Obs and gynae

Question 1

3 antidepressants that can be used in pregnancy

Answer 1

sertraline
fluoxetine
amitriptyline

Question 2

Anembryonic miscarriage definition

Answer 2

gestational sac empty

Question 3

Incomplete mistcarriage definition

Answer 3

Retained products of conception

Question 4

Inx of choice for ectopic pregnancy

Answer 4

Monitor hcg
if 63% in 48hrs then IUP
If less than 63% rise in 48hrs then ectopic

Question 5

Patient presents with open OS and vaginal bleeding. What type of miscarriage is this

Answer 5

Inevitable miscarriage

Question 6

4 Risks and 4 protective factors for endometrial cancer

Answer 6

Risks
- Early onset Mences 
- Few children 
- obesity 
- PCOS
Protective 
- COCP
- Merina coil 
- Pregnancies
- Cigarrete smoking

Question 7

Vaginal bleeding and closed OS. What kind of misscarriage is this

Answer 7

Threatened miscarriage

Fetal heartbeat may be present

Question 8

Uterus empty and OS is closed, possible hx of vaginal bleed. What kind of miscarriage

Answer 8

Completed miscarriage

Question 9

Golden symptoms + 2 others for endometrial cancer

Answer 9

POST MENOPAUSAL BLEEDING
Intermenstrual bleeding
Post coital bleeding

Question 10

2 inx for cervical cancer

Answer 10

Colposcopy + acetic acid/iodine stain

Large Loop Excision of the transitional zone (LLETZ)

Question 11

hp viruses that cause cancer

Answer 11

16 and 18

Question 12

All hp viruses in the vaccine

Answer 12

6, 11, 16, 18.

Question 13

RF for endometrial cancer

Answer 13

More periods
early fences/late menopause 
tamoxifen 
few pregnancies 
PCOC
oestrogen only pill
obesity

Question 14

Patient presents with chronic menorrhagia and dysmenorrhea. Possible diagnosis, inx and mx

Answer 14

Fibroids/polyps
Hysterectomy
Mirena coil is first line

Question 15

What is vasa previa

Answer 15

When umbilical vessels go over the internal OS before the baby.

Question 16

Risk of having vase previa

Answer 16

Membrane rupture leads to fatal blood loss

Question 17

Vasa previa management

Answer 17

corticosteroids at 32 weeks

planned c section at 34-36 weeks

Question 18

Common cause of big postpartum haemorrhage

Answer 18

Placenta accrete

Question 19

RF for placental abruption

Answer 19

Early pregnancy bleeding
twins
fatal growth restriction
Cocaine

Question 20

Management of Placenta praevia (if diagnosed on USS)

Answer 20

Delivery at 36-37 weeks

Prednisolone at 34 and 35+6 weeks

Question 21

Causes for pruitis, fatigue and dark urine in pregnancy

Answer 21

Obstetric cholestasis

Caused by raised oestrogen and progesterone

Question 22

Causes of primary PPH

Answer 22

Atony (most common)
Trauma
Coagulopathy

Question 23

Mx of obstetric cholestasis

Answer 23

LFTs and Bile acids

Ursodeoxycholic acid

Question 24

Management of fibroids

Answer 24

<3cm - merina coil or cocp + NSAIDs/tranexamic acid
Endometrial ablation
myomectomy to preserve fertility

Question 25

Down syndrome screening results

Answer 25

Increased BHCG Decreased PAPPA nuchal translucency >6mm decreased serum estriol

Question 26

Management of urinary incontinence (urge)

Answer 26

Bladder training Anti-cholenergic (oxybutin, tolterodine) Oxybutin ci in elderly (falls risk)

Question 27

HELLP syndrome

Answer 27

Cause = pre-eclampsia Haemolysis Elevated Liver enzymes Low Platelets

Question 28

Mx for syphilis

Answer 28

Antibody serology for T. Pallidum RPP and VDBL testing IM benzylpenicillin STAT

Question 29

Big No No's for COCP

Answer 29

``` 0/6 weeks pregnant 0-6 months breast feeding BP >140/90 (3) BP >160/100 (4) CVD/stroke VTE hx. fhx or hx of thrombophilia Major surgery Migraine with aura Current breast cancer ```

Question 30

Most common sight for ectopic pregnancy

Answer 30

Ampulla of fallopian tube

Question 31

Which contraceptive is associated with increase in weight gain

Answer 31

Depot progesterone (depo-provera)

Question 32

How long will a pregnancy test stay + post termination

Answer 32

4 weeks Is + then advice to retest in one week (+)ve > 4 weeks then likely retained products of conception or active trophoblast

Question 33

COCP mechanism of action

Answer 33

Inhibits ovulation

Question 34

Risks associated with COCP

Answer 34

``` Breast and cervical cancer breast tenderness Headache and hypertension VTE MI/Stroke Dysmenorrhoea in first 3/12 ```