Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Obs and Gynae > Obs and Gynae > Flashcards

Obs and Gynae Flashcards

(349 cards)

Start Studying
1
Q

Painful bleeding in pregnancy

A

Placental Abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Painless bleeding in pregnancy

A

Placenta Previa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of placenta accreta

A

Accreta - restricted to decide
Increta - invade myometrium
Percreta - invade perimetric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is vasa praaevia?

A

Blood vessels overlie the os so when the waters break the vessels break and get a massive blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of PPH

A 
Call for help
Lie flat
Give O2
Massage uterus
IV access 
Give syntocinon
Give carboprost
Give misoprostol
Give tranexamic acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

For Ts of PPH

A

Tone
Trauma
Thrombin
Tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of atony

A 
Empty bladder
Massage uterus
Bimanual compression
Syntocinon
Syntometrine
Prostaglandins IM
Misoprostol
Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Surgical manoeuvres of atony

A 
Bakri ballon
Vaginal Pack
B Lynch suture
Ligation of the uterine and internal iliac arteries
Interventional radiology
Hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Risk factors of placenta praaevia

A

Twins
High parity
Old age
Scarred Uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Risk factors for placental abruption

A 
IUGR
Preeclampsia
Autoimmune disease (antiphospholipid syndrome)
Maternal smoking
Cocaine usage
Previous history of placental abruption
Multiple pregnancy
High parity
Thrombophillia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Woody hard uterus

A

Placental abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What classes as a PPH

A

loss of > 500ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Risk factors of PPH

A 
Previous hx
Previous c section
Coagulation defect
Retained placenta
APH
Multiparity 
Uterine malformation
Polyhydramniosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bleeding the first 12 weeks of pregnancy causes

A

Miscarriage
Ectopic pregnancy
Molar pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Commonest site of ectopic pregnancy

A

Ampulla of fallopian tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What counts as an APH

A

Bleeding from 24 weeks onwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you investigate placenta praaevia

A

TVUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you investigate placenta accreta

A

MRI and doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Prevention of preeclampsia

A

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of hyperreflexia in preeclampsia

A

Magnesium sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risk factors of cord prolapse

A 
Premature rupture of membranes
Polyhydramnios
Long umbilical cord
Fetal malpresentation
Multiparity
Multi pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Management of cord prolapse

A 
Fill bladder
Tredelenburg position - feet higher than head
Constant fetal monitoring
Alleviate pressure on cord
C-section
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Myotomes affected in Erbs palsy

A

C5 and C6 - waiters tip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Management for shoulder dystocia

A 
H - help
E - episiotomy
L - legs in mc roberts
P - suPrapubic pressure
E - enter pelvis
R - rotational manoeuvres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is zavanelli manoeuvre
push baby in and try for c-section
26
Principles of screening
- knowledge of the disease (condition important, easy symptomatic stage, course of disease understood) - knowledge of test (suitable, test acceptable) - treatment of disease (accepted treatment, facilities available) - cost considerations
27
Fetal Anomaly screening happens when
18+0 - 20+6
28
what does metal anomaly screening screen for
downs pataus edwards
29
what does the newborn blood spot screen for
``` cf congenital hypothyroidism sickle cell disease pku mcadd msud ```
30
name the chromosome extra copies in downs, edwards and pataus
downs - 21 edwards - 18 pataus - 13
31
Risk factors for breast cancer
``` age FH alcohol obesity HRT OCP early menarche late first child ```
32
protective factors of breast cancer
breast-feeding | exercise
33
when does breast screening happen
47-73 every 3 years mammography
34
name some genes in breast cancer
BRCA 1 and 2 Tp53 Peutz Jeghers
35
Locally advanced breast cancer presentation
palpable painless lump - irregular hard fixed nipple discharge nipple indrawing skin tethering
36
Oestrogen sensitive breast cancer treatment
oestrogen sensitive breast cancer - tamoxifen (premenopausal) - aromatase inhibitors (postmenopausal)
37
What drug is HER2 sensitive
Trastuzumab
38
What else should you give to postmenopausal women with oestrogen receptor positive cancer
Bisphosphonates
39
Abortion act
- not exceeded 24 wks and continuation of pregnancy is ore risky that terminating it - termination needed to prevent physical or mental health problems - continuation would involve risk to woman - if child was born they would suffer physical or mental abnormalities
40
Fraser guidelines
- patient understands advice - encourage parental involvement - patient likely to have sex with or without contraception - pt physical or mental health will suffer if does not receive treatment - is it in its best interests to provide contraceptive treatment without parental consent
41
What is endometriosis
endometrial tissue outside the endometrial cavity - responsive to oestrogen so cyclical with periods
42
where is endometriosis commonly found
pouch of douglas
43
how does endometriosis present
constant pelvic pain worse during periods | pain during sex
44
where else can endometriosis occur
extraperitoneal - umbilicus - bladder - nose - lungs
45
CA125 is high in what
Ovarian cancer and endometriosis
46
Complications of endometriosis
- high risk of recurrence - impact on fertility - impact on quality of life
47
what is the gold standard investigation of endometriosis
laparoscopy
48
Medical treatment of endometriosis
OCP - causes glandular atrophy and stops ovulation GnRH agonist - continuous GnRH makes them menopausal Oral progestogens Depo provera mirena coil
49
Surgery of endometriosis
ablation, excision, oophorectomy, pelvic clearance
50
why does endometriosis cause infertility
endometriosis release immune factors causing oocyte toxicity, adhesions, tubal dysfunction, ovarian dysfunction
51
What is adenomyosis
invasion of endometrial tissue into the myometrium
52
who does adenomyosis commonly occur in
menopausal women (not related to oestrogen bu pain similar)
53
fibroids affect what tissue
benign uterine smooth muscles tumours
54
symptoms of fibroids
heavy periods, infertility, miscarriages, pain
55
when is cancer no longer classed as benign
when abnormal cells invade the basement membrane and are so able to get into the bloodstream and lymphatic system
56
Name the tumour suppressor genes and their roles
P53 - regulates cell cycle | Rb - prevents excessive cell growth
57
Post menopausal bleeding is a red flag for what
Endometrial cancer
58
Risk factors for endometrial cancer
obesity (fat cells make more oestrogen), diabetes, nulliparity, late menopause, PCOS, HRT, tamoxifen, HNPCC
59
Staging of endometrial cancer
FIGO
60
Investigations for endometrial cancer
TVUS, biopsy, hysteroscopy
61
treatment of endometrial cancer
hysterectomy, radiotherapy, progesterone
62
Risk factors for HPV
``` missed vaccination early age intercourse multiple sexual partners STDs previous CIN OCP cigarette smoking ```
63
What oncogenes does the HPV vaccine cover
16 and 18
64
what cells does cervical cancer effect
squamous cell carcinoma
65
treatment of cervical cancer
microscopic - just remove part of the cervix | macroscopic - hysterectomy
66
clinical features of vulval cancer
``` vulval itching vulval soreness persistent lump bleeding pain on passing urine PMH of lichen sclerosis ```
67
what is protective against ovarian cancer
OCP
68
What is the marker in ovarian cancer
CA125
69
what cells does ovarian cancer affect
epithelial cells
70
What is the risk of malignancy index of ovarian cancer
CA125 X USS X years postmenopausal >250 refer to gynae
71
clinical features of ovarian cancer
``` no symptoms bloating abdo pain change in bowel habit urinary frequency ```
72
What is a molar pregnancy
Complete mole - mass of abnormal cells in the womb and no foetus develops Partial mole - an abnormal foetus starts to develop but can't survive
73
What is the latent phase of labour
``` irregular contractions show mucoid plug cervix effacing and thinning encourage to stay at home 6hrs - 2 days ```
74
What is the effacement of labour
starts in fungus retraction/shortening of muscle fibres build in amplitude as labour progresses foetus forced down
75
How is labour assessed?
Presentation (anatomical part of the tutus which it presents itself through the birth canal) Lie (the relationship between the long axis of the fetus and the long axis of the uterus) Attitude (presenting part flexed or deflexed) Engagement (widest part of the presenting part has passed through the brim of the pelvis) Station (relationship between the lowest pint of the presenting part and the ischial spines)
76
When is active labour
4 cm dilated regular and frequent contractions progressive oxytocin released
77
SE to entonox
nausea and vomiting
78
SE to opiates
fetal respiratory depression, diminished feeding behaviours, longer labour
79
SE to epidural
longer labour, decreased contractions
80
Role of thecal cells
sensitive to LH, synthesise progesterone and testosterone from cholesterol
81
role of granulose cells
sensitive to FSH convert testosterone to oestrogen,
82
What causes the dominant follicle to grow
FSH
83
what does hCG do
prevents the decline of corpus lute ensuring that corpus lute synthesises progestins until placenta forms
84
What is apposition
interaction between the blastocyst and maternal epithelium
85
What do endovillus trophoblasts do
invade maternal spiral artery to tap maternal blood supply
86
What do the NK cells do
mediate invasion of endovillus trophoblasts so that invasion does not reach the myometrium
87
risk factors for preeclampsia
``` primigravidity young females black people twins HTN renal disease ```
88
What is chronic HTN
HTN diagnosed before the 20th week gestation and not resolved postpartum
89
What is gestational HTN
new HTN after 20 wks gestation
90
Preeclampsia
New HTN after 20 wks with increase BP and proteinuria
91
Pathophysiology of preeclampsia
abnormal spiral artery formation causing an ischaemic placenta causing the release of thromboplastin causing DIC and renin causing vasoconstriction, HTN, proteinuria and oedema
92
What is HELLP syndrome?
Preeclampsia can lead to H - haemolysis EL - elevated liver enzymes LP - low platelets
93
Risk factors for preterm birth
``` genital infection cervical weakness vaginal bleeding multiple pregnancy previous term birth smoking ```
94
What does a high fibronectin indicate
may indicate disruption of attachment of membranes and decidua
95
Investigation of incontinence
frequency volume chart urinalysis residual urine measurement ePAQ
96
What is the histology of the detrouser muscle
smooth muscle | transitional epithelium
97
What is the detrouser muscle innervated by?
S2-S4
98
Treatment of overactive bladder
oxybutynin mirabegron botulism
99
Treatment of stress incontinence
restore pressure to utethra colposuspension - stitched bilaterally in the vagina tension free vaginal tape - mesh sling around the urethra
100
What would cause an abnormal CTG
``` chromosomal abnormalities SGD LGD twins plataued growth cord prolapse oligo/polyhydramnios group B strep ```
101
Interpreting a CTG
``` Dr - define risk C- contractions Bra - baseline rate V - variability (>5bpm) A - accelerations D - decelerations O - overall assessment ```
102
What are variable decelerations indicative of
Cord compression
103
Late decelerations are a sign of what
hypoxia
104
treatment of chlamydia
azithromycin/doxycycline
105
What is a chocolate cyst
an ovarian endometrioma - benign oestrogen-dependent cyst found in women of reproductive age
106
what is a threatened miscarriage
there is bleeding but the foetus is still alive and os is closed
107
What is an inevitable miscarriage
bleeding and os is open
108
What is an incomplete miscarriage
some fetal parts passed, bleeding diminished, os closed
109
What is a missed miscarriage
relies on scan - fetus sis not develop but not recognised until bleeding occurs
110
How to tell the difference between miscarriage and ectopic pregnancy
Miscarriage: bleeding > pain (present at 10wks) | Ectopic : pain > bleeding (present earlier)
111
Risk factors for ectopic pregnancy
previous ectopic, PID, endometriosis, copper IUD, minipill)
112
Plateauing or declining hCG levels
Ectopic or non-viable pregnancy
113
Medical management of ectopic if hCG is < 3000
methotrexate (give anti D if rhesus negative)
114
Medical management of miscarriage
misoprostol +/- mifepristone
115
Surgical management of miscarriage
evacuation of retained products of conception (ERCP) under anaesthetic using vacuum aspiration
116
whats the difference between small for dates and IUGR
Small for dates - estimated fetal weight below 10th centile | IUGR - pathological small for dates
117
What is symmetrical IUGR early in pregnancy suggestive of?
chromosomal abnormalities
118
What is asymmetrical IUGR are in pregnancy suggestive of?
IGUR/preeclampsia
119
What is large for dates?
estimated fetal weight greater than 90th centile
120
Reduced placental function effect on fetus
polycythaemia hypoglycaemic increased adrenaline, noradrenaline decrease in cardiac output
121
What is an absent EDF suggestive of?
placental insufficiency
122
Reversal of EDF is associated with an increased risk of what
``` IUGR neonatal thrombocytopenia NEC mortality long term neurological damage ```
123
Management of absent EDF
Mother admitted given steroids if < 34wks and has daily CTG
124
Causes of polyhydramnios
``` intrauterine infection Rh incompatibility maternal cardiac or renal problems maternal DM (urine) multiple pregnancies ```
125
Complications of polyhydramnios
``` Cord prolapse placental abruption premature birth perinatal death congenital abnormalities ```
126
low level of PAPP-A at 12 weeks can be associated with what
Downs syndrome
127
If FBS pH is below 7.2 what should be done
expedite the delivery as sign of fetal distress
128
What is the most favourable position of a baby for vaginal delivery
Occipito-anterior
129
What acts on the hypothalamus and pituitary as a negative feedback
Inhibin and oestrogen produced by the ovaries
130
If the SRY gene is absent what happened in utero
Mullerian ducts persist and fuse to form the upper vagina, cervix and uterus
131
If the SRY gene is present what happens in utero
testes determinant factor is produced and Wolfian ducts persist and mullein ducts degenerate
132
What dose the anterior pituitary excrete?
GH, LH, FSH, prolactin
133
What does the posterior pituitary produce?
ADH, oxytocin
134
What is primary amenorrhea?
periods never started
135
causes of primary amenorhoea
``` imperforate hymen turners syndrome kallmans syndrome (GnRH deficiency and impaired sense of smell) low weight stress hypothalamic hypogonadism ```
136
what is secondary amennorhoea?
periods started but then stopped
137
causes of secondary amennorhoea
``` pregnancy hypothyroidism hypothalamic hypogonadism theehans syndrome cushings disease ```
138
how does cushings disease cause secondary amennorhoea
high cortisol inhibits LH secretion
139
What is Sheehans syndrome?
massive PPH causes avascular necrosis of the pituitary gland
140
What is Ashermans syndrome?
Adhesions cause infertility
141
Symptoms of hyperprolactinaemia
milky nipple headache bitemporal hemianopia (if pituitary tumour) amennorhoea
142
Treatment of hyperprolactinoma
Cabagoline
143
Hypothyroidism on blood results
High TSH | Low T3 T4
144
PCOS triad
polycystic ovaries on US irregular periods excess androgens
145
Blood results of PCOS
high testosterone high LH (3 X higher than FSH) high/normal prolactin low SHBG
146
Treatment of PCOS
``` lose weight OCP metformin clomifene - for when they re trying to get pregnant laparoscopic ovarian drilling ```
147
Causes of hypogonadotrophic hypogonadism
``` Kallermanns (inherited) damage to pituitary or hypothalamus from surgery, injury or infection high dose steroids high prolactin severe stress nutritional problems ```
148
investigation of hypogonadotrophic hypogonadism
LH response to GnRH to see if it is a lack of GnRH production or a problem with the pituitary
149
Treatment of hypogonadism
hormonal contraceptives or GnRH injections
150
Hypothalamic causes of amennorhoea blood results
low FSH and LH
151
How do we assess ovarian function
Mid luteal progesterone (usually day 21 on a 30 day cycle)
152
What hormone is a reflection on the number of eggs
Anti-mullerian hormone
153
Causes of female infertility
``` Turners Infection Obesity PCOS Endometriosis Ashermans Anatomical abnormalities Chemo Mumps ```
154
What are the tubal patency tests called
HSG | H1COS
155
Causes of male infertility
CF Steroids kallermans Previous STDs
156
Commonest cause of anaemia in pregnancy
Iron deficiency
157
Treatment of obstetric cholestasis
ursodeoxycolic acid
158
Non hormonal treatment of menopause
Clonidine
159
Risks of HRT
Increase risk of breast cancer, VTE, CVD (best put it in a patch do it does not pass through the liver and induce live enzymes and clotting factors)
160
What is premature ovarian insufficiency
Menopause < 40
161
How long do you stay fertile during the menopause
Fertile for 2 years if menopause < 50 years | Fertile for 1 year of menopause > 50 years
162
Causes of menorrhagia
``` Uterine fibroids Uterine polyps Adenomyosis Endometriosis Gynae malignancy ```
163
How to treat painful bleeding
Mefanamic acid
164
How to treat heavy bleeding
Transexamic acid
165
Surgical treatment of menorrhagia
Endometrial ablation
166
HNPCC/Lynch syndrome is a strong risk factor for what cancer
Endometrial cancer
167
Factors for endometrial cnacer
``` obesity nulliparity early menarche PCOS late menopause DM ```
168
What does the Edinburgh scale screen for
post natal depression
169
how does puberal psychosis present
in the first 2-3 weeks of childbirth | severe mood swings
170
abortion management < 9wks
mifepristone
171
abortion management < 13 wks
surgical dilation and suction
172
abortion management > 15 wks
surgical dilatation and evaluation of uterine contents
173
Name a muscarinic antagonist
tolterodine, oxybutynin, solifenacin
174
at what weeks does routine care and anti-D prophylaxis occur
28 and 34 weeks
175
what are dates of birth confirmed
10 - 13+6
176
When are blood results back in ANC
16 wks
177
when is the anomaly scan
18 - 20+6
178
when is the booking visit
8 - 12 wks
179
when is downs syndrome screened for
11 -13 + 6
180
Name some drugs contraindicated in pregnacny
``` tetracycline ciprofloxacin lithium benzos methotrexate sulphonylurea amiodarone carbimazole ```
181
what is the leading indirect cause of maternal deaths
cardiac disease
182
Features of a normal CTG
accelerations present variability > 5bpm No decelerations HR 110-160
183
Prophylaxis of Group B strep
BenPen
184
IUGR prevention
aspirin
185
What drug for overactive bladder should not be used in the elderly
oxybutynin
186
Treatment of mastitis
fluclox and continue breast feeding
187
What is raised in fetal abdominal defects
AFP - raised in omphalocele and neural tube defects and multiple pregnancy
188
When is AFP reduced
Downs DM Edwards Maternal obesity
189
what do you give id there is a magnesium sulphate induced respiratory depression
calcium gluconate
190
Hyperemesis Gravidum treatment
IV fluids antihistamine Metoclopramide Vit B and C
191
What is given before hysterectomy to reduce the size of the uterus
GnRH agonists
192
Name contraindications of the OCP
``` > 35 and smoking cigs BMI > 35 FH of VTE HTN immobility carrier of BRCA ```
193
Oligohydramnios causes
``` premature rupture of membranes fetal renal problem (renal agenesis) intrauterine growth restriction post-term gestation preeclampsia ```
194
treatment of hot flushes
fluoxetine
195
what antibiotic is given in PROM
erythromycin
196
What is Fitz-Hugh-Curtis syndrome
complication of PID where inflammation of the liver capsule causes lesions between the liver and abdominal wall
197
Ovarian torsion on US
Whirlpool sign and free pelvic fluid
198
what is rovsings sign
palpation of LIF causes RIF tenderness - appendicitis
199
Stages of labour
stage 1: from the onset of true labour to when the cervix is fully dilated stage 2: from full dilation to delivery of the fetus stage 3: from delivery of fetus to when the placenta and membranes have been completely delivered
200
where do bartholins abscess occur
glands next to the vagina entrance
201
how do you treat bartholins abscess
marsupialisation
202
what is an ectropion
columnar epithelium present on ectocervix due to elevated oestrogen vagonal discharge, post-coital bleeding
203
What causes a boggy uterus
adenomyosis
204
what causes a bulky uterus
fibroids
205
what does a bishops score of less that 5 indicate
labour is unlikely to start
206
What is the treatment of BV and trichomonas
metronidazole
207
what is the treatment of thrush
clotrimazole pessary
208
PPH management
``` Bimanual uterine compression IV syntocinon Ergometrine (contraindicated in HTN) Syntocinon infusion Carboprost Misoprostol rectally ```
209
what do you give if pregnant lady is exposed to chicken pox and is not immune
VZIG
210
What causes hyperemesis gravidum
beta hCG levels
211
Treatment of HTN in preeclampsia
Labetalol | Nifedipine if asthmatic
212
When is ECV offered from in a nulliparous and breech baby
36 weeks
213
Investigation of adenomyosis
MRI
214
How often do women have smears between 50-64
5 years
215
What is hCG secreted by
syncitotrophoblasts
216
commonest cause of post coital bleeding
ectropion cervix
217
what hormone is significantly raised in menopause
FSH
218
circumstances when anti D is given
``` delivery of a Rh + infant whether live or still for any termination of pregnancy miscarriage if > 12 weeks ectopic pregnancy managed surgically external cephalic version APH amniocentesis FBS chorionic villus sampling ```
219
treatment for a woman wit large fibroids but wants to conceive
myomectomy
220
What is reduced in pregnancy
reduced urea | reduced creatinine
221
Increase in nuchal translucency is indicative of what?
downs syndrome congenital heart defects abdominal wall defects
222
What is meigs syndrome
bening ovarian tumour (usually a fibroma) associated with ascites and pleural effusion
223
BP meds in pregnancy
labetalol nifedipine methyldopa hydralazine (IV)
224
Clinical features of preeclampsia
``` headache flashing lights vomiting abdo and epigastric pain swelling of extremities and face ```
225
Routine abs after c section
cef and met
226
What is stage 3 of FGM (Infundibulation)
narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minor and or major with or without the excision of the clitoris
227
reasons for FGM
``` respect preserves virginity rite of passage cleanliness religious requirement social acceptance ```
228
What is the UN convention on childrens rights
Article 6 - survival and development right Article 12 - respect of child's views Article 34 - all health parties should take measures to abolish damaging traditions Article 19 - protection from violence
229
Gynaecological complications of FGM
``` dyspareunia sexual dysfunction with anorgansmia chronic pain keloid scar formation dysmenorrhoea UTIs PTSD difficulty conceiving ```
230
Obstetric complications of FGM
increased likelihood of csection, PPH, episotomy | difficulty monitoring fetus
231
What causes precocious puberty
secretion of high amplitude pulses of GnRH by the hypothalamus
232
Can you detain people without a psychiatric condition under the mental health act
No - it is unlawful to detain someone under the mental health act for treatment of any disease other than a psychiatric condition
233
In which section are patients already inpatients
section 5
234
When can lifesaving treatment not be administered in an emergency
when there is a valid advanced directive (signed by a doctor)
235
Consent for treatment
patient understands patients needs and wishes known complexity of the treatment risks
236
What is in ellesette solo
estradiol only
237
Symptoms of ovarian torsion
constant pain, does not improve with painkillers
238
PCOS long term risks
endometrial hyperplasia sleep apnoea diabetes acne
239
RMI calculation
US (1-5 features) x menopause status (3 if menopausaL) x CA125 >250 = urgent referral
240
Post menopausal bleed red flag
endometrial cancer - US pelvis and pipette biopsy
241
PID treatment
IM ceftriaxone oral doxycline oral metronidazole
242
Risk factors for 3rd degree tear
shoulder dystocia maternal age prolonged 2nd stage of labour forceps delivery
243
what is a suspicious and pathological CTG
suspicious - 1 non-reassuring features | pathological - 2 non-reassuring features or 1 abnormal features
244
What should not be cut in an episiotomy
ischiocavernosus
245
Drugs for infection of labour for intrauterine death
Mifepristone (cervical ripening) | Mifeprostol (onset of contractions)
246
Manoeuvre for shoulder dystocia
McRoberts
247
What is a contraindication to epidural
``` hypotension systemic infection skin infection bleeding disorders low platelets ```
248
What makes up the lower vagina
cloaca
249
What makes up the uterus
paramesonephric duct (mullerian)
250
what makes up the vas and epididymis
mesonephric (wolfing)
251
What does the corpus lutem secrete
progesterone
252
What hormone does hCG shares the same alpha subunit with
TSH
253
Combined test in downs
High nuchal translucency Low PAPP-A High beta hCG
254
Slapped cheek is caused by
Parvovirus
255
Neonatal meningitis is caused by
Group B strep
256
Can a UTI lead to premature delivery
yes - irritable uterus
257
Treatment of PROM
erythromycin
258
What is anydramnios suggested of
renal agenesis
259
Where is endometriosis commonly found
pouch of douglas
260
where is cervical cancer found usually
transformational zone
261
Turners karyotype
XO
262
Endometrioma on US
groundless appearance
263
Endometrioma on laparoscopy
chocolate cyst
264
Ovarian cancer is related to what cells
epithelial
265
Granulosa cell tumours are related to
precocious puberty
266
Fibroids can mask what
leiomyosarcoma
267
Clue cells are related to
BV
268
Complete mole is
diploid
269
partial mole is
triploid
270
When do you manage a miscarriage expectantly
7-14 days
271
SLE in pregnancy can cause what
miscarriage preeclampsia prematurity IUGR
272
Can women with GDM develop T2 DM after pregnancy
30-60% do develop T2 DM
273
What is the quadruple test
unconjugated oestriadiol hCG AFP inhibin A
274
Changes in pregnancy
increase in fibrinogen and factors VII, X, XII increase in stroke volume decrease in Hb soft systolic flow murmur
275
What infections are screened for in ANC
syphyllis rubella Hep B HIV
276
How to treat embolism in pregnancy
enoxparin
277
When can ECV be carried out
36 wks if nulliparous | 37 wks if multiparous
278
contraindications to ECV
preeclampsia oligohydramnios scarred uterus APH
279
what do you give a pregnant woman if she comes into contact with chicken pox
check for antibodies | give IVIg within 10 days
280
Difference between threatened miscarriage and an APH
threatened miscarriage bleeding < 24 weeks | APH bleeding > 24 weeks
281
treatment of incomplete miscarriage
misoprostol
282
treatment of hyperemesis gravidarum
crystalloid and antiemetic
283
when is a pseudo sac seen
ectopic pregnancies
284
if a patient had dysparunia, post-coital bleeding and abdominal pain what is important to rule out
cervical cancer
285
What scan do you do for an ectopic pregnancy
TVUS to see if anything is in the uterus
286
treatment of PPH
1) flood resuscitation 2) oxytocin infusion 3) uterine massage 4) IV ergometrine 5) bimanual compression 6) Bakri ballon 7) intramyometrial uterotonics
287
what does CMV cause in the neonate
visual/hearing loss microcephaly neurodevelopment disability
288
DIC blood results
low platelets | high PT and APTT
289
what does the APGAR score look at
``` tone colour breathing heart rate reflex irritability ```
290
PE blood gas
respiratory alkalosis
291
what is peri-partum cardiomyopathy
develops in the last month of pregnancy to five months post part - SOB, tachycardia, tachypnoea
292
Fetal physiology after birth
umbilical blood vessels occlude decrease in venous turn back to the heart increase in RA pressure (closes foramen ovale) 1st breath decreases pulmonary circulation pressure and increases RV output increase in venous return back to the heart increases left side pressure and closes ductus arteriosus
293
HPV for cervical cancer and genital wart
16 + 18 - cervical cancer | 6 + 11 - warts
294
pathophysiology of CAH
inadequate cortisol adrenal hyperplasia excessive androgenic precursors
295
Hyaditidiform moles on US
snow storm appearance
296
triad of PCOS
anno/oligoovulation hyperandrogegism US - < 12 follicles
297
how does COCP affect cancer
decrease in bowel and ovarian cancer | increase in cervical
298
when is a transvaginal tape used
urinary stress incontinence
299
OHSS presentation
hyper coagulability - VTE | hyperprolactinaemia - ascites
300
Hormone levels in hypothalamic hypogonadism
low FSH, LH, oestradiol
301
Where does the ureter pass in relation to the uterine artery
Under | Water under the bridge
302
what is megs syndrome
pleural effusion associated with ovarian fibroma
303
investigation of ovarian cancer
CT
304
symptoms of ovarian cancer
like IBD - bloating and abdominal pain
305
First line management in pre-eclampsia management
labetalol (if asthmatic - nifedipine)
306
Risk factors for pre eclampsia
``` FH CKD DM SLE hypertensive disease during previous pregnancies first pregnancy > 40 high BMI ```
307
What does preeclampsia predispose to
``` eclampsia HELLP CVH placental abruption DIC pulmonary oedema ```
308
Features of severe preeclampsia
``` HTN>170/110 proteinuria headache visual disturbance papilloedema epigastric pain hyperreflexia low platelets ```
309
Prevention of group B strep
IV Ben Pen
310
Risk factors for strep B
premature PROM previous sibling with GBS maternal pyrexia
311
Risk factors for placental abruption
``` IUGR preeclampsia preexisting HTN smoking prev abruption ```
312
Passage of fetus through the birth canal
E - engagement D - descent ``` F - flexion I - internal rotation E - extension R - rotation external E - expulsion ```
313
Mechanical factors that determine progress throughout labour
Power (degree of force expelling the fetus) Passage (dimensions of pelvis and resistance of soft tissues) Passenger (diameters of fetal head)
314
Stages of labour
stage 1 - 4 cm - 10cm stage 2 - delivery of baby stage 3 delivery of placenta
315
Induction of labour
1) membrane sweep 2) vaginal prostaglandin 3) amniotomy 4) oxytocin
316
Prevention of cord compression
elevate the presenting part either manually or by filling the urinary bladder
317
Complications which can occur to mother with shoulder dystocia
PPH Perineal tear Urethral and bladder injuries
318
Complications which can occur to fetus in shoulder dystocia
brachial plexus injury (Erbs palsy C5-7) hypoxia hypoxic ischaemic encephalopathy death
319
risk facotrs for shoulder dystocia
macrosomia high maternal BMI DM prolonged labour
320
Shoulder dystocia management
``` H - help E - episiotomy L - legs in mc roberts P - suPrapubic pressure E - enter pelvis R - rotational manoeuvres ```
321
risk factors for cord prolapse
``` prematurity breech abnormal lie polyhydramnios artificial rupture of membranes twins ```
322
Presentation of uterine rupture
``` 3rd trimester maternal shock severe abdo pain vaginal bleeding severe abdo pain fetal bradycardia scar tenderness chest or shoulder tip pain ```
323
management of uterine rupture
urgent surgical delivery
324
how does amniotic fluid embolisation present
Presents like a PE - tachypneoa, tachcardia, SOB, palpitations, cough then has a haemorrhage phase - DIC
325
Management of PPH
Syntocinon Ergometrine IM carboprost surgical options
326
Risk facotrs for PPH
``` previous PPH APH prolonged labour preeclampsia polyhydramnios increased maternal age macrosomia ```
327
Postnatal depression screening tool
Edinburgh Scale
328
When would you give oestrogen and progesterone to treat menopause
if they still have a uterus to reduce risk of endometrial hyperplasia
329
Treatment of menorrhagia
IUS COCP Tranexamic acid
330
Causes of primary amenorrhoea
``` consitutional delay anorexia hyperprolactinaemia hypo/hyperthyroidism adrenal hyperplasia turners syndrome androgen insensitivity imperforate hymen ```
331
causes of secondary amenorrhoea
``` pregnancy menopause lactation anorexia hyperprolactinaemia hypo/hyperthyroidism adrenal tumour PCOS premoture ovarian failure Ashermans ```
332
Amenorrhoea investigations
``` pregnancy test FSH/LH prolactin levels testosterone SHBG TFTs pelvic US (PCOS) ```
333
Causes off painful periods
``` endometriosis adenomyosis PID ovarian tumour fibroids ```
334
Medical, surgical and radilogical treatment of fibroids
Medical - tranaexamic acid, IUS, COCP, ulipristal acetate, Zoladex Surgical - hysterectomy, myomectomy Radiological - uterine artery embolisation, myometrial ablation
335
What is adenomyosis?
endometrium grows into the myometrium causing moderate enlargement
336
Risk factors for endometrial carcinoma
- exogenous oestrogen (unopposed oestrogen, tamoxifen) - endogenous oestrogen excess (PCOS, obesity) - T2DM - Lynch type II syndrome - HNPCC
337
red flag for endometrial cancer
postmenopausal bleeding
338
Blood results in PCOS
increased testosterone increased insulin decreased SHBG
339
Management of PCOS
- weight loss - COCP - clomifene or tamoxifen for ovulation - metformin - ovarian diathermy
340
risk of malignancy index
US findings x menopausal status X CA125 pre menopausal = 1 post menopausal = 3 1 US sign = 1 > 2 US signs = 3 >250 - MDT
341
tx of PID
doxycycline, ceftriaxone, metronidazole
342
ANC visit
``` <12wks first visit 11-13 weeks scan (dates, nuchal translucency) 18-20 weeks anomaly scan 36weeks check lie and presentation 37 weeks head engaged ```
343
when is aspirin given in pregnancy
if there is a risk of pre eclampsia - previous pre eclampsia - FH - diabetes - obesity - chronic HTN - autoimmune disorders
344
frail old woman treatment for endometrial cancer
progestogens
345
Most common type of cervical cancer
squamous cell
346
HPV serotypes in cervical cancer
16 18 33
347
What happens to fibroids in pregnancy
Red degeneration - presents with low-grade fever, pain and vomiting
348
Why is there shoulder tip pain
peritoneal bleeding irritates diaphragm and causes shoulder tip pain through the phrenic nerve
349
ovarian tumour histology
epithelial epithelium

Obs and Gynae (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions