O+G 3

Question 1

Mx of urge incontinence surgically?

Answer 1

Before surgical consideration - do urodynamic studies

1st = Botulinium toxin type A injection (carries risk of temp urinary retention)

Percutaneous sacral nerve stimulation if overactive bladder doesnt respond to bot tox a / not willing to self catheterise

Question 2

What is colposuspension used to treat?

Answer 2

Stress urinary incontinence (elevates bladder and anchoring to coopers ligament)

Question 3

Punctuate haemorrhages in speculum?

Answer 3

Trichomonas vaginalis

Question 4

…………. presents with massive postpartum haemorrhage, severe abdominal pain and
examination will find a uterine fundus that is not palpable abdominally

Answer 4

Uterine inversion

Question 5

Antenatal steroid administration?

Answer 5

2 x dexamethasone - 24hr apart

Question 6

What are the signs of MgSO4 toxiciity?

Answer 6

Resp depression - IMPORTANT TO MONITOR

Arrhytmias

Loss of deep tendon reflexes

Question 7

Reversal of MgSO4 tox?

Answer 7

10 10 calcium gluconate

Question 8

Stages of delivery?

Answer 8

Descent
Engagement
Flexion
Internal rotation
Extension
Crowning
External rotation
Delivery of shoulders + body

Question 9

FIGO staging?

Answer 9

1 - Uterus only
2 - Connective tissue of cervix but not outside uterus
3 - Beyond uterus and cervix but not beyound pelvis
4 - Beyond pelvis

Question 10

Mx of genital herpes in pregnancy?

Answer 10

w/in 6w of delivery = oral aciclovir should be started immediately and should
continue until delivery + recommend planned c-section

1st / 2nd trimester = oral aciclovir from 36w and expectant vaginal delivery

Question 11

Main side effect to warn about re implant contraceptive?

Answer 11

Irregular periods

Question 12

What does this describe Common condition characterised by the presence of excoriated papules on the extensor surfaces of the limbs, abdomen, and shoulders?

Answer 12

Purigo of pregnancy

Question 13

What does this describe?

It is a rare pruritic autoimmune disorder
characterised by the presence of blisters that begin on the abdomen and become widespread

Answer 13

Pemphigoid gestation

Question 14

What causes linea nigra?

Answer 14

Thought to occur due to an increase in melanocyte-stimulating hormone produced by the placenta

Question 15

Mx of shoulder dystocia?

Answer 15

Call for help!

Mcroberts

Suprapubic pressure

Episiotomy

Internal rotational manourvres (rubin, wood screw etc)

Place on all 4s + repeat manouvres

Last resort = symphisiotomy, cleideotomy or Zavenelli

Question 16

What is the staging of urogenital prolapses?

Answer 16

First degree - The lowest part of the prolapse descends halfway down the
vaginal axis to the introitus

Second degree - The lowest part of the prolapse extends to the level of the
introitus and protrudes through the introitus on straining

Third degree - The lowest part of the prolapse extends through the introitus
and lies outside the vagina.

Procidentia - Severe third degree prolapse, where the uterus lies entirely
outside the vagina and is associated with complications, such as
ulceration

Question 17

What is lambda’s sign and where is it found?

Answer 17

Lambda sign is an ultrasound feature of dichorionic pregnancies where the gap
between the two amniotic membranes forms a wedge shape

Question 18

What is T sign and where is it found?

Answer 18

T-sign is when the junction between the intertwin

membrane and the placenta forms a right angle, and it is suggestive of a monochorionic diamniotic pregnancy

Question 19

What type of pregnancy has no intertwin membrane

Answer 19

monochorionic monoamniotic twins

Question 20

What marker is raised in endometriomas?

Answer 20

CA-125

Question 21

What are the functional ovarian cysts?

Answer 21

Functional cysts
are the most common type of cyst and can either form from follicles (follicular
cysts) or from the corpus luteum (corpus luteal cysts).

As follicles are a normal
physiological phenomenon, they are only considered cysts once the diameter
exceeds 3 cm

Question 22

What causes theca lutein cysts?

Answer 22

bilateral functional cyst that occur due to excessive stimulation by β-hCG

Question 23

What are theca lutein cysts associated w?

Answer 23

gestational trophoblastic disease and multiple pregnancies

Question 24

germ cell tumours are also known as?

Answer 24

dermoid cysts / mature teratomas

Question 25

Which cysts are more common in PM women? what are the different types?

Answer 25

Epithelial cysts are most common in perimenopausal women

There are three main types: serous, mucinous, and Brenner tumours

Question 26

What are tumours of the stromal part of ovary?

Answer 26

Sex cord
stromal tumours arise from the stromal component of the ovary — they also
have three main types: fibroma, thecoma, and granulosa cell tumour

Question 27

Mx of HIV in pregnancy - when is vaginal delivery allowed? what f/u in this case?

Answer 27

Patients should also be
monitored closely by measuring viral load every 2–4 weeks, at 36 weeks, and after delivery

Planned vaginal delivery is possible in patients who have a viral load less than 50 copies/mL at 36 weeks’ gestation

Elective vaginal delivery with 4–6-week course of zidovudine for the baby

Question 28

What is medical mx of ToP + where?

Answer 28

Mifepristone and misoprostol at clinic