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MS4 - OnG > O&G lectures > Flashcards

O&G lectures Flashcards

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1
Q

3 meds that should be avoided at (almost) all cost during pregnancy

A

Methoterexate Radioactive iodine (lithium)

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2
Q

Meds for medical termination of pregnancy (MTOP)

A

methotrexate

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3
Q

Factors affecting fertility

A

Reversible effect: hormones for menorrhagia Irreversible effect: chemotherapy and smoking

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4
Q

What are fibroids

A

smooth muscle tumours of the uterus

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5
Q

Sx of pelvic inflammatory disease (PID)

A

Gradual onset lower abdo pain Unwell Dyspareunia Abnormal vaginal discharge

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6
Q

What is this

A

Fitz-Hughs-Curtis

Rare complication of PID: adhesions between liver and diaphragm

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7
Q

Long term complications of PID

A

Adhesions

Infertility

Chronic pelvic pain

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8
Q

Treatment of PID patients

A

14 days of abx

Doxycycline + metronidazole

Or

Ofloxacin + metronidazole

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9
Q

Other considerations in management of PID

A

Treat partner + contact tracing

No intercourse whilst on abx

Full STIs screening (hep b,c HIV)

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10
Q

Cause of Ovarian hyperstimulation

A

Fertility treatment giving too much FSH causing hyperplasia of the ovaries

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11
Q

Sx of ovarian hyperstimulation

A

ascites

pain

thrombosis

pleural effusion

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12
Q

What is typical hx for miscarriage septic

A

prolonged heavy vaginal bleeding

3-5 days post miscarriage

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13
Q

What is this condition

How is it treated?

A

Bartholins cyst/abscess

Abx or

surgery and marsupialisation

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14
Q

location and function of bartholins glands

A

Posterior vulval wall at 4 and 8 o clock

Lubrication of intercourse

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15
Q

Which pathogen is bartholins abscess associated with

A

20% associated with Gonorrhoea

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16
Q

Marsupialisation

A

curring a slit into an abscess

suturing it in a way that can drain freely

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17
Q

Differential for abnormal menstrual bleeding (AUB)

A

PALM-COEIN

Polyps

Adenomyosis

Leiomyoma

Malignancy

Coagulopathy

Ovulatory dysfunction

Endometrial

Iatrogenic

Not yet classified (eg dysfunctional uterine bleeding: everything is normal but still bleeding)

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18
Q

Causes of vaginal bleed in 1 week old?

A

Oestrogen withdrawal

or

Rhabdomyosarcoma (vaginal cancer)

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19
Q

Medical management of heavy menstrual bleeding?

A
  1. tranexamic acid
  2. NSAIDS: mefenamic acid/ ibuprofen
  3. Iron
  4. Hormonal (IUS, COCP, etc)
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20
Q

What is this

What sx does it give?

A

Cerivical ectropion

Columnar epithelium of cervix replaces stratified squamous of the vagina

Very vascular, post coital bleeding

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21
Q

Organisms causing cervicitis

A

Chlamydia

Gonorrhoea

Trichomonas vaginalis

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22
Q

Organisms causing vaginitis

A

Gardnella vaginalis

Candida Albicans

Trichomoniasis Vaginalis

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23
Q

Abx for Chlamydia

A

doxycycline 100mg BD- 7 days (CI pregnancy)

Azithromycin 1gm PO- stat dose

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24
Q

Gonorrhoea Abx

A

Ceftriaxone 250mg IM- stat dose

Cefixime 400mg PO- stat dose

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25
Causes of oligomenorrhoea
Thyroid Pituitary Exercise and diet PCOS
26
Medical mangement of stress urinary incontinence
Duloxetine
27
Interventional procedures for stress urinary incontinence
Urethral bulking Midurethral sling Colpsuspension
28
Types of Pelvic organ prolapse
Anterior Vaginal wall: urethrocele, cystocele Posterior vaginal wall: rectocele, cystocele Apical vaginal (vault prolapse, post-hysterectomy) Uterine (I-IV)
29
Overactive bladder medical mx
Antimuscarinics: Tolterodine XL 4mg OD Solifenacin 5mg - 10 OD Trospium XL 60 mg OD Mirabegron 50 mg PO OD
30
HPV vaccines
Cervarix Gardasil (6,11,16,18)
31
Cervical cancer risk factors?
HPV COCP Smoking Immunosuppression low social class
32
What type of cancer is the majority of cervical
80% squamous, 20 adeno
33
Endometrium cancer risk factors
Unopposed E2 FHx: HNPCC
34
Conditions with increased Oestrogen (E2) exposure
Early menarche/ late menupause Nulliparity Obesity HRT PCOS Tamoxifen Liver cirrhosis
35
How obesity increases E2 exposure
adipose tissue produces E2
36
Presentation of endometrial cancer
post menopausal bleed Abdnormal pre/peri menopausal bleed
37
Vulval cancer presentation
Long history of itch and irritation Lump/ ulcers bleeding / pain
38
Ovarian cancer presentation
Dyspepsia Increased abdominal girth Altered bowel habits Anorexia Cachexia
39
Trachelectomy
remove cervix anastomise vagina and utrerus
40
Average life expectancy for an untreated HIV patient
10-12 yrs
41
Average life expectancy for a treated HIV patient
near normal 2-10 yrs less
42
When to test for HIV
at 4 weeks post exposure if v high risk, also at 8 week post exposure
43
What is PEPSE
Post exposure prophylaxis after sexual exposure
44
When to take PEPSE
within 72 hours of exposure HIV test 8-12 weeks post exposure
45
How long is a course of PEPSE
1 month
46
What drugs used in PEPSE
Truvada od Raltegravir bd
47
PrEP
Pre-exposure prophylaxis for HIV taken before sex
48
Diagnosis of chlamydia
NAAT: First catch urine in men Vaginal or endocervical swab in women
49
Rx of chlamydia
doxycycline 100 mg bd 7/7 or azithromycin 1g
50
Gonorrhoea diagnosis
NAAT: First catch urine in men High Vaginal or endocervical swab in women
51
Gonorrhoea Rx?
Ceftriaxone 500 mg IM AND Azithromycin 1g PO
52
Transmission of genital warts?
skin to skin
53
Pathogen causing genital warts
HPV 6, 11
54
Mx of genital warts
Podophyllotoxin (warticon) Cryotherapy Imiquimod (aldara- immune modulator)
55
What causes lymphogranulumoa venereum
Chlamydia tracchmoatis serovars L1-3 Results in local destruction and lymphadenopathy
56
What is this
Molluscum contageosum Pink raised lesions on skin
57
How is Molluscum contageosum transmitted
skin to skin
58
What is this
genital warts
59
What is this
genital Herpes
60
What is this
scabies
61
scabies transmission
skin to skin
62
Scabies caused by
Mite sarcoptes scabiei
63
What causes the itch in scabies
mite poo into skin capillaries causing hypersensitivity
64
Managment of scabies
Topical : permethrin/ malathion avoid contact with partners wash clothes from last 4 days at 60 C Itch mx: crotamiton cream
65
Mx of pubic lice
Malathion (leave on for 2-12hrs) Permethrim (rinse after 10 mins) Phenothrin (wash off after 2hrs)
66
oro-labial herpes causes
HSV1
67
Genital herpes cause
HSV2
68
Which HSV recurrs more frequently
HSV 1 | (\<1/yr vs 2-3 yr)
69
Diagnosis of HSV
swab from lesion
70
Rx for HSV
`Aciclovir for 5 days - either 400 mg TDS - or 200mg 5 times/day
71
What is this
syphilis
72
Dx of syphilis
Dark ground microscopy or serology
73
Mx of syphilis
Benzathine penicillin or doxyccyline
74
Window for DNA retrieval for adults and children after sexual assault
adults 7 days children 3 days
75
Clomiphene use?
Induce ovulation in anovulatory infertility
76
Danazol use?
Treat endometriosis
77
Rx of anovulatory infertility (PCOS)
Clomifene Metformin Ovarian diathermy GnRH analogues
78
Prevention of pre-eclampsia
Aspirin start at 12th week (reduces the risk of pre-eclampsia development)
79
Normal endometrial thickness
\<4 mm
80
Contraceptive needs post menopause
No need if: \<50 yo: 2 years of no periods \>50 yo: 1 year of no period
81
Mech of action of copper coil
decrease sperm utility and survivlal
82
IUS mech of action
prevents endometrial proliferation thickens cervical mucous
83
When to give anti-D
First dose at 28 wks Second at 34 wks
84
When should offer ECV
Prim: after 36 wks Multip: after 37 Before may change spontaneously
85
Which contraception to give post-menupause
IUS Dont give COCP to older than 40 yo
86
Sheehans syndrome
Pituitary grows during pregnancy Sudden drop in BP post-partum causes necrosis
87
Asherman's syndrome
Scarring of the uterus (iatrogenic) endometrium doesn't respond to E2 as well
88
Krukengberg tumours
GI tumour, mets to ovaries Signet ring cells
89
Meig's syndrome
benign ovarian tumour ascites pleural effusion spindle shaped fibroblast
90
Insertio velamentosa
Umbilical cord vessels pass through amniotic membrane before entering placenta
91
Haematometra
Blood collected inside uterus (due to imperforate hymen)
92
Snowstorm USS
molar pregnancy
93
Order of fetal distress ix
Doppler/CTG Scalp electrode FBS Deliver
94
Forceps vs Ventouse
Forceps- quicker, more damaging Ventouse- when fetus not distressed and there is time
95
Early vs Late syphillis
early \<2yrs late \>2yrs
96
Mx of early syphillis
Single dose Pen G/Benpen
97
Mx of late syphillis
BenPen once wkly for 3 wks
98
Secondary syphillis sx
Rash Fever Joint pain Malaise Condylomata lata
99
Condylomata lata
Wart like lesion
100
Gummatous syphillis
plaques in all solid organs
101
Pre-mensutrual syndrome
AKA premenstural tension headache depression
102
Depression post birth
Baby blues days Puerperal depression/psychosis wks Postnatal depression months
103
Uterine prolapse degrees
1st: cervix above introitus 2nd degree: cervix at introitus 3rd degree: cervix below introitus 4th degree: cervix, uterus and vaginal prolapse
104
Introitus
Vaginal opening that leads to the vaginal canal
105
Chorionic villous sampling date
From 11 wks
106
Amniocentesis date
From 15 wks
107
Primary vs secondary dysmenorrhoea
Primary: pain before mensturation Secondary: pain before and during menstruation
108
Treatment dysmenorrhoea
COCP Mefanemic acid
109
PROM mx
Admit Pen/Erythromycin for 10 days Corticosteroids Consider delivery after 34 wks
110
RFs for neural tube defects
Obesity NTD Hx/FHx Sodium Valproate Coeliac Thalasaemia trait
111
Strawberry cervix
trichomonas vaginallis infection
112
Clue cells
Bacterial vaginitis
113
Flagellated protozoa STI
Trichomonas vaginallis
114
Gram -ive rods STI
chlamydia
115
Gram -ive dipplococci STI
Gonorrhoea

MS4 - OnG (5 decks)

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