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FINALS Passmedicine > 14/07 > Flashcards

14/07 Flashcards

1
Q

What causes ovulatory DUB?

A

Inadequate progesterone production

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2
Q

Issues with molar pregnancy

A

Complete = higher risk of developing in chorocarcinoma

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3
Q

Examination finding of adenomyosis

A

Boggy uterus

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4
Q

First line for fibroids

A

Mirena IUS

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5
Q

How are fibroids diagnosed?

A

TVUS

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6
Q

How long after birth can you get pregnant?

A

Day 21 postpartum

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7
Q

Best way to assess ovulation

A

Day 28 progesterone

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8
Q

When does progesterone peak?

A

7 days after ovulation

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9
Q

What is the Tayside limit for surgical TOP?

A

Up to 12 wks

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10
Q

What is the Tayside limit for medical TOP?

A

Up to 18wks 6 days

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11
Q

What is the first stage of medical TOP?

A

Oral MIFEPRISTONE 200mg (anti-progesterone)

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12
Q

What is the second stage of medical TOP?

A

24-48hrs later

Vaginal or oral prostaglandin (e.g. misoprostol)

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13
Q

Describe 2 different methods of surgical TOP and when each would be used

A

6-12 wks = Cervical priming (vaginal prostaglandin) then vacuum aspiration

13-24 wks = dilation + evacuation (not avails in Scotland)

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14
Q

What is the follow-up for TOP?

A

Urine pregnancy test at 2-3 weeks
Potentially Anti-D
Counselling
Contraception

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15
Q

When can levonelle be given as emergency contraception?

A

Up to 72 hrs post UPSI

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16
Q

When can levonelle not be given?

A

With enzyme inducers

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17
Q

When can ellaOne be given as emergency contraception?

A

Up to 120 hrs post UPSI

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18
Q

What can ellaOne not be given with?

A

Antacids

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19
Q

When can copper IUD be given as emergency contraception?

A

Up to 120 hrs post UPSI

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20
Q

Follow-up for emergency contraception

A

Urine pregnancy test at 3 weeks

21
Q

What does HIV use to transcribe?

A

Reverse transcriptase

22
Q

What CD4 level is at risk of infections?

A

<200 (normal = 500-1600)

23
Q

Which type of penunmonia do HIV patients get?

A

pneumocystis

24
Q

Abx for pneumocystis pneumonia

A

Cotrimoxazole

25
Q

Which virus is NH Lymphoma associated with?

A

EBV

26
Q

What does 4th Gen HIV testing test?

A

Antibody + antigen (p24)

27
Q

How is mother to child HIV transmission reduced?

A

HAART during pregnancy
If detected viral load - c section
4 weeks PEP for neonate
No breastfeeding

28
Q

Which infections are screened for at booking visit?

A

Syphillis
Rubella
HIV
Hep B + C

29
Q

How is Downs screened for from 11-13+6 wks?

A

Nuchal thickness
HCG
PAPP-A

30
Q

Snow-storm appearance on US

A

Molar pregnancy

31
Q

Strawberry vagina

A

Trichomniasis

32
Q

What is the Bohr effect?

A

Fetal Hb can carry more oxygen in low PCO2 than high PCO2

33
Q

What anxiety treatment should be avoided in pregnancy?

A

Benzos (cleft, neonatal withdrawal)

34
Q

Which bipolar meds should be avoided in pregnancy?

A

Valproate (NTD, reduced IQ, cleft, CV abnormalities)
Carbamazepine
Lamotrigine (SJS if breast fed)
Lithium = contraindicated in bf

35
Q

Which schizophrenic medications should be used in pregnancy?

A

Typical anti-psychotics = safe

36
Q

Which anti-depressants are contraindicated in pregnancy?

A

Venlafaxine

Paroxetine

37
Q

Definition of prolonged second stage

A

> 3 hrs if prim (2 hrs without analgesia)

> 2 hrs if multi (1 hr without analgesia)

38
Q

What is placenta accreta?

A

Placenta invades myometrium

39
Q

what condition classically presents with foetal bradycardia?

A

Vasa praevia

40
Q

Management of PPH

A 
Uterine massage 
5 units IV syntocin 
40 units syntocin in 500ml
Urinary catheter
500mcg ergometrine IV (avoid if cardiac disease/hypertensive)
41
Q

Eclamptic seizure management

A

Magnesium sulphate

42
Q

Main cause of death in eclampsia

A

Pulmonary oedema

43
Q

Thromboprophylaxis in pregnancy

A

LMW Heparin

Till 3 months after delivery or 6 months after treatment

44
Q

Warfarin in pregnancy

A

Stop 6 weeks before labour

45
Q

What does HELLP stand for?

A

Haemolysis
Elevated liver enzymes
Low platelets

46
Q

Management of HELLP

A

IV magnesium sulphate (seizure prophylaxis)
IV dexamethasone
DELIVER

47
Q

3 features of Meig’s syndrome

A

Benign ovarian mass
Ascites
Pleural effusion

48
Q

When must surgical management of TOP be used?

A

Rupture

HCG > 1500

FINALS Passmedicine (8 decks)

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