Passmed (WH) Flashcards by Oliver Carruthers

Guidelines for chicken pox exposure in pregnancy?

Exposed:
<20 wk, vzIG w/i 10days
>20 wk VzIG/acyclovir after 2 weeks

Developed:
<20 wk, acyclovir w/ caution
>20 wk - acyclovir w/i 24hr of rash (oral!)

How well did you know this?

Not at all

Perfectly

Definition of gestational hypertension vs pre-eclampsia?

GH: >140/90 after 20 weeks
PRe: Htn + symptoms (i.e. swelling) OR proteinurea

How well did you know this?

Not at all

Perfectly

Fasting glucose > 7mmol, first line managment?

Insulin (w/ or w/o metformin)

How well did you know this?

Not at all

Perfectly

Fasting glucose < 7mmol, managrment?

Start with diet & exercise offered

How well did you know this?

Not at all

Perfectly

Managment of fibroids that are:
A) Large
B) Sub-fertility

Myomectomy

How well did you know this?

Not at all

Perfectly

Which cancer does combined HRT cause an increased risk of?

Breast cancer (oestrogen & progestogen)

Whereas remember COCP protects from ovarian & endometrial & inc B&C

How well did you know this?

Not at all

Perfectly

How to remember different management for stress & urinary incontinence?

Stress: lower causes, PFMT, Duloxetine
Urge: avoid trigger, bladder training, anti-muscarinics

How well did you know this?

Not at all

Perfectly

Marker of an ectopic vs missed?

Both would show empty uterus but ectopic would still have bHCG>1,500

How well did you know this?

Not at all

Perfectly

What are the different time limits for emergency contraception?

120 hours for ellaOne 72 for levonelle one

How well did you know this?

Not at all

Perfectly

When should you do a saplingectomy instead of otomy?

If the other tube is still patent

How well did you know this?

Not at all

Perfectly

When does smoking become part of UKMEC4?

If 35 yo + and 15 or more per day

How well did you know this?

Not at all

Perfectly

Acroynm for shoulder dystocia mx?

HelpERR H- call for help
E- evaluate for episiotomy
L- leg to McRoberts
P- supraPubic Pressure
E- enter: rotational manouevres
R- remove the posterior arm
R- roll pt to hands and knees

How well did you know this?

Not at all

Perfectly

Primary Mx of ovarian Ca: Ca125 or TVU first?

CA125, after pelvic and abdominal exam

How well did you know this?

Not at all

Perfectly

Best anti-depressant for PPD?

Sertraline

Citalopram and duloxetine are present at higher levels in breast milk and so are less favourable compared with sertraline.

How well did you know this?

Not at all

Perfectly

Risk factors for hypermesis?

Nulliparity, obesity, multiple parity

How well did you know this?

Not at all

Perfectly

First line meds for PP thyroiditis

Propanolol (Sx mx) not carbimazole

Since PP T just becomes hypothyroid so can make it worse

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

First investigation for reduced foetal movements? Past how many weeks is serious?

Hand-held Doppler. Past 28 weeks

How well did you know this?

Not at all

Perfectly

Concern of old woman with lump on labia?

Vulval carcinoma

How well did you know this?

Not at all

Perfectly

What to do if a 1 cocp pill is missed?

Take the latest asap even if means having to take 2 in one day

How well did you know this?

Not at all

Perfectly

Side effects of the progesterone only pill?

irregular vaginal bleeding

How well did you know this?

Not at all

Perfectly

What is dialation and curettage?

Dilation of the cervix and scrapping out the endometrial cavity

How well did you know this?

Not at all

Perfectly

What is the reason why those with migraines cannot have the Pill

Since increased risk of ischemic stroke

How well did you know this?

Not at all

Perfectly

How to remember which is the medical treatment for urinary stress incontinence?

Duloxetine - if you’re stressed need to relaaax (SNRI)

n.b. desmopressin in enuresis, anti-muscarinic in OAB

How well did you know this?

Not at all

Perfectly

What is the rule for followup of individuals who have been already treated for CIN ?

6 months

How to remember the bishops score components?

Call PEDS for station: Cervical position effacement, dilatiion, softness; foetal station

Bishop score components are scored from 0-3, what is 2 score?

P: anterior E: 60-70% D: 3-4cm S: soft station, -1,0

What does bishops score >8 mean?

Spontaneous labour soon

Criteria for pre-eclampsia?

>20 weeks, >140/90 & pain or proteinurea

What drugs are contraindicated in pregnancy?

- antibiotics: (ciprofloxacin, tetracycline, chloramphenicol, sulphonamides) - psychiatric drugs (lithium, benzos) - aspirin - carbimazole - methotrexate - sulfonylureas - cytotoxic drugs - amiodarone

Women with risk factors of pre-eclampsia should take what from when?

75-150mg of aspirin from 12 weeks gestation

For women at risk of gestational diabetes how should they be investigated?

OGTT after booking and at 24-28

Moderate risk factors for pre-eclampsia? How many needed before you need to take aspirin?

first pregnancy age 40 years or older pregnancy interval of more than 10 years body mass index (BMI) of 35 kg/m² or more at first visit family history of pre-eclampsia multiple pregnancy 2 or more

COC missed pill guidelines

1 miss pill -> 2 next day 2+ miss pill -> 2 next day & barrier for 7 Wk 1 : take emergency pills Wk 2 : no need emergency pills, just barrier 7 days Wk 3 : no need emergency pills and omit pill free interval

Tamoxifen is an SERM (selective oestrogen receptor modulator), how does it act in the body?

It blocks E receptors in the breast (prevent ca) and stimulates in the uterus & bones (preventing osteop’ but encouraging endometrial hyperplasia)

Which contraceptives are effective the quickest?

Instant: IUD 2 days for POP

What are some methods of surgical Mx of miscarriage?

Dilation & curettage, manual/electric vacuum aspiration

Policy if only one pill missed (COCP)

Can just take the next pill

Side effect of GNrH agonists?

Loss of bone mineral density

In a lady with a 35 day cycle, what day would be best to measure her progesterone?

So working back from 35, (-14) is start of luteal phase, so half way through then (i.e. 28)

Candidiasis treatment: not actually clotrimazole, what is it?

Oral fluconazole 150mg as a single dose first line

What is the medication for suppressing a woman’s lactation?

Cabergoline (think of a pair of breasts like cabbages)

Congenital rubella syndrome vs congenital cytomegalovirus?

Both might have low birth weight, seizures etc but rubella would classically have deafness & eye abnormalities

Bishops score, score milestones?

< 5 means unlikley to start w/o induction. >=8 spontaneous gonna happen

When is the HELPPER management used ?

In shoulder dystocia; help epistomy, legs in mcroberts, pressure suprapubic

When can women start to use the COCP post-partum?

Either after 6 weeks (if breast feeding, or 3 if not)

Chicken pox exposure brief guidelines?

Give VZ IG if needed <20 weeks; CP threat high: >20wk oral acyclovir, <20wk consider w/caution

If a semen sample is abnormal, when does it need to be re-tested?

ideally 3 months later

What is a long-term complication of vaginal antereo-posterior repair?

Vaginal vault prolapse. Prevents each side of the roof caving in but the top might droop in

The 3 methods of emergency contraception and when they can be used?

Levonorgesterel, w/i 72hrs; Ulipristal w/i 120hrs. IUD (copper) w/i 5 days or w/i 5 days of likely ovulation

How to remember the high risk factors for pre-eclampsia?

Hypertensive disease in pregnancy / chronic hypertension SLE etc Diabetes 1/2

What is the preventative risk for women with at least 1 high risk factor for pre-eclampsia?

Aspirin 75-150mg from 12 weeks

Which women need to take folate supplementation until 12th week?

Previous NTD; eplieptic/coeliac/diabetes; obese (BMI 30+)

What is androgen insensitivity syndrome?

Where they have testes but these don't develop properly due to insensitivity. But they still develop breasts (testosterone converted into oestrogen)

What is the first line management for post-partum haemorrhage?

To compress the uterus (& catheritise) | For managing aTony, ## Footnote Tissue, Tone, Trauma, Thrombin

Which genital tract infections present with discharge? How to differentiate?

- BV (fishy white) - Trich (green/grey) - Candidiasis (cottage cheese)

Summarise the antibiotics used for genital infections?

Bv - Metronidiazole Trich - metronidiazole Gonorrhoea - IM ceftriaxone (gram -) Chalmydia - doxycycline /azithromycin

When are we using mifepristone & misoprostol vs using methotrexate?

Methotrexate in ectopic. Other in termination

When do you need to have stopped methotrexate?

6 months before doing (m&f) | I.e. methosexate

Is candidiasis more acidic or alkali? Treatment normally vs pregnant?

More alkali. Oral fluconazole. Need clotrimazole pessary in pregnancy

How to remember risk factors for hyperemesis?

- Inc levels of B-HcG (twins/tropho' d) - First time (nuliparity) - Obesity - Past Hx (family or personal) | n.b. smoking decreases B-HcG so actually lower rise of HG

Passmed (WH) Flashcards

(61 cards)