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Year 3 > Repro last min stuff > Flashcards

Repro last min stuff Flashcards

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1
Q

3 blood supplies to breast and where they come from?

A

Internal mammary from internal thoracic

Posterior intercostal from thoracic aorta

Lateral thoracic from subclavian

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2
Q

Most lymph from breast drains to axillary - where does the rest drain to?

A

Parasternal
Abdorminal nodes
Nodes of contralateral breast

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3
Q

Popcorn calcification on mammography?
Tea cup?
Rod shaped?
Microcalcifications?

A

Popcorn - fibroadenoma
Tea cup - micro cyst
Rod - duct ectasia
Micro - normally DCIS, some may be invasive carcinoma (usually pleomorphic)

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4
Q

Cobblestone breast and cyclical pain

A

fibrocystic change

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5
Q

older women, lump, blood stained discharge

A

pappiloma

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6
Q

subareolar lump, purulent +/- blood stained discharge

A

duct ectasia

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7
Q

Grading of breast cancer?

A

Grade based on

  • pleomorphism (1-3)
  • tubular differentiation (1-3)
  • Mitotic activity (1-3)

3-5 = grade 1
6, 7 = grade 2
8, 9 = grade 3

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8
Q

Staging of breast cancer?

A

T1 <2cm
T2 2-5cm
T3 >5cm

N0 no nodes
N1 mobile node
N2 fixed node

M0 no mets
M1 mets

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9
Q

Best & worst prognosis of breast cancer in terms of hormones?

A

Best - ER +, PR +, HER2 -

Worst = ER -, PR -, HER2 +

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10
Q

Poor prognostic factors for breast cancer?

A

<35
HER2 +
ER -
PR -

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11
Q

When is WLE done?

A

<4cm

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12
Q

When is mastectomy done?

A

> 4 nodes
Grade 3
4cm
Poor surgical margins <1cm

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13
Q 
Extremely low birth weight?
Very low?
Low?
Normal?
Large?
A 
Ex <1000g
VL <1500g
Low <2500g
Normal 2500-4000g
Large >4000g
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14
Q 
Miscarriage?
Still birth?
Perinatal mortality?
Neonatal mortality?
Postnatal mortality?
Infant mortality?
A 
Miscarriage <24 weeks
Still 24 weeks - birth
Peri - 24 weeks - 1 week post 
Neonatal - birth - 4 weeks
Post - 4 weeks-1 year
infant - birth - 1 year
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15
Q

APGAR?

A

Appearance: 0 pals, 1 pale extremities, 2 pink
Pulse: 0 absent, 1 <100, 2 >100
Grimace: 0 no reaction, 1 grimace/ pull away, 2 grimace + cough/sneeze cry
Activity: 0 floppy, 1 some tone, 2 active motion
Resp: 0 absent, 1 slow, irregular, 2 cries well

> 7 normal
4-6 low
<4 critical

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16
Q

Histology of bronchopulmonary dysplasia?

A

Necrotising bronchitis

Hyperinflation

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17
Q

mucous/bloodstained diarrhoea, poor feeding, abdo distension/tenderness, CXR bowel wall oedema + pneumostasis intestinalis?

A

Necrotising enterocolitis

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18
Q

Hypoxic ischaemic encephalopathy?

A

Complication of birth-related asphyxia - failure to establish spontaneous breathing after birth

Seizures, loss of muscle tone, decreased ability to breathe

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19
Q

Sign on head of intraventricular haemorrhage?

A

Bulging frontanelles

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20
Q

Causes of pathological jaundice? (5)

A

sepsis, haemorrhagic disease of newborn, Rh/ABO incompatability, G6PD deficiency, spherocytosis

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21
Q

Causes of prolonged jaundice? (4)

A

hypothyroidism
Infection (TORCH/UTI)
biliary atresia
CF

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22
Q

2 main cyanotic heart defects? CXR?

A

tetralogy of fallot - boot shaped cardiomegaly

transposition of great vessels - egg-shaped cardiomegaly

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23
Q

Gastroschisis?

Exomphalos?

A

extrusion of abdo viscera

herniation of viscera covered in peritoneum - more common in chromosomal abnormalities

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24
Q

Causes of early (<48hrs) sepsis?

Late (>48 hrs)?

A

GBS, e. coli

Listeria, staph

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25
Standard treatment of neonatal sepsis? Treatment of neonatal pneumonia? Meningitis? UTI?
Benzylpenicillin + gentamicin Amox Ceftriaxone + amoxicillin amox + gent
26
Presentation of PPHN? | Rx?
RDS, cyanosis, loud S2 Supportive, inotropes
27
Male repro duct?
Male - Wolffian duct/mesonephric Female - Mullerian/paramesonephric
28
How does male/female differentiation occur?
If Y chromosome then testes sectete testosterone (wolffian duct grows) and anti-mullerian hormone (mullerian duct degenerates) If no Y chromosome absence of testosterone (wolffian duct degenerates) and absence of anti-mullerian hormone (mullerian duct grows) Presnce/absence of testosterone causes development of male/female genitalia Presence/absence of anti-mullerian hormone causes development of male/female repro tract
29
When does sex differentiation occur? | When is it seen on USS?
9 weeks 16 weeks
30
What is androgen insensitivity syndrome?
Congenital insensitivity to androgens 46 XY genotype but female phenotype - X-linked recessive Testes develop but do not descend Mullerian inhibition occurs so testes, and short vagina Presents at puberty with primary amenorrhoea and failure to develop secondary sexual characteristics
31
Management of cryptorchidism? (undescended testes)
Orchidoplexy if <14y/o If adult then orchidectomy (6x risk of testicular germ cell cancer)
32
Function Leydig cells? | Sertoli cells?
Leydig - release testosterone in response to LH Sertoli - form blood/testicular barrier, nutrients, phagocytosis, secrete inhibin/activin, secrete androgen binding globulin
33
Release of LH/FSH in males?
Controlled by GnRH, under -ve feedback from testosterone
34
Function of activin and inhibin?
Inhibin prevents FSH release Activin causes FSH release
35
Systemic causes of amenorrhoea?
hyperthyroidism Renal failure Pituitary disease Haemochromatosis
36
Genetic causes of amenorrhoea?
Kallmann's Turner's syndrome Prader willi
37
Systemic causes of menorrhagia?
``` Hypothyroidism Diabetes Adrenal disease ITP vWD Renal disease Liver disease ```
38
Pearl index of: - depot? - coil? - mirena? - Implant? - tubal ligation?
``` depot - 0.3% coil - 0.5% mirena - 0.2% implant - 0.1% tubal - 0.5 ```
39
MOA: - depot? - coil? - mirena? - implant?
``` depot - inhibits ovulation coil - prevents fertilisation mirena - prevents implantation implant - inhibits ovulation COCP - inhibits ovulation POP - thickens cervical mucous +/- inhibits ovulation ```
40
CI depot?
Breast cancer
41
Side effects of depot?
weight gain delay in return of fertility irregular bleeding
42
CI copper coil/mirena?
peptic ulcer disease PID fibroids Hx endometrial/cervical cancer
43
SE copper coil?
menorrhagia infection ectopic
44
SE mirena?
irregular bleeding initially infection ectopic
45
Problems with patch?
Reduced efficacy if obese Breast pain, nausea, painful periods, increased thrombotic risks compared to other combined ones
46
How long after EC can contraception be used?
Levonelle immediately EllaOne 5 days
47
CO COCP?
``` BP>160/95 Migraine with aura Smoking >15 if >35 BMI >34 IHD Hx breast cancer APS Hx thrombosis Advanced diabetes ```
48
Oestrogen changes around menopause?
Decreased E2 - produced from ovaries, main one Increased E1 - produced from fat
49
3 most common symptoms of pre eclampsia?
headache visual disturbance epigastric discomfort
50
Treatment of eclampsia?
Mg SO4 | consider diazepam if repeated seizures despite repeated MgSO4 boluses
51
Who would the following cases be referred to: - woman with ovarian cyst strongly suggestive of malignancy - woman with stage III cervical cancer? - woman with strong FHx of breast/ovarian Ca - woman with fibroids wanting embolisation
- gynaecological oncologist - radiotherapist - geneticist - radiologist
52
Treatment options for fibroids?
Symptomatic - tranexamic/mefanamic acid pre-surgery - GnRH anologues Nulliparous - myomectomy Family complete - hysterectomy
53
Is the COCP CI before laparoscopic sterilisation?
No - only major surgery
54
Treatment of HPV warts in pregnancy?
NOT podophyllin, local techniques?
55
First line Ix for woman with PMB on Tamoxifen?
Hysterescopy & Biopsy - TVUS cannot differentiate potential cancer from thickening due to tamoxifen
56
3 things that cause polyhydramnios?
Diabetes mellitus multiple pregnancy Things that decrease foetal swallowing e.g. trachea-oesophageal fistula/anencephaly
57
Things that cause oligohydramnios?
NSAIDs | renal agenesis
58
Ix for tubal infertility?
Laparoscopy and dye hydrotubulation
59
Staging of uterine cancer?
``` 1A <50% myometrium 1B >50% 2 - cervical stroma 3A - serosa 3B - vagina 4A - bladder/bowe; 4B - distant mets ```
60
Contraindications for forceps/ventouse?
mal-presentation i.e. breech | Absolute cephalopelvic disproportion
61
Definition of: - extremely preterm? - very preterm? - mod-late preterm? - term? - post-term?
``` <28 28-32 32-37 37-42 >42 ```
62
If woman goes into premture labour - meds for baby?
If <34 weeks delay with Nifedipine Dexamethasone MgSO4 Consider dexamethasone up till 36 weeks
63
When is OFTT done if RF?
28 weeks
64
Combined test?
up to 14 weeks nuchal thickness PAPPA hCG
65
Quadruple test?
15-20 weeks hCG PAPP-A AFP E3
66
If sensitisation event <20 weeks? | If >20 weeks?
< 20 = anti-D | >20 weeks = anti-D + kelihauer

Year 3 (19 decks)

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