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Specialties exam > O&G Passmed > Flashcards

O&G Passmed Flashcards

1
Q

Drug that causes increased risk of placental abruption

A

Cocaine

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2
Q

Foetal consequences of maternal rubella infection

A 
SN deafness
cataracts
congenital heart defects
growth retardation
cerebral palsy
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3
Q

Contraceptives and their methods of action

A

COCP
- Inhibits ovulation
POP
- Thickens cervical mucus
Desogestrel only pill
- Inhibits ovulation, also thickens mucus
Injectable contraceptive (medroxyprogesterone acetate aka Provera)
- Inhibits ovulation, also thickens cervical mucus
Implantable contraceptive (etonogestrel)
- Inhibits ovulation, also thickens cervical mucus
Intrauterine contraceptive device
- Decreases sperm motility and survival
Intrauterine system (levonorgestrel)
- Prevents endometrial proliferation, also thickens cervical mucus

EMERGENCY CONTRACEPTIVES
Levonorgestrel - inhibits ovulation
Ulipristal - inhibits ovulation
Intra-uterine device - Toxic to sperm and ovum, also inhibits implantation

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4
Q

COCP: Cancer risks

A

Increases risk of breast and cervical (the oens we screen for). Also more risk of cervical ectropion
Decreases risk for ovarian and endometrial cancer

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5
Q

Abdo trauma in pregnancy, no other signs, all else appears normal. RX?

A

Blood type and RhD testing

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6
Q

Management of uterine fibroid <3cm

A

medical treatment (e.g. IUS, tranexamic acid, COCP)

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7
Q

Struggling to conceive for 12 months, mild endometriosis

A

Try for another 12 months

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8
Q

Risk factors for placenta praevia

A

multiparity
multiple pregnancy
embryos are more likely to implant on a lower segment scar from previous caesarean section

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9
Q

Placenta praevia: features

A 
shock in proportion to visible loss
no pain
uterus not tender
lie and presentation may be abnormal
fetal heart usually normal
coagulation problems rare
small bleeds before large
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10
Q

Suitable contraception for women taking carbamezapine

A

Copper IUD
Carbamezapine is an enzyme inducer, so something without hormones is preferred
However, if heavy bleeding is an issue, give Mriena (IUS)

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11
Q

Management of endometriosis

A

COCP if not wishing to conceive (taken every day)

Referral to fertility services and laparoscopic adhesiolysis if wishing to conceive

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12
Q

Continuous dribbling incontinence after birth

A

Vesicovaginal fistulae suspected

Urinary dye studies

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13
Q

Unsure of diagnosis for incontinence or plans for surgery

A

urodynamic studies

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14
Q

Pearl index

A

Used for contraception

Number of women who become pregnant if 100 women use that contraceptive for 1 year

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15
Q

Woman on microgynon 30, missed one tablet and had sex last night

A

Reassure, no action needed
If 2 or more pills missed
- Take last pill (even if 2 in one day) and abstain from sex until 7 days of consecutive pill taking

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16
Q

Second screen for anaemia and atypical red cell alloantibodies

A

28 weeks

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17
Q

Nuchal scan

A

11-16+6 weeks

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18
Q

Emergency contraception options

A

Levonorgestrel 1.5mg stat - 84% effective within 72hrs
Ulipristal (ellaOne), 30mg, up to 120hrs
IUD: within 5 days, 99% effective, can be left in for long term

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19
Q

First line medication to restore normal ovulation in PCOS

A

metformin or Clomifene

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20
Q

Pregnant women, contact with chickenpox, unsure if she had it before. No other symptoms

A

Check varicella antibodies

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21
Q

Contraceptive associated with weight gain

A

Medroxyprogesterone acetate

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22
Q

Contraindicated drugs during breastfeeding

A 
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin
carbimazole
methotrexate
sulphonylureas
cytotoxic drugs
amiodarone
clozapine
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23
Q

Causes of primary post partum haemorrhage

A 
Causes can be grouped into the 'four T's':
tone (atonic uterus, most common)
tissue (retained placenta)
trauma
thrombin (coagulation abnormalities)
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24
Q

What normally happens to maternal blood pressure in pregnancy

A

Falls in first half of pregnancy before rising to pre-pregnancy levels before term

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25
Q

Management of menorrhagia

A

Investigations
- FBC
- Transvaginal ultrasound if symptomatic or abnormal pelvic exam findings
Rx (no contraception needed)
- Mefenamic acid 500mg tds or tranexamic acid 1g tds
- try these drugs whilst referring
Rx (needs contraception)
- intrauterine system (mirena) first line
- COCP
- Long acting progestogens
Norethisterone 5 mg tds can be used as a short-term option to rapidly stop heavy menstrual bleeding.

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26
Q

1 day post c-section, pain and heavy vaginal bleeding and heavy, offensive lochia and boggy, poorly contracted uterus

A

Retained products of conception (take care to remove all placental membranes during C section)
Exam under anaesthesia to remove the products

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27
Q

vaginal candidiasis in pregnancy

A

clomitrazole pessary

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28
Q

abdo discomfort, distension, nausea and vomiting after egg retrieval for IVF

A

Ovarian hyperstimulation syndrome
Caused by use of HCG in maturation of follicles
Treat with fluid replacement and thromboprophylaxis

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29
Q

vasa previa features

A

PROM followed by Painles PV Bleeding and Foetal bradycardia

30
Q

management of atonic uterus

A

ABC
Bladder epmtying, uterine massage
IV ergometrine bolus
Ocytocin infusion

31
Q

management of epilepsy in pregnancy

A

Lamotriogine

32
Q

uterine tenderness, rupture of the membranes with a foul odour of the amniotic fluid and maternal signs of infection (for example tachycardia, pyrexia, and leukocytosis).

A

Chorioamnionitis

33
Q

Next step for late decellerations on CTG

A

Foetal blood sampling (apparently)

34
Q

Appropriate drug before fibroid surgery

A

GnRH analogues to reduce size

35
Q

breastfeeding woman. Tender, erathematous breast. No other abnormalities

A

Mastitis, usually caused by milk stasis

Continue breastfeeding, simple analgesia and warm compresses

36
Q

Which causes a big delay in returning to normal fertility after stopping

A

Progesterone only injection (takes up to 12 months)

37
Q

Bishop’s score of 4 is calculated. What treatment is most suitable?

A

PGE2 vaginally to induce labour

38
Q

Vaginal discharge after UTI treatment

A

Candida

39
Q

Rx of simple cyst on USS

A

Repeat in 12 weeks, if still there refer to gynae

40
Q

Mother had pervious group B strep infection. Additional Rx:

A

Intrapartum antibiotics

41
Q

Medication to reduce risk in pregnant women with history of pre-eclampsia

A

low dose aspirin

42
Q

cyclical pain but no bleeding, concerns periods haven’t started yet

A

Imperforate hymen

43
Q

Which drug should be administered to the mother to reduce the chance of respiratory distress syndrome in the newborn?

A

Dexamethasone

44
Q

37 weeks pregnant, fainting and sudden severe abdo pain, hypotension and tachycardia. Cold on examination

A

Placental abruption

45
Q

HRT recommendations

A

Cyclical combined HRT if LMP is less than 1 year ago
Continuous combined if:
- Taken cyclical combined for >1yr
- LMP was >1yr ago
- LMP was >2yrs ago if menopause before 40

46
Q

Which methods of contraception should be discontinued once a woman reaches 50

A

Depo-provera (injectivle contraceptive)

COCP

47
Q

Sudden onset iliac fossa pain, nausea and vomiting

A 
Ovarian torsion (usually coincides with exercise)
Miscarriage (follows a period of amenorrheoa)
48
Q

Complications of PCOS

A 
Subfertility
Diabetes mellitus
Stroke &amp; transient ischaemic attack
Coronary artery disease
Obstructive sleep apnoea
Endometrial cancer
49
Q

Comlications of pre-eclampsia

A

fetal: prematurity, intrauterine growth retardation
eclampsia
haemorrhage: placental abruption, intra-abdominal, intra-cerebral
cardiac failure
multi-organ failure

50
Q

When do post-menopausal women still need contraception

A

when <50YO

51
Q

hormone measured at day 21 to test for ovulation

A

Progesterone

52
Q

term used to describe the head in relation to the ischial spine

A

Station

53
Q

Pregnant women exposed to VZV and is not immune. Next step

A

VZIG ASAP

54
Q

At what point in her menstrual cycle can the IUD be inserted?

A

Any time

55
Q

Sudden collapse soon after rupture of membranes

A

Amniotic fluid embolism

56
Q

Rx for simple fibroids to retain fertility

A

Myomectomy

57
Q

Contraceptives - time until effective (if not first day period):

A

instant: IUD
2 days: POP
7 days: COC, injection, implant, IUS

58
Q

combination of menorrhagia, subfertility and an abdominal mass

A

Fibroids

59
Q

Rokitansky’s protuberance.

A

teratoma (dermoid cyst)

60
Q

Confirmed extopic pregnancy, no pain or other symptoms, bHCG<1500. Ectopic <35mmFirst line Rx

A

Methotrexate, as long as willing to attend follow up

Failing any of these criteria, laparosopic salpingectomy

61
Q

16 weeks gestation, painless PV bleeding, morning sickness, SOB
Ultrasound revealed a solid collection of echoes with numerous small anechoic spaces. What is the most likely diagnosis?

A

Hydatoform mole (molar pregnancy)

62
Q

The following results would be expected in a trisomy 21 (Down’s syndrome) pregnancy:

A
  • High bHCG
  • Low PAPP-A, AFP, Oestriol
  • Thickened nuchal translucency
63
Q

complication of vaginal hysterectomy

A

Vaginal vault prolapse

64
Q

Sheehan’s syndrome: Pathology

A

Sheehan’s syndrome (otherwise known as postpartum hypopituitarism) is a reduction in function of the pituitary gland following ischaemia necrosis due to blood loss and hypovolaemic shock following birth.

65
Q

Cervical screening programme for HIV Positive women

A

Annual cervical cytology

66
Q

increased nuchal translucency. Other than Down’s syndrome, which one of the following is most associated with this finding?

A

congenital heart defects

67
Q

Risk factors for placenta accreta

A

Placenta accreta describes the attachment of the placenta to the myometrium, due to a defective decidua basalis. As the placenta does not properly separate during labour there is a risk of post-partum haemorrhage.

Risk factors
previous caesarean section
placenta praevia

68
Q

9 weeks pregnant, the high vaginal swab has isolated group B streptococcus (GBS). How should she be managed?

A

Intrapartum IV benzylpenicilin

69
Q

Foods to avoid in prenancy

A

Liver (contains Vit A) and other Vit A supplements as Vitamin A is teratogenic

70
Q

UKMEC classification system (contraception options)

A

UKMEC 1: a condition for which there is no restriction for the use of the contraceptive method
UKMEC 2: advantages generally outweigh the disadvantages
UKMEC 3: disadvantages generally outweigh the advantages
UKMEC 4: represents an unacceptable health risk

Specialties exam (4 decks)

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