GOSH

Question 1

5 reasons for a cat 1 LSCS

Answer 1

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

Question 2

How do urea and creatine levels change in pregnancy

Answer 2

Both decrease

Question 3

First line management for endometriosis

Answer 3

NSAIDS
i.e not COOP
(always blood catches me out)

Question 4

After NSAIDS what is first line option in endometriosis

Answer 4

COCP

Question 5

Most common eye condition in babies born under 32 weeks

Answer 5

retinopathy of prematurity

Question 6

2 causes of a raised AFP

Answer 6

Abdominal wall defect

Neural tube defect

Question 7

How does down syndrome affect AFP levels

Answer 7

Decreased

Question 8

Which tests are part of combined screening and what results would suggest T21

Answer 8

beta hCG - (high = downs)
PAPPA - (low = downs)

Nuchual

Question 9

When can the combined screening test be performed

Answer 9

11-14 weeks

Question 10

What does the quadruple test include

Answer 10

Inhibin-A

Question 11

What does the triple test include and when is it done

Answer 11

Beta hCG - high is bad
AFP - low is bad
Serum oestrogen - low is bad

14-20 weeks

Question 12

What is hb cut off to treat iron deficiency anaemia in post partum women

Answer 12

100

Question 13

What should transgender people assigned male at birth use as contraception

Answer 13

CONDOMS

Question 14

If a women is high risk for pre-eclampsia, what should they take and when

Answer 14

Aspirin

12 weeks until birth

Question 15

5 reasons why women would deffo get aspirin from 12 weeks

Answer 15

CKD
Previous pre-eclampsia
Autoimmune
T1DM T2DM
Current HTN

Question 16

6 moderate pre-eclampsia risk factors

Answer 16

FH of pre-e
First pregnancy
Gap of more than 10 years between pregnancy
Multiple pregnancy
BMI >35
Age over 40

Question 17

3 causes of increased nuchal thickness

Answer 17

Downs
Abdominal wall defect
Congenital heart defect

Question 18

Where is an ectopic most common and where is most dangerous

Answer 18

Danger danger isthmus

Common common ampulla

Question 19

What is Cabergoline used for

Answer 19

Suppressing lactation

Question 20

When can cu-iud be inserted

Answer 20

Which ever is later from:

5 days after UPSI
5 days after likely ovulation date

Question 21

Hormones raised in PCOS and LH:FSH ratio

Answer 21

LH high
FSH high

LH:FSH (LH high)

Insulin high
Testosterone high

Question 22

Where in the body is the issue in Kallaman syndrome

Answer 22

Hypothalamus so GNRH, FSH and LH are all low

Question 23

Would you do any investigations for post partum thyroiditis

Answer 23

TFTs

Question 24

Medical management of a miscarriage in the UK

Answer 24

Misoprostol alone

Question 24

Medical management of a miscarriage in the UK

Answer 24

Misoprostol alone

Question 25

If a women has had GDM in previous pregnancy, when will she be offered an OGTT

Answer 25

at booking and the normal 24-28 weeks

Question 26

How long does POP take until effective

Answer 26

2 days If in first 5 days, protected immediately

Question 27

How long does injection take till effective

Answer 27

7 days Protected immediately if first 5 days of cycle

Question 28

How long does IUS take to be effective

Answer 28

7 days Protected immediately if first 7 days of cycle (this is unique everything else is 5 except copper)

Question 29

How long does implant take to work

Answer 29

7 days Protected immediately if first 5 days of cycle

Question 30

You fit a women with a coil. She is happy and goes home. What does the Dr do next?

Answer 30

Shit question but follow up in 3-6 weeks to check threads

Question 31

How does COCP work

Answer 31

Inhibits ovulation

Question 32

How does the implant work

Answer 32

Inhibits ovulation

Question 33

Other than the copper coils, which contraceptive primary method of working is not inhibiting ovulation

Answer 33

POP | Thickens cervical mucus

Question 34

Why should liver be avoided in pregnancy

Answer 34

High levels of vitamin A

Question 35

From what day post partum do women need contraception

Answer 35

21

Question 36

At what week should mum be referred for not feeling fetal movements

Answer 36

24 weeks

Question 37

When in pregnancy would you give MMR

Answer 37

You do not as MMR is a live vaccine. Can have rubella seperate

Question 38

4 defects associated with rubella infection in pregnancy

Answer 38

Congenital cataracts, deafness, LD and heart disease (PDA and P stenosis)

Question 39

Which nerve may be blocked in labour when planning an instrument delivery

Answer 39

Pudendal

Question 40

How to stage endometrial cancer

Answer 40

MRI

Question 41

What medication do mothers of twins need

Answer 41

5mg FA Vit D 75mg Aspirin probably (OGTT at 28)

Question 42

When giving maternal steroids, when is maximal effect

Answer 42

7 days after

Question 43

What is the most common painful genital ulcer

Answer 43

Herpes Herpes hurts

Question 44

Most common painless genital ulcer

Answer 44

Syphilus Herpes hurts

Question 45

Women with PCOS wants to get pregnant what should you perform

Answer 45

OGTT before conception

Question 46

What swab would you use and where in BV

Answer 46

Clinical diagnosis but if needed Charcoal swab -> look under microscope for clue cells High or low vaginal swab

Question 47

What does vaginal candida infection discharge smell of?

Answer 47

It doesn't! Think creamy white

Question 48

Young women is treated with canister cream, what advice must you give

Answer 48

Condoms may be less effective for 5 days after use

Question 49

Where should trichomoniasis swabs be taken from

Answer 49

Charcoal swab taken from posterior fornix of vagina

Question 50

Low lying placenta at 20/52 scan management

Answer 50

Rescan at 34 weeks. Scan every 2 weeks till 37/38 Elective LSCS at 38 weeks

Question 51

Does aspirin reduce risk of VTE in pregnancy

Answer 51

No

Question 52

RF for VTE in pregnancy

Answer 52

Previous oestrogen related VTE | Thrombophillia

Question 53

Implications of LMWH in delivery

Answer 53

Cannot have regional anaesthetic for 12 hours if prophylaxis, 24 if therapeutic

Question 54

What dose of LMWH do you prescribe in pregnancy

Answer 54

Current weight | Therapeutic vs prophylaxis

Question 55

How fast should first stage of labour take place

Answer 55

Latent: 0-3: 0.5cm per hour Active 3-7: 1 cm every 1-2 hours Transition 7-10: 1 cm every 1-2 hours

Question 56

How long is a normal second stage

Answer 56

2 hours in nulliparous | 1 houe in multiparous

Question 57

In HMB in a 45F when coil, TXA and mefanamic acid, COCP, POP does not work: what can you do?

Answer 57

Endometrial ablation

Question 58

Other than big 3, complications in hysterectomy

Answer 58

VTE Return to theatre Injury to bladder Prolapse

Question 59

Blood test to rule out ectopic

Answer 59

BHCG over 48 hours | Should rise by greater than 66%

Question 60

Why may a women have signs of hyperthyroidism in early pregnancy

Answer 60

Molar pregnancy - very high bHCG

Question 61

When taking a ? Molar pregnancy history, what symptoms would it be important to ask about

Answer 61

``` Rapidly growing uterus Hyperthyroid Bleeding Excessive morning sickness USS showing snow storm appearance ```

Question 62

How to manage molar pregnancy

Answer 62

Evacuation of uterus Then bHCG levels monitored closely Register with trophoblastic tumour centre

Question 63

Difference between third degree tears

Answer 63

A: less than 50% of external anal syphincter B: more than 50% of external anal sphincter C: internal anal sphincter

Question 64

How many days for COCP to work

Answer 64

First 5 days straight away | After that 7 days

Question 65

How long does implant last

Answer 65

Three years

Question 66

Which emergency contraception cannot be used if a women is already on a POP

Answer 66

Ulpristal Cannot be used with other hormonal contraception 5 days before or after

Question 67

Proctitis and lymphitis in MSM -> dx

Answer 67

Lympogranuloma venereum

Question 68

When should no fetal movements felt be referred to FM

Answer 68

24 weeks

Question 69

Reversal agent of MgSo4

Answer 69

Calcium gluconate

Question 70

What is caused by parvovirus B19

Answer 70

Slapped cheek syndrome