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Y5 OSCE > Knowledge revision - O&G > Flashcards

Knowledge revision - O&G Flashcards

1
Q

What are the important parts of a Gynae history?

A

o LMP
o Painful periods, bleeding after sex/between periods
o Last cervical smear
o Sexual history inc STI testing

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2
Q

What is a miscarriage?

A

Spontaneous loss of an intra-uterine pregnancy before 24 weeks

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3
Q

What is the most common cause of early miscarriage (before 13 weeks)?

A

Chromosomal abnormality

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4
Q

What is the most common cause of late miscarriage (between 13 and 24 weeks)?

A

Cervical incompetence

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5
Q

What are the two key examination/investigations to diagnose miscarriage?

A

Speculum examination and TV USS

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6
Q

What are the management options for miscarriage?

A

Surgical - MVA/surgical evac
Medical - misoprostol
Expectant

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7
Q

What follow-up is required in expectant management of miscarriage?

A

Preg test 3 weeks later – if positive, need to investigate for retained POC

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8
Q

Give some potential causes of recurrent miscarriage.

A

 Genetics
 Thrombophilia
 Endocrine disorders
 Structural abnormalities

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9
Q

TOP is legal up til what gestation?

A

23+6 weeks

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10
Q

What legislation are TOPs conducted under?

A

Abortion Act 1967

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11
Q

Under what circumstances can terminations of pregnancy be offered?

A

Where continuing the pregnancy involves a greater risk for the physical or mental health of the woman or her existing children

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12
Q

What are the two main options for TOP?

A

Medical or surgical

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13
Q

How are medical abortions conducted?

A

Mifepristone (anti-progestogen)
Misoprostol (prostaglandin analogue) 1-2 days later

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14
Q

What are the two surgical abortion options?

A

MVA and surgical evac

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15
Q

At what gestations can MVA and surgical evac be performed?

A

o MVA – usually up to 14 weeks
o Surgical evac – usually 14-24 weeks

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16
Q

In which circumstances should Anti-D be given in TOP?

A

Rh -ve woman AND
Surgical abortion or medical abortion > 10 weeks

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17
Q

What is the first screening test available for Down’s Syndrome?

A

Combined test

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18
Q

When can the combined test be administered?

A

10-14 weeks

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19
Q

What is involved in the combined test?

A

o Maternal age
o bHCG
o PAPP-A
o Nuchal translucency (NT)

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20
Q

What is involved in the quadruple test?

A

o Maternal age
o AFP, bHCG, inhibin-A, uE3

21
Q

When can the quadruple test be administered?

A

14 - 20 weeks

22
Q

What is the quoted miscarriage rate for CVS/amniocentesis?

A

1 in 200

23
Q

What is usually recommended in high-risk of Down’s syndrome pregnancies?

A

NIPT

24
Q

What are the main methods of emergency contraception?

A

Levonorgestrel
UPA
Copper IUD

25
Q

How long after UPSI can Levonorgestrel be used?

A

Within 72 hours

26
Q

How long after UPSI can UPA be used?

A

Within 5 days

27
Q

How long after UPSI can Copper IUD be used?

A

Within 5 days of UPSI or within 5 days of estimated date of ovulation

28
Q

What is the most effective method of emergency contraception?

A

Copper IUD

29
Q

‘Fishy smelling white/watery PV discharge’ suggests…

A

BV

30
Q

What is the treatment for BV?

A

Metronidazole

31
Q

‘Thick, white itchy PV discharge’ suggests…

A

Thrush/candidiasis

32
Q

How is thrush treated?

A

anti-fungal – clotrimazole cream/pessary or single fluconazole tablet

33
Q

How are chlamydia and gonnorhoea investigated?

A

Swabs for NAAT testing

34
Q

What is the treatment for chlamydia?

A

doxycycline 100mg twice a day for 7 days

35
Q

What is the treatment for gonorrhoea?

A

Single dose IM ceftriaxone

36
Q

Trichomonas vaginalis is treated with…

A

Metronidazole

37
Q

How is syphillis diagnosed?

A

Blood test - antibody

38
Q

How is syphillis treated?

A

Single dose IM Penicillin

39
Q

Painful, blistering genital lesions suggests…

A

Genital herpes

40
Q

Which type of HSV is most associated with genital herpes?

A

HSV-2

41
Q

How is breech presentation managed?

A

Most women offered ECV at 37 weeks if still breech, or planned c-section - can have SVD if counselled regarding risks

42
Q

What are the management options for ectopic pregnancy?

A

Expectant
Medical
Surgical

43
Q

Which women with ectopic pregnancy may be offered expectant management?

A

Clinically stable
GS < 35mm
bHCG < 1000

44
Q

Which women with ectopic pregnancy should be offered surgical management first-line?

A

Significant pain
Adnexal mass > 35mm
Foetal heartbeat on USS
bHCG > 5000

45
Q

What are the initial management options for PPH?

A

Mechanical
Medical - oxytocin/ergometrine
Surgical - intra-uterine balloon

46
Q

What is the advice in the case of one missed COCP pill?

A

take as soon as realise - protected

47
Q

What is the advice in the case of two or more missed COCP pill?

A

Use extra contraception for 7 days
Only use emergency contraception if missed in week 1

48
Q

What is the advice for missed POP?

A

Take as soon as realise
Not covered for next 2 days - use extra contraception

Y5 OSCE (7 decks)

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