Pastest Repro

Question 1

What happens to serum T4 levels in pregnancy

Answer 1

Increase up till week 12 gestation

Question 2

What should be done to medication dose with regards to Hypothyroidism in pregnancy

Answer 2

Increase Levothyroxine by 25mg

Question 3

A thin red vulva and spotting is suggesting of which disease

Answer 3

Atrophic Vaginitis

Question 4

How is Atrophic Vaginitis typically treated

Answer 4

Local estrogen cream

Question 5

Post-coital spotting suggests a problem with which area

Answer 5

cervix

Question 6

What group of girls are more prone to developing cervical ectropion

Answer 6

Those on the COCP - due to effects of estrogen

Question 7

Define Polyhydramnios and give 5 causes

Answer 7

>2-3L of fluid 
Diabetes
Rhesus disease
GI obstruction
Increased fetal urine output
Poor fetal swallowing

Question 8

What are the first, second and 3rd line treatments for stress incontinence

Answer 8

1st –> Lifestyle changes (lower caffeine, alcohol and weight)
2nd –> at least 3 months of pelvic floor exercises
3rd –> Duloxetine

Question 9

If a woman has a past medical history of diabetes then when should be screened during gestation

Answer 9

OGTT at booking appointment

Question 10

If a woman has a first degree relative with diabetes then when should be screened during gestation

Answer 10

OGTT at 24-28weeks

Question 11

A woman presenting with depression, irritability and emotional liability during her Luteal phase suggests what condition and how could this be treated

Answer 11

Pre-Menstrual Syndrome

SSRI

Question 12

How is PID treated in the outpatient setting

Answer 12

IM Ceftriaxone and 14 days of Doxycycline + Metronidazole

Question 13

Define primary and secondary PPH

Answer 13

Primary - within first 24 hours of delivery

Secondary - 24 hours to 6 weeks postpartum

Question 14

What is first line for PPH

Answer 14

IV syntocinon

Question 15

What is the second line management for PPH and how does it work

Answer 15

Ergometrine

Alpha, Serotonin and Dopamine agonist

Question 16

When is ergometrine contra-indicated

Answer 16

High blood pressure

Question 17

Define proteinuria

Answer 17

> 300mg/24hours

Question 18

How is chickenpox immunity tested in pregnancy and what are the solutions

Answer 18

IgM = recent or current infection
IgG = Immunity
If not immune give varicella immunoglobulin

Question 19

If the bishop score is <5 or >9, what action should be taken

Answer 19

<5 –> Vaginal prostaglandin

>9 –> wait

Question 20

Define Oligohydramnios and give 5 causes

Answer 20

<500ml at 32-36 weeks 
PROM
Renal Agenesis 
IUGR
Post-term 
Pre-eclampsia

Question 21

What are the blood pressure cutoffs for the COCP being contraindicated

Answer 21

> 160 systolic

>95 diastolic

Question 22

If an ectopic pregnancy with the presence of a fetal heartbeat is found, what is the appropriate management

Answer 22

Surgical

Question 23

Which triad of symptoms is common to both Endometriosis and PID and how can they be differentiated

Answer 23

Dysmenorrhoea, Dyspareunia & Subfertility
PID –> cervical excitation
Endometriosis –> pain associated with menstruation

Question 24

An offensive yellow-green discharge and a strawberry cervix suggests which pathology

Answer 24

Trichomonas vaginalis

Question 25

What is the treatment for Trichomonas vaginalis

Answer 25

oral Metronidazole

Question 26

Sub-epithelial reactive lymphoid follicles is a description of which disease

Answer 26

Follicular cervicitis

Question 27

Name 5 risk factors for breech presentation

Answer 27

``` Fibroid Placenta Praevia Poly/Oligohydramnios Fetal abnormality Pre-term ```

Question 28

What is the triad of symptoms which suggest vasa praevia

Answer 28

PROM Painless Vaginal Bleeding Fetal Bradycardia

Question 29

What is a Kleihauer test used for

Answer 29

Detection of fetal cells in maternal circulation | used for any potential sensitization event past 20 weeks

Question 30

How does a molar pregnancy change thyroid concentration

Answer 30

Increased bHCG, Increased Thyroxine, Low TSH

Question 31

What is the protocol if a cervical smear is due during pregnancy

Answer 31

Re-schedule to at least 12 weeks postpartum

Question 32

What are the 3 main questions to answer when considering hormone replacement therapy

Answer 32

Is there a uterus present? Peri/Post-menopausal? Systemic or Local HRT needed?

Question 33

How is post-menopausal defined

Answer 33

12 months since last menstrual period

Question 34

Who should be offered cyclical/ continuous HRT

Answer 34

Continous --> Post-menopausal | Cyclical --> Peri-menopausal

Question 35

When can systemic estrogen-only HRT be offered

Answer 35

If complete hysterectomy

Question 36

When is contraception no longer needed with regards to menopause

Answer 36

if < 50 --> not until at least 2 years since LMP | if > 50 --> not until at least 1 year since LMP

Question 37

What is given for infection prophylaxis in PROM

Answer 37

Erythromycin

Question 38

What is given for Group B strep Prophylaxis

Answer 38

Benzylpenicillin

Question 39

When should the fundus be palpable at the level of the umbilicus

Answer 39

20 weeks

Question 40

When should the fundus be palpable at the level of the xiphisternum

Answer 40

36 weeks

Question 41

With regards to the combined contraceptive patch, what should be done if one is missed

Answer 41

If delay < 48hours --> new patch + no action If delay > 48 hours --> new patch + condoms for 7 days If the patch removal is delayed at the end of week 3 --> removed as soon as possible and the new patch applied on the usual cycle start day for the next cycle If patch application is delayed at the end of a patch-free week, additional barrier contraception should be used for 7 days following any delay at the start of a new patch cycle

Question 42

Name 4 risk factors for cord prolapse

Answer 42

Prematurity Multiparity Polyhydramnios Placenta praevia

Question 43

How is cord prolapse managed

Answer 43

Elevate presenting fetal part and put woman on knees and elbows

Question 44

What is Asherman's Syndrome

Answer 44

Intra-Uterine adhesions after invasive procedure

Question 45

Unilateral breast pain and erythema in a wedge shape distribution suggests what

Answer 45

Lactational Mastitis