obs and gynae

Question 1

when do you start contraception after taking levonorgestrel emergency pill

Answer 1

can start it immediately after

Question 2

up to what week in pregnancy is considered a miscarriage

Answer 2

up to 24 weeks

Question 3

what marks the end of the first stage of labour

Answer 3

cervix dilated to 10cm

Question 4

what is the most common cause of postpartum pyrexia

Answer 4

endometritis

Question 5

first line menorrhagia

Answer 5

IUS

Question 6

tx of baby losing >10% weight in first week of life

Answer 6

refer to midwife led breastfeeding clinic

Question 7

fluids given in hyperemesis gravidarum?

Answer 7

saline + potassium as hypokalaemia is common

Question 8

rf for perineal tears

Answer 8

primigravida
large babies
precipitant labour
shoulder dystocia
forceps delivery

Question 9

which form of HRT does not increase the risk of VTE

Answer 9

transdermal HRT

Question 10

most common cause of early onset neonatal sepsis

Answer 10

group B strep

Question 11

what consideration is important before prescribing metocloperamide for hyperemesis gravidartum

Answer 11

avoid use for more than 5 days as risk of acute dystonia
ie extrapyramidal side effects

Question 12

HB cut off for post partum females

Answer 12

<100g/L

Question 13

first line medical mx of infertility in PCOS

Answer 13

clomifene

metformin is second line !!

Question 14

combined test for downs syndrome

Answer 14

nuchal transparency
beta HCG
PAPPA

Question 15

quadruple test for downs syndrome

Answer 15

AFP
unconjugated oestriol
human chorionic gonadotrophin
inhibin A

Question 16

moderate RF for pre-eclampsia

Answer 16

first pregnancy
age 40 years or older
pregnancy interval of more than 10 years
body mass index (BMI) of 35 kg/m² or more at first visit
family history of pre-eclampsia
multiple pregnancy

Question 17

high RF for pre-eclampsia

Answer 17

hypertensive disease in a previous pregnancy
chronic kidney disease
autoimmune disease, such as systemic lupus erythematosus or antiphospholipid syndrome
type 1 or type 2 diabetes
chronic hypertension

Question 18

when should a pregnant lady be prescribed aspirin for pre-eclampsia risk reduction

Answer 18

if >1 high risk factors
>2 moderate RF

Question 19

in labour, when can an external cephalic version be attempted?

Answer 19

if the amniotic sac hasnt ruptured and isnt in active labour (>4cm dilated)

Question 20

most common cause of vulval itching?

Answer 20

contact dermatitis

Question 21

admission criteria for hyperemesis G?

Answer 21

Failure of oral antiemetics to control symptoms, ketonuria and weight loss (>5% of pre pregnancy body weight)

Question 22

mx of pregnant woman with previous VTE hx

Answer 22

LMWH throughout pregnancy until 6 weeks postnatal

Question 23

how many days barrier contraception needed when switching from POP to COCP

Answer 23

7 days

Question 24

side effect of GNRH agonist

Answer 24

loss of bone mineral density
hot flashes
vaginal dryness

Question 25

thresholds for OGTT and fasting glucose in gestational diabetes

Answer 25

fasting >5.6 OGTT >7.8

Question 26

routine recall for smear for diff age groups?

Answer 26

Age 25–49 years — screening every 3 years Age 50–64 years — screening every 5 years

Question 27

treatment for premenstrual syndrome

Answer 27

drospirenone-containing COC taken continuously

Question 28

abx for PPROM

Answer 28

10 days erythromycin

Question 29

management for magnesium sulphate induced respiratory depression

Answer 29

calcium gluconate

Question 30

which cancer is at higher risk when prescribing a progesterone and oestrogen HRT

Answer 30

Breast

Question 31

if not started on first day of period, ho long does it take the diff types of contraceptive to be effective?

Answer 31

instant: IUD 2 days: POP 7 days: COC, injection, implant, IUS

Question 32

most common type of ovarian cancer

Answer 32

serous carcinoma

Question 33

blood glucose targets gestational diabetes

Answer 33

FBG <5.3 OGTT <6.4 if not met with diet/exercise - start insulin

Question 34

flying and pregnancy?

Answer 34

dont if: - >37 weeks, singleton, uncomplicated >32 weeks twin preg if longer than 4 hours = compression stockings advisable if VTE risk -> LMWH may be needed

Question 35

non-hormonal treatment for menorrhagia

Answer 35

Painless menorrhagia - Tranexamic acid PainFul menorrhagia - MeFenamic acid

Question 36

placental abruption <36 weeks with no signs of fetal distress -> MX?

Answer 36

admit and admin steroids no tocolysis threshold to deliver will depend on gestation

Question 37

placental abruption >36 weeks -> MX?

Answer 37

if distress = c section no distress = vaginal delivery

Question 38

contraceptive patch advise

Answer 38

Contraceptive patch regime: wear one patch a week for three weeks and do not wear a patch on week four for first 3 weeks wear every day then can be changed weekly if delayed change more than 48 hours in 1st or 2nd week then change immediately, use barrier contraception 7 days, if UPSI in last 5 days = emergency

Question 39

placenta percreta

Answer 39

the chorionic villi invade through the perimetrium

Question 40

BP target for hypertension in pregnancy

Answer 40

135/85

Question 41

results for trisomy testing

Answer 41

Low alpha fetoprotein (AFP) Low oestriol High human chorionic gonadotrophin beta-subunit (-HCG) Low pregnancy-associated plasma protein A (PAPP-A) Thickened nuchal translucency high inhibin A

Question 42

what is sheehans syndrome

Answer 42

postpartum hypopituitarism - ischaemic necrosis of the pituitary gland following PPH symptoms - lack of menstruation and lactation - hypothyroidism

Question 43

why do fibroids grow in pregnancy

Answer 43

due to increased oestrogen levels which drives its growth

Question 44

how to estimate a mid-luteal date for progesterone testing

Answer 44

7 days before end of regular cycle

Question 45

indications of CTG tracing during delivery

Answer 45

suspected chorioamnionitis or sepsis, or a temperature of 38°C or above severe hypertension 160/110 mmHg or above oxytocin use the presence of significant meconium fresh vaginal bleeding that develops in labour - this was a new point added to the guidelines in 2014

Question 46

which contraception shoudl be used in caution with asthma

Answer 46

ulipristal -> ella one

Question 47

what week is earliest ECV can be offered

Answer 47

36 weeks

Question 48

Rokitansky protuberance on abdominal US indicates what pathology?