obs and gynae

Question 1

first line management for urge incontinence

Answer 1

oxybutynin, anti-muscarinic agent on smooth muscle

Question 2

management for urge in continence if first line is contraindcated

Answer 2

mirabegron- is a potent and selective agonist of beta-3 adrenergic receptors

Question 3

management for stress incontinence

Answer 3

duloxetine

Question 4

pt with a previous history of caesarean and pelvic inflammatory disease presents with delayed third stage of labour what is the diagnosis

Answer 4

hysterectomy in situ

Question 5

difference between cholestasis of pregnancy and acute fatty liver

Answer 5

acute fatty liver is generalised symptoms and jaundice while cholestasis during pregnancy presents with severe pruritis

Question 6

difference between IUS and IUD

Answer 6

IUD makes periods heavier, IUS makes them lighter and you can use them in people with hypertension

Question 7

what do you use for those in a low mood before menstruation but improves after menstruation

Answer 7

new COCP

Question 8

first and second line for premenstrual syndrome

Answer 8

1) new COCP 2) SSRI

Question 9

first line treatment for suspected VTE/DVT in pregnancy

Answer 9

LMWH

Question 10

what should pregnant patients with suspected VTE/DVT be tested for when under 50kg or over 90kg

Answer 10

anti-xa activity and platelet count

Question 11

What is the UKMEC 1 and 5

Answer 11

no restriction to use the COCP and unacceptable to use the COCP

Question 12

protocol if you see female genital mutilation

Answer 12

call the police

Question 13

When do you need to take aspirin during pregnancy

Answer 13

12 weeks till delivery if you have 2 moderate risk factros or 1 high risk of preeclampsia

Question 14

what does smelly discharge indicate

Answer 14

STI

Question 15

all patients with secondary dysmenorrhea should….

Answer 15

referred to gynaecology

Question 16

does PPH look at birth of the baby or the placenta

Answer 16

baby

Question 17

after how many weeks would you give an immediate ultrasound if there is no fetal heartbeat or reduced movements

Answer 17

28/30

Question 18

In which two disorders would you find cervical excitation

Answer 18

PID and ectopic pregnancy

Question 19

What is vaginal bleeding, a firm fixed uterus and maternal shock a sign of

Answer 19

placental abruption

Question 20

Which of the following have to be stopped during pregnancy: metformin, glicazide

Answer 20

glicazide

Question 21

Which cancers is COCP a risk factor for

Answer 21

breast and cervical

Question 22

Which cancer is COCP protective against

Answer 22

endometrial and ovarian

Question 23

what is the difference between primary and secondary dysmenorrhea

Answer 23

primary is with menustration and secondary is before

Question 24

pain gets better after period

Answer 24

endometriosis

Question 25

first line investigation for endometriosis

Answer 25

laproscopic

Question 26

What are the risk factor for post partum haemorrhage

Answer 26

multiparous, parity over 4, placental abruption, placental pravia, ecclampsia, macrosomia

Question 27

What is the most common cause of PPH and how is it seen

Answer 27

uterine atophy and high soft uterus

Question 28

what is the mechanical management of PPH

Answer 28

rubbing the uterus and catheterisation

Question 29

What is the medical management of PPH

Answer 29

ergoteramine, oxytocin, crabtoperol and tranzexamic acid

Question 30

What is the surgical management for PPH

Answer 30

intrauterine balloon tamponade, hysterectomy and uterine artery ligation

Question 31

what is secondary post partum haemorrhage

Answer 31

500ml of blood loss from 24 hours - 12 weeks postpartum

Question 32

What are the two most common causes of secondary post partum haemorrhage

Answer 32

infection like endometriosis and retained tissue

Question 33

string of pearls on ultrasound

Answer 33

PCOS

Question 34

role of clomiphene

Answer 34

stimulant of FSH

Question 35

which contraception should you not use in high risk of breast cancer, uncontrolled hypertension and migrane without aura

Answer 35

COCP

Question 36

which contraception can we not use in people with PID or wilsons disease and only use after a screenign or chylamydia and gonorrhoea

Answer 36

mirena

Question 37

what does FSH over 10 suggest

Answer 37

reduced ovarian follicles

Question 38

what does FSH over 40 suggest

Answer 38

premature ovarian failure

Question 39

which contraceptive method acts immediately

Answer 39

IUD

Question 40

which contraception works after 2 days

Answer 40

progesterone only pill

Question 41

which contraception works after a week

Answer 41

injection, implant, combined oral contraceptive and IUS

Question 42

management in pregnany women with VTE prophylaxis

Answer 42

take LWMH until 6 weeks postnatally

Question 43

treatment for epileptics during pregnancy

Answer 43

lamotrigine

Question 44

treatment for nausea and vomiting during pregnancy

Answer 44

promethazine

Question 45

first line treatment for endometriosis

Answer 45

NSAID's and if this doesnt work give COCP

Question 46

appendicits pain is unlikely to be of sudden onset

Question 47

bishops score

Answer 47

Cervical position Posterior Intermediate Anterior - Cervical consistency Firm Intermediate Soft - Cervical effacement 0-30% 40-50% 60-70% 80% Cervical dilation <1 cm 1-2 cm 3-4 cm >5 cm Fetal station -3 -2 -1, 0 +1,+2 Interpretation a score of < 5 indicates that labour is unlikely to start without induction a score of ≥ 8 indicates that the cervix is ripe, or 'favourable' - there is a high chance of spontaneous labour, or response to interventions made to induce labour

Question 48

first HPV test is high risk but negative and second test is negative

Answer 48

normal recall

Question 49

first HPV is high risk but negative and second test is that same

Answer 49

repeat smear in 12 months

Question 50

first HPV is high risk but negative and second test is that same

Answer 50

repeat smear in 12 months

Question 51

first line management for gestational diabetes

Answer 51

metformin

Question 52

fasting glucose is still more than 5.6mmol/L on metformin

Answer 52

start insulin

Question 53

which day on the cycle can an IUD be inserted

Answer 53

any day during the cycle

Question 54

what to do in a rhesus negative women who is pregnant

Answer 54

one dose anti D immunoglobulin followed by a Kleihauer test

Question 55

meig's syndrome

Answer 55

benign ovarian syndrome, pleural effusion and ascietes

Question 56

why should metoclopromide not be used for more than 5 days

Answer 56

its can lead to increased upper muscle tone or extrapyramidal side effects

Question 57

medical management for ectopic pregnancy

Answer 57

oral methotrexate

Question 58

first line treatment for left over products of conception

Answer 58

vaginal misopristol and second line is surgical vaccum

Question 59

A cut-off of ---g/Lshould be used in the postpartum period to determine if iron supplementation should be taken

Answer 59

100

Question 60

fetal head is not engaged and high

Answer 60

placental praevia

Question 61

maternal and fetal tachycardia and maternal pyrexia

Answer 61

chorioamnionitis

Question 62

what are the risk factors for endometrial and cervical cancer

Answer 62

endometrial: polycystic ovarian syndrome cervical: parity

Question 63

how does placenta accreta

Answer 63

a woman who has had two previous caesarean sections develops massive bleeding shortly after giving birth a 30-year-old woman develops a massive post-partum haemorrhage. An emergency hysterectomy is performed. Pathological examination demonstrates that the placenta is attached to the myometrium

Question 64

painless vaginal bleeding

Answer 64

placental praevia

Question 65

risk caused by tamoxifen

Answer 65

endometrial cancer

Question 66

ectopic pregnancy bhcg levels

Answer 66

more than 1500 is ectopic pregnancy

Question 67

fibroids less than 3cm, not distorting the cavity

Answer 67

less than 3cm medical management like COCP, IUS and mirena, and more than 3cm is a myomectomy

Question 68

characteristics cervical ectropion

Answer 68

endocervix(columnar part) is exposed outside, excess discharge that is not purulent, can result in post-coital bleeding, increased in those who use COCP and are pregnant,