Female Health

Question 1

How long does it take for cocp, depo, implant, IUS to become active? If it’s not started on day 1 of period.

Answer 1

7 days

Question 2

how long does it take for POP to become active? If not started on day 1 of period

Answer 2

2 days

Question 3

Antidepressants safe in pregnancy?

Answer 3

Sertraline or paroxetine

Question 4

Management of uterine atony?

Answer 4

Syntocin

Question 5

Anaemia in pregnancy

Answer 5

<110 in 1st trimester
<105 in 2nd and 3rd
<100 post-partum

Question 6

Exposure to chickenpox >20 weeks gestation and not immune

Answer 6

Oral acyclovir or VZIG 7-14 days after exposure NOT IMMEDIATELY

Question 7

Shoulder tip pain =

Answer 7

irritation of peritoneum –> think ectopic

Question 8

True or False?

IgM = Active disease

Answer 8

True, IgG = chronic or vaccine

Question 9

Exposure to chickenpox <20 weeks gestation and not immune

Answer 9

VZIG

Question 10

1st line in gestational hypertension/pre-eclampsia?

Answer 10

Labetalol

Question 11

Treatment of gestational hypertension in asthma?

Answer 11

Nifidipine

Question 12

Treatment for pre-menstrual syndrome

Answer 12

New generation COCP taken continuously

Question 13

When is mastectomy performed over WLE?

Answer 13

Multifocal tumour
DCIS >4cm
Central tumour
Large lesion, small breast

Question 14

Hormone therapy in breast cancer

Answer 14

Tamoxifen if pre/peri menopausal

Aromatase inhibitors such as anastrozole in post menopausal

Question 15

Why is tamoxifen not used in post menopausal women?

Answer 15

Unopposed oestrogen antagonism increases risk of uterine cancer and VTE

Question 16

Most common biological therapy in breast cancer?

Contraindications?

Answer 16

Herceptin (trastuzumab) in HER2 positive tumours

contraindicated in heart disorders

Question 17

What should anyone receiving antenatal VTE prophylaxis also receive?

Answer 17

6 weeks prophylaxis postnatally

Question 18

Ca125

Answer 18

Tumour marker for ovarian cancer

Question 19

Whirlpool sign on USS

Answer 19

Ovarian torsion

Question 20

Beads on a string

Answer 20

Primary sclerosing cholangitis

Question 21

Snow storm appearance on USS

Answer 21

Molar pregnancy

Question 22

1st line treatment of menorrhagia

• needs contraception
• doesn’t need contraception

Answer 22

• IUS

- TXA or mefanamic acid

Question 23

1st line management of acute STEMI
receiving PCI -
Not receiving PCI -

Answer 23

Aspirin + ticagrelor + LMWH + immediate PCI

Tissue plasminogen activator or streptokinase

Question 24

Can a miscarriage be diagnosed with a single scan?

Answer 24

Yes only if verified by 2 professionals and CR>7 or gestational sac >25

if under these measurements then rescan in 7-10 days.

Question 25

what is a leiomyomata?

Answer 25

Fibroid - being tumour of myometrium

Question 26

1st line treatment for heavy periods?

Answer 26

Mirena

Question 27

Should combined HRT be used if the woman doesn't have a uterus?

Answer 27

Oestrogen only

Question 28

Why is combined HRT required for women with a uterus?

Answer 28

Unopposed oestrogen would increase risk of endometrial cancer

Question 29

What other examination is important in prolapse?

Answer 29

Abdo - prolapse can be worsened by abdominal mass

Question 30

Management of lichen sclerosis?

Answer 30

Dermovate | + avoid fragrant body wash etc

Question 31

Epithelium of endocervix? | Epithelium of ectocervix?

Answer 31

Columnar Stratified squamous An ectropion of when the columnar epithelium is present on the ectocervix - associated with increased oestrogen (pregnancy/COCP). Columnar more fragile and can bleed with sex

Question 32

Management of cervical ectropion?

Answer 32

Asymptomatic - Nothing will self resolve with time or when stops COVP/pregnancy ends Problematic bleeding - cauterisation with silver nitrate

Question 33

Drugs that should be avoided when breastfeeding?

Answer 33

``` antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides psychiatric drugs: lithium, benzodiazepines aspirin carbimazole methotrexate sulfonylureas cytotoxic drugs amiodarone ```

Question 34

Management of hyperemesis gravidarum?

Answer 34

1st line = antihistamine (cyclizine/promethazine) | 2nd line = metoclopramide/ondansetron

Question 35

Ketones in urine during pregnancy

Answer 35

May suggest hyperemesis gravidarum

Question 36

UTI when breastfeeding

Answer 36

trimethoprim

Question 37

gestational diabetes criteria

Answer 37

5678 fasting glucose >5.6 2 hour >7.8

Question 38

GBS prophylaxis

Answer 38

benzylpen

Question 39

Induction of labour

Answer 39

1. vaginal prostaglandin 2. Membrane sweep or IV oxytocin Induction indicated with bishop score <5 as labour is unlikely to occur spontaneously

Question 40

Gillick competence vs Frazer guidelines

Answer 40

Gillick competence used in children <16 years old - if they understand enough to be able to consent/make medical decisions Frazer guidelines = prescribing contraception to a female <16 and maintaining confidentiality - can only happen if they have Gillick competence and are likely to continue having sex regardless of your decision, you should encourage them to discuss with their parents but this isn't a requirement

Question 41

When can FSH be checked to assess ovarian reserve?

Answer 41

Day 2-5 of cycle Low number of eggs i.e. poor ovarian reserve = high FSH as more hormone required to activate the follicles

Question 42

how can you check that ovulation is occurring?

Answer 42

DAY 21 PROGESTERONE or 7 days before day 1 oof cycle

Question 43

A fasting glucose of what in pregnancy requires treatment with insulin

Answer 43

>7

Question 44

Indications for continuous CTG monitoring in labour?

Answer 44

suspected chorioamnionitis or sepsis, or a temperature =>38°C severe hypertension 160/110 mmHg or above oxytocin use the presence of significant meconium fresh vaginal bleeding that develops in labour

Question 45

Management of stress incontinence?

Answer 45

Pelvic floor exercises | Duloxetine

Question 46

management of painful periods

Answer 46

NSAIDS first line | COCP second line

Question 47

Contraceptive linked with weight gain?

Answer 47

depo-povera