O&G revision lecture

Question 1

What does FSH do in the follicular phase?

Answer 1

Stimulates development of the follicles and granulosa cells to produce oestrogen

Question 2

What does oestrogen do to the follicles?

Answer 2

Inhibits FSH production

Question 3

When does the LH surge occur?

Answer 3

Occurs 36 hours before ovulation

Question 4

What does the corpus luteum produce and what does this do?

Answer 4

The corpus luteum produces progesterone which is needed for the uterus lining

Question 5

What causes growth of the endometrial glands and stroma?

Answer 5

Oestrogen

Question 6

Which antibodies would you see in anti-phospholipid syndrome?

Answer 6

Anticardiolipin, lupus anticoagulant

Question 7

Definition of spontaneous miscarriage

Answer 7

Expulsion of products of conception before 24 weeks of gestation

Question 8

Causes of polyhydramnios

Answer 8

Duodenal atresia

Anencphaly

Question 9

If the ovum is fertilised, what will is produce to maintain the corpus luteum?

Answer 9

If the ovum is fertilised, the implanted embryo will produce HCG, which maintains the corpus luteum

Question 10

Medications, which can cause renal hypoplasia

Answer 10

Diuretic

ACEi

Question 11

Characteristic triad of pre-eclampsia?

Answer 11

Hypertension, oedema and proteinuria (>0.3g/L)

Question 12

If someone has pre-eclampsia and epigastric/RUQ pain what should you consider?

Answer 12

HELP

Question 13

This medication is an alpha and beta-blocker

Answer 13

Labetalol

Question 14

Nifedipine mechanism of action

Answer 14

CCB

Question 15

Hydralazine mechanism of action

Answer 15

Vasodilator

Question 16

Methyldopa mechanism of action

Answer 16

Centrally acting alpha agonist

Question 17

Treatment of eclampsia?

Answer 17

IV labetalol and IV hydralazine

Question 18

How does magnesium sulphate work?

Answer 18

Works by decreasing Ca2+ uptake by smooth muscle

Question 19

Medication you can give to reverse effects of magnesium sulphate?

Answer 19

Calcium gluconate

Question 20

When would you want to provide active management for the 3rd stage of labour, and how would you do it?

Answer 20

Prolonged if lasts >30 minutes
Consider prophylactic oxytocin or ergometrine, cord clamping, controlled cord traction, empty bladder, oxytocin into cord

Question 21

EDFIERE

Answer 21

Engages
Descent
Flexion
Internal rotation
Extension
Resuscitation
Expulsion

Question 22

Bishops score <6

Answer 22

Labour unlikely to start spontaneously

Question 23

Bishops score >8

Answer 23

Vaginal delivery likely

Question 24

What does a foley catheter do?

Answer 24

Manually dilates the cervix

Question 25

What is an amniotomy and why is it good?

Answer 25

This is artificial rupture of membranes - stimulates prostaglandin synthesis

Question 26

Medications you can give for stimulating labour?

Answer 26

Oxytocin/syntocinon/ergometrine

Question 27

Risks of giving oxytocin/syntocinon/ergometrine?

Answer 27

Risk of hyperstimulation (this can increase risk of foetal distress/uterine rupture) and vasopressin-like effect causing anti-diuresis

Question 28

What is atosiban?

Answer 28

Oxytocin receptor antagonist

Question 29

What is indomethacin?

Answer 29

Prostaglandin synthesis inhibitor

Question 30

Name three drugs that can be used to inhibit labour?

Answer 30

Atosiban, terbuatline, indomethacin

Question 31

You can sometimes used bethamethasone in tocolysis, but when is it contraindicated?

Answer 31

Contraindicated in maternal or foetal bleeding or distress

Question 32

What pH would you like the fetal scalp to be?

Answer 32

Ideally >7.25

Question 33

How do you diagnose syphilis?

Answer 33

Serology

Question 34

What does IgM ELISA mean?

Answer 34

Recent untreated infection (i.e. active disease)

Question 35

What does TPPA mean?

Answer 35

Indicates ever infection

Question 36

What does VDRL mean?

Answer 36

Active infection

Question 37

This procedure carries a risk of placental mosaicism

Answer 37

Chorionic villus sampling

Question 38

Can be used to detect cytogenic abnormalities and measure amniotic AFP

Answer 38

Amniocentesis

Question 39

When do you need to offer emergency contraception for in cases with the combined contraceptive patch?

Answer 39

Need to offer emergency contraception if patch has been off for more than 48 hours and there has been unprotected sexual intercourse within the last 5 days

Question 40

When do you need to offer emergency contraception in people using the contraceptive vaginal ring?

Answer 40

Need to offer EC if ring has been left out of vagina for more than 3 hours in weeks 1 or 2 and there has been UPSI in the 7 days before this