Repro + Sexual Health

Question 1

Woman at moderate to high risk of pre-eclampsia - what should they take?

Answer 1

Aspirin from 12 weeks gestation until birth

Question 2

Progestogen added to HRT to reduce the risk of what cancer?

Answer 2

Endometrial cancer

Unopposed oestrogen increases risk of endometrial cancer

Question 3

Menorrhagia 1st line contraceptive ?

Answer 3

Mirena coil (IUS)

Question 4

Group B strep prophylactic antibiotic?

Answer 4

Benzylpenicillin

Question 5

Difference between the inguinal lymphadenopathies in lymphogranuloma venereum vs syphilis ?

Answer 5

LGV = painful inguinal lymphadenopathy (buboes)
Syphilis = non-tender, painless

Question 6

When should women take folic acid 400mcg when having a baby?

Answer 6

3 months before conception then up to 12 weeks gestation

Question 7

Which hormone increases risk of breast cancer?

Answer 7

Pro-breast-ogen

(Progestogen = Breast, Oestrogen = EndomOetrial)

Question 8

Shin rash on pregnant woman?

Answer 8

Erythema nodosum

Question 9

Hepatic adhesions = ?

Answer 9

Fitz-Hugh-Curtis syndrome

Question 10

When to give IV iron in postpartum?

Answer 10

Hb < 100g/L

Question 11

When can you start taking the POP postpartum?

Answer 11

Immediately

Take the POP as soon as you pop

Question 12

Vaginal thrush management ?

Answer 12

Oral fluconazole

if contraindicated (e.g. in pregnancy), give clotrimazole intravaginal pessary

Question 13

Oxybutynin in frail, elderly patients ?

Answer 13

Stop oxybutynin

increases risk of falls

Question 14

How much blood loss = PPH ?

Answer 14

> 500ml

Question 15

Cause of secondary amenorrhoea in very athletic women?

Answer 15

Hypothalamic hypogonadism

Question 16

Foetal heartbeat in ectopic pregnancy?

Answer 16

Surgical management

Question 17

When to give methotrexate for ectopic?

Answer 17

• Serum β-hCG levels <5000 IU/L
• No fetal cardiac activity
• Absence of significant abdominal pain or mass on ultrasound

Question 18

Take MORE folic acid (5mg)

Answer 18

M= Metabolism diseases (diabetes, coeliac)
O= Obesity (BMI >30)
R= Relative (family Hx of NTD)
E= Epilepsy (taking anticonvulsants)

Question 19

Gestational diabetes, fasting glucose <7 mmol/L - next step after diet + metformin ?

Answer 19

Insulin

(if fasting glucose >7 mmol/L, start insulin immediately)

Question 20

most significant long-term side effect of GnRH agonists (Goserelin)

Answer 20

Osteoporosis

Question 21

Erb’s vs Klumpke’s palsy

Answer 21

Erb’s = Waiter’s tip
Klumpke’s = Extended MCPs (grabbing a clump)

Question 22

Surgical risk factor of miscarriage?

Answer 22

Large cervical cone biopsy

Question 23

All the serum tests are low in Down’s, except for…

Answer 23

The ones which are ‘HI’
(hCG and inhibin A)

Question 24

BV vs Thrush (candidiasis)

Answer 24

BV = thin, fishy
(metronidazole)

Thrush = thick, cottage-cheese
(oral fluconazole, single dose)

Question 25

Examples of muscarinic antagonists used for urge incontinence?

Answer 25

Oxytocin Solifenacin Tolterodine

Question 26

Group B prophylaxis ?

Answer 26

Benzylpenicillin gBs - Benpen

Question 27

Treatment of eclampsia following delivery/last seizure?

Answer 27

Magnesium sulphate - should continue for 24 hours after last seizure or delivery (40% of seizures occur postpartum)

Question 28

Woman with endometriosis trying to conceive?

Answer 28

Laparoscopic excision / ablation of endometriosis

Question 29

BMI which warrants high-dose folic acid (5mg) in pregnancy

Answer 29

BMI >30

Question 30

Induction of labour - most common complication ?

Answer 30

Uterine hyperstimulation (too frequent / prolonged contractions can cause foetal distress

Question 31

MOA of mifepristone?

Answer 31

primes the uterus to enhance its responsiveness to misoprostol

Question 32

Contraceptive which causes weight gain?

Answer 32

Depo-provera

Question 33

Which contraceptive method leads to a delay in returning to normal fertility?

Answer 33

Injectable progesterone (maintains therapeutic drug levels for much longer)

Question 34

How long is arm implant (Nexplanon) effective for?

Answer 34

3 years (3 Ns in Nexplanon)

Question 35

Breastfeeding cessation - which medication is used to suppress lactation?

Answer 35

Cabergoline

Question 36

What should be monitored on magnesium sulphate (for eclampsia) ?

Answer 36

Respiratory rate + reflexes (the Rs)

Question 37

How often is Depo Provera given?

Answer 37

Every 12 weeks

Question 38

Elevation of testicle eases pain?

Answer 38

Epididymitis