O&G Flashcards by Dominika Zwolinska

Hyperemesis gravidarum first line treatment?

Oral Antihistamines e.g. cyclizine, promethazine or prochlorperazine

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Hyperemesis gravidarum 2nd line treatment?

Ondansetron (increased risk of cleft palate) and metoclopramide (no more than 5 days)

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When would you admit someone for Hyperemesis gravidarum?

Continued nausea and vomiting and is unable to keep down liquids or oral antiemetics
Continued nausea and vomiting with ketonuria and/or weight loss (greater than 5% of body weight), despite treatment with oral antiemetics
A confirmed or suspected comorbidity (for example she is unable to tolerate oral antibiotics for a urinary tract infection)

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First line for pre-eclampsia?

oral labetalol

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First line for pre-eclampsia with asthma?

Nifedipine or hydralazine

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Treatment for eclampsia which presents with seizure?

IV magnesium sulphate for 24 hours after last seizure / delivery

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Management of PID?

oral ofloxacin + oral metronidazole (outpatient)
or
IM ceftriaxone + oral doxycycline + oral metronidazole (inpatient - risk of gonorrhoea)

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Management of gestational diabetes with fasting glucose <7mmol/l?

lifestyle modifications trial for 1-2 weeks
add metformin if targets aren’t met
add short-acting insulin if targets not met

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Management of gestational diabetes with fasting glucose >7mmol/l?

short-acting insulin

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Pregnant woman with BP >/- 160/90?

admit for observation

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management of nexplanon causing unscheduled bleeding?

3 month course of COCP

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> 28 weeks gestation with reduced fetal movement?

doppler for heartbeat
if no HR then immediate USS
if HR then CTG for 20 mins

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Main drugs contraindicated in breast-feeding?

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

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prophylaxis for pre-eclampsia?

low dose aspirin

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placenta praevia at 20 weeks?

rescan at 32 weeks - if still present then rescan every 2 weeks, if present at delivery may need a c-section.

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treatment for stage 2-4 ovarian cancer?

surgical excision +/- chemotherapy

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Management of premature ovarian insufficiency?

HRT or COCP until age of normal menopause (51y)

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Gold standard investigation for endometriosis?

laparoscopy

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management of endometriosis?

NSAIDS/ paracetamol for symptomatic relief
COCP or progestogens (e.g. medroxyprogesterone acetate)
GnRH analogues
surgery

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PMS manegement?

lifestyle
COCP
SSRI

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Chlamydia management

Azithromycin (1dose) or doxycycline (7 days)

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Gonorrhoea management?

IM cefriaxone 1g

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Bacterial vaginosis management?

Metronidazole

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TOP drugs?

Misoprostol + mifepristone

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Induction of labour management?

bishop score (cervical position, consistency, effacement, dilation and fetal station) Bishop score 6 - amniotomy and IV oxytocin

Medical management of miscarriage?

Misoprostol

Prolactinoma first line?

Dopamine receptor agonist E.g. bromocriptine or cabergoline

Drug of choice for epilepsy with pregnancy

Lamotrigine or carbamazepine

Fibroids <3cm management

Progesterone IUS

Folic acid dose before pregnancy (low risk)?

400mcg 12 weeks before pregnancy until 12 weeks gestation

Folic acid dose if high risk?

5mg

What are the two screening and two diagnostic tests for trisomy 21?

1. Nuchal transparency test (+ blood hCG and PAPP-A) 2. Quadruple blood test (AFP + hCG + inhibin A + unconjugated oestriol ) - between weeks 15 - 22. 1. Chorionic villus sampling (karyotyping - from 11 weeks until 13 weeks) 2. Amniocentesis ( from 15 weeks)

When is the anomaly scan done and what does it check for?

Between 18 - 21 weeks Checks for spina bifida + anencephaly

What is sheehan syndrome?

A rare complication of PPH where there is a lack of oxygen in brain causing necrosis of the anterior pituitary causing hypopituatarism

What is the most common symptom of Sheehan syndrome?

Failure to lactate due to low prolactin

High risk of gestational diabetes investigation?

OGTT at 24-28 weeks

fertility treatment for people with PCOS ?

1. weight reduction 2. clomifene 3. metformin

pregnant woman with autoimmune conditions should take what?

aspirin 75mg to try prevent pre-eclampsia

choice of anti-depressant for breastfeeding woman?

sertraline or paroxetine

Pregnant + OGTT +ve + fasting glucose <7mmol/l?

1. trial of diet and exercise 2. metformin 3. insulin

Pregnant + OGTT +ve + fasting glucose >7mmol/l?

1. insulin - 1st line 2. metformin + exercise/diet

4 T's of PPH?

1. tone 2. trauma 3. tissue 4. thrombin

Suspected PE in pregnant woman with a confirmed DVT treatment?

Low molecular weight heparin then rule in/ out

Woman with Pyrexia is >38 degrees during labour should get which antibiotic to prevent group B strep?

Benzylpenicillin

syphilis management?

IM benzylpenicillin or doxycycline

genital herpes investigation?

NAAT (nucleic acid amplification test)

multiple, non-keratinised genital warts management?

topical podophylltoxin

solitary, keratinised genital warts management?

cryotherapy

Pre-eclampsia investigations?

- FBC - LFT - Renal function- U&E's (creatinine) - coagulation screen - consider

Combined screening test results which would suggest down's syndrome?

↑ HCG, ↓ PAPP-A, thickened nuchal translucency

Complications of gonnorhoea?

urethral strictures, epididymitis and salpingitis (hence may lead to infertility) Disseminated gonococcal infection (DGI) - tenosynovitis migratory polyarthritis, dermatitis gonococcal arthritis

Antiphospholipid syndrome in pregnancy management?

Aspirin + LMWH

Gonorrhoea treatment if patient refuses IM treatment?

oral cefixime + oral azithromycin

Thrush in pregnancy treatment?

clotrimazole pessary

Thrush treatment?

Oral fluconazole

What are the different degrees of perineal tears + treatment ?

1st - superficial damage (no surgical repair) 2nd - perineal muscle damage but not involving anal sphincter (suturing on ward) 3rd - perineal muscle damage + sphincter damage (repair in theatre) 4th - perineal muscle damage + sphincter + rectal mucosa damage (repair in theatre)

Premature ovarian failure - LH/FSH patterns?

both high

management of premature preterm rupture of membranes?

- admission - regular observations to ensure chorioamnionitis is not developing - oral erythromycin (10 days) - antenatal corticosteroids (dexamethasone) should be administered to reduce the risk of respiratory distress syndrome - delivery should be considered at 34 weeks of gestation

Ovarian cancer investigations?

1. CA125 2. if raised then USS. 3. consider CT.

Normal nuchal thickness?

<3.5mm

O&G Flashcards

(60 cards)