Obstetrics

Question 1

what age to refer for infertility

Answer 1

1y if under 36
earlier referral if gynae issues or women older

Question 2

androgen insensitivity syndrome genetics

Answer 2

AR 46XY
born female - no varies or uterus

Question 3

primary amenorrhea with boobs or not with boobs

Answer 3

with boobs 15
no boobs 13

Question 4

meohrrhage treatment

Answer 4

mirena
TXA/NSAIDs/COPC/POP
refer

Question 5

size if fibroids

Answer 5

over 3cm then refer

Question 6

primary dysmorhhoea treatment

Answer 6

NSAID
COCP

Question 7

secondary dysmenorrhea causes

Answer 7

endometriosis
fibroids
IUD
PID

Question 8

endometriosis treatment

Answer 8

NSAIDS, paracetamol
COCP/POP
refer if trying to conceive

Question 9

PCOS diagnosis

Answer 9

hypergonadism
infrequent/no periods
polycystic ovaries >12 follicles 2-9mm, or ovarian volumes >10cm

Question 10

ovarian cancer risk factors

Answer 10

brca1/2 early menarche late menopause no pregnancy

Question 11

smears

Answer 11

25-49 3 yearly
50-64 5 yearly

24-64 5 yearly in scotland

Question 12

HPV cervical cancer

Answer 12

16 and 18

Question 13

endometrial hyperplasia

Answer 13

persistent oestrogen - obese, tamoxifen, PCOS, DM, nill parity

Question 14

what age do you refer for PMB

Answer 14

over 55

Question 15

RF for ectropion

Answer 15

preg, COCP

Question 16

PID treatment

Answer 16

oflaxacin and metro or
IM left and doxy and metro

Question 17

anti d to be given when

Answer 17

28 and 34 weeks

Question 18

downs 11-13+6

Answer 18

nuchal thickness and high HCG and low PAPPA

Question 19

4-20 w bloods
HCG
AFP
inhibin A
unconjug bilirubin

Answer 19

high HCG
low AFP
high inhibin A
low unconjuc bilirubin

Question 20

prem correction

Answer 20

1year for 32-36w
2y for <32w

Question 21

prem age

Answer 21

24-26 w

Question 22

post dates

Answer 22

<42w

Question 23

OGTT done when
fasting
2h

Answer 23

24-28w
5.6
7.8

Question 24

treatment for GDM

Answer 24

metformin, insulin
if fasting >7 insulin

Question 25

cholescystasis treatment

Answer 25

USDCA induce at 37w

Question 26

anaemia first trim 2/3rd trim

Answer 26

<11 <10.5

Question 27

HTN normal BP in first trip and then from 20w

Answer 27

falls then rises at 20-24w

Question 28

diagnosis for HTN in preg

Answer 28

140/90 or SBP 30 and DBP 15 from booking

Question 29

preg induced HTN diagnosed when

Answer 29

20 weeks

Question 30

risk factors 2 for PET

Answer 30

first preg 40yo 10y between pregnancies BMI >35 FH MP

Question 31

risk factors 1 for PET

Answer 31

HTN in preg preg CKD AI dx DM HTN

Question 32

treatment for PET risks

Answer 32

aspirin from 12w gestation

Question 33

HELLP

Answer 33

haemolysis elevated liver enzymes low PLT

Question 34

HIV vag delivery when babies score

Answer 34

<50 at 36w >50 then 3x ART and if <50 zidovudine

Question 35

USS snowstorm

Answer 35

molar pregnancy

Question 36

APH when

Answer 36

>24w

Question 37

placenta preview is what

Answer 37

implanted in lower uterine segment painless bleeding

Question 38

placenta accrete is what

Answer 38

invades myometrium c section before is risk

Question 39

vasa praevia

Answer 39

bleeding from fatal vessels

Question 40

causes of PPH

Answer 40

tone trauma tissue trombin

Question 41

treatment for PPH

Answer 41

uterine massage IV syntocin ergometrine - not in HTN/DM

Question 42

baby blues when rx

Answer 42

d3-d10 self lim

Question 43

post natal rep when treatment

Answer 43

2-6w PN counselling sertraline, paroxetine, amitryp/noratryp

Question 44

puerperal psychosis

Answer 44

2-3w PN

Question 45

sore cracked nipples treatment

Answer 45

positioning express milk

Question 46

engorgement

Answer 46

express before feeds warm bath

Question 47

mastitis

Answer 47

simple analgesia fluclox

Question 48

raynauds

Answer 48

intermittent pain heat packs, no caffeine, no smoking

Question 49

thrush BF

Answer 49

miconazole cream <4m nystatin >4m miconazole gel

Question 50

POF age FSH done when

Answer 50

<40 4-6w apart >40

Question 51

when to stop contraception

Answer 51

55

Question 52

cyclical HRT when

Answer 52

<12m since last period or under 54

Question 53

continuous HRT when

Answer 53

>12m since last period of >54

Question 54

S/E of HRT

Answer 54

VTE breast cancer stroke CHD endom cancer

Question 55

when to refer for bleeding on HRT

Answer 55

post 6m bleeding on HRT

Question 56

follow up for HRTn

Answer 56

3 monthly then annually

Question 57

GU syndrome for menopause

Answer 57

low dose vaginal oestrogen moisturisers and lubricant

Question 58

non HRT treatment

Answer 58

fluoxetine citalopram venlafaxine clonidine

Question 59

emergency contraception - levonorgestrel when can you take dose and for BMI >26 / 70kg

Answer 59

within 72 hours 1.5mg 3mg can be used more than once in a cycle

Question 60

ella one when can you take dose BF

Answer 60

120 hours 30mg delay by 1 weeks protection 5 days

Question 61

IUD when can you insert

Answer 61

5 days or 5 days after ovulation

Question 62

TOP when

Answer 62

23+6 in UK

Question 63

when to give anti D in TOP

Answer 63

post 10w

Question 64

DEPO how does it work how long does it take to work how often

Answer 64

inhibits ovulation 7 days 13 weeks

Question 65

when to use depo

Answer 65

day 5 of cycle

Question 66

side effects of depo

Answer 66

weight gain osteoporosis irregular bleeding delay in fertility returning by 12 m

Question 67

CI to depo

Answer 67

breast cancer

Question 68

IUS when to put in how long to abstain when PP

Answer 68

7 days of period 7 days abstain 48 hours or over 4 weeks

Question 69

how long can you have IUS for endometrial protection for HRT

Answer 69

4 years

Question 70

IU=D when is it effective

Answer 70

immediately effective

Question 71

implant hormone ? how does it work when to put it in abstain

Answer 71

progesterone prevent ovulation 5 day 7 days

Question 72

side effects of implant

Answer 72

irregular bleeding headache nausea breast pain

Question 73

CI to implant

Answer 73

IHD/ stroke vag bleeding liver disease breast cancer

Question 74

COCP when to start abstain

Answer 74

d5 7 days

Question 75

COCP risks

Answer 75

VTE stroke HI breast cancer cervical cancer

Question 76

1 missed pill 2 missed pills and abstain d1-d7 15-21

Answer 76

take take last and 7 days EC miss pill free weeks

Question 77

CI to COCP

Answer 77

>35 and smoker BMI > 35 migraine epileptic

Question 78

POP side effect

Answer 78

irregular periods

Question 79

when to start POP how long to abstain

Answer 79

d1-d5 2 days

Question 80

history of GDM and second pregnancy when to do OGTT

Answer 80

ASAP and at 24-28w

Question 81

what form of contraception can people with gastric sleeve/bypass NOT have

Answer 81

oral contraceptives

Question 82

how many days after giving birth is contraception not needed

Answer 82

21 days

Question 83

rate of failure of female sterilisation

Answer 83

1 in 200