Obs + gynae

Question 1

What is a side effect of magnesium sulphate toxicity?

Answer 1

loss of deep tendon reflexes (1st symptom), respiratory depression, and cardiac arrest

Question 2

What is the most common cause of postmenopausal bleeding?

Answer 2

Vaginal atrophy

Question 3

What disease causes post-coital bleeding in pre-menopausal?

Answer 3

Cervical cancer

Question 4

What is the most common cause of puritis vulvae (itching)?

Answer 4

Contact dermatitis

Question 5

What is given for stress incontinence?

Answer 5

Duloxetine

Question 6

What is given for urge incontinence?

Answer 6

Oxybutynin

Question 7

What does COCP protect you against?

Answer 7

ovarian and endometrial cancer

Question 8

What does COCP increase the risk of?

Answer 8

breast and cervical cancer

Question 9

When can expectant management of an ectopic pregnancy be performed?

Answer 9

1) An unruptured embryo
2) <35mm in size
3) Have no heartbeat
4) Be asymptomatic
5) Have a B-hCG level of <1,000IU/L and declining

Question 10

What are the symptoms of uterine fibroids?

Answer 10

Menorrhagia, anaemia, bulk-related symptoms e.g. bloating/urinary frequency

Question 11

What is Ovarian hyperstimulation syndrome caused by?

Answer 11

Side effect of ovulation induction/ IVF

Question 12

What are symptoms of Ovarian hyperstimulation syndrome ?

Answer 12

ascites, low blood pressure and tachycardia

Question 13

What is lochia?

Answer 13

Bleeding that presents for the first 2 weeks following giving birth (vaginal or C-section birth).

Question 14

How to treat lochia?

Answer 14

Reassure and discharge unless red flags:
- bad smell
- increase in blood loss/ is not stopping
- abnormal stats/ NEWs

Question 15

What is given for severe nausea and vomiting in pregnancy?

Answer 15

• 1st line is Metoclopramide
• 2nd line is Ondansetron

Question 16

What do you give for hirsutism and acne for PCOS?

Answer 16

COCP

Question 17

What do you give for oligomenorrhoea for PCOS?

Answer 17

Levonorgestrel-releasing intrauterine system

Question 18

A women suffered from an eclamptic seizure and was given magnesium sulfate. When do you stop the magnesium sulphate?

Answer 18

Magnesium treatment should continue for 24 hours after delivery or after last seizure (whatever comes last)

Question 19

What is the initial management of a pregnant woman who reports reduced fetal movements?

Answer 19

handheld Doppler should be used to confirm fetal heartbeat as a first step

Question 20

What is the gold standard investigation for endometriosis?

Answer 20

Laparoscopic visualisation of the pelvis

Question 21

At what age can you NOT consent for sexual intercource?

Answer 21

younger than 13 (so 12 and below)

Question 22

What are symptoms of cocaine abuse in pregnant women?

Answer 22

• placental abruption which causes hyperreflexia
• dilated pupils

Question 23

What are symptoms of heroin abuse in pregnant women?

Answer 23

• does NOT cause placental abruption
• pinpoint pupils

Question 24

What can cause placental abruption?

Answer 24

• Cocaine abuse
• pre-eclampsia
• HELLP syndrome

Question 25

What bacterial will ause neonatal sepsis after prolonged premature rupture of membranes (PROM)?

Answer 25

Group B Streptococcus

Question 26

When can’t Ulipristal be used?

Answer 26

in severe asthmatics

Question 27

What are the C-section categories?

Answer 27

1. immediate threat to the life of the mother or baby. Must be done in 30 min 2. maternal or fetal compromise which is not immediately life-threatening. Must be dine in 75 min 3. delivery is required, but mother and baby are stable 4. elective caesarean

Question 28

If you have a bishop score

Answer 28

vaginal prostaglandins or oral misoprostol mechanical methods such as a balloon catheter can be considered if the woman is at higher risk of hyperstimulation or has had a previous caesarean

Question 29

If you have a bishop score 7 or 8, what should be used to induce labour?

Answer 29

amniotomy and an intravenous oxytocin infusion

Question 30

What bishop score indicates that labour will unlikely start without induction?

Answer 30

<5

Question 31

What bishop score indicates that labour will be likely spontaneous?

Answer 31

>/= 8

Question 32

When can you not give the COCP in breastfeeding women?

Answer 32

<6 weeks postpartum

Question 33

When can a external cephalic version (ECV) be attempted?

Answer 33

36 weeks for primiparous women, and at 37 weeks for multiparous women

Question 34

Can nearly all anti-epileptics be given to breast feeding women?

Answer 34

Yes

Question 35

What are the blood results of a molar pregnancy?

Answer 35

Hugh beta hCG, low TSH, high thyroxine

Question 36

What is given first line for hyperemesis gravidarum?

Answer 36

0.9% saline with potassium

Question 37

When is lifestyle changes gone in gestational diabetes?

Answer 37

Fasting plasma glucose <7

Question 38

When is insulin +/- metformin given in gestationa, diabetes?

Answer 38

Fasting glucose >7