monday 14th

Question 1

what length of time determines if its A premature rupture of membranes

Answer 1

> 4hr between ROM and contractions = PROM

Question 2

minimum dilatation for amniotomy

Answer 2

2cm

Question 3

what type of decelrations are bad in labour on CTG

Answer 3

late decelerations reduced FHR for 15 beats fro 15 secs

Question 4

a foetal scalp pH of what would indicate delivery

Answer 4

<7.2

Question 5

after how long in maternal arrest do you deliver baby

Answer 5

3 mins

Question 6

initial mangement in any maternal collapse

Answer 6

left tilt

Question 7

how long does puerperium last

Answer 7

6 weeks post partum

Question 8

the three types of dicharge post birth and how long they last + colour

Answer 8

rubra - red -3-4 days
serosa- brown - 4-14
alba- yellow - 10-20

Question 9

what hormones in hibit milk production

Answer 9

progesterone adn oestrogen

Question 10

how long should someone breastfeed for

Answer 10

first 6 months exclusively then add solids +breast for up to 2 years

Question 11

causes adn treatment of mastitis

Answer 11

staph - aureus
continue breast feed plus analgesia
if sys unwell or does not improve for 2 days oral fluclox

Question 12

where do abscesses unrelated to breast feeding tend to be

Answer 12

sub areolar

Question 13

levels of PPH

Answer 13

minor = 500-1L
major > 1L or shock

Question 14

how to work out someones blood volume

Answer 14

100ml per kg

Question 15

mangement of PPH uterine atony

Answer 15

• ABCDE
• catheterise
• bimanual massage
• syntocin
• ergometrine
  -carboprost
• misoprostol
  -TXA ?

Question 16

surgicla mangement of PPH

Answer 16

ballon
b-lynch sutures
artery ligation
hysterectomy

Question 17

desrcibe degree of perineal tears

Answer 17

first - skin only
second - skin and levator ani
third- involving anal spinchter
fourth 0 involving sphincter and rectal mucosa

Question 18

what level of tears require theatre

Answer 18

3rd and 4th

Question 19

lifestsyle advice for stress incontinence

Answer 19

weight loss, smoking cessation, avoid constipation, heavy lifting avoid and reduce caffeine

Question 20

treatment fo UTI in pregnant women

Answer 20

1/2 trimestetr - nitrofurantoin
3- trimepthoprim

Question 21

role of sertoli cells

Answer 21

secrete aeminiferous fluid, androgen globuli, inhibin adn activin

Question 22

role of leydig cells

Answer 22

secrete testpsterone

Question 23

what pituitary hormone regulates spermatogeneisis

Answer 23

FSH

Question 24

how can diabetes impact fertiliy

Answer 24

reduces testosetrone in men

Question 25

what hormones are high in PCOS

Answer 25

LH and testosterone

Question 26

describe duct system in breast

Answer 26

terminal ductules- intralobular collecting duct - lactiferous duct - lactiferous sinus - nipple

Question 27

what is involved in breast triple assessment

Answer 27

- clinical - imaging eg- mam, us , MRI - biopsy

Question 28

blue doems breast lump with pale fluid

Answer 28

fibrocystic change

Question 29

treatment of kawasaki

Answer 29

high dose aspirin IVIG do an echo

Question 30

complications of kawaski

Answer 30

cornornary artery aneurysm

Question 31

management of duct ectasia

Answer 31

abx stop smoking excise

Question 32

leaf breast tumout

Answer 32

phyloddes

Question 33

what breast cancer can be seen only through screening

Answer 33

intraductal papilloma

Question 34

what is the precursor to Ductal carcinoma in situ

Answer 34

intraductal papilloma

Question 35

what child rash causes spots on uvula and high fever with maculopapular rash

Answer 35

roseola infantum

Question 36

what virus casues roseola

Answer 36

HHV6

Question 37

most common complication of chicekn pox in adults

Answer 37

varicella pneumonia

Question 38

tx for impetigo

Answer 38

1% hydro peroxide

Question 39

diff between lobular carcinoma in situ and atypical lobular hyperplasia

Answer 39

atypical lobular hyperplasia <50% of lobule involved in situ > =50% involved

Question 40

most common type of breast cancer

Answer 40

invasive ductal carcinoma

Question 41

what type of malignant breast cancer is not palpable and seen on mammogram

Answer 41

lobular in situ

Question 42

what type of breast cancer is more common ductal or lobular

Answer 42

ductal

Question 43

what is a DCIS called when it involves the nipple

Answer 43

pagets disease of nipple

Question 44

A DCIS of what size indicates mastectomy over wide local excision

Answer 44

>4cm = mastectomy

Question 45

risk factors for breast cancer

Answer 45

nulliparity early menarche, late meno cocp obestity BRCA/p53

Question 46

examples fo anti oestrogen therapies

Answer 46

tamoxifen aromatase inhibitors - letrozole/anastrozole GnRh analogues - goserelin oophrecetomy

Question 47

side effects of anti-oestrogen therapy in breast cancer

Answer 47

hot flushes VTE Endometrial cancer menstrual disturbances

Question 48

side effects of aromatase inhibiots

Answer 48

osteoporosis hot flushes insomnia

Question 49

What therpay is used after breast cancer wide local excision

Answer 49

radiotherapy

Question 50

anti-oestrogen therapy used in pre and post menopausal women

Answer 50

pre- tamocifen post-aromatse inhibitos (more effective so reserved for these women )

Question 51

what therapy is used in HER2+ve breats cancer and when is it contraindicated

Answer 51

trastuzamab (HERCEPTIN) contra in hx of heart problems

Question 52

is +ve HER2 good or bad

Answer 52

BAD

Question 53

what is the best hormone profile to have in breast cancer

Answer 53

OE+, PR+ HER2-ve

Question 54

what therapy can be done pre-surgery in breast cancer

Answer 54

chemo

Question 55

do breast cancers have incresaed or decresaed vascularity

Answer 55

increased

Question 56

what is USS bad for seeing - breast cancer

Answer 56

DCIS

Question 57

difference between partial and complete mole

Answer 57

partial - 3 sets of DNA - 1 egg, 2 sperm - may have foetus completet - no maternal DNA in egg -no foestu

Question 58

how long post molar pregancy before can get pregnant

Answer 58

12 months

Question 59

risk following molar preg

Answer 59

choriocarcinoma

Question 60

features of threatened misscariiage vs inevitble

Answer 60

threatened - closed os light bleeding inevitable - open os - heavy bleed +clots

Question 61

what is a missed/delayed miscarriage

Answer 61

gestational sac present but no foetus

Question 62

what is classed as recurrent miscarriages

Answer 62

3 or more consec losses - screen for phosph and thrombophilia

Question 63

indications for medical or surgical miscarriage managment over conservative

Answer 63

increased risk of haemorrhage prev traumatic experience eg still birth infection

Question 64

medical management of miscarriage

Answer 64

vaginal misoprostol - see doctor if no bleeding in 24 hrs

Question 65

a b-HCG of what points towards ectopic preg

Answer 65

>1,500

Question 66

indication for surgical management of ectopic

Answer 66

>35mm foetal heart beat pain hcg>5000

Question 67

if b-hecg >1000 but<1500 what management is indicated

Answer 67

medical amangeemnt - mehtotrexate- follow up

Question 68

pneumonia with hyponatraemia + deranged LFT and dx test

Answer 68

legionella - urine antigen test

Question 69

raised antibodies in autoimmune hepatitis

Answer 69

ANA/SMA/LKM1 antibodies, raised IgG levels

Question 70

plateelt transfusion thresholds

Answer 70

<30 <100 if significant bleeding

Question 71

how long after acute stroke should AF meds be started

Answer 71

2 weeks

Question 72

ECG changes in hyperkaalemis

Answer 72

tall t , widened QRS , flat p waves

Question 73

most common organism from line infections

Answer 73

staph epidermidis

Question 74

seizure following sleep deprivation

Answer 74

juvenile myoclonic epilepsy

Question 75

first line screening test in those with iron deficient anaemia

Answer 75

anti -ttg