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Year 3 > Women's Health > Flashcards

Women's Health Flashcards

1
Q

Chicken pox >20 weeks

A

Oral Acyclovir or VZIG

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2
Q

<20 weeks and not immune to Varicella

A

VZIG

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3
Q

Risk for Hyperemesis

A

Twin pregnancy

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4
Q

Draggy and heavy uterus

A

Urogenital prolapse

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5
Q

Cervical excitation causes

A

PID and Ectopic pregnancy

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6
Q

> 8 Bishops score

A

Vaginal birth likely

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7
Q

<6 Bishops score

A

Vaginal birth unlikely and needs induction

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8
Q

Chocolate cyst

A

Endometriotic cyst

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9
Q

Most common ovarian cancer

A

Serous Carcinoma

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10
Q

Simple cysts in young woman

A

follicular or corpus luteal

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11
Q

Bladder palpable after urination

A

urinary overflow

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12
Q

Signs of labor

A

Regular and painful uterine contractions, shedding mucos plus, ROM, shortening and dilation of cervix

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13
Q

Stages of Labor Stage 1:

A

onset of true labor to when cervix is fully dilated
10-16 hours in primigravida
latent phase: 0-3 cm dilation
Active phase: 3-10 cm

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14
Q

Stage 2 labor

A

From full dilation to delivery of fetus
Passive second stage: absence of pushing
Active second stage: maternal pushing
> 1 hour- ventouse extraction, forceps or C section

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15
Q

Stage 3

A

from delivery of fetus to when the placenta and membrane have completely delivered

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16
Q

Management of GBS

A

intrapartum Antibiotics such as Benzylpenicillin

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17
Q

Breech babies at or after 36 weeks

A

USS at 6 weeks

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18
Q

Reduce size of fibroid using

A

GNRH analogues

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19
Q

Mefenamic Acid

A

treat dysmenorrhea and Heavy menstrual bleeding

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20
Q

transxamic Acid

A

Menorrhagia and excessive blood loss

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21
Q

Antiphospholipid syndrome

A

Recurrent miscarriage;

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22
Q

Snow-storm appearance of uterus and abnormally large uterus and high hCG

A

Hydatiform mole

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23
Q

Most common cause of post-coital bleeding

A

Cervical Ectropion

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24
Q

Location of most ectopic pregnancy

A

Ampulla of Fallopian tube

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25
Q

Cocaine use is associated with (pregnancy)

A

Placental abruption

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26
Q

What ovarian tumour is related to Endometrial Hyperplasia

A

Granulosa cell tumour

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27
Q

Investigation of choice in Ectopic pregnancy

A

TVUS

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28
Q

Medical management of Miscarriage

A

Misoprostol

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29
Q

Known Previa going to labour prior to elective C-section

A

conduct an emergency c section

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30
Q

Spirometry in IPF- FEV1, FEV1/FVC and TLCO

A

FEV1 increased or normal
FEV1/FVC decreased
FVC decreased

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31
Q

Week when External cephalic version can be performed

A

36 week

37 if multiparous

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32
Q

Red degeneration

A

Fibroid degeneration during pregnancy, Low grade fever, pain, and vomiting
Managed with rest and analgesia, resolves in 4-7 days

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33
Q

Risks associated with Abruption

A

Maternal age, Multiparity and Advanced age

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34
Q

What is a galactocele

A

Women recently stopped breastfeeding; occlusion of a lactiferous duct; cystic lesion formed

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35
Q

1st line for management of Fibroids <3 cm

A

Levonorgestrel IUS

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36
Q

Breast tumour less then 4 cm

A

Wide local excision

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37
Q

Best imaging to diagnose Adenomyosis

A

MRI pelvis

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38
Q

Gold standard diagnosis for placenta previa

A

TVUS

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39
Q

Management of Post parturition Hemorrhage

A

1st line: IV syntocinon (oxytocin) or IV ergometrine
2nd line: carboprost

Surgical management: Intrauterine balloon tamponade - Uterine Atony is the cause

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40
Q

Pre-eclampsia Features

A

Eclampsia, fetal complications - IGR, prematurity, liver enzymes elevated, hemorrhage and cardiac failure

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41
Q

Ovarian torsion is associated with what sign on USS

A

Whirlpool sign

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42
Q

high risk pregnancy management

A

Aspirin 150mg daily from 12 week

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43
Q

High blood sugar in pregnancy

A

Fasting = 5.6 and 2 Hour =7.8

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44
Q

Placenta Accreta

A

Abnormal adherence by placental villi

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45
Q

Increta

A

Chorionic villi invade the myometrium

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46
Q

Pancreta

A

chorionic villi penetrate the uterine serosa and other organs such as bladder

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47
Q

Perineal tears

A

1st degree: vaginal mucosa torn

2nd degree: perineal muscles torn

3rd degree: Anal sphincter torn

4th degree: Rectum torn

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48
Q

Snowstrom Appearance on USS

A

Hyadtiform mole/ molar pregnancy

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49
Q

Investigation for miscarriage

A

TVUS

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50
Q

management of simple ovarian cysts

A

If asymptomatic - NO action

>5 cm - surgery; CA-125

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51
Q

Early pregnancy, smoking, spotting, Pain

A

Ectopic pregnancy

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52
Q

C-section is a risk factor for what pain causing 3rd trimester condition

A

Placenta Praevia

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53
Q

Most common cause of post-partum hemorrhage

A

Uterine Atony

4 Ts tone tissue trauma and thrombin

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54
Q

Cord prolapse

A

Push the head and not the cord

Immediate C-section

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55
Q

string on pearls on USS

A

PCOS

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56
Q

Abnormal smear and abnormal cytology

A

Colposcopy

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57
Q

Most common symptom associated with fibroids

A

Heavy menstrual bleeding/ Menorrhagia

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58
Q

Oligomenorrhia + Subfertility + Hirstuism + USS - beads on string

A

PCOS

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59
Q

Ectropion is commonest cause of

A

Post-coital bleeding

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60
Q

Most significant risk of vaginal birth after C-section

A

Uterine Rupture

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61
Q

Placenta praevia going for preterm birth

A

Emergency C-section ASAP!!!

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62
Q

Eclampsia treat with

A

MGSO4 (immediate) + C-section

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63
Q

Oligohydraminos cause

A

poor functional fetal kidneys

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64
Q

Polyhydraminos Cause

A

duodenal atresia and maternal diabetes

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65
Q

Thin and unilocular cyst is linked to

A

Simple cysts

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66
Q

Surfactant lung disease risk factors

A

Male sex; diabetic mother, C-section and 2nd premature twin

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67
Q

Investigation of PROM

A

Speculum exam

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68
Q

Hyperreflexia is an important symptom of

A

Pre-eclampsia

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69
Q

When should Vitamin K be given in epilepsy in a pregnant woman

A

36 week onwards

Carries a risk of hemorrhagic disease of the newborn

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70
Q

HIV is screened at booking scan - True or false

A

True

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71
Q

Combined test for Downs

A

Nuchal translucency, HCG, PAPP-A

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72
Q

Triple test for downs

A

Combined + AFP + oestriol and inhibin A

73
Q

Quadruple

A

HCG, estriol, AFP, Inhibin A

74
Q

Pulmonary hypertension, hypoxia, amniotic fluid and fetal matter in maternal lungs, collapse, respiratory distress, central cyanosis, DIC

A

Amniotic fluid embolism

75
Q

10-13 weeks antenatal timetable

A

Booking scan- Advice, smoking, alcohol, folic acid, Bloods, rhesus status, HIV test, syphilis, Hepatitis screen.

Dating scan - USS
Down’s Screening

76
Q

18-20 weeks antenatal timetable

A

Anomaly scan

77
Q

24 weeks antenatal timetable

A

SFH measure

78
Q

28 weeks

A

Anti-D for rhesus negative mothers

GTT

79
Q

36 weeks

A

identify presentation

80
Q

Risk for preterm labor

A

Acute illness, low BMI, Multiple pregnancy, polyhydraminos, PROM, cervical surgery, smoking, uterine abnormality

81
Q

Management of shoulder dystocia

A

Episiotomy, Mcrobert’s, suprapubic pressure, internal rotation

82
Q

Miscarriage and antiD

A

RH-ve mother and >12 weeks gestation

83
Q

Surgical treatment of ectopic

A

Laparoscopic salpingectomy of affected tube
salpingostom if contralateral tube is absent or damaged
Laparotomy if unstable

84
Q

1st trimester surgical Termination

A

Vaccum aspiration

85
Q

2nd trimester termination

A

dilatation and evacuation

86
Q

Endometrial cancer risks

A

Obesity, tamoxifen, HRT, increased estrogen, Lynch syndrome

87
Q

Dysmenorrhea, deep dyspareunia, chronic pelvic pain, and ovulation pain; subfertility, dyschezia

A

Endometriosis

88
Q

Menorrhagia causes

A

Fibroids, coagulopathy, pelvic cancers

89
Q

Treatment of fibroids

A

Submucosal: trans-cervical resection
Intramural and subserosal: myomectomy
Hysterectomy
uterine artery embolization

90
Q

PPH management

A

Oxytocin

91
Q

Main lymph drainage of ovary

A

Para-aortic nodes

92
Q

Mittelschmerz

A

mild suprapbic pain due to ovulation; subsides in 1-2 days

93
Q

When should a referral made for no fetal movements in pregnancy

A

24 weeks

94
Q

Management of Atrophic vaginitis

A

Moisturiser, water based lubricant and topical estrogen therapy

95
Q

Most common site for Ectopic pregnancy

A

Ampulla in Fallopian tube

96
Q

Why does ectopic pregnancy cause Shoulder tip pain

A

Ruptured contents in the abdomen causes irritation of the diaphragm

97
Q

Risks for an ectopic pregnancy

A

Previous ectopic; IUD use, chronic inflammation, tubule surgery, progesterone only pill and IVF

98
Q

Investigations in Ectopic pregnancy

A

First line: beta HCG and urinalysis

Gold standard: Transvaginal USS

99
Q

Viable pregnancy in ectopic

A

HCG will double every 48 hours

100
Q

What are the indications for expectant management in ectopic

A 
Size <35mm 
Unruptured 
Asymptomatic and no heart beat 
Serum bHCG <1000 
Compatible with another intrauterine pregnancy
101
Q

Indication for medical management with Methotrexate in ectopic pregnancy

A 
Size <35 mm 
Unruptured 
No pain 
No fetal heart beat 
<1500 hcg
102
Q

Surgical management of ectopic by Laparoscopic or laparotomy - indications

A 
Size >35 mm 
Ruptured 
Pain 
Visible fetal heartbeat 
>1500 hCG
103
Q

Endometrioma in ovary is called

A

Chocolate cysts

104
Q

Chronic pain, dysmenorrhea, deep dyspareunia, sub-fertility

A

Endometriosis

105
Q

Gold standard diagnosis for endometriosis

A

Laparoscopic surgery

106
Q

Management of endometriosis

A

NSAIDs/ paracetamol - 1st line
COCP or progestrins such as medroxyprogesterone acetate

Fertility priority
GNRH analogues
Laparoscopic excision and laser treatment

107
Q

When does red degeneration of a fibroid occur

A

During pregnancy

108
Q

Menorrhagia, iron deficiency, cramping abdominal pains and menstruation, subfertility, polycythemia

A

Fibroids

109
Q

Diagnosis of fibroids

A

transvaginal USS

110
Q

Medical and surgical treatment of fibroids

A

Progesterone tablets, GnRH analogues

Surgical: Myomectomy, hysteroscopic endometrial ablation, uterine artery embolization

111
Q

Management of menorrhagia secondary to fibroids

A

Levonorgestrel Intrauterine system - IUS

NSAIDs such as Mefenamic acid, tranexamic acid, COCP

112
Q

Bleeding from a closed cervical, does not result in a miscarriage

A

Threatened miscarriage

113
Q

Bleeding from an open cervix, abdominal cramps, uterine contents visible during pelvic examination, heavy bleeding

A

Inevitable miscarriage

114
Q

Open cervix, passing of uterine contents, Not all products are yet expelled and the OS is open and bleeding

A

Incomplete miscarriage

115
Q

Uterine cavity is empty

A

Complete miscarriage

116
Q

No symptoms of expulsion, fetus is not viable

A

Missed miscarriage

117
Q

Diagnosis of miscarriage

A

TVUS
Pelvic exam
HCG levels

118
Q

Treatment of missed, incomplete and inevitable miscarriage

A

Vaginal Misoprostol
vacuum aspiration or suction curettage
Dilation, curettage and uterine aspiration

119
Q

Expectant miscarriage management

A

Wait and watch - 7 to 14 days

High risk patients: Coagulopathy, later first trimester

Previous adverse events and infection

120
Q

Commonest type of ovarian cyst

A

Follicular cyst

121
Q

These cysts are only seen during pregnancy

A

Theca lutein cysts

122
Q

Most common ovarian tumour in young women (under 30)

A

Dermoid cysts (likely to cause torsion)

123
Q

Most common benign epithelial tumour

A

Serous cystadenoma

124
Q

Which cyst on rupture can cause pseudomyxoma peritonei

A

Mucinous cystadenoma

125
Q

Diagnosis of ovarian cysts

A

Abdominal USS, MRI, CA-125, histology USS guided

126
Q

> 5 cm ovarian cyst

A

Laparoscopically removed

127
Q

What is the ratio of LH and FSH in PCOS

A

LH > FSH 2:1

128
Q

Decreased SHBG, Raised free testosterone; insulin resistance, raised testosterone and Estrogen

A

PCOS

129
Q

Diagnosis of PCOS

A

Anovulation (primary)
Hyperandrogenism
PC ovary >12 on TVUS

130
Q

What is an endometrial complication of PCOS

A

Endometrial hyperplasia

131
Q

Acanthosis nigricans

A

Skin patches related to PCOS

132
Q

Management of PCOS

A

OCPs and Co-cyprindiol
Topical eflornithine

Fertility - Clomiphene and met Forman
Ovarian drilling - surgical

133
Q

Prevention of Anemia in pregnancy

A

60 mg iron and 400 mcg folic acid until 12 weeks

5 mg if high risk pregnancy - NTD, SCD

134
Q

Descent of umblical cord through cervix along with or past the presenting part in PROM

A

Cord prolapse

135
Q

Risks of cord prolapse

A

Artificial ROM, breech position, polyhydramnios, congenital anomalies and previous cord prolapse

136
Q

Management of cord prolapse

A

push the head not the cord
Bladder filling
exaggerated Sims position
C-section if not dilated

137
Q

Placental hormones that can relate to gestational diabetes

A

Growth hormone, CRH, Placental lactogen

138
Q

Risks for GD

A

Increased maternal age, obesity, previous macrosomia, FH, PCOS, South asian

139
Q

GD screening occurs at

A

24 to 28 weeks

140
Q

> 7 mmol/L fasting glucose (normally 5.6)

A

Insulin should be started

141
Q

Pre-existing diabetes

A

High risk preganancy and treat with folic acid 5 mg, glycemic control and 20 w anomaly scan

142
Q

What vitamin is recommended in AEDs taking mothers babies

A

Vitamin K

143
Q

LFTs in Obstretic cholestasis

A

High bilirubin, ALT, AST and bile acids - 10-100 times

144
Q

Management of obstretic cholestasis

A

Ursodeoxycholic acid
Vitamin K
37 week induction of labour

145
Q

when placenta lies near the OS

A

Placenta Previa

146
Q

Risk factors for previa

A

Endometrial scarring - Previous C-section, increased parity and prior Curettage, smoking, multiple gestation and high altitude

147
Q

Painless PV bleeding, shock, non-tender uterus,

A

Previa

148
Q

Accreta

A

abnormal placental implantation into the uterus by placental villi

149
Q

Increta

A

Chorionic villi invade the myometrium

150
Q

Percreta

A

Involves uterine serosa and other organs

151
Q

Diagnosis of Previa and other placental abnormality

A

Tranvaginal USS

MRI- Accreta

152
Q

Management of previa

A

repeat USS at 34 weejs

at 37 week C-section

153
Q

Painful 3rd trimester bleeding, tender tense uterus, coagulation problems, Anuria, pre-eclampsia

A

Placental abruption

154
Q

confirmation of placental abruption diagnosis

A

USS - retroplacental blood clot or collection

155
Q

<36 weeks and alive fetus in abruption

A

Distress- c-section

no distress- steroids

156
Q

> 36 weeks in abruption

A

Distress- C-section

no distress- vaginal induction

157
Q

Fetus dead in abruption

A

Vaginal delivery

158
Q

Commonest cause of PPH

A

Uterine atony

159
Q

Risk factors to PPH

A

previous PPH, prolonged labour, pre-eclampsia, increased age, polyhydramnios, placental abnormalities such as previa and accreta

160
Q

Management of PPH

A 
Oxytocin aka syntocin 
Syntometrine: oxytocin + Ergot drugs 
Uterine massage 
Surgical: intrauterine balloon tamponade - uterine atony 
B- lynch suture
161
Q

Secondary PPH occurs

A

between 24 hours to 12 weeks

162
Q

Triad of pre-eclampsia

A

Hypertension + proteinuria + oedema

163
Q

HELLP syndrome

A

Hemolysis, elevated liver enzymes and low platelets

164
Q

Risk reduction in pregnancy - hypertension

A

> 1 high risk factor or >2 moderate risks - Aspirin 75 to 150 mg daily from 12 weeks until the birth

165
Q

Medications in Gestational hypertension

A

Labetalol 1st line

Nifedipine is asthmatic

166
Q

Antibiotics that can be used in Pregnancy

A

Trimethoprim cant be used in 1st trimester
Amoxicillin and nitrofurantoin
do not use nitrofurantoin in last trimester
treat for 7 days

167
Q

What is the classic feature of vasa previa

A

Fetal bradycardia

168
Q

Risk factor for vasa previa

A

placenta previa, multiple pregnancy, iVF

169
Q

Screen for VCI

A

vasa previa - velamentous insertion of the cord; no wharton’s jelly

170
Q

Treat dysmenorrhea

A

Nsaids such as mefenamic acid

COCP 2nd line

171
Q

Whirlpool sign

A

Torsion

172
Q

how mant visits in first pregnancy

A

10 antenatal visits

173
Q

How many in non-first pregnancy

A

7 antenatal visits

174
Q

18-21 weeks what happens in antenatal time period

A

Anomaly scan

175
Q

first dise of anti-D prophylaxis

A

28 weeks

176
Q

2nd dose of anti-d

A

34 week s

177
Q

Offer external cephalic version

A

36 week s

178
Q

latent phase of stage 1

A

0-3 cm dilation

179
Q

active phase of stage 1

A

3-10 cm dilation

Year 3 (11 decks)

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