomy 18
^maternal age
most die before birth/shortly after

204
Q

what is patau’s syndrome, maternal risk factor and prognosis

A

trisomy 13
^maternla age
most die before birth/shortly after

205
Q

what does screening for downs edwards and pataus involve and when

A

combined test- US [nuchal trans] and bloods [PAPPA-A and BHCG]
10-14 weeks [same time as dating scan]

206
Q

downs high risk from combined test, what next?

A

offered diagnositic test:
<15 weeks chorionic villous sampling
>15 weeks amniocentesis

207
Q

when do pregnant women have USSs and what are they for?

A

8-14 weeks: gest age, fetal demise, multi preg, fetal abnorm/nuchal trans
18-21: abnorm [gastroschisis, spina bifida, anencephaly]

208
Q

what’s PKU

A

inability to metabolise phenylalanine. leads to leanring dis. need special diet

209
Q

when do newborn and infant physical exams take place

A

within 72 hrs, 6-8 weeks

210
Q

why ask about Abx in sexual Hx

A

may partially treat STI > false -ve test

211
Q

why do you ask male when last void urine in sexual Hx

A

if weed in last hr, sample may be false -ve

212
Q

ix sexual medicine female

A

vaginal swab [gon/chlam]
bact vag, trichomonas vaginalis,candida
bloods [syph/hiv]
urine dip

213
Q

Ix sexual med heterosexual male

A

first void urine [chlam/gon]
urethral swab
urine dip
blood [hiv/syph]

214
Q

ix sexual med MSM

A 
urine
pharyngeal swap
rectal swab
bloods [hiv/syph/hepB]
culture plates
215
Q

who would yoiu test for hepB

A

commercial sex workers
MSM
IV drug users
from high risk area [africa/asia]

216
Q

when are women breast screened

A

50-70 every 3 years

217
Q

symptomatic breast clinic, what Ix in < and >40

A

<40 USS

>40 USS and mamogram

218
Q

breast cancer tend to be mobile or fixed?

A

fixed

219
Q

what is the definition of prematurity?

A

<37 weeks

220
Q

health consequences of prematurity

A

chronic lung disease
developmental delay
CP
visual impairmen

221
Q

contributors to improved survival after prematurity

A 
Antenatal steroids
Artificial surfactant
Ventilation
Nutrition
Antibiotics
222
Q

risk factrs for preterm birth

A 
multiple preg
APH
previous preterm
infection [UTI/BV/pyeloneph/appendicitis/pneumonia]
Cervical weakness
223
Q

primary and tertiary prevention of preterm birth

A

primary: smoking, STIs, no multiple pregs, cervical assessment [20-26wks] -Transvaginal cervical ultrasound, Fetal fibronectin swab
tertiary: tocolytics, steroids, Abx

224
Q

what are the aims of primary, sec, tertiary prevention in preterm labour

A
  1. population/public health interventions
  2. target those at risk/surveillance
  3. prevent morbidity/mortality
225
Q

risk factors for pre-eclampsia

A 
prev preE
chronic HTN, or HTN in prev preg
CKD
DM
autoimm disease [SLE/antiphospholipid/thrombophilia]
1st baby
^BMI
>40
FH
multi preg
226
Q

diff between gestational HTN and pre-eclampsia

A

preE have proteinuria

227
Q

pathophysiology of preeclampsia

A

no trophoblastic invasion of spiral arteries = Xdilatation -> placental ischaemia

228
Q

what are the consequences of dec placental perfusion in preE

A

fetal growth restriction

maternal vasoconstriction, kidney dysfn

229
Q

severe complications of preE including causes of maternal morbidity

A 
eclampsia
placental abruption
IUGR
iatrogenic prematurity [ony cure is to deliver]
HELLP syndrome
DIC
haemorrhagic stroke
multiorgan failure/ renal failure
ARDS
230
Q

what makes up HELLP syndrome

A

haemolysis
elevated
liver enzymes
low platelets

231
Q

what is the time range when preE can occur?

A

20 weeks gestation to 6 weeks post-delivery

232
Q

describe relfexes in preE

A

hyperactive/brisk

233
Q

Ix in preE

A 
BP
LFT
FBC [low HB, platelets]
USS
urine dip
234
Q

side effects of mag sulph to treat eclampsia seizures

A

cardiac arrest

toxicity [lose reflexes]

235
Q

name the 3 main preg hormones

A

hcg, oest, prog

236
Q

at day 6-7, blastocyst signals to mother by secreting

A

hcg

237
Q

where does progesterone come from during gestation?

A

corpus lutuem up to 7/8 weeks then placenta takes over

238
Q

roles of prog during preg

A

Proliferation/vascularisation of endometrium
myometrial quiescence
^maternal ventilation
fat storage

239
Q

what is the principle fetal nutrient

A

glucose

240
Q

what is Haemolytic disease of the new born

A

[rhesus disease] rhesus -ve mum produces antibodies against rhesus +ve fetus’s RBCs

241
Q

Tx for rhesus diseas?

A

anti-D

242
Q

sx/signs of rhesus disease in foetus

A

jaundice

anaemia

243
Q

roleof oxytocin in labour

A

uterine contraction

244
Q

tocolytic drugs used in preterm labour

A

nifedipine

atosiban

245
Q

mx postmaturity in preg

A

membrane sweep
vaginal prostaglandin
artificial rupture of membranes
oxytocin

246
Q

risks to fetus of gestational diabetes

A

macrosomia -shoulder dystocia, birth diff
malformation - cleft palate
death

247
Q

most common pathological cause of heavy menstruation

A

uterine fibroids

248
Q

what is adenomyosis

A

endometrial tissue within the myometrium

249
Q

causes/differentials to consider in menorrhagia

A

fibroids
hypothyroidism
clotting disorder
drugs [warfarin]

250
Q

Ix of menorrhagua

A

FBC

transvaginal sonography

251
Q

Tx of menorrhagia

A 
mirena
tranexamic acid
mefanamic acid
progestagen
COCP
endometrial ablation/ hysterectomy
252
Q

what is a bartholins cyst

A

blocked gland that produces lubrication. on labia minora

253
Q

define FGM

A

partial or total removal of, or injury to female external genitalia for non-medical reasons

254
Q

define type 1-4 FGM

A
  1. CLITORIDECTOMY partial/total removal of clitoris
  2. EXCISION part/total removal of clitoris & labia minora [+/- majora]
  3. INFIBULATION narrowing vaginal orifice +/- clitoris
  4. anything else
255
Q

complications of FGM

A 
chronic pain
dyspareunia
anorgasmia
keloid scar
PTSD
recurrent UTI
PPH
CS
episiotomy
256
Q

causes of primary amenorrhoea by age 16

A

genes
turners/swyers syndrome
imperforate hymen

257
Q

causes of secndary amenorrhoea [cessaton after onset]

A 
weight loss
excessive exercise
PCOS
pregnancy
stress
hyperprolactinaemia
hypo/hyperthyroid
Sheehan's syndrome
POF
258
Q

causes of precocius puberrty

A

CAH
hydrocephalus
adrenal tumor
ovarian tumuor

259
Q

Ix delayed puberty

A 
FBC -amaenia
CRP
U and E
LFT
Bone profile
Coeliac
TFT
260
Q

name 5 risk factors for endometrial cancer

A 
obesity
DM
nulliparity
late menopause
ovarian tumour
HRT, 
Pelvic irradiation, 	
Tamoxifen, 
PCOS, 
HNPCC
261
Q

Ix for endometrial cancer

A

transvaginal US
endometrial biopsy
hysteroscpoy

262
Q

Tx endometrial cancer

A

hysterectomy +/- lymph
radiotherapy
progesterone therapy

263
Q

risk factors for cervical cancer

A 
HPV
1st intercourse <16
STD
smoking
multiparity
previous genital tract cancer
OCP
264
Q

Mx cervical cancer

A

diathermy
radio
chemo

265
Q

Tx vulval cancer

A

surgery, radio, chemo

266
Q

presentation ovarian cancer

A 
Bloating
Abdo pain
Change in bowel habit
Urinary frequency
Bowel obstruction
267
Q

risk factors for ovarian cancer

A 
BRCA gene
OCP
HRT
age 
obesity
menopause
268
Q

Ix in ovarian cancer

A

CA125 bloods

USS

269
Q

Mx of ovarian cancer

A

surgery

chemo

270
Q

causes of female infertility

A 
PCOS 
prolactinoma
chlamydia
congenital uterus abnormality
endometriosis
adhesions from surgery
obesity
271
Q

Ix for female infertility

A 
mid-luteal progesterone 
FSH
chlamydia
USS
HSG xray
272
Q

management of anovulation

A

weight loss/gain
clomifene citrate
laparoscopic ovarian drilling [PCOS]

273
Q

what % of couples <40 will conceive in 1st year

A

80%

274
Q

female infertility - criteria for early referral (before 1 yr)

A 
>35 yrs
no periods/irregular
prev STI
adbo/pelvic surgery
abnorm pelvic exam
275
Q

pre-conception advice

A 
stop smoking
folic acid
lose weight
no alcohol
sex 2-3X/week
smear
276
Q

reproductive probs associated w/ obesity

A 
PCOS
dec success of ART
miscarriage
infertility
obstetric complications
277
Q

Ix of male infertility

A 
semen analysis
examine testicles
CF
hormones- test/LH/FSH/prolactin
karyotype
278
Q

Mx for male infertility

A 
IUI
IVF
surgical sperm recovery [azoospermia]
epididymal block correction
hormones
smoking, weight
279
Q

criteria for PCOS

A

2 out of 3:

  1. oligo/amenorrhoea [anovulation]
  2. polycystic ovaries on USS
  3. raised androgens
280
Q

TX for PCOS

A

clomefine [+metformin]

281
Q

causes of tubal defect infertility

A

STI
surgery
endometriosis

282
Q

risks of IVF

A

Multiple Pregnancy
Miscarriage
Ectopic

283
Q

management of infertility due to anovulation [pituitary tumour]

A

bromocriptine

284
Q

name a condition that worsens in preg, one that improves, and one that can go either way

A

worsens - mitral stenosis
improves- RA
asthma variable

285
Q

complications of maternal iron deficiency

A

low brith weght

preterm delivery

286
Q

1st and 2nd most common anaemia in preg

A
  1. iron def

2. folate def

287
Q

Prgenant woman with low haemoglobin, low MCV. type of anaemia, likely cause, and management?

A

microcytic, iron def,

iron tabs > infusion > D/W haematology

288
Q

preg woman. low haemoglobin, ^MCV. type of anaemia, likely cause, Tx?

A

macrocytic, folate deficiency, ^ folic acid dose

289
Q

changes to resp function and blood gas during preg

A

^O2 consumption
^tidal vol
arterial O2^, dec CO2

290
Q

maternal asthma risk to foetus

A

inadequate placental perfusion
fetal growth restriction
prem delivery

291
Q

asthma drugs in preg

A

same as non-preg

292
Q

cardiac changes in preg

A

^cardiac output due to ^stroke vol

293
Q

Commonest liver disease in pregnancy

A

obstetric cholestasis

294
Q

1 Sx and one Ix result seen in obstetric cholestasis

A

itch

deranged LFTs

295
Q

complications of obstetric cholestasis

A

stillbirth

prem labour

296
Q

obstetric cholestasis resolves when?

A

after delivery

297
Q

risks of hyperthyroidism in preg

A

maternal thyroid crisis >cardiac failure

fetal thyrotoxicosis

298
Q

risk of untreated maternal hypothyroidism

A

early fetal death

neurodevelopmental impairment

299
Q

Tx for obstetric hypothyroidism? most important trimester and why?

A

thyroxine

1st - fetal thyroid takes over at 14 weeks

300
Q

what is erb’s palsy?

A

paralysis of arm caused by damage to brachial plexus by shoulder dystocia

301
Q

diabetes drugs which are acceptable in preg

A

insulin

metformin

302
Q

statins in preg?

A

contraindicated

303
Q

kidney changes in preg and effect on blood creat/alb

A

^renal blood flow and GFR

dec serum creat/alb

304
Q

fetal risks of maternal epilepsy

A

abnormality [drugs +/-epilepsy]

fetal hypoxia associated with maternal seizure

305
Q

risk factors for maternal thromboembolism

A

surgical delivery
age
obesity

306
Q

prevention Tx of maternal thromboembolism in preg

A

low molecular weight heparin

307
Q

how would you 1st investigate suspected obstetric PE

A

doppler US for DVT

308
Q

intermens bleeding could suggest?

A

fibroids

309
Q

which vaccination is importnant to ask aboput in fertility history

A

rubella

310
Q

gravidity

A

total no. of pregnancies, even if terminated etc

311
Q

parity

A

total number of deliveries, even stillborn, >24 weeks

312
Q

define timeframe for neonatal death

A

death in 1st 28 days of life

313
Q

define preterm and postterm

A

<37, >42 weeks

314
Q

define puerperium

A

from the delivery of the placenta to six weeks following the birth

315
Q

define 1st to 4th degree tear

A

1st skin
2nd perineal muscle
3rd rectal muscle/sphincter
4th into rectal mucosa

316
Q

severe maternal postnatal problems

A 
sepsis
pph
eclampsia
uterine prolapse
incont
thrombosis
depression
317
Q

After delivery of the placenta, the uterus is at the size of ?-week pregnancy

A

20

318
Q

postnatally palpable uterus reduces by what measure each day

A

1 finger breadth

319
Q

what is lochia and what does it contain

A

vaginal discharge to 6 weeks after giving birth containing blood, mucus, and trophoblastic tissue

320
Q

reasons for deviation from reduction in uterus size postnatally

A

fibroids, RPOC, infection

321
Q

at how many weks gestation does fundus reach umbilicus?

A

20-24

322
Q

reasons for discrepancy between fundal height and dates

A 
inacurate menstrual histry
multi preg
maternal size
hydatiform mole
polyhydramnios
fibroids
323
Q

confirmed ectopic, drug Tx

A

methotrexate

324
Q

define acute and chronic pelvic pain

A

pelvic pain = below belly button

chronic =6 months or longer

325
Q

name 4 causes of chronic pelvic pain

A 
endometriosis
PID
adenomyosis
IBS
constipation
fibroids
326
Q

name 4 causes of acute pelvic pain

A 
appendicitis
ovarian torsion
ectopic pregnancy
ovarian cyst rupture
UTI
PID
327
Q

copper coil increases risk of what cause of pelvic pain

A

PID

328
Q

21 yr old female, severe LIF pain. IX?

A 
urine pregnancy test
urinalysis
CRP, FBC
serum beta HCG
USS
triple swabs for chlam/gon
329
Q

management of ectopic

A

methotrexate
surgery
pain relief

330
Q

management of PID

A

ceftriaxone, doxycycline, metronidazole

331
Q

caauses of PID

A 
STI
IUCD insertion
post-partum
hysteroscopy
appendicitis
332
Q

drug treatment for heavy periods

A

transansamic acid

mefanamic acid

333
Q

28 yr old, lower abdo pain starts 3 days before period and ends 1 day after. Dysmenorrhoea, dyspareunia. Hasn’t got pregnant despite 3 yrs off OCP

A

endometriosis

334
Q

describe uterus on VE in endometriosis

A

fixed, retroverted

335
Q

what is the gold standard Ix for endometriosis

A

laparoscopy with biopsy

336
Q

at how many weeks would you normally induce a preg woman

A

42

337
Q

abruption, placenta praevia, vasa praevia. In which is it acceptable to dok vaginal delivery?

A

abruption. Never in other 2

338
Q

causes of antepartum haem

A

vasa praevia
placenta praevia
abruption

339
Q

causes of bleeding in 1st trimester of preg

A

miscarriage

ectopic

340
Q

define priamry and secondary PPH in time frame

A

prim 1st 24 hrs

sec over 24 hrs

341
Q

causes of primary PPH

A

Tone
Tissue
Trauma
Thrombin

342
Q

causes of secondary PPH

A

tissue

infeciton

343
Q

delivery plan for placenta praevua

A

if major [covering os] - CS 38 weeks

344
Q

acute immediate management of obstetric haemorrhage

A 
regular Obs
2 wide, bore cannulae
blood - clotting, crossmatch, Hb
fluids
transfusion
O2
catheter
345
Q

define placenta accreta

A

abnormal adherence of placenta to uterus

346
Q

what are placenta increta and percreta

A

increta - myometrium infiltrated

percreta - reaches serosa

347
Q

name an aspect of a woman’s obs History that increases risk of placenta acreta

A

previous CS

348
Q

implications of placenta accreta for moyher

A

PPH

hysterectomy

349
Q

relationship between APH and PPH

A

APH increases riskm of PPH

350
Q

3rd trimester pregnancy, vaginal bleeding, contaction and abdo pain

A

abruption

351
Q

risk factors for abruption

A

smoking, drugs, ^maternal age, trauma, pre-E

352
Q

most common cause of PPH

A

uterine atony

353
Q

why catheterise in PPH

A

urine output [renal failure]

full bladder can stop uterus contracting

354
Q

side effects of uterotonics

A

nausea and vomiting

355
Q

surgical measures for PPH

A

rusch balloon
B-lynch suture
uterine artery ligation/embolisation

356
Q

what is DIC

A

Disseminated intravascular coagulation
widespread activation of the clotting cascade
blood clots form in small blood vessels

357
Q

why do you get vaginal bleeding in ectopic pregnancy

A

hormones cause endometrium to build up, but when no uterine pregnancy grows, the lining sheds

358
Q

why does ectopic cause internal bleeding and what symtoms may this cause

A

vascular tube ruptures
shoulder pain when lying down due to irritation of the diaphragm
diarrhoea due to irritation of rectum

359
Q

what conditions may cause raised CA125

A

ovarian cyst
malignancy [VERY HIGH]
PID

360
Q

In early pregnancy, at what level of serum beta HCG would you expect to see an intrauterine pregnancy?

A

1500+

361
Q

why do you give Anti D in a miscarrying rhesus -ve woman?

A

to protect next pregnancy from rhesus disease

362
Q

gold standard diagnostic test for ectopic

A

laparoscopy

363
Q

cervical excitation leads to increased pain - diagnosis and why?

A

ectopic

irritates structures/tubes

364
Q

risk factors for ectopic

A

previous ectopic
pelvic surgery
coil

365
Q

what contraception would you advise against following ectopic

A

coil

366
Q

measures of progression in labour

A

decent of head
effacement
dilatation

367
Q

most common cause of failure to progress in labour in prima gravida

A

poor contraction

368
Q

most common cause of failure to progress in labour in multigravida

A

cephalo-pelvic disproportion

369
Q

how much dilatation of cervix should you see in active phase of the 1st stage of labour in 1 hr

A

1cm/hr prima

2cm/hr multi

370
Q

why does rupturing membranes speed up labour?

A

releases prostaglandins

371
Q

management of failure to progress in labour

A

oxytocin infusion

consider CS

372
Q

risks of oxytocin infusion in multiparous

A

rupture of uterus

373
Q

1st stage of labour - latent phase is up to how many cm dilated

A

4

374
Q

36-year-old woman wants contraceptive advice.
Heavy, painful periods. Family is complete. Smoker.

(a) Combined oral contraceptive pill
(b) Cyclical progestogens
(c) Endometrial ablation
(d) Hysterectomy
(e) Mirena intrauterine system

A

e) mirena

375
Q

25-year-old pregnant woman has insulin-dependent DM.

Which of the following is true?

(a) Determination of glycated haemoglobin levels is a measure of glycaemic control
(b) Dietary advice includes avoidance of carbs
(c) Should switch to an oral hypoglycaemic agent
(d) risk of congenital anomaly is similar to non-diabetic
(e) risk of fetal growth restriction is increased

A

a) HbA1c

376
Q

9 year old with eczema presents with increasing pruritis of hands + behind knees, despite regular emollient use. Unkempt/ dry skin, in particular on hands and behind knees. Skin is very erythematous + painful with multiple pustules and a yellow crust.

What is the most appropriate additional treatment?

(a) Aciclovir
(b) Flucloxacillin
(c) Hydrocortisone cream
(d) UV therapy
(e) Washing of linen and application of permethrin

A

b) fluclox

infected eczema

377
Q

risk factors for small for gestational age fetus

A 
previous SGA baby
smoking
preE
high BMI
excessive exercise
low fruit intake
TORCH
378
Q

examination and Ix IN A SUSPECTED SGA BABY

A 
maternal bmi
bp
fundal height
USS
umblical artery doppler
CO
TORCH screen
379
Q

why would HC, AC, FL, AFI be 50th centile but estimated fetal weight below 10th?

A

customised growth chart

380
Q

management of IUGR

A

regular growth scans
induction at 37 weeks
corticosteroids

381
Q

what are the criteria for APGAR score and what is the maximum score

A

Appearance, Pulse, Grimace, Activity, Respiration

max 10

382
Q

casues of polyhydramnios

A

matrernal DM, cardiac/renal failure

fetal duodenal atresia

383
Q

management of macrosomia

A

induction
offer CS
warn of shoulder dystocia risk

384
Q

complications of polyhydramnios

A 
preterm contractions/ ROM/ labour
malposition
maternal resp compromise
umbilical cord prolapse
uterine atony
placental abruption
385
Q

if a pregnant women is too late in her pregnancy for the usual combined test for downs/edwards/patau’s, what next?

A

quadruple test bloods for downs at 14-20

edwards/patau’s at 20 week scan for abnormality

386
Q

Ix for amenorrhoea

A 
BHCG
serum androgens [PCOS]
FSH/LH
kayotype
prolactin
TFT
387
Q

define pagets disease of the breast

A

eczema-like changes to the nipple associated with breast cancer

388
Q

define fibroadenoma

A

benign firm smooth mobile breast lump, common in young women

389
Q

1st line antiepileptic in pregnancy

A

lamotrigine

390
Q

1st line for UTI in preg

A

nitrofurantoin

391
Q

benign fluid filled rounded lump in 45 yr old woman. Not fixed, occasionally painful. Diagnoiss?

A

breast cyst

392
Q

peri-menopausal smoker presents with green/brown/bloody nipple discharge + nipple retraction + lump

A

duct ectasia

393
Q

differentials for breast lump

A 
CA
fibroadenoma
cyst
abscess/mastitis
duct ectasia
fat necrosis

3A GH (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions