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O&G Flashcards

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1
Q

Hyperemesis gravidarum first line treatment?

A

Oral Antihistamines e.g. cyclizine, promethazine or prochlorperazine

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2
Q

Hyperemesis gravidarum 2nd line treatment?

A

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

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3
Q

When would you admit someone for Hyperemesis gravidarum?

A
  • 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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4
Q

First line for pre-eclampsia?

A

oral labetalol

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5
Q

First line for pre-eclampsia with asthma?

A

Nifedipine or hydralazine

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6
Q

Treatment for eclampsia which presents with seizure?

A

IV magnesium sulphate for 24 hours after last seizure / delivery

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7
Q

Management of PID?

A

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

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8
Q

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

A
  1. lifestyle modifications trial for 1-2 weeks
  2. add metformin if targets aren’t met
  3. add short-acting insulin if targets not met
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9
Q

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

A
  1. short-acting insulin
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10
Q

Pregnant woman with BP >/- 160/90?

A

admit for observation

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11
Q

management of nexplanon causing unscheduled bleeding?

A

3 month course of COCP

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12
Q

> 28 weeks gestation with reduced fetal movement?

A
  1. doppler for heartbeat
  2. if no HR then immediate USS
  3. if HR then CTG for 20 mins
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13
Q

Main drugs contraindicated in breast-feeding?

A
  • antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
  • psychiatric drugs: lithium, benzodiazepines
  • aspirin
  • carbimazole
  • methotrexate
  • sulfonylureas
  • cytotoxic drugs
  • amiodarone
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14
Q

prophylaxis for pre-eclampsia?

A

low dose aspirin

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15
Q

placenta praevia at 20 weeks?

A

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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16
Q

treatment for stage 2-4 ovarian cancer?

A

surgical excision +/- chemotherapy

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17
Q

Management of premature ovarian insufficiency?

A

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

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18
Q

Gold standard investigation for endometriosis?

A

laparoscopy

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19
Q

management of endometriosis?

A
  1. NSAIDS/ paracetamol for symptomatic relief
  2. COCP or progestogens (e.g. medroxyprogesterone acetate)
  3. GnRH analogues
  4. surgery
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20
Q

PMS manegement?

A
  1. lifestyle
  2. COCP
  3. SSRI
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21
Q

Chlamydia management

A

Azithromycin (1dose) or doxycycline (7 days)

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22
Q

Gonorrhoea management?

A

IM cefriaxone 1g

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23
Q

Bacterial vaginosis management?

A

Metronidazole

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24
Q

TOP drugs?

A

Misoprostol + mifepristone

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25
Induction of labour management?
bishop score (cervical position, consistency, effacement, dilation and fetal station) Bishop score 6 - amniotomy and IV oxytocin
26
Medical management of miscarriage?
Misoprostol
27
Prolactinoma first line?
Dopamine receptor agonist E.g. bromocriptine or cabergoline
28
Drug of choice for epilepsy with pregnancy
Lamotrigine or carbamazepine
29
Fibroids <3cm management
Progesterone IUS
30
Folic acid dose before pregnancy (low risk)?
400mcg 12 weeks before pregnancy until 12 weeks gestation
31
Folic acid dose if high risk?
5mg
32
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)
33
When is the anomaly scan done and what does it check for?
Between 18 - 21 weeks Checks for spina bifida + anencephaly
34
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
35
What is the most common symptom of Sheehan syndrome?
Failure to lactate due to low prolactin
36
High risk of gestational diabetes investigation?
OGTT at 24-28 weeks
37
fertility treatment for people with PCOS ?
1. weight reduction 2. clomifene 3. metformin
38
pregnant woman with autoimmune conditions should take what?
aspirin 75mg to try prevent pre-eclampsia
39
choice of anti-depressant for breastfeeding woman?
sertraline or paroxetine
40
Pregnant + OGTT +ve + fasting glucose <7mmol/l?
1. trial of diet and exercise 2. metformin 3. insulin
41
Pregnant + OGTT +ve + fasting glucose >7mmol/l?
1. insulin - 1st line 2. metformin + exercise/diet
42
4 T's of PPH?
1. tone 2. trauma 3. tissue 4. thrombin
43
Suspected PE in pregnant woman with a confirmed DVT treatment?
Low molecular weight heparin then rule in/ out
44
Woman with Pyrexia is >38 degrees during labour should get which antibiotic to prevent group B strep?
Benzylpenicillin
45
syphilis management?
IM benzylpenicillin or doxycycline
46
genital herpes investigation?
NAAT (nucleic acid amplification test)
47
multiple, non-keratinised genital warts management?
topical podophylltoxin
48
solitary, keratinised genital warts management?
cryotherapy
49
Pre-eclampsia investigations?
- FBC - LFT - Renal function- U&E's (creatinine) - coagulation screen - consider
50
Combined screening test results which would suggest down's syndrome?
↑ HCG, ↓ PAPP-A, thickened nuchal translucency
51
Complications of gonnorhoea?
urethral strictures, epididymitis and salpingitis (hence may lead to infertility) Disseminated gonococcal infection (DGI) - tenosynovitis migratory polyarthritis, dermatitis gonococcal arthritis
52
Antiphospholipid syndrome in pregnancy management?
Aspirin + LMWH
53
Gonorrhoea treatment if patient refuses IM treatment?
oral cefixime + oral azithromycin
54
Thrush in pregnancy treatment?
clotrimazole pessary
55
Thrush treatment?
Oral fluconazole
56
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)
57
Premature ovarian failure - LH/FSH patterns?
both high
58
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
59
Ovarian cancer investigations?
1. CA125 2. if raised then USS. 3. consider CT.
60
Normal nuchal thickness?
<3.5mm

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