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1

how many no. of pregnancies are induced

1/5

2

indications for induction of pregnancy

diabetes
post dates
DVT/Preeclampsia
oligohydramnios
growth concerns

3

post dates time frame for induction of pregnancy

+7 days

4

Bishop's score is for

clinically assessing the cervix and the success of induction

5

first stage suboptimal progress for primigravid women are

less than 0.5cm per hour

6

first stage suboptimal progress for parous women are

less than 1cm per hour

7

average rate of C section percentage is

25%

8

post partum we see midwife for how many days?

9-10 days

9

postnatal checkup at GP is at what week?

6

10

primary postpartum haemorrhage classification

>500mls within 24hrs of delivery

11

secondary postpartum haemorrhage classification

blood loss > 500ml from 24 hrs post partum 6 weeks

12

how many times is a pregnant women likely to develop a DVT

6-10 times

13

a quarter of women who died six weeks and one year after pregnancy due to

mental health related causes

14

morning sickness affects what percentage of women

80-85%

15

morning sickness is related too

increased human chorionic gonadotrophin

16

HR in pregnancy increases too

70-90bpm

17

CO increases in pregnancy by

30-50%

18

why does blood pressure drop in second semester

expansion of uteroplacental circulation
fall in systemic vascular resistance
reduction in blood viscosity
reduction in sensitivity to angiotensin

19

renal plasma flow increases by

25-50%

20

GFR increases by

50%

21

serum urea and creatinine increases or decreases?

decreases

22

RBC mass increases by

25%

23

plasma volume increases by

50%

24

iron req. for pregnancy increases or decreases by

increases by 1g

25

platelets increases or decreases preg.

falls

26

WBC increases or decreases preg.

increases slightly

27

why does Gi motility decrease preg

increased progesterone, reduced motilin

28

oxygen consumption increases in pregnancy by

20%

29

effects of progesterone centrally

increased tidal volume, RR and plasma pH

30

is plasma PO2 effected by pregnancy

unchanged

31

what happens to respiratory mucous membranes in pregnancy

hyperaemia

32

what number of pregnancies are unplanned

1/3

33

hepatitis B solutions in pregnancy if tested positive

passive and active immunity for the baby

34

syphilis for pregnancy if positive

penicillin

35

isoimmunisation screening is for

rhesus disease, anti-c, anti-kell

36

overall risk for Down syndrome is

1/700

37

further testing for down syndrome is risk is greater than

>1 in 150

38

CVS is performed between the weeks of

10-14 weeks

39

amniocentesis is conducted between

15 weeks onward

40

bladder injury risk in C section

1/1000

41

risk of ureteric injury in C section

1/10000

42

physiological hydro nephrosis can occur how long post partum

6 weeks

43

what side is dilatation more pronounced for ureters

right

44

differentials for severe right iliac fossa pain, tender in RIF, guarding, tachycardia

ovarian torsion
appendicitis
renal calculi
constipation
ectopic pregnancy

45

oestradiol arises from

granulosa cells

46

bulbourethral gland produces what percentage of seminal fluid

5%

47

prostate gland produces what percentage of seminal fluid

30%

48

seminal vesicle produces what percentage of seminal fluid

60%

49

mammography is normally for people over the age of

40

50

mammography for under the age of 40 if

suspicion of cancer
FH >40%

51

US is first line for

under 40 age group

52

sensitivity or specificity for MRI of breast disease

specificity is poor

53

breast screening is for women

50-70

54

how many years between breast screens

3 years

55

how mammograms detect cancer per 1000

5

56

5 year survival all stages of ovarian cancer is

30%

57

high risk families constitute what percentage of ovarian cancers

5-10%

58

genetic types for high risk ovarian cancer families

HNPCC, BRAC1, BRAC2

59

what percentage of women with ovarian cancer have raised CA 125

80%

60

stage 1 ovarian cancer

limited ovaries with capsule intact

61

stage 2 of ovarian cancer

one or both ovaries with pelvic extension

62

stage 3 of ovarian cancer

one or both ovaries with peritoneal implants outside pelvis or + nodes

63

stage 4 of ovarian cancer

distant metastasis

64

first line pharma treatment for ovarian cancer

platinum and taxane

65

ovarian cancer chemo should be within how many weeks of surgery

8 weeks

66

66 year old para 1 with 6 month Hx of abd discomfort, early satiety and constipation, Ca 125 2560 you consider...

ovarian cancer

67

what percentage of vulvovaginal candiosis is candida albicans

90%

68

progesterone converts endometrium into

decidua

69

what occurs as endometrium into decidua

increases vascularity, between glands and vessels enlarge and become procoagulant

70

what are the cells on the outer edge of chorion

trophoblast cells

71

what types of pregnancy is susceptible to twin to twin transfusion

monochorionic diamniotic
monochorionic monoamniotic

72

two separate placenta, two sacs means

dichorionic diamniotic

73

one sac one placenta

monochorionic monoamniotic

74

T sign on ultrasound refers too

monochorionic

75

Lamda signs on US refers too

dichorionic

76

spontaneous miscarriage refers too before how many weeks of gestation

before 24 weeks

77

incidence of spontaneous miscarriage

15%

78

aetiology of spontaneous miscarriage

abnormal conceptus
uterine abnormality
cervical incompetence
maternal
idiopathic

79

incidence of ectopic pregnancy

1:90

80

risk factors for ectopic pregnancy

pelvic inflammatory disease
tubal surgery
previous ectopic
assisted conception

81

placenta praevia refers too

all or part of placenta implants in lower uterine segment

82

incidence of placenta praevia

1/200

83

placenta praevia more common in

multiparous women
multi pregnancy
prior C section

84

placenta praevia grade 1

encroaching on lower segment but not internal cervical os

85

placenta praevia grade 2

reaches internal os

86

placenta praevia grade 3

placenta eccentrically covers os

87

placenta praevia grade 4

central

88

key feature of placenta praevia

PAINLESS PV BLEEDING

89

what examination should never be done with placenta praevia

vaginal examination

90

placental abruption refers too

haemorrhage from premature separation of placenta before birth of baby

91

incidence of placental abruption

0.6%

92

key feature of placental abruption

pain

93

spot urinary protein: creatinine ratio is (in pregnancy for hypertension)

>30 mg/mmol

94

24 hour urine protein collection is (in pregnancy for hypertension)

>300mg/day

95

physiology of pre-eclampsia

immunity
genetic
failure of maternal spiral arterioles
imbalance between prostacyclin/thromboxane

96

the pearl index refers too

no. of contraceptive failures per 100 women-years of exposure

97

most sperm survive less than how many days?

4

98

highest chance of pregnancy is from sex on day

8-19

99

standard regime for combined hormonal contraception

21 days with a hormone free week

100

EVRA patch has to be changed every

week

101

Nuvaring has to be changed every

3 weeks

102

how long can a nuvaring be removed for and still be effective

3 hrs in 24hr

103

what is the reduction in ovarian and endometrial cancer for combined method of hormonal contraception

50%

104

benefits of combined hormonal contraception

reduced/ regulate bleeding
stop ovulation
reduction in functional cysts
reduction in ovarian and endometrial cancer
improve acne
reduction in benign breast disease, RA, colon cancer and osteoporosis

105

avoid CHC in

smokers >35m PH of arterial thrombosis, focal migraine, age >50, hypertension, BMI >34, previous VTE, relative under 45 with VTE, thrombophilia, active gall bladder disease, previous tumour

106

delay in return to fertility with injectable progestogen

9 months

107

what percentage of progestogen implants have prolonged frequent bleeding

30%

108

intrauterine contraception risk of perforation

1:1000

109

risk of intrauterine contraception of expulsion

5:100

110

how many years can a copper IUD last

5-10 years

111

emergency contraception Copper IUD time frame

within 120 hours or by day 19 of a 28 day cycles

112

if 100 women use an emergency IUD there will be how many pregnancies?

<1

113

levonorgestrel pill timeframe for emergency use

72 hrs

114

levonorgestrel 100 women emergency use how many pregnancies?

2-3

115

ulipristal pill emergency take within what timeframe?

120hours

116

ulipristal pill how many women use emergency will result out of pregnancy 100

1-2

117

can get pregnant how many days after delivery?

21

118

how many days can one get pregnant post miscarriage or abortion?

5 days

119

termination of pregnancy what number of women In the u.k will have an abortion

1/3

120

role of misoprostol in termination of pregnancy

initiates uterine contraction which opens cervix and expels pregnancy

121

mifepristone is an

oral antiprogestogen tablet for termination of pregnancy

122

bladder fills at the rate of

0.5-5mls/min

123

what percentage of women aged 15-60 report urinary incontinence

10-25%

124

what percentage of women over the age of 60 in the community report incontinence

15-40%

125

what percentage of women in nursing home are incontinent

50%

126

pharmacological treatment for overactive bladder syndrome

anti-muscarinic, tri-cyclic antidepressants

127

FNA needle is a

23G

128

cytology scoring for breast disease C1

unsatisfactory

129

cytology scoring for breast disease C2

benign

130

cytology scoring for breast disease C3

atypia (probably benign)

131

cytology scoring for breast disease C4

suspicious (probably malignant)

132

cytology scoring for breast disease C5

malignant

133

limitations for FNA in breast disease

grading or invasion not assessed
lesion missed
difficulty to examine
interpretation

134

complications of FNA

pain
haematoma
fainting
infection
pneumothorax

135

core biopsy needle size

14G

136

Duchenne muscular dystrophy is a

x-linked fatal disease that occurs in early adult life

137

what can Duchenne muscular dystrophy be diagnosed

prenatal diagnosis, pre-implantation diagnosis

138

screening in babies for

PKU, congenital hypothyroidism, CF, MCADD

139

what number of couples report infertility problems?

1/7

140

definition of infertility

 It is defined as inability of a couple to conceive after 12 months of regular intercourse without use of contraception.

141

what percentage of couples conceive within 1 year

80% of couples in the general population will conceive within 1 year

142

Klinefelter syndrome is a chromosomal abnormality of

XXY

143

fertility issues of Klinefelter syndrome

small testes and almost always azoospermia

144

A 24-year-old presents with an 18-month history of amenorrhoea since stopping the oral contraceptive pill 18 months ago in order to try for a pregnancy. She had been on the combined pill since she was 16, during which time her periods had been regular. Her BMI currently is 31.
What is the most appropriate next step for investigation?

1)A diagnostic laparoscopy

2)A pelvic ultrasound scan

3)Hormone profile to check SHBG, free testosterone and FSH and LH and prolactin

4)MRI of pelvis to exclude pelvic mass

3) hormone profile

145

A 24-year-old presents with an 18-month history of amenorrhoea since stopping the oral contraceptive pill 18 months ago in order to try for a pregnancy. She had been on the combined pill since she was 16, during which time her periods had been regular. Her BMI currently is 31.
What is the likely diagnosis?

1)Anorexia nervosa

2)Hyperprolactinaemia

3)Hypogonadotrophic hypogonadism

4)Polycystic ovarian syndrome

5)Premature ovarian failure

4) PCOS

146

Which of the following is correct with regards to the diagnosis of PCOS?

1)A high FSH and LH level

2)Affected women are very fertile

3)Affects >50% of the infertile population

4)Metformin is contraindicated

5)Ultrasound appearance of a large number of follicles arranged peripherally in the ovarian cortex of large volume ovaries

Ultrasound appearance of a large number of follicles arranged peripherally in the ovarian cortex of large volume ovaries

147

A 28-year-old with PCOS and primary subfertility of 4 years attends the fertility clinic. Her cycles are very irregular and she is currently on metformin, which is helping with her weight control (BMI 28), but is she still is amenorrhoeaic. She is very keen to commence with fertility treatment. An hysterosalpingogram confirmed bilaterally patent tubes.
What is the most appropriate initial management of her subfertility?

1)Advice on weight loss and review in 6 months

2)Intrauterine insemination for six cycles

3)Laparoscopic diathermy to ovaries

4)Ovulation induction with clomifene 50 mg for 6 months

5) Recommend one cycle of IVF treatment

Ovulation induction with clomifene 50 mg for 6 months

148

maternal mortality timeframe

while pregnant or within 42 days of termination of pregnancy

149

1 maternal death occurs every how much minutes?

2

150

what percentage of maternal death is preventable?

>80%

151

leading cause of maternal death worldwide?

haemorrhage

152

normal frequency of menstruation

24-38 days

153

normal regularity of menstruation

<20 days variation

154

normal duration of menstruation

2-7 days

155

volume normal of menstruation

5-80 mls

156

what percentage of women aged between 30-49 see a GP in regards to heavy menstrual bleeding?

5%

157

PALM COEIN causes for heavy bleeding

Polyp
Adenomyosis
Leiomyoma
Malignancy
Coagulopathy
ovulation dysfunction
endometrium
iatrogenic
not yet classified

158

within the second stage of labour a primigravida birth should be expected within how many hours?

2hrs

159

within the second stage of labour a multigravida birth should be expected within how many hours?

one hour

160

Gillick competence refers too

Children under 16 can consent if they have sufficient understanding and intelligence to fully understand what is involved in a proposed treatment, including its purpose, nature, likely effects and risks, chances of success and the availability of other options

161

if a child fails the Gillick competence then

the consent of a person with parental responsibility (or sometimes the courts) is needed in order to proceed with treatment.

162

what percentage of adolescents presenting with chronic pelvic pain have endometriosis

38%

163

intraduct papilloma usually effects what age group of women?

middle aged women

164

appearance of breast fat necrosis of histology

histocytes with foamy cytoplasm, lipid filled cysts, calcifications

165

what has an egg shell appearance on a mammography?

fat necrosis

166

phyllodes tumour appearance

leaf like pattern and cysts on cut surface

167

fibroadenoma is most common breast tumour in which group?

adolescent and young adult women

168

phyllodes tumour spread is

haematogenous

169

what percentage of breast cancers can be attributed to inherited factors

5-10%

170

ER/PR positive breast tumour marks strong response to

hormonal therapy

171

HEr-2 positive breast tumour predicts response to

20/30% to trastuzumab

172

prolapse percentage effecting of multiparous women

12-30%

173

biggest risk of teratogenicity is during which phase?

3-8 weeks during organogenesis

174

male Sertoli cells role

support sperm, producing cells, produce inhibin

175

Leydig cells in men produce

testosterone

176

CRP increases or decreases in pregnancy

maintains the same

177

ESR increases or decreases in pregnancy

increases

178

24hr protein increases or decreases in pregnancy

increases

179

total protein increases or decreases in pregnancy

decreases

180

albumin increases or decreases in pregnancy

decreases

181

Alk Phos increases or decreases

greatly increases

182

D dimer increases or decreases

increases

183

CI to systemic HRT

hormone dependent cancer endometrium/breast
active liver disease
abnormal bleeding
thrombophilia
prior breast cancer or BRCA carrier

184

why is breast imaging sensitivity be reduced in young women

increased presence of glandular tissue

185

T2 breast cancer

tumour size 2-5cm

186

T3 breast cancer

5>cm

187

T4a breast cancer

tumour invading skin

188

T4b breast cancer

invading chest wall

189

T4c breast cancer

tumour invading both

190

T4d breast cancer

inflammatory breast cancer

191

complications of axillary treatment

lymphoedema
sensory disturbance
decrease ROM of shoulder joint
nerve damage
vascular damage
radiation induced sarcoma

192

endometrial cancer stage 1A

inner half of myometrium

193

endometrial cancer stage 1B

outer half of myometrium

194

endometrial cancer stage 2

invades cervix

195

endometrial cancer stage 3A

serosa/adnexa

196

endometrial cancer stage 3B

vagina/parametrium

197

endometrial cancer stage 3C

pelvic or para-aortic nodes

198

endometrial cancer stage 4

bladder/bowel/intra-abdominal/inguinal nodes

199

average incubation period of Gonorrhoea

5-6 days

200

follow up for reinfection for chlamydia

3-12 months

201

follow up for reinfection for Gonorrhoea

2 weeks and test of reinfection at 3 months

202

what percentage of the U.K. population has herpes

15-20%

203

anogenital warts causes

HPV type 6 and 11