O&g

Front 1

Fasting glucose target DM and pregnant

Back 1

5.6

Front 2

1h post meal glucose target DM and pregnant

Back 2

7.8

Front 3

2h post meal glucose target DM and pregnant

Back 3

6.4

Front 4

First line for hyperemesis gravidarum

Back 4

Antihistamines (promethazine)

Front 5

Medical management of missed miscarriage

Back 5

Vaginal misoprostol + antiemetics + pain relief

Front 6

If mum gets singles, does it affect the baby

Back 6

No

Front 7

Do you treat varicella in pregnancy

Back 7

Yes. Give Aciclovir

Front 8

If mum has HIV, what do you give her in labour and when?

Back 8

Zidovudine infusion started 4h before delivery

Front 9

Quadruple test for downs (14-20 weeks)

Back 9

(high) Inhibin A

(High) BHCG

(Low) AFP

(Low) Unconjugated oestriol

(And woman's age)

Front 10

Over what age can you keep in the IUD til you no longer need contraception

Back 10

>40

For the IUS, it's >45 and no periods on the IUS, then you can keep it in til you no longer need contraception

Front 11

What must you strongly advise if you give the contraceptive patch

Back 11

Don't smoke

The risk of stroke is high because 60% more oestrogen in the patch than the COCP!

Front 12

What combined hormonal contraception can be used if you have IBD

Back 12

Vaginal ring

Bypasses first pass metabolism

Front 13

How long must female barrier methods be left in after sex

Back 13

6h at least

Front 14

Difference between preimplantation genetic diagnosis and screening

Back 14

Front 15

Difference between ABx for mastitis in lactating and non-lactating women

Back 15

Non-lactating - co-amox

Lactating - flucloxicillin

Front 16

What injections could you give to a mother who has APH and is awaiting surgery

Back 16

corticosteroids if the baby if less than 34 weeks gestation

Anti-D should be given to Rhesus- negative mothers

Front 17

Define APH

Back 17

Bleeding PV after 24 weeks (but before the onset of labour).

Front 18

Describe the USS timeframe for placenta praevia

When should you admit and when should you do a C section (assuming no APH)

Back 18

Low lying placenta seen at routine 20 week scan

Rescan at 32 weeks to see if it's still low

If still low, scan fortnightly until 36 weeks

At 37 weeks, if the placenta remains low, she should be admitted and elective C-section performed at 39 weeks.

Front 19

What does placenta praevia with previous Caesarean put you at risk of

Back 19

Placental abruption (as the scar is low-lying)

Front 20

When do you go the postpartum DM test if they had GDM

Back 20

6w

It's a GTT that you do to test

Front 21

When are the extra USS for GDM

Back 21

28w and every 4w from then

Front 22

What is a normal weight increase when pregnant if healthy BMI

What's most of that weight from?

Back 22

11-16kg

Blood volume!

Front 23

What does oestrogen do in pregnancy

Back 23

Simulates prolactin release

Breast growth

Protein synthesis

Front 24

When does the placenta start to produce progesterone

Back 24

After 35 days of gestation

Front 25

What does progesterone do in pregnancy

Back 25

Reduces smooth muscle excitability (vasculature, uterus, gut, ureters)

Raises body temperature

Counters prolactin

Front 26

Why does the follicle with the most FSH receptors become dominant

Back 26

Because more FSH-Rs mean more aromatase and therefore more oestrogen made.

Front 27

What does the rise in oestrogen do in the menstrual cycle

Back 27

Causes surge of LH and FSH which cause ovulation

Optimises chances of FERTILISATION by making mucus more hospitable to sperm, spiral arteries emerge, thicken functional layer of endometrium

Front 28

After the LH surge and ovulation, what does the corpus luteum do

Back 28

Theca cells produce progesterone due to low LH

Granulosa cells produce inhibin due to low FSH (which decreases FSH which decreases oestrogen)

Front 29

What does progesterone do in the menstrual cycle

Back 29

Makes uterus receptive to IMPLANTATION

Negative feedback to decrease LH and FSH

Front 30

Do you screen everyone for GDM with a GTT

Back 30

No, just people who had GDM before, had previous big baby, BMI >30 or 1st degree FH of DM

(I think you pick up the others from the urine dip, and send them for GTT)

Front 31

When do you give routine anti-D if Rh -ve pregnancies

Back 31

28 and 34w

Front 32

Postnatally, what should you do for a Rh -ve mother

Back 32

Check blood Rh group of baby

Do Kleihauer test on mum (especially important in stillbirth as cause may have been transplacental haemorrhage)

Then give anti-D within 72h

Check maternal blood every 48h to determine clearance of cells and need for continuing anti-D

Front 33

When should anti-D be given in unsuccessful pregnancies and after procedures of Rh -ve women (within ? hours)

Back 33

Within 72 hours

Any TOP

Evacuation of hydatiform mole

Miscarriage after 12w

Threatened miscarriage after 12w

Ectopic pregnancy if managed surgically

APH

Amniocentesis etc.

External cephalic version

Front 34

Why do we not do amniocentesis earlier

Back 34

Increased risk of talipes, resp problems and death

Front 35

What does a nuchal thickness of 2.5mm Vs 3.5mm make you think of

Back 35

>2.5 downs

>3.5 cardiac issues eg heart failure for whatever reason, or congenital malformations

Nuchal thickness often looks thick in monochorionic twins but it's false positives

The greater the extent of FNT, the greater the risk of abnormality.

Front 36

What decreases PAP-A

Back 36

Smoking (also increases inhibin)

Downs

Front 37

What is high (hi) in down syndrome

Back 37

HCG

Inhibin

(hi)

Front 38

If someone had GBS in previous pregnancy

Back 38

Either

Offer IV ABx prophylaxis

Or testing in pregnancy (35-37w) then ABx if positive

Front 39

Regardless of GBS status, maternal IV ABx prophylaxis (BenPen) should be offered to...

Back 39

Women in preterm labor

Pyrexial during labor

GBS+ve in previous pregnancy

Previous baby with GBS

Front 40

If swab isolated GBS in PPROM, what ABx would you give

Back 40

Penicillin and clindamycin

Front 41

How short is a short cervix

Treatment?

Back 41

<25mm at <24 weeks

Progesterone

Cerclage (can also put in if history-indicated by 3 or more preterm births/late miscarriages)

Front 42

What's the usefulness of foetal fibronectin

Back 42

Check for in PPROM.

If negative, rules out labour

(But if positive, doesn't rule in labour)

Front 43

When is the time limit for putting in a cerclage

Back 43

24w

Or you risk ROM

Front 44

When would you NOT give PROPHYLACTIC ABx in preterm LABOUR

Back 44

When the membranes haven't ruptured

There's an increased risk of cerebral palsy!

But if something needs TREATING then give ABx, despite intact membranes

Front 45

What are the indications for tocolytics? Name some

Back 45

To delay delivery in preterm labour so that you can give steroids or transfer woman to neonatal unit

If there's cord prolapse

Nifedipine

Atosiban

(MgS)

Front 46

If, after 24-48h observations, a woman with PPROM isn't in labour and doesn't have a temperature, what should you do

Back 46

Send them home and they much take their temperature every 4h

They have bi-weekly FBC & CRP measurements

Aim to deliver at 34 weeks

(They must finish their 10 day course of erythromycin)

Front 47

The OCP is protective for which cancers?

Back 47

Endometrial

Ovarian

Front 48

What is normal endometrial thickness

Back 48

<4mm

Front 49

When would you send for a scan rather than a 2ww for suspected endometrial ca

Back 49

If >55

With unusual discharge

+Haematuria

Or +thrombocytosis!

Or with haematuria

+Low Hb

Or +thrombocytosis

Or +high bgl

Front 50

Difference between treatment of endometrial hyperplasia with atypoa, and stage I endometrial cancer

Back 50

Hysterectomy for EHWA

With bilateral salpingo-oophorectomy for stage I cancer (and radio if Ib or worse)

Front 51

Postnatally, what should you do for the baby of an Rh -ve mother

Back 51

Take cord blood for:

FBC

grouping

Direct coombs test (will tell you if there are Abs on baby's rbc's)

Front 52

High risk of pre-eclampsia (CHAD)

Back 52

CKD

HTN during previous pregnancies

AI diseases (SLE, antiphospholipid)

DM

Front 53

What are absolute CIs for tocolytics

Back 53

Chorioamnionitis

Foetal death or lethal abnormality

Condition needing immediate delivery, of course