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Obs and Gynae > Passmedicine > Flashcards

Passmedicine Flashcards

(71 cards)

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1
Q

Which chemotherapy drug increases the risk of which type of gynae cancer?

A

Tamoxifen increases the risk of endometrial cancer

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2
Q

Most common cause of post-coital bleeding

A

Cervical ectropion

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3
Q

Risks of hysterectomy surgery with antero-posterior repair

A

Enterocele and vaginal vault prolapse

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4
Q

What is Meigs syndrome?

A

OAP
Ovarian tumour (benign)
Ascites
Pleural effusion

-usually occurs in those over age 40

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5
Q

One of your patients has endometrial hyperplasia, which medication is associated with the development of this condition?

A

Tamoxifen

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6
Q

What is premature menopause?

A

Menopause that occurs in a woman below the age of 40

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7
Q

The most common type of ovarian epithelial tumour

A

Serous cystadenoma

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8
Q

If this ovarian tumour ruptures, it may cause pseudomyxoma peritonei

A

Mucinous cystadenoma

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9
Q

What inhibits FSH and LH?

A

Oestrogen

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10
Q

Which LFT might be raised in pregnancy?

A

ALP (because of placental ALP)

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11
Q

What might raise your CA-125?

A

Ovarian cancer
Endometriosis
Pelvic inflammatory disease
Raised at certain points of menstrual cycle

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12
Q

In terms of the bishop score, what level is 0 for fetal station

A

0 = level of ischial spines

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13
Q

When are people with rubella contagious?

A

From 7 days before rash, to 4 days after rash

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14
Q

What is port-partum haemorrhage?

A

A loss of 500mls or more

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15
Q

What is primary post-partum haemorrhage?

A

Haemorrhage that occurs within 24 hours

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16
Q

What is secondary post-partum haemorrhage?

A

Haemorrhage that occurs between 24 hours and 12 weeks

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17
Q

Most common cause or primary post-partum haemorrhage?

A

Uterine atony

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18
Q

Which antibiotic would you give a breastfeeding woman with a UTI?

A

Trimethoprim

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19
Q

When would you offer external cepahlic version? (ECV)

A

At 36 weeks

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20
Q

What might cause a macrocytic anaemia?

A

B12 or folate deficiency

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21
Q

What is the Kleihauer test?

A

Used to measure the amount of fetal RBCs present in the maternal circulation

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22
Q

When are oxytocin and vaginal prostaglandin contraindicated?

A

In foetal distress

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23
Q

Treatment for baby affected in rhesus

A

Transfusions, UV phototherapy

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24
Q

Why might you be more likely to have placenta praevia?

A

Caesarian sections, multiparity

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25
Invesitgation if you suspect placenta praevia
Ultrasound
26
Management of placenta praevia with bleeding
Admit, treat shock, cross match Caesarean section for grades III/IV Vaginal delivery for grade I
27
First line treatment for gestational hypertension
Oral labetalol
28
When can gestational hypertension be diagnosed?
From 20 weeks
29
Which anti-epileptic medication can be used during pregnancy?
Lamotrigine
30
The combined test
HCG and PAPP-A
31
The triple test
HCG, AFP and oestriol
32
Low and raised AFP
Raised AFP - neural tube defects | Low AFP - Down syndrome
33
How often should fetal heart rate be checked in labour
Every 15 minutes
34
How often should contractions be assessed in labour
Every 30 minutes
35
How often should maternal pulse be checked during labour?
Every 60 minutes
36
How often should maternal BP and temp be checked during labour?
Every 4 hours
37
How often should maternal urine be checked during labour?
Every 4 hours (check for ketones and protein)
38
How often should vaginal exam be performed during labour?
Should be offered every 4 hours to check for progression of labour
39
Antibiotic of choice for premature rupture of membranes
Erythromycin
40
Say a patient had PROM and a swab should group B strep, what antibiotics would you give?
Penicillin and clindamycin
41
A mother has hep B, what should you give her baby?
Should be given a complete course of vaccination and hep B immunoglobulin
42
Which women are screened for hep B?
All women
43
Is it safe for a woman with hep B to breastfeed her baby?
yes
44
Can hep B or HIV be transmitted during breast feeding?
Hep b - no | HIV - yes (avoid even if taking anti-virals as still risk of transmission)
45
A 19 year old woman presents with a 2 day history of central lower abdominal pain and one day history of vaginal bleeding. Her last period was 8 weeks ago. On examination her cervix is tender to touch
Ectopic preganancy
46
Which procedure commonly predisposes to Asherman's syndrome?
Dilatation and curettage
47
Initial definitive management for cord prolapse?
Place hand into vagina to elevate the presenting part
48
How might cord prolapse present?
Variable decelerations
49
When do the majority of cord prolapses occur?
At artificial rupture of the membranes
50
Most common explanation for short episodes (<40 minutes) of decreased variability on CTG?
Baby is sleeping | start to worry if decelerations last longer than 40 minutes
51
A pregnant lady comes into contact with someone with chicken pox, what should you do?
1) ask her if she has ever had chicken pox 2) if she doesn't know, then check her antibodies 3) if she isn't immune then give her varicella immunoglobulin (within 10 days of exposure)
52
Risk factors for uterine atony?
Multiple pregnancy | Induction of labour
53
When are women screened for anaemia?
At booking visit (done at 8-10 weeks) | and at 28 weeks
54
What normally happens to blood pressure during pregnancy?
Falls in first half of pregnancy before rising to pre-pregnancy levels before term
55
Diagnostic criteria for hyperemesis gravidarum?
5% pre-pregnancy weight loss AND dehydration AND electrolyte imbalance
56
What is the direct Coombs test?
Investigation used to look for autoimmune haemolytic anaemia
57
What is the indirect Coombs test?
Investigation used antenatally to detect antibodies in the maternal blood that can cross the placenta and result in haemolytic disease of the newborn
58
How much folate should an epileptic planning to get pregnant take?
5mg per day
59
A hepatitis B serology positive woman gives birth to a healthy baby girl. The mother is surface antigen positive. What treatment should be given to the baby?
Hap B vaccine and 0.5 millilitres of HBIG within 12 hours of birth, with a further vaccine at 1-2 months and a further vaccine at 6 months
60
Deficiency of which vitamin causes Wernickes encephalopathy?
Vitamin B1
61
Budd-chiari triad
Ascites Liver enlargement Abdominal pain
62
Where is hCG secreted from?
Secreted by syncytiotrophoblasts
63
What does HCG do?
Maintains the production of progesterone by the corpus luteum (basically stops the corpus luteum from breaking down)
64
When can HCG be detected in the maternal blood stream?
Can be detected in the maternal blood as early as 8 days after conception
65
What happens to HCG levels during pregnancy?
hCG levels double approximately every 48 hours in the first few weeks of pregnancy. Levels peak at around 8-10 weeks gestation. Measurement of hCG levels form the basis of many pregnancy testing kits
66
Active management of the third stage of labour involves what?
Uterotonic drugs Deferred clamping and cutting of cord, over 1 minute after delivery but less then 5 minutes Controlled cord traction after signs of placental separation (also give oxytocin to reduce risk of post-partum haemorrhage)
67
What is HELLP syndrome?
A severe form of pre-eclampsia
68
When is the anomaly scan performed?
18-20+ 6 weeks
69
Which diabetes medication is safe during breastfeeding?
Metformin
70
What is lochia?
Vaginal discharge containing blood, mucous and uterine tissue, which may continue for 6 weeks after childbirth
71
What should you give a pregnant lady with Factor V Leiden?
Low molecular weight heparin (LMWH) antenatally AND for 6 weeks postpartum (i.e. during and after pregnancy)

Obs and Gynae (8 decks)

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