Obs and Gynae pretest Flashcards Preview

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Flashcards in Obs and Gynae pretest Deck (34):
1

What level is the epidural needle inserted into?

Inserted between L3/L4 (as below spinal cord, which ends at L1/L2)

2

What level does the spinal cord end at?

L1/L2

3

Which space is the spinal anaesthetic inserted into?

The subarachnoid space

4

What should you give a woman prior to an epidural and why?

Should give 500ml-1000ml crystalloid fluid as epidural will lower her blood pressure

(hypotension because of vasodilation)

5

To provide relief for pain caused by uterine contractions, which levels must you block?

Must block levels T10-S4
T10-T12 -sympathetic nerves
L1 - ilioinguinal nerve
S2,S3,S4 - pudendal nerve

6

Lymphatic drainage of fundus of uterus

Para-aortic nodes

7

Lymphatic drainage of cervix

Internal and external iliac nodes

8

Lymphatic drainage of bladder

Internal and external iliac nodes

9

Lymphatic drainage of ovary

Para-aortic nodes

10

Lymphatic drainage of labia minora?

Superficial inguinal nodes

11

Which drug is given to a woman with eclampsia to treat seizures and prevent further seizures?

Magnesium sulphate

12

How should you check liver function in pre-eclampsia?

Serum ALT

13

How should you check renal function in pre-eclampsia?

Serum urate

14

How should you check haematological system in pre-eclampsia?

Check platelet count

15

How should you check neurology in pre-eclampsia?

Patellar reflexes

16

How should you check placental sufficiency in pre-eclampsia?

Umbilical artery doppler

17

How long is the female urethra?

4cm

18

Lymphatic drainage of ovaries?

Para-aortic nodes

19

When does the uterus rise from the pelvis in pregnancy?

Rises out of pelvis at 12 weeks

20

Is the posterior fornix of the vagina related to the peritoneal cavity (pouch of douglas)?

Yes, vaginal injury damaging the posterior fornix will open the peritoneal cavity and facilitate spread of infection to the cavity

21

Most common HPV causing cervical cancer?

HPV 16 and 18

22

Where does cervical intraepithelial neoplasia usually occur?

CIN usually occurs in the transformation zone at the squamo-columnar junction

23

Which percentage of ovarian cancers are genetic and which genes are associated?

Around 5% of cases are genetic
Associated with BRCA1 and BRCA2

24

How may ovarian cancer present?

Usually presents with non-specific symptoms such as abdominal pain, dyspepsia and weight loss.
MAY ALSO present initially as leg pain and swelling as a result of DVT

25

Ovarian cancer survival

Most people die 3-5 years after diagnosis

26

Does the pudendal nerve pass in front or behind the ischial spine?

Behind

27

How big is the vagina?

About 8cm

28

Which vessel does the ovarian artery arise from?

Arises from the aorta

29

At ovulation, is the ovum extruded into the peritoneal cavity?

Yes - as the ovum is extruded into the peritoneal cavity, it is possible to develop an intra-peritoneal ectopic pregnancy

30

Does plasma volume increase during pregnancy?

Yes, plasma volume increases by about 50% during pregnancy (this means blood becomes diluted so physiological anaemia)

31

When does blood pressure decrease in pregnancy?

Blood pressure decreases in second trimester due to vasodilation

32

What happens to glomerular filtration during pregnancy?

Glomerular filtration increases to cope with the additional load of the fetus - this results in a decrease in creatinine and urea levels

33

Are systolic murmurs common in pregnancy?

yes - there is about a 35-40% increase in cardiac output during pregnancy, so systolic murmurs are common

34

By how much is your risk of thromboembolism increased in pregnancy?

Increased by about 10%