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ACMMCQ-my Qbank > OBGYN > Flashcards

OBGYN Flashcards

1
Q

In the absence of an ultrasound scan assessment and measurement of crown-rump
length before 18 weeks

A

First trimester clinical assessments of uterine size provide a more accurate assessment of gestation than any of the other options given,

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2
Q

Recurrent urinary infection related to sexual activity

A

-The most common antibiotics used are trimethoprim or nitrofurantoin
-Prophylactic postcoital therapy is as effective as continuous therapy.

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3
Q

Pyelonephritis in pregnancy

A

-Affects approximately 2% of patients.
-When unilateral, more common right sided
-Symptoms include anorexia, nausea and vomiting.
-Escherichia coli is the predominant causative micro-organism
-not related to any change in the immune status

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4
Q

Chlamydia infection during pregnancy, Tx

A

Erythromycin

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5
Q

MC non-bacterial intrauterine fetal infection

A

CMV

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6
Q

Toxic shock syndrome associated with tampon usage

A

Staphylococcus aureus

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7
Q

whenever the abdomen is opened for an apparent clinical diagnosis of acute appendicitis and
no other intra-abdominal cause is apparent on inspection, Tx

A

Appendicectomy and incision closure.

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8
Q

Although there is immunological suppression in pregnancy, this does not result in suppression of the localising signs of acute appendicitis.

A
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9
Q

Multiple pregnancy related risk

A

-Peirinatal morbidity
-Premature
-Feto-feto transfusion
-Postpartum haemarrhage
-IUGR
-Umbilical cord prolapse

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10
Q

The D antigen present on erythrocytes of Rh (+) is at

A

7 weeks of gestation

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11
Q

Best evaluation regarding foetus of a Rh(-) pregnant woman

A

-20-26 weeks, fetal blood sampling
-26-34 weeks, liquor bilirubin level

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12
Q

Recurrent glycosuria in pregnancy, Tx

A

A full glucose tolerance test should be performed
when glycosuria is found on two or more occasions.

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13
Q

Pancreatitis during pregnnacy, mc cause

A

cholelithiasis

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14
Q

Cholastasis

A

-Intrauterine fetal demise
-Fetal growth restriction
-Premature labor; preterm birth
-Recurrence in subsequent pregnancies

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15
Q

Assessment of an unresponsive young pregnant woman

A

-Respiratory status
-Level of consciousness
-presence of bleeding
-assessment of possible shock
-assessment of fetal viability

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16
Q

Labour may be obstructed by

A

-Distended urinary bladder
-Ectopic or pelvic kidney
-Ovarian tumours
-Myomata (uterine fibroids)

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17
Q

The obstruction whcih may occur with non-immune hydrops is not at the shoulder level but at the lower chest-abdominal level

A
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18
Q

A pudendal anaesthetic block

A

S2, 3, 4

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19
Q

Best sign for monitoring adequacy of blood volume replacement.

A

Urine output

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20
Q

Most useful diagnostic testing in the shortest time for a life-threatening uterine postnatal bleeding

A

Observation of clotting and estimation of the whole blood clotting time

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21
Q

Uterine inversion

A

-Brisk postpartum hemorrhage
-Abrupt profound shock out of proportion to the bleeding
-Lower abdominal pain
-Round mass (inverted uterus) protruding from the cervix or vagina
-Absent fundus (top of the uterus) at the periumbilical position during transabdominal palpation

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22
Q

Highest maternal mortality complication

A

Primary pulmonary hypertension (50%)

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23
Q

Puerperium

A

-Colostrum for 2-3 days
-Vascular and lymphatic engorgement of the breasts
-Transient leucocytosis

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24
Q

Psychotic depression associated with pregnancy

A

Within a month after delivery

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25
Q

Low Apgar score at 1min and 5min indicate

A

The infant needs resuscitation

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26
Q

Tx for apnoea of prematurity

A

Theophylline and caffeine

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26
Q
A
27
Q

Tx for apnoea due to narcotic suppression (pethidine)

A

Naloxone

28
Q
A
28
Q

Recurrence rate of previous open spina bifida if not taking prophylactic folate therapy

A

2-5%

29
Q

Danazol teratogen effect

A

Androgenisation of the female fetus.

30
Q

Nalidixic acid is not considered to be teratogenic and can be used to treat urinary infections in pregnancy without adverse fetal effects.

A
31
Q

Characteristics of inevitable abortion

A

Vaginal bleeding with cramping and an open cervix.

31
Q

Cervical incompetence can present as follows:

A

-Painless cervical dilatation
-Increased cervical mucous discharge associated with cervical dilatation
-Premature rupture of the membranes
-Second trimester miscarriage after a virtually painless labour
-Premature labour and/or delivery

32
Q

chance of miscarriage post invasive procedure

A

-CVS: 1/100
-Amniocentesis: 1/200

33
Q

Manifestation of imperforate hymen

A

-Cyclic lower abdominal pain
-Urinary retention
-Diffuse lower abdominal pain
-Lower abdominal distension

34
Q

Danazol

A

Progestegen derived from testosterone, androgenic side effect of weight gain, fluid retention, acne and voice change, androgenice a female uterus, treatment of endometriosis and menorrhagia

35
Q

An inhibited sexual excitement phase in marital sex, cause

A

Merital discord

36
Q

Benefits of taking contraceptive pills

A

-Excellent contraception
-Reduced dysmenorrhoea
-Reduced iron-deficiency anaemia
-Reduced menstrual loss
-Reduced benign breast disease
-Reduced functional ovarian cysts
-Reduced ovarian and endometrial cancer
-Reduced pelvic inflammatory disease.

37
Q

Pearl index

A

The number of pregnancies in 100 women using the particular contraceptive method for 1 year (i.e. pregnancies per 100 women years).

38
Q

The MC cause of death atributable to tubal sterilisation

A

Anaesthesia

39
Q

Primary amenorrhoea: cause

A

Turner Syndrome

40
Q

Dysmenorrhoea

A

-Commencing prior to menses and persisting for the first 1-2 days of the period)
-One of the MC gynaecological disorders
-Commonly relieved considerably with anti-prostaglandin preparation
-Secondary dysmenorrhoea is secondary to one of the organic causes
-Placebo treatment provides symptomatic relief to 20-50% of patients

41
Q

Galactorrhoea in a multigravid woman with normal prolactin and normal menstrual cycles

A

Reassurance

42
Q

Responses used to detect the timing of ovulation

A

-Detection of a rise in plasma LH at midcycle
-Alteration in cervical mucus
-Plasma oestradiol peak at mid cycle

43
Q

Response of ovulation has occurred

A

-An elevated plasma progesterone (more accurate)
-A biphasic temperature chart

44
Q

Best predictor of ovulation

A

Regular periods with some dysmonorrhoes

45
Q

Copious, clear, elastic cervical mucus

A

effective amount of oestrogen

46
Q

Reduced, thick, cellular, non-elastic mucus

A

Production of progesterone

47
Q

Hyperprolactinaemia

A

-Stress response
-Concomitant phenothiazine administration
-PCOS
-A pituitary or suprapituitary adenoma

48
Q

MC site of endometriosis

A

-Ovaries
-Uterosacral ligaments
-The pelvic peritoneum
-The Pouch of Douglas.

49
Q

Age of menopause

A

Genetically determined

50
Q

Severity of vasomotor symptoms (hot flushes) is directly correlated with

A

-Menopause before 40 yeas old
-A low percentage of body fat
-Low serum oestrone level
-Low serum levele os oestradiol bound to non-sex hormone-binding globulin (non-SHBG)

51
Q

Low serum levels of GnRH

A

Increased/more endogenous oestrogen production

52
Q

The amount of calcium required for normal calcium balance after menopause.

A

approximately 1g/day

53
Q

Calcium supplementation, in postmenopausal women, is poorly absorbed and thus relatively ineffective in preventing bone loss

A

and has little impact on trabecular bone re-absorption

54
Q

The MC micro-organism causing
septic shock in obstetrics and gynaecology

A

E coli

55
Q

Adenomyosis

A

-MC found between the ages of 35 and 50
-The adenomyotic glands respond poorly to
hormonal suppression

56
Q

First step of menorrhagia

A

Uterine curettage

57
Q

Menorrhagia in a 45-year-old woman with irregular periods

A

Anovulatory cycles

58
Q

A 5cm unilocular ovarian cyst in a 25-year-old asymptomatic woman

A

-Reexamine in 6 weeks
-then CA125
-A trial of hypothalamic/pituitary suppressive therapy with acombined oral contraceptive pil considered or laparoscopic assessment and/or removal fothe cyst arranged.

59
Q

MC invasive malignancy found in the vagina

A

-Extension of squamous carcinoma spread from the cervix

60
Q

Regular narcotic usage is commonly required for pain relief ni gynaecological cancers. Its MOST TROUBLESOME side-effect

A

Constipation

61
Q

MC postoperative complications after major gynaecological surgery

A

-Urinary tract infection
-Vaginal vault haematoma
-Pneumonia
-Deep venous thrombosis
-Hydronephrosis due to ureteric damage or obstruction

62
Q

Side effect of OCPs

A

-Increase risk of hypertension
-VTE
-Hepatic adenoma
-Myocardial infarction
-Stroke

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