Brainscape's Knowledge GenomeTM

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


See full index

Phase 4 > Obs and Gynae Continued > Flashcards

Obs and Gynae Continued Flashcards

1
Q

what is the name of 3 HER2 receptor blocker medications?

A

trastuzumab
pretuzumab
Neratinib

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

what medications can be used in tripple negative breast cancer?

A

immunomodulators

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

what medications can be used in braca1 and 2 cancers?

A

PARP inhibitors

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

what is the first line management of cholestasis of pregnancy?

A

1 - emmolients and antihistamines

2- ursodeoxycholic acid

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

what are 4 risk factors for shoulder dystocia?

A

macrosomia
High maternal BMI
Diabetes
Prolonged labours

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

what is the 1st line management of shoulder dystocia?

A

McRoberts manoeuvre

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

what is the management of one missed COCP?

A

take missed pill even if have to take two in one day

no additional contraceptive needed

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

what is the management if 2+ OCPs are missed?

A

take yesterdays and todays dose then continue taking normally

Use condoms for 7 days

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

what is the management of unprotected sex on OCP with missed pills in week 1?

A

emergency contraception

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

what is the management of unprotected sex on OCP with missed pills in week 2?

A

no need for additional contraception

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

what is the management of unprotected sex on OCP with missed pills in week 3?

A

finish pills in current pack and start new pack immediately no need for pill free interval

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

where is the most common site of ectopic pregnancy?

A

ampulla of fallopian tubes

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

what are 4 risk factors for hyperemesis gravidum?

A

increased levels of beta-hCG - multiple pregnancies, trophoblastic disease
nulliparity
obesity
family or personal history of NVP

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

what is associated with decreased levels of hyperemesis gravidum?

A

smoking

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

what is the triad of hyperemesis gravidum?

A

5% pre-pregnancy weight loss
dehydration
electrolyte imbalance

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

what is the first line management of hyperemesis gravidum?

A

antihistamines: oral cyclizine or promethazine

phenothiazines: oral prochlorperazine or chlorpromazine

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

what is the second line management of hyperemsis gravidum?

A

oral ondasetron
oral metoclopramide or domperidone

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

what complication can ondansetron use in pregnancy cause?

A

cleft lip and palate

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

what are 4 complications of hyperemesis gravidum?

A

acute kidney injury
Wernicke’s encephalopathy
oesophagitis, Mallory-Weiss tear
venous thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are 7 features of fibroids?

A

asymptomatic
menorrhagia - may result in iron-deficiency anaemia
bulk-related symptoms
lower abdominal pain: cramping pains, often during menstruation
bloating
urinary symptoms, e.g. frequency, may occur with larger fibroids
subfertility

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

how are fibroids diagnosed?

A

TV USS

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

what is the management of menhorrhagia in fibroids?

A

levonorgestrel intrauterine system (LNG-IUS)
NSAIDs e.g. mefenamic acid
tranexamic acid
combined oral contraceptive pill
oral progestogen
injectable progestogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the management to treat fibroids?

A

GnRH analogues
surgery - myomectomy, hysteroscopic endometrial ablation, hysterectomy, uterine artery embolisation

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

what can be a cause of thick green nipple discharge most common in postmenopausal smokers?

A

Mammary duct ectasia

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

what type of contraception can be used in trans men?

A

Progesterone only
non-hormonal

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

How long after UPSI can Levonorgestrel (Levonelle) be taken?

A

72 hours

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

How long after UPSI can Ulipristal (ella one) be taken?

A

120 hours

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

what patients should Ulipristal use be cautioned in?

A

Asthmatics

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

How long after taking Ulipristal do you need to wait to start hormonal contraception?

A

5 days

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

How long after UPSI can the copper IUD be fitted?

A

5 days

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

what is the most common ovarian cyst?

A

follicular cyst - due to non-rupture of the dominant follicle or failure of atresia in a non-dominant follicle

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

what is the most common benign ovarian tumour in women <30?

A

Dermoid cyst - torsion in more likely

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

what is amniotic fluid embolism?

A

when fetal cells/ amniotic fluid enters the mothers bloodstream and stimulates a reaction which results in cyanosis, hypotension, bronchospasms, tachycardia. arrhythmia and myocardial infarction.

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

what antibiotics should be avoided in breast feeding?

A

ciprofloxacin, tetracycline, chloramphenicol, sulphonamides

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

what psychiatric drugs should be avoided in breast feeding?

A

lithium, benzodiazepines

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

What are 6 drugs that should be avoided in breast feeding?

A

aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone

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

what medication can be used to suppress lactation?

A

cabergoline

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

what are 5 risk factors for breech presentation?

A

uterine malformations, fibroids
placenta praevia
polyhydramnios or oligohydramnios
fetal abnormality (e.g. CNS malformation, chromosomal disorders)
prematurity (due to increased incidence earlier in gestation)

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

when should external cephalic version (ECV) be offered in breech presentation?

A

37 weeks (can be 36 in primies)

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

what are 5 reasons for a Cat 1 section?

A

suspected uterine rupture
major placental abruption
cord prolapse
fetal hypoxia
persistent fetal bradycardia

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

how quick should a cat 1 section be?

A

within 30 mis

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

How quick should a cat 2 section be?

A

within 75 mins

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

what is the results of a positive combined test?

A

↑ HCG, ↓ PAPP-A, thickened nuchal translucency => Downs likely

44
Q

what tests are included in the quadruple test?

A

alpha-fetoprotein
unconjugated oestriol
human chorionic gonadotrophin
inhibin A

45
Q

what is the quadruple test result for downs?

A

alpha-fetoprotein - LOW
unconjugated oestriol - LOW
human chorionic gonadotrophin - HIGH
inhibin A - HIGH

46
Q

what is the quadruple test result for edwards?

A

alpha-fetoprotein - LOW
unconjugated oestriol - LOW
human chorionic gonadotrophin - LOW
inhibin A - NORMAL

47
Q

what is the quadruple test result for neural tube defects?

A

alpha-fetoprotein - HIGH
unconjugated oestriol - NORMAL
human chorionic gonadotrophin - NORMAL
inhibin A - NORMAL

48
Q

what is the management of eclampsia in pregancy?

A

IV magnesium sulphate

49
Q

How long should magnesium sulfate continue after delivery in eclampsia?

A

24 hours

50
Q

what is the first line management for mag sulfate induced respiratory depression in eclampsia?

A

calcium gluconate

51
Q

what folic acid supplementation should pregnant women take?

A

400mcg of folic acid until the 12th week of pregnancy

52
Q

What risk factors mean women should take 5mg of folic acid pre-pregnancy?

A

Personal or FHx of neural tube defect
anti-epileptic drugs
coeliac disease, diabetes, or thalassaemia trait
BMI >30 kg/m2

53
Q

what is the diagnostic threshold for gestational diabetes?

A

fasting glucose is >= 5.6 mmol/L
2-hour glucose is >= 7.8 mmol/L

5,6,7,8

54
Q

what is the fasting glucose target in pregnancy for those with diabetes?

A

5.3 mmol/L

55
Q

what is the 1 hour post meal glucose target in pregnancy?

A

7.8 mmol/L

56
Q

what is the 2 hour post meal glucose target in pregnancy?

A

6.4 mmol/L

57
Q

what are 6 indications for induction?

A

Overdue >41 weeks
PPROM/PROM
diabetic mother > 38 weeks
pre-eclampsia
obstetric cholestasis
intrauterine fetal death

58
Q

what score is used to assess whether induction of labour is necessary?

A

Bishop score

59
Q

what is the bishop score that indicates need for induction?

A

<5

60
Q

what is the bishop score that indicates no need for induction?

A

> 8 inclusive

61
Q

what is the management of bishop score <6 inclusive?

A

vaginal prostaglandins or oral misoprostol

balloon catheter if higher risk of hyperstimulation or prev c-sections

62
Q

what is the management of bishop score >6?

A

amniotomy and an intravenous oxytocin infusion

63
Q

what is the main complication of induction of labour?

A

uterine hyperstimulation

64
Q

what are 4 complications of PROM?

A

fetal: prematurity, infection, pulmonary hypoplasia
maternal: chorioamnionitis

65
Q

what can be seen on sterile speculum exam in PROM?

A

pooling of amniotic fluid in the posterior vaginal vault

66
Q

How can PROM be tested for if fluid pooling not seen?

A

testing the fluid for placental alpha microglobulin-1 protein (PAMG-1) or insulin-like growth factor binding protein‑

67
Q

what medication should be given in PROM?

A

Oral erythromycin 10 (TEN) days
Corticosteroids (<34 weeks)

68
Q

What are 8 situations where anti-D should be given ASAP?

A

delivery of Rh +ve infant - live or stillborn
termination of pregnancy
miscarriage > 12 weeks
ectopic pregnancy - surgically managed
external cephalic version
antepartum haemorrhage
amniocentesis, chorionic villus sampling, fetal blood sampling
abdominal trauma

69
Q

what tests should be done on the cord blood of any baby born to Rh -ve mother?

A

FBC
Blood group and save
Direct coombs test

70
Q

what are the 3 stages of postpartum thyroiditis?

A

Thyrotoxicosis
hypothyroid
return to normal

71
Q

what is the management of the thyrotoxic phase of postpartum thyroiditis?

A

propanalol - to treat symptoms

72
Q

what is the management for fibroids <3cm?

A

1 - Mirena coil

symptomatic - tranexamic and mifenamic acid

2 - COCP, cyclical progestogens

Surgical - Endometrial ablation, resection of submucosal fibroids during hysteroscopy, Hysterectomy

73
Q

what is the management of fibroids >3cm?

A

refer to gynae - options as <3cm +

Uterine artery embolisation
Myomectomy
Hysterectomy

+ GnRH analogues to shrink before myomectomy

74
Q

what are 8 complications of fibroids?

A

iron deficiency anaemia
Reduced fertility
Pregnancy complications
Constipation
Urinary outflow obstruction + UTI
Red degeneration
Torsion of the fibroid
Malignant change to a leiomyosarcoma - very rare (<1%)

75
Q

what is red degeneration of fibroids?

A

ischaemia, infarction and necrosis of the fibroid due to disrupted blood supply usually in pregnancy

Presents with severe abdominal pain, low-grade fever, tachycardia and often vomiting. Management is supportive, with rest, fluids and analgesia.

76
Q

when should induction be offered in cholestasis of pregnancy?

A

37-38 weeks

77
Q

what other than ovarian cancer can cause a raised Ca125?

A

adenomyosis
ascites
endometriosis
menstruation
breast cancer
ovarian torsion
endometrial cancer
liver disease
metastatic lung cancer

78
Q

what are 8 things that increase risk of IUGR?

A

Maternal age of <16 or >35
low BMI or a pre-pregnancy weight of >75kg. interpregnancy interval < 6 months or >10 years
Pre-eclampsia
smoking, drugs and alcohol
clotting disorders
diabetes
congenital abnormalities

79
Q

what are 4 features of congenital syphilis?

A

Generalised lymphadenopathy
Hepatosplenomegaly
Rash
Skeletal malformations

80
Q

what are 4 causes of retrograde ejaculation?

A

Bladder neck surgery
Congenital abnormality
Diabetic autonomic neuropathy
Transurethral resection of the prostate

81
Q

which cells does HIV affect?

A

CD4 T-Helper cells

82
Q

What are 6 Aids defining infections

A

Kaposi’s sarcoma
Pneumocystis jirovecii pneumonia (PCP)
Cytomegalovirus infection
Candidiasis (oesophageal or bronchial)
Lymphomas
Tuberculosis

83
Q

what is the normal CD4 count?

A

500-1200 cells

84
Q

What is the treatment of HIV?

A

Antiretroviral therapy (ART)

85
Q

what medication can be given people with a very low CD4 count in HIV to prevent pneumocystis jirovecii infection?

A

Prophylactic co-trimoxazole

86
Q

How often do people with HIV get cervical smears?

A

Yearly

87
Q

what infectious disease screening is offered in pregnancy?

A

HIV
syphilis
hepatitis B

88
Q

when does the dating scan happen?

A

11+2-14+1 weeks

89
Q

when is the booking visit and what happens?

A

<10 weeks
Ht and Wt
screening offered
BP and urinalysis
risk assessed
vaccines offered

90
Q

when does the anatomy scan occur?

A

18-20+6 weeks

91
Q

when is Anti-D given in normal pregnancy?

A

28 weeks and 34 weeks

92
Q

what are 11 risk factors for small for gestational age baby?

A

Maternal age >40
Smoker
Maternal cocaine use
Maternal daily vigorous exercise
Previous SGA baby
Previous stillbirth
FHx SGA
Chronic hypertension
Diabetes with vascular disease
Renal impairment
Antiphospholipid syndrome

93
Q

what are 6 foetal surveillance techniques?

A

Symphyseal fundal height Foetal abdominal circumference.
Femur length.
Head circumference / biparietal diameter.
Liquor volume / amniotic fluid index (normal = 5-25cm)
umbilical/MCA artery Doppler

94
Q

what level is raised bile acids in pregnancy?

A

> 19 micromol/L

95
Q

what are 3 analgesias used in labour?

A

Entonox
IM opioids - diamorphine or morphine
Epidural - bupivacaie and fentanyl

96
Q

what counts as delay in the first stage of labour?

A

cervical dilation <2cm in 4 hours

97
Q

what counts as delay in the second stage of labour?

A

nuliparous > 2 hours
multiparous >1 hour

98
Q

what are 6 contraindications to the copper IUD and the IUS?

A
  1. PID
  2. Gonorrhoea or chlamydia
  3. Unexplained vaginal bleeding / endometrial cancer
  4. Postpartum / post-abortion septicaemia
  5. Gestational trophoblastic disease
  6. Purulent cervicitis, pelvic TB
99
Q

at what crown rump length should a foetus have a heart beat?

A

> 7 mm

100
Q

what is the normal positioning of the baby throughout birth?

A

Descent, engagement, flexion, internal rotation, crowning, extension of presenting part, external rotation of head, delivery

101
Q

what is the management of asymptomatic bacteriuria in pregnancy?

A

Confirm presence of bacteriuria with second culture and begin culture dependent antibiotic

102
Q

What counts as polyhydramnious?

A

AFI of >24cm (or 2000ml+)

103
Q

what counts as oligohydramnious?

A

AFI of <5cm (or under 200ml)

104
Q

what are 4 neonatal complications due to anti-epileptic use in pregnancy?

A

Orofacial defects
neural tube defects
congenital heart defects
haemorrhagic disease of the new born

105
Q

what are 6 causes of hydrops fetalis?

A

severe anaemia
cardiac abnormalities
chromsomal abnormalities (turners, downs, edwards, pataus)
Infection (toxoplasmosis, rubella, CMV, varicella, parvovirus)
twin-twin trasnfusion syndrome
chorioangioma

106
Q

what is the Hb monitored in pregnancy?

A

booking and 28 weeks

107
Q

How do you read CTGs?

A

DR C BRAVADO

DR - Define risk
C - contractions - <5 in 10 inclusive
BRa - Baseline rate - 110-160 BPM
V - Variability - 5 -25 bpm variability
A - Accelerations - rise of 15bpm for >15s, should be 2 every 15 mins
D - Decelerations - drop of 15bpm for >15s
O - overall impression

Phase 4 (19 decks)

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