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1

where is CIN most likely to arise

the transformation zone at the squamo-columnar junction

2

how long is the female urethra

4cm

3

at what stage of pregnancy does the uterus rise out of the pelvis

12 weeks

4

describe some of the physiological changes that occur during pregnancy

an increase in plasma volume by 50% resulting a physiological anaemia.
Blood pressure decreases from second trimester due to vasodilatation.
Glomerular filtration increases to cope with the additional load of the fetus, resulting in a decrease in creatinine and urea levels.
Due to increase 30-45% increase in cardiac output, systolic ejection murmurs are common.
Thromboembolism increase in pregnancy due to the thrombophilic state resulting from haemostatic and fibrinolytic changes

5

how long does the vagina measure

8cm

6

where does the pudendal nerve pass in relation to the ischail spine

The pudendal nerve passes behind and below the ischial spine

7

where does the ovarian artery arise

the aorta

8

in preeclampsia what is defined as significant proteinuria

more than 300mg/L

9

a small for gestational age baby is one which has an abdominal cicumferance below which centile

10th

10

what factors increase the risk of endometrial cancer

PCOS
diabetes
obesity

11

what weight is defines as macrosomia

birthweight more than 4 kg regardless of gestational age

12

what incontinence medication should not be used in frail elderly people

oxybutinin

use tolteridine instead

13

what is adenomyosis

endometrial tissue within the myometrium

14

how is adenomysosis diagnosed

MRI pelvis

15

what is the combined test for down's syndrome and when in pregnancy is it done

nuchal translucecny on ultrasound scan + bHCG and PAPP-A

recommended at 10-14 weeks
in down's syndrome PAPP-A is low and bHCG is high

16

what is the quadruple test for down;s syndrome and when is it done in pregnancy

Alfa-fetoprotein (AFP), unconjugated oestriol, beta-hCG and inhibin A.

In pregnancies with Down Syndrome, AFP and unconjugated oestriol are low and beta-hCG and inhibin A are raised.

done if combined test window missed - weeks 14-20

17

what changes on a CTG would be termed pre terminal and thus require emergency caesarian

terminal bradycardia - HR below 100 for more than 10 minutes
terminal decelerations - HR drops and does not recover within 3 minutes

18

who gets anti D give prophylactially in pregnancy at at what gestations

given to Rh neg mothers what have not been senstitised ad 28-34 weeks

19

how should you managed a pregnant woman who comes into contact with chicken pox and is unsure if they have had it before

check varicella IgM and IgG if IgG neg it suggests never having had it

give varicella immunoglobulin if there is doubt about immunity

do not give vaccine as it is live attenuated and there is a small risk of causing chicken pox

20

how do you manage a women who has a high vaginal swab postivie for GBS during pregnancy

do not need to treat immediately

give IV benzylpenicillin during delivery "intrapartum"

21

how long should magnesium sulphate be continue in pre eclampsia

either 24 hours after delivery or 24 hours after last seizure

22

what drugs are safe in breastfeeding

antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin

23

what drugs are contraindicated in breastfeeding

Lithium
Aspirin
Methotrexate
Benzos
Amioderone
Sulphonylureas
Tetracyclines
4Cs- Carbimazole, Ciprofloxacin, Chloramphenicol, Cytotoxics

24

Rokitansky's protuberance.

Dermoid cyst/teratoma

25

what does a positive fetal fibronectin (fFN) test indicated

that preterm labour is likely (not definite)

26

what makes up the risk malignancy index in ovarian cancer

USS, Ca125 and menopausal status

27

what should babies born to mothers acutely or chronically infected with hep B during pregnancy

hep B vaccine at birth , one month and 6 months

if mother is antigen positive then also hep b immuniglobulin at birth

28

woman who does not want to take HRT - what can you give her for the vasomotor symptoms of menopause

SSRI

29

give causes of polyhydramnios

multiples
fetal anomolies
diabetes
hydrops fetalis
idiopathic

30

give causes of oligohydramnios

premature rupture of membranes
fetal renal problems e.g. renal agenesis
intrauterine growth restriction
post-term gestation
pre-eclampsia

31

at what cut off should a woman recieve oral iron therapy in pregnancy

HB less than 11 at booking or 10.5 at 28 weeks

32

contraindications to breastfeeding

HIV
galactosaemia

33

what medications are avoided in breast feeding

antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines, cloazapine
aspirin
carbimazole
methotrexate
sulphonylureas
cytotoxic drugs
amiodarone

34

what medications are okay in breastfeeding

antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin

35

first line treatment of post natal depression in a woman with no previous history of depression

psychological intervention (CBT)

SSRI or TCA if not improving with CBT or if CBT refused

36

chlamydia +perihepatic adhesions

fitz hugh curtis

37

scissoring of legs

cerebral palsy

38

A 6-year-old girl presents with a one week history of febrile illness with sore throat and headache. One day prior to hospital admission, the patient awoke with pain and swelling in the right ankle. On examination, she has a warm swollen right ankle and a systolic heart murmur, consistent with mitral regurgitation.

rheumatic fever - group A step ie step pyoogenes