1
Q
UTI in pregnancy - trimester 1 and 2
A
Nitrofurantion
2
Q
UTI in preg - trim 3
A
- trimethoprim
- cefalexin
3
Q
absent end diastolic flow?
A
delivery by 34-36 weeks
4
Q
reversed end diastolic flow
A
admit for CTG
consider urgent CS
5
Q
pregnancy hormones increasing insulin resistance
A
- human placental lactogen
- progesterone
6
Q
electrolyte disturbance in vomiting pic (HG)
A
hypokalaemia
metabolic alkalosis
7
Q
medical management for ectopic
A
methotrexate
8
Q
MOA for misoprostal
A
prostaglandin analogue
softens cervix+ stim contract
9
Q
gestational sac diameter 25mm, no foetal pole?
A
anembryonic pregnancy
10
Q
1st line tx NVP
A
promethazine
cyclizine
11
Q
2nd line tx for hyperemesis
A
ondansetron/ metoclopramide
12
Q
ondansetron/ metoclopramide S/E?
A
QT prolongation
13
Q
maternal complication following NVP/HG
A
wernicke’s encephalopathy
14
Q
complication following incomplete miscarriage
A
endometritis
15
Q
treatment for APS in pregnancy?
A
low dose aspirin
low dose LMWH
16
Q
when is fetal HB expected on USS?
A
C-R length 7mm
17
Q
- severe morning sickness
- raised hCG
- large uterus
- vaginal bleeding
A
molar pregnancy
18
Q
methotrexate management of ectopic?
A
hCG level < 5000
confirmed absence of IU preg
cannot get pregnant for 3 months after
19
Q
> 20 wks
severe headache / vision
high BP
urine dip - 3+ protein
A
pre-eclampsia
20
Q
1st line for mild/mod pre eclampsia?
A
oral labetalol
21
Q
1st line for severe pre-eclampsia?
A
IV labetalol / hydralazine
22
Q
1st line for eclampsia?
A
magnesium sulfate
23
Q
- haemolysis
- elevated liver enzymes
- low platelets
A
HELLP syndrome
24
Q
diagnostic for HELLP?
A
- LDH > 600 + schistocytes
- AST/ALT> 70
- platelets<100
25
when + what is given prophylaxis for pre-eclampsia?
12wks -> aspirin
1x high RF
>1 Moderate RF
26
1st line for preeclampsia AFTER delivery
enalapril
27
1st line ix for adenomyosis
TVUSS
28
gold standard for diagnosis adenomyosis
MRI pelvis
29
most common endometrial cyst?
follicular cyst "functional"
30
surgical options for fibroids, hysterectomy declined?
uterine artery embolisation
31
1st line ix for endo?
TV USS
32
DIAGNOSTIC ix for endo?
laparoscopy
33
- prev dull adnexal pain
- after sex, very painful
- peritoneal irritation?
ovarian cyst -> ruptured
34
dermoid cyst raised hormones?
a-FP
hCG
35
2 week referral in suspected ovarian cancer?
- ascites
- pelvic mass felt
- abdominal mass felt
36
PID tx?
doxy
+ metronidazole
+ IM ceftriaxone
37
diagnostic ix for PID?
laparoscopy
38
- enlarged boggy uterus
- pain before period starts
- HMB
adenomyosis
39
junction at cervix transitional zone?
squamo-columnar junction
40
metaplasia at squamo-columnar junction?
squamous -> glandular
41
function of inhibin?
inhibits release of FSH
prevents follicle development after ovulation
42
FSH function?
imitates growth of primary follicles
43
LH function?
stimulates further development of follicles (into secondary) after FSH
44
layer of endometrium that is shed?
stratum functionalis
45
GnRH released from?
hypothalamus
46
hormones that trigger follicles to release oestrogen?
FSH + LH
47
how is an egg released?
LH causes rupture of Graafian cell (egg is expelled)
48
Most common cause of female infertility
ovulatory disorder
49
examples of ovulatory disorders?
PCOS
hypothalamic dysfunction
high prolactin
thyroid
50
1st line test to assess ovulation?
serum progesterone 7 days before cycle ends (ie d21 in a d28 cycle)
51
when can FSH and LH be measured?
day 2-5
52
gold standard investigation for tubal latency?
if PID: laparoscopy
if untouched tubes: hydrosalpingogram
53
1st line management for PCOS to improve fertility?
clomifene citrate
54
Initial management for preterm labour?
corticosteriods
+ tocolytics
55
drug improves success of external cephalic version
terbutaline
56
management for induction of labour - closed/ long cervix?
vaginal prostaglandin E2 pessary
57
Components of bishop score?
cervical:
- dilation
- effacement
- consistency
+ foetal station
58
name that congenital infection:
- limb hypoplasia
- skin scarring (contracture)
- eye defects
- microcephaly
congenital varicella zoster syndrome
59
sign of placental separation - 3rd stage of labour?
lengthening of umbilical cord
60
tx for asymptomatic bacturia in pregnany
cefalexin
61
2nd degree perineal tear?
damage to perineal muscles
62
3a perineal tear?
<50% damage to external anal sphincter
63
3b perineal tear
>50% damage to external anal sphincter (internal sphincter still spared)
64
3c perineal tear
damage to external AND internal anal sphincter
65
4th degree perineal tear
damage to anal sphincter + rectum
66
anti-folates to stop in pregnancy?
methotrexate
trimethoprim
phenytoin
67
lambda sign on USS?
dichorionic diamniotic twins (2x placenta + 2x sacs)
68
when should dichorionic diamniotic twins be delivered?
37 weeks
69
when should monochorionic diamniotic twins be delivered?
36 -36+6 weeks (risk of TTTS)
70
labour:
First stage - active phase?
cervical dilation from 3cm - 10cm
71
labour:
first stage - latent phase?
cervical dilation from 0.3 - 3cm
72
labour:
second stage - engagement?
descent of foetal head into pelvis, presenting part reaches ischial spine (station 0)
73
labour:
second stage - restitution
external rotation of foetus following delivery of foetal head - bring shoulders into AP position
74
labour:
third stage?
delivering placenta
75
during labour
sudden gush of fluid
foetal HR drop
deep decels on CTG?
cord prolapse (occurs when water breaks - gush)
76
1st line for PPH?
1. Tranexamic acid
2. uterine massage (atony)
3. oxytocin
77
2nd line PPH?
tranexamic acid
78
erbs palsy nerves affected?
C5-C6
79
klumpke's palsy nerves affected?
C8-T1
80
internal rotation of forearm + wrist + finger flexion (waiter tip sign)
Erb's palsyb
81
dermatomal sensory loss + 'claw hand'
Klumpke's palsyb
82
congenital infection:
- cataracts
- systolic murmur
- petechiae
- intracranial calcifications
rubella
83
1st line ix for placenta praevia
TVUSS
84
post exposure prohylaxis for VZV in pregnancy?
oral aciclovir day 7-14 post exposure
85
surgical interventions for PPH?
1. intrauterine balloon
2. brace suture / B-lynch
3. stepwise uterine devascularisation
4. uterine artery embolisation
5. hysterectomy - last
86
pROM
vaginal bleeding
foetal brady
vasa praevia
87
placenta accreta?
placenta invades mymetrium
88
placenta increta?
placenta invades >50% through myometrium
89
placenta parecreta?
through perimetrium (into other structures)
90
treatment ladder for PPH?
1. uterine massage
2. empty bladder
3. pharmacological
4. surgical
91
pharmacological tx for PPH?
1. oxytocin
2. ergometrine
92
Induction of labour, BISHOP<6?
vaginal prostaglandin E2
93
Induction of labour, BISHOP >6?
amniotomy
94
cardiac physiology changes in pregnancy?
3rd HS
peripheral oedema
ejection systolic murmur
forceful apex beat
95
metoclopramide S/E (in hyperemesis)
extrapyramidal - tremor
96
promethazine S/E?
drowsiness
97
promethazine MOA?
histamine H1 receptor
98
management for ruptured ectopic?
emergency laparotomy
99
gestational diabetes, fasting glucose>7?
immediate insulin tx
100
gestational diabetes, resistant sugars on metformin?
metformin + insulin
101
1st line labour induction?
1. membrane sweep
2. prostaglandin E2 pessary
102
lab findings in pregnancy?
- decreased serum urea
- decreased creatinine
- increase urine protein loss
(+trace glucose in urines)
103
hormonal contraceptive that delays fertility return once stopped?
Depo / implant (12 weekly)
104
POP S/E?
irregular bleeding
105
time until contraceptives are effective?
IUD: instant
POP: 2 days
COCP/ IUS: 7 days
106
umbilical artery doppler:
no forwrad blood flow during diastole
absent end-diastolic flow
107
umbilical artery doppler:
Blood flow reverses direction during diastole
reversed end diastolic flow
108
management for absent-end diastolic flow?
consider steroids, monitor via CTG
109
management for reversed-end diastolic flow?
urgent delivery
110
ABG in vomiting (HG)
metabolic alkalosis
hypokalaemia
111
first line ix for primary ovarian failure?
serum FSH x2
4-6 weeks apart
112
active stage of labour?
from 4cm dilation --> delivery, should take no longer than 12 hours
113
Year 3
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