Repro Misc. Flashcards
1
Q
What are the two primitive genital tracts called
A
Mesonephric/ Wolffian
Paramesonephric/ Mullerian
2
Q
Which two chemicals do fetal testes release and what does this cause
A
Testosterone and Mullerian Inhibiting Factor
Causes the Mullerian tract to degenerate
3
Q
What is metrorrhagia
A
Bleeding between periods
4
Q
Define Polymenorrhoea
A
Bleeding < 21-day interval
5
Q
Define Oligomenorrhoea
A
Bleeding > 35-day interval
6
Q
What endometrial thickness on transvaginal ultrasound is indicative of a need for biopsy
A
Premenopausal - >16mm
Postmenopausal - >4mm
7
Q
Name a normal bacterial flora in the vagina
A
Lactobacillus
8
Q
What do Lactobacillus produce in the vagina
A
produce lactic acid and hydrogen peroxide
9
Q
Which organism causes vaginal thrush
A
Candida Albicans
10
Q
How is vaginal thrush diagnosed
A
Swab + culture
11
Q
Clue cells on microscopy indicate which disease
A
Bacterial vaginosis
12
Q
How is vaginal thrush treated
A
Topical Clotrimazole
13
Q
How is bacterial vaginosis treated
A
Oral Metronidazole
14
Q
How is bacterial prostatitis diagnosed and treated
A
Diagnosed by first pass urine sample
Treated with ciprofloxacin for 28 days
15
Q
How are chlamydia and gonorrhoea diagnosed
A
NAAT/ swab
16
Q
How is gonorrhoea treated
A
IM Ceftriaxone 500mg
17
Q
How is chlamydia treated
A
100mg Doxycycline bd 7 days
18
Q
What is another name for gestational trophoblastic disease
A
Molar pregnancy
19
Q
What is the main difference between a miscarriage and a molar pregnancy
A
The embryo is viable in miscarriage
The embryo is abnormal in a molar pregnancy
20
Q
What is a buzzword for a partial molar pregnancy
A
Grape-like clusters
21
Q
Which type of molar pregnancy involves 1 or 2 sperm fertilising an egg with no DNA
A
Complete mole
22
Q
Describe the genetic material in a partial mole
A
1 sperm ( reduplicating DNA material) or 2 sperms fertilising an egg, resulting in triploidy
23
Q
A woody hard uterus suggests which pathology
A
Placental abruption
24
Q
What is the classical presentation of Placenta Praevia and what should you do next
A
Recurrent painless bleeding > 24 weeks
Ultrasound
*do not perform PV exam
25
What is Placenta Accreta and what is a major risk factor
The placenta invades the myometrium
| previous C-section is a risk factor
26
How is Pearl Index calculated
[Number of accidental pregnancies x 1200] / total months of exposure
27
Which three forms must be filled out after an abortion and which one requires 2 doctors to sign it
HSA1, HSA2, HSA4
HSA1 requires 2 doctors
HSA2 completed within 24hours
HSA4 sent to CMO in 7 days
28
What is the limit for social termination of pregnancy
23weeks 6 days
29
What is the Tayside medical termination of pregnancy limit
18 weeks 6 days
30
What is the Tayside surgical termination of pregnancy limit
12 weeks
31
What is the lamda sign on ultrasound a buzzword for
Strongly suggests a dichorionic (each twin has its own placenta) twin pregnancy
32
Which sign may be seen on ultrasound to suggest a monochorionic pregnancy
T- sign
33
Name 2 ways in which Hypertension in pregnancy is diagnosed
> 140/ 90 on 2 ocassions
| > 160/ 110 once
34
What are the three 1st line drugs for hypertension during pregnancy
Methyldopa
Nifedipine
Labetalol
35
When might methyldopa be contra-indicated
Depression
36
Name two drugs which are 2nd line for hypertension during pregnancy
Hydralazine
| Doxazocin
37
What should be given to those women at risk of pre-eclampsia
75mg Aspirin from 12 weeks gestation till birth
38
Which system is used to grade vaginal prolapses and which structure does it use as a reference
POP-Q system
| Hymen used as a reference point
39
How long should a baby be exclusively breastfed
6 months
40
How and when should mastitis be treated
If poor attachment, flucloxacillin 1g qd
41
Define hydrops fetalis and give an example
Accumulation of fluid in at least 2 fetal compartments
| e.g ascites and pleural effusion
42
What are the two types of ultrasound scan and which one requires the bladder to be full
Trans-abdominal --> bladder full
| Trans-vaginal
43
Lynchy syndrome predisposes to which 2 reproductive tumours
Ovarian mainly
| also endometrial
44
Which tumour marker is raised in up to 80% of ovarian tumours
CA 125
45
Which tumour marker is tested to exclude metastases from a primary GI tumour
Carcinoembryonic antigen (CEA)
46
What is the vertex of the fetal skull
Area of fetal skull outlined by anterior & posterior fontanelles & parietal eminences
47
What are the two layers of the endometrium
Stratum Functionalis
| Stratum Basalis
48
Which pathology is being described by "sub-epithelial lymphoid follicles present in the cervix"
Follicular Cervicitis
49
How does follicular cervicitis typically present and what are the consequences of this
Usually asymptomatic
| Can lead to infertility due to silent fallopian tube damage
50
What do
| sudden unilateral pelvic pain + free fluid in pelvic cavity suggest
Ruptured ovarian cyst
51
What are the guidelines with regards to breech position of a fetus
If breech before 36 weeks --> watch and wait
| Offer External Cephalic Version if breech at 36 weeks
52
What is a mnemonic for the fetal cardinal movements
```
Don't --> Descent and engagement
Forget --> Flexion
I --> Internal rotation
Enjoy --> Extension
Really --> Restitution
Expensive --> External Rotation
Equipment --> Expulsion
```
53
What are Mefenamic acid and Tranexamic acid and which condition can they be given for
Mefenamic acid - NSAID
Tranexamic acid - Anti-fibrinolytic
Given for Menorrhagia
54
What drugs are used for rapid tranquillisation
if a history of cardiac disease/ no previous typical anti-psychotics --> Lorazepam 1-2mg
If significant typical antipsychotic use --> Lorazepam ± Haloperidol
55
What 3 things are included in the diagnostic criteria for Hyperemesis Gravidarum
5% pre-pregnancy weight loss
Dehydration
Electrolyte imbalance
56
What is the best measure of ovulation and when should this be measured
Progesterone level
| Should be measured 7 days post ovulation (day 21 in a 28-day cycle)
57
Which ovarian tumour can be associated with atypical endometrial hyperplasia
Granulosa Cell tumours
| they can secrete estrogen
58
After which week gestation would you suspect gestational related hypertension rather than pre-existing hypertension
20 weeks
59
What differentiates gestational hypertension from pre-eclampsia
No proteinuria
60
How does Tamoxifen act in the body
Anti-estrogen in breast tissue
| Pro-estrogen in uterus
61
With regards to surgery, when should the COCP be stopped and restarted
Stopped 4 weeks prior
| Can be restarted 2 weeks after
62
Which contraceptive method is associated with a delay in return to normal fertility
Progesterone injection
| up to 1-year delay
63
What is the definitive management for placenta accreta
Hysterectomy with placenta left in situ
64
What is the medical management of a missed miscarriage
Vaginal misoprostol
65
Which drugs can be given to shrink fibroid size before surgery
GnRH agonists e.g leuprolide
66
Which 3 contraceptive methods are unaffected by enzyme inducing drugs e.g. carbamazepine
IUS
IUD
Progesterone only pill
67
How can you test for premature ovarian failure
FSH levels
| high in menopausal patients
68
What is adenomyosis and how is it diagnosed
Endometrial tissue in the myometrium
| Diagnosed via MRI
69
What are 2 management options for adenomyosis
GnRH agonists
| Hysterectomy
70
What is the Rokitansky protuberance
The inner lining of a mature cystic teratoma
71
Which three things can cause increased nuchal translucency
Down's syndrome
Congenital heart defects
Congenital abdominal wall defects
72
Which two conditions should you suspect with cervical excitation
Pelvic Inflammatory Disease
| Ectopic Pregnancy
73
When does the IUD become effective as contraception if it isn't started on the 1st day of a period
instantly as it is non-hormonal
74
When does the progesterone only pill become effective as contraception if it isn't started on the 1st day of a period
in 2 days time
75
When do the IUS and COCP become effective as contraception if it isn't started on the 1st day of a period
in 7 days time
76
With regards to Down Syndrome screening, when are Nuchal translucency, BHcG and PAPP-A checked
10-14 weeks
| combined test
77
What is the quadruple test
AFP, Unconjugated Estriol lowered
BHcG, Inhibin A raised
14-20 weeks, to screen for Down's syndrome
78
When would you be required to give a double dose of the levonorgestrel emergency contraceptive
If BMI >26 or if weight >70kg §
79
What is the mnemonic used for CTG reading
DR C BraVADO
80
Name 4 maternal illnesses which would render a pregnancy as high risk
Epilepsy
Gestational diabetes
Asthma
Hypertension
81
What is a normal duration and frequency of uterine contractions
10-45 seconds
| 3-4 per 10minutes
82
How is the baseline fetal heart rate measured on CTG
The average heart rate of the fetus over a 10min window
83
What is a normal fetal heart rate
110-160bpm
84
Name 4 causes of fetal tachycardia
Fetal/Maternal Anaemia
Hypoxia
Chorioamnionitis
Hyperthyroidism
85
Define fetal bradycardia on a CTG
HR <110 for 3 or more mins
86
Name 4 causes of fetal bradycardia
Cord prolapse
Cord compression
Maternal seizure
Rapid fetal descent
87
What does variability refer to with regards to a CTG
Refers to the variation of the fetal HR from one beat to the next
88
How is variability calculated with regards to a CTG
Observing how much the peaks and troughs deviate from the baseline rate
89
What are reassuring, non-reassuring and abnormal values for variability on a CTG
Reassuring 5-25bpm
Non-reassuring <5bpm for 30mins OR >25bpm for 15mins
Abnormal -
<5 for 50mins OR >25 for 25mins OR sinusoidal
90
What does sinusoidal variability on CTG indicate
Severe hypoxia/haemorrhage/anaemia
91
What are some causes of decreased CTG variability
Fetus sleeping
| Fetal hypoxia --> acidosis
92
Define accelerations on a CTG
An abrupt increase in the fetal baseline rate of >15bpm for >15 seconds
93
What does the presence of accelerations on a CTG indicate
A healthy fetus --> reassuring sign
94
Define decelerations on a CTG
An abrupt decrease in the fetal baseline rate of >15bpm for >15 seconds
95
What are the 3 types of decelerations seen on CTG and what do each of them indicate
Early --> physiological due to increased ICP and increased vagal tone
Variable --> often indicate oligohydramnios
Late --> Begin at peak of the contraction and recover after it has ended --> indicates hypoxia + acidosis
