Brainscape's Knowledge GenomeTM

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


See full index

Yr 4 - PassMed Corrections > GOSH 5 > Flashcards

GOSH 5 Flashcards

1
Q

What is the aim of hormonal treatment in endometriosis?

A

Prevent hormonal stimulation of ectopic endometrial tissue through the inhibition of ovarian hormone production.

Gold standard –> Mirena coil.

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

What are some surgical options for endometriosis?

A

1) Removal of endometriosis; ablation or excision

2) Adhesiolysis (resection of adhesions)

3) Bilateral oophorectomy

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

What are endometriomas on the ovaries known as?

A

Chocolate cysts

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

Role of GnRH analogues in endometriosis?

A

Induce menopause like state.

Should only be given to women close to menopause.

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

What causes ovulation?

A

LH surge

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

How are polycystic ovaries described on USS?

A

“string of pearls”

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

Describe hormone levels in PCOS

A

Increased LH
Decreased FSH
Decreased oestrogen
Increased androgens
Increased total testosterone
Decreased SHBG

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

What 3 tests can be done in PCOS to rule out other causes of oligo/amenorrhoea?

A

1) TFTs

2) Prolactin

3) Pregnancy test

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

What are 2 key long term complicatiosn of PCOS?

A

1) T2DM

2) CVS disease

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

3 mx options to induce ovulation in PCOS?

A

1) Weight loss +/- metformin

2) Clomifene

3) Gonadotrophins (if resistant to clomifene)

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

At what gestational age is expectant mx of miscarriage possible?

A

Only if <14 weeks gestation

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

What is a good resource for support following miscarriage? (e.g. in counselling OSCE stations)

A

Miscarriage association

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

Counselling tips in miscarriage OSCE:

A
  • Relatively common (1 in 5 pregnancies end in miscarriage)
  • Emphasise that there was likely nothing they could have done to prevent it
  • Advise to try again when they feel they are ready as a couple
  • Emphasise probable success on next attempt (only 14% will go on to have another miscarriage)
  • Other lifestyle measures e.g. folic acid, smoking cessation, dietary mx
  • Miscarriage association
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Next step if TV USS report states a ‘pregnancy of unknown location’?

A

Serum hCG at 0 and 48 hours:

  • hCG decrease >50% –> likely failing pregnancy, repeat PT in 3 weeks
  • hCG increase <63% –> likely ectopic, clinical review within 24h
  • hCG increase >63% –> likely thriving intrauterine pregnancy, repeat TV US in 7-14d
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

General staging for gynae cancer? (FIGO)

A

Stage 1 - confined to organ

Stage 2 - local spread but confined to pelvis

Stage 3 - abdo spread but confined to peritoneal cavity

Stage 4 - distant spread

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

How can the thyroid be affected in pregnancy?

A

During pregnancy, there is an increase in the levels of thyroxine-binding globulin (TBG).

This causes an increase in the levels of TOTAL thyroxine, but doesn’t affect the FREE thyroxine level.

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

What 2 infections can cause erythema nodosum?

A
  • strep e.g. pharyngitis
  • TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the ommonest skin disorder found in pregnancy?

A

Atopic eruption of pregnancy

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

How does atopic eruption of pregnancy typically present?

A

An eczematous, itchy red rash.

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

Mx of atopic eruption of pregnancy?

A

no specific treatment is needed

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

Describe polymorphic eruption of pregnancy

A
  • Pruritic condition associated with last trimester
  • Lesions often first appear in abdominal striae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does mx of polymorphic eruption of pregnancy depend on?

A

severity: emollients, mild potency topical steroids and oral steroids may be used

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

What skin condition during pregnancy can cause pruritic BLISTERING lesions?

A

Pemphigoid gestationis

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

Mx of Pemphigoid gestationis?

A

oral corticosteroids are usually required

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

When can a person assigned male at birth have breast cancer screening?

A

If they have been taking feminising hormones for 2 years or more

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

If analgesia doesn’t help in endometriosis, what should be tried next?

A

Hormonal (COCP or progestogens)

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

When is an US indicated for lochia?

A

If lochia persists >6 weeks

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

What should be given to all women with PPROM?

A

10 days erythromycin

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

After how many weeks gestation is same day delivery an option in pre-eclampsia?

A

34 weeks

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

1st line for 1ary dysmenorrhoea?

A

NSAIDs e.g. ibuprofen, mefenamic acid

Then you would trial the COCP

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

What is 1ary dysmenorrhoea?

A

When there is no underlying pelvic pathology.

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

Give some causes of 2ary dysmenorrhoea

A
  • endometriosis
  • adenomyosis
  • PID
  • IUD (copper)
  • fibroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the most common complication of a myomectomy?

A

Adhesions

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

What ovarian tumour is associated with the development of endometrial hyperplasia?

A

Granulosa cell tumour

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

If 2 pills are missed in week 1, when should you consider emergency contraception?

A

If they have had unprotected sex during the pill free interval or week 1

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

What are the 2 phases of the 1st stage of labour?

A

Latent phase = 0-3cm dilation

Active phase = 3-10cm dilation

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

When should women who have been treated for CIN (I, II or III) be invited back for cervical screening?

A

6 months after treatment for a test of cure repeat cervical sample.

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

Regarding surrogacy, who is the legal mother?

A

The party GIVING BIRTH to the child is its legal mother.

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

Is amiodarone safe in breatfeeding?

A

No

It is highly lipid-soluble and therefore, extensively stored in body tissues, including breast milk.

This can result in neonatal hypothyroidism or hyperthyroidism.

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

When does a deceleration become foetal bradycardia?

A

After 3 minutes

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

What is the most common gynae cancer?

A

Endometrial cancer

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

What scan is used to stage endometrial cancer?

A

MRI

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

Is BRCA 1 or BRCA 2 mutation a greater risk for ovarian cancer?

A

BRCA 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Some questions to ask regarding ovarian cancer symptoms:

A
  • Abdo distension or bloating
  • Early satiety or anorexia
  • Changes to bowel habit
  • Urinary symptoms e.g. frequency or urgency
  • Dyspareunia
  • Weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Next step if a MASS is found on abdo examination at GP in potential ovarian cancer?

A

2 week wait referral (for USS abdo + pelvis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Next step if NO mass is found on abdo examination at GP in potential ovarian cancer?

A

Ca-125
If this is raised –> urgent abdo and pelvic US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What type of cancer are the majority of cervical cancer?

A

Squamous cell carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Risk factors for cervical cancer?

A
  • HPV (16 & 18)
  • Multiple partners
  • COCP (more likely to not use barrier contraception)
  • Immunocompromised e.g. (body can’t clear HPV)
  • Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Some presenting complaints of cervical cancer?

A
  • PCB
  • IMB
  • PMB
  • Dyspareunia
  • Pelvic pain
  • Unexplained vaginal discharge
  • Dysuria
50
Q

Define dysplasia

A

Abnormal cells, usually a pre-cancerous change

51
Q

Define CIN

A

Cervical intra-epithelial neoplasia (cancer precursor) detected on colposcopy

This can be low grade (CIN I) or high grade (CIN II & III)

52
Q

Define carcinoma in situ

A

Early stage cancer

53
Q

How does HPV predispose to cervical cancer?

A

HPV causes the down regulation of tumour suppressor genes (like p53).

54
Q

Which strain of HPV is responsible for most cervical cancers?

A

16 (followed by 18)

55
Q

What happens during cervical screening?

A

Cells from the transformation zone are collected using a small brush and then reviewed under a microscope.

They are reviewed for:

1) HPV status

2) Cytology (i.e. dysplasia) –> depth & severity of dysplasia predicts cancer risk.

56
Q

Should patients presenting with red flag cervical cancer symptoms be referred for a smear?

A

No - refer straight to colposcopy via 2WW

57
Q

How is a diagnosis of cervical cancer made?

A

Using colposcopy + biopsy (+/- staging CT)

58
Q

Typical mx of pre-cancerous lesions in the cervix?

A

LLETZ –> note, this increaes the chance of preterm labour due to incompetent cervix (shortened)

59
Q

Mx of early stage cervical cancer?

A

1) Trachelectomy –> for those who wish to preserve fertility

2) Radical hysterectomy +/- radiotherapy

60
Q

What is involved in a trachelectomy?

A

Removal of cervix, pelvic lymph nodes with preservation of the uterus for those who wish to preserve fertility.

61
Q

Why is ciprofloxacin generally avoided in breastfeeding?

A

Due to its potential to cause arthropathy.

62
Q

Placenta accreta vs increta vs percreta?

A

Accreta - chorionic villi of placenta attach to the myometrium

Increta - chorionic villi invade INTO the myometrium

Accreta - chorionic villi invade THROUGH the perimetrium

63
Q

Next step in suspected cases of rubella in pregnancy?

A

Suspected cases of rubella in pregnancy should be discussed with the local Health Protection Unit

64
Q

What is the benefit of catheterising the woman in prolapsed cord and filling the bladder with saline?

A

As this will lift the presenting part off the cord.

Otherwise, the presenting part should be lifted manually to prevent cord compression.

65
Q

How is the thyrotoxicosis phase of postpartum thyroiditis generally managed?

A

Propanolol

66
Q

Next step if abnormal cytology is found on a smear?

A

Refer to colposcopy

67
Q

Mx of endometritis?

A

If endometritis is suspected, the patient should be referred to hospital for IV Abx (clindamycin and gentamicin until afebrile for greater than 24 hours).

68
Q

Is PPH defined as after delivery of the baby or delivery of the placenta?

A

Delivery of the baby

69
Q

What is the mechanism of action of terbutaline (tocolytic)?

A

Beta agonist

70
Q

In cardiac arrest in pregnancy, when should delivery of the baby occur?

A

After 4 minutes and within 5 minutes of starting CPR

71
Q

what is the most common type of uterine fibroid?

A

Intramural (confined to the myometrial layer of the uterus)

72
Q

When is bleeding concerning in postmenopausal women?

A

If haven’t had a period for OVER 1 year

73
Q

What contraception can patients who have had a gastric sleeve/bypass/duodenal switch NOT have?

A

Oral contraception - due to lack of efficacy, including emergency contraception.

74
Q

Mx of trace glycosuria in pregnancy?

A

Reassurance and safetynet.

Trace glycosuria is common in pregnancy due to the increased GFR and reduction in tubular reabsorption of filtered glucose.

75
Q

When is CVS done in pregnancy?

A

11 - 13+6

76
Q

When is amniocentesis performed in pregnancy?

A

From week 15 onwards

77
Q

Appearance of VIN vs vulval carcinoma?

A

VIN - tend to be white or plaque like and DON’T tend to ulcerate

Vulval carcinoma - commonly ulcerated

78
Q

When is dating scan done in pregnancy? (also to exclude multiple pregnancy)

A

10-13+6

79
Q

What drug is typically used in patient controlled analgesia (PCA) in labour?

A

Remifentanl (short acting opiate)

80
Q

Give some options for pain relief in labour

A

1) Simple analgesia (e.g. paracetamol but NOT ibuprofen)

2) Gas & air

3) Epidural

4) IM pethidine/diamorphine

5) PCA with remifentanil

81
Q

Define delay in 3rd stage of labour

A

> 30 mins with active mx

> 60 mins with physiological mx

82
Q

What 2 medications must be accessible if giving a PCAwith remifentanil in labour?

A

1) Naloxone (for respiratory depression)

2) Atropine (for bradycardia)

83
Q

Define delay in 2nd stage of labour

A

> 2 hours in nulliparous

> 1 hour in multiparous

84
Q

Mechanism of tranexamic acid?

A

Tranexamic acid binds to plasminogen and STOPS it from converting to plasmin.

Plasmin normally dissolves fibrin in blood clots (TXA therefore stops breakdown of blood clots).

85
Q

Define delay in 1st stage of labour

A

Either:

1) <2cm dilation in 4 hours

2) Slowing of progress in multiparous

86
Q

What are the 2 anaesthetic options for an epidural?

A

Levobupivacaine or bupivacaine mixed with fentanyl.

87
Q

When are steroids indicated in pregnancy?

A

In all cases of PPROM (i.e. <37 weeks)

88
Q

How are steroids given for prematurity in pregnancy?

A

IM dexamethasone

89
Q

is lithium safe in breastfeeding?

A

no

90
Q

What should women with pyrexia (>38 degrees) during labour receive?

A

GBS prophylaxis with benzylpenicillin

91
Q

To use the ventouse, where is the cup applied?

A

In the midline, 3cm anterior from the posterior fontanelle.

Or 6cm posterior to anterior fontanelle.

92
Q

What is an operative vaginal delivery defined as?

A

The use of an instrument to aid delivery of the foetus

93
Q

How are operative vaginal deliveries classified?

A

By the degree of foetal descent –> lower classification = less risk of complications

94
Q

What are the 3 classfications of operative vaginal deliveries?

A

1) Outlet

2) Low

3) Midline

95
Q

Define the ‘outlet’ classification operative vaginal delivery

A

Any of the following:

  • Foetal scalp visible with the labia parted
  • Foetal skull reached the pelvic floor
  • Foetal head on perineum
96
Q

Define the ‘low’ classification operative vaginal delivery

A

Lowest presenting part (not caput) is +2, or further below the ischial spines.

Subdivided to:

a) >45 degrees - rotation needed
b) <45 degrees - no rotation needed

97
Q

Define the ‘midline’ classification operative vaginal delivery

A
  • 1/5 palpable abdominally
  • Lowest part is above +2, but is lower than the ischial spines

Subdivided to:
a) >45 degrees - rotation needed
b) <45 degrees - no rotation needed

98
Q

Define foetal station

A

Fetal station refers to how far a baby’s head has descended into your pelvis.

Stations range from -5 to +5, with 0 station meaning the head is aligned with the ischial spines.

-5 = 5cm above ischial spines
0 = at ischial spines
+5 = 5cm below ischial spines (i.e. at vaginal opening)

99
Q

What is recommended after instrumental delivery to reduce the risk of maternal infection?

A

Single dose of co-amoxiclav

100
Q

In patients with hyperemesis gravidarum, why should fluids containing dextrose NOT be given?

A

As dextrose increases the body’s need for thiamine (B1) which might precipitate Wernicke’s encephalopathy.

101
Q

When is the foetus said to be ‘engaged’?

A

When the largest part of the head has entered the pelvis.

102
Q

What terminology is used to describe the head in relation to the ischial spine?

A

Station

103
Q

What is the linea nigra?

A

A physiological form of hyperpigmentation commonly seen in the first trimester of pregnancy.

A dark vertical line that runs down the middle of the abdomen and it can be one of the earliest indicators of pregnancy.

104
Q

How is a diagnosis of endometrial cancer made?

A

1) TV US with pipelle biopsy

In most cases a pipelle biopsy can be used to diagnose endometrial cancer.

If pipelle has been inconclusive:

2) Hysteroscopy with biopsy

105
Q

Give 3 causes of a raised AFP in pregnancy

A

1) Abdominal wall defect e.g. omphalocele

2) Neural tube defect

3) Multiple pregnancy

106
Q

Define cat 2 vs cat 3 c-section

A

Cat 2 - maternal or fetal compromise which is not immediately life-threatening

Cat 3 - delivery is required, but mother and baby are stable

107
Q

What is a cat 4 c-section?

A

elective caesarean

108
Q

When does vaginal bleeding count as a potentially sensitising event in a Rh-ve woman?

A
  • Vaginal bleeding <12 weeks, only if painful, heavy or persistent
  • Any vaginal bleeding >12 weeks
109
Q

What is foetal fibronectin?

A

A protein that is released from the gestational sac.

Having a high level has been shown to be related with early labour.

110
Q

T1DM and pre-eclampsia?

A

T1DM is a high risk factor for pre-eclampsia

111
Q

1st line investigation in possible vesicovaginal fistula?

A

Urinary die studies –> a dye stains the urine and identifies the presence of a fistula.

112
Q

Mx of any woman in whom pre-eclampsia is suspected?

A

Urgent 2ary care assessment

113
Q

Is maternal colonisation with GBS a risk factor for neonatal sepsis?

A

It is a minor risk factor for early onset sepsis in the newborn.

114
Q

Mx of newborns with:

a) 1 minor risk factor for early onset sepsis

b) 2 or more minor risk factors or one red flag

A

a) Remain in hospital for at least 24 hours with regular observations

b) Empirical Abx therapy with benpen + gent & full septic screen

115
Q

What is lichen sclerosus?

A

An autoimmune inflammatory skin condition that predominantly affects the genitalia in post-menopausal women.

This inflammation leads to atrophy of the epidermis and the formation of white ‘plaques’.

116
Q

What is a hallmark symptom of lichen sclerosus?

A

Pruritus vulvae –> can be severe enough to disturb a patient’s sleep.

Can also cause dyspareunia and dysuria.

117
Q

Mx of lichen sclerosus?

A

High-potency topical corticosteroids complemented by emollients to address dryness.

118
Q

Can HIV be transmitted via breastfeeding?

A

YES

119
Q

Can hep B be transmitted via breastfeeding?

A

No

120
Q
A

Yr 4 - PassMed Corrections (36 decks)

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