Obs And Gynae

Question 1

What needs to be done before pelvic exam in patient with antepartum haemorrhage

Answer 1

Exclude placenta Previa

Question 2

What are contractions like in placental abrupt ion

Answer 2

Continuous (due to blood irritation)

Can differenTiate between this and Previa

Question 3

Difference between lower and upper uterus.

Relation to placenta Previa

Answer 3

Upper has more muscle - prevent too much bleeding from placenta

Previa - lower - increased bleeding

Question 4

What is TORCH in pregnancy

Answer 4

toxoplasmosis, rubella, cytomegalovirus, herpes simplex, and HIV, but it can also include other newborn infections.

Question 5

Where do cervical cancers occur and why

Answer 5

Transformation zone

Cells are pluripotent and can form columnar / squamous epithelium

Question 6

What is looked at on a cytology report of smear test

Answer 6

The nucleus : cytoplasm ratio

Big nucleus due to cells dividing quicker (not having time for cytoplasm to increase)

Question 7

Why does acetic acid turn areas of high nuclei white

Answer 7

‘Chemical cooking ‘ of protein (DNA) - like egg white cooking

Question 8

Stages of smear dyskaryosis

Answer 8

Normal 
Low grade dyskaryosis 
High grade 
Glandular dyskaryosis 
?malignant cells

Question 9

Why can’t a smear test diagnose malignancy and only ? It ?

How can you confirm diagnosis

Answer 9

Malignant must invade basement membrane / mucosa

Need a biopsy to confirm

Question 10

Sugar imbalance after giving steroids

Answer 10

Hyperglycaemia (even more if diabetic)

Question 11

Hypo vs hyper glycemic - which is worse for baby/ mother

Answer 11

Hyper kills baby

Hypo kills mother

Question 12

Why are steroids given in premature labour

Answer 12

Help mature lungs (surfactant ) therefore preventing respiratory distress syndrome

Question 13

How does a long labour increase risk of pph

Answer 13

Thinning of uterine muscle (which usually contracts to prevent blood loss)

Question 14

What should be measured in prolonged labour and why does it change? And where from ?

Answer 14

Ph as may be using anaerobic metabolism -> acidotic

Babies scalp

Question 15

Why can’t you give oxytocin if there is no ROM

Answer 15

Can lead to amniotic embolism -> lungs -> death

Question 16

What triosmies are screened for ? Chromosomes affected?

Answer 16

Downs 21
Edwards 18
Pataus 13

Question 17

Features of Edwards triosmy

Answer 17

Overlapping fingers, prominent occipit / heels, small mouth, flexed big toe

Question 18

Features of pataus

Answer 18

Small head, absent eyebrows, cleft lip/ palate, clenched hand, polydactyly, undescended / abnormal tests

Question 19

What does clomid do ? How ?

Answer 19

Stimulates ovulation by acting as anti oestrogen (prevents -ve feedback)

Question 20

What can be given to prevent seizures after birth post severe pre eclampsia ? Side effect?

Answer 20

Magnesium sulphate

Makes baby sleepy

Question 21

Glucose tolerance test scores in GDM

Answer 21

5678

Fasting 5.6 , random 7.8

Question 22

What can be given to reduce beeding in menorrhagia

Answer 22

Mefenamic acid (NSAID)

Question 23

What blood test can check whether someone is ovulating

Answer 23

Day 21 progesterone (must be >30)

Question 24

What can make blood hyper coagulable (already increased) during pregnancy

Answer 24

Sepsis

Question 25

How does ovarian torsion present

Answer 25

Pain which localises to L /R

50% vomit , 50%diarrhoea, slight pyrexia

Question 26

Risk factors for ovarian torsion

Answer 26

Cysts, young, old, fertility treatment

Question 27

How long after event does PID usually present and how?

Answer 27

2/52, 75% vaginal discharge, pain on sex

Question 28

How does a degenerating fibroid present?

What is found on bloods

Answer 28

Abdo pain and heavy bleeding, may get a temp

Increased platelets and decreased Hb

Question 29

Management of ovarian torsion

Answer 29

Laparoscopic surgery to untort / remove

Question 30

Treatment of acute PID

Answer 30

Broad spectrum and review for 72hrs

Question 31

2 types of c section scar

Answer 31

Pallen steel - curved , 2cm above pubic symphysis

Joel - straight , 3cm above (stretched open)

Question 32

Why can’t methotrexate be given in pregs

Answer 32

Folate inhibitor

Question 33

Why can’t retinoids be given in pregnancy

Answer 33

Affects pharangeal arches - ears and face ….

Question 34

Why can’t ACEi be given in pregs

Answer 34

Renal impairment and oligoaminos

Question 35

Rapid acting and long acting egs of insulin

Answer 35

Humulog

Levomir

Question 36

Why does an abscess cause swinging pyrexia

Answer 36

Bits break off and enter blood

Question 37

What needs to be checked after LLETZ ? Why? What can be offered?

Answer 37

Cervical competence
Risk of opening and premature labour
Cervical stitch

Question 38

What does taking warfarin in pregnancy do

Answer 38

Baby gets pepper pot head and beak nose

Question 39

Used to treat uti in pregnancy

Answer 39

Trimethoprim

Question 40

What is a pessary used for

Answer 40

Inducing labour - contains hormones (goes in vag)

Question 41

What can lying on your back do in pregs

Answer 41

Compress IVC -> dizzy and hypotension

Question 42

What is present in urine if you vomit a lot and why

Answer 42

Ketones

Vomit -> increased ph, make more Ffa to replace -> ketones