| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Abnormalities in FSH:LH ratio | High => Menopause, POF. Low => PCOS | |||||||||||||||||
2 | Abortion time limits | Medical <9 weeks. Surgical 9-14 weeks. Induced miscarriage/late surgical 14-24 weeks | |||||||||||||||||
3 | Acetic acid in colposcopy | Removes mucous covering/coagulates intracellular proteins. Any area with an increased nuclear/cytoplasmic ratio will appear whiter. Squamous metaplasia => Faintly white. Neoplasia => Much more distinct | |||||||||||||||||
4 | Advise on contraception for a new couple | Use condoms for at least 3 months to cover all the STD incubation periods | |||||||||||||||||
5 | Appearance of Intraepithelial Neoplasia vs Cancer | No discrete lesion | |||||||||||||||||
6 | Argyll Robertson pupil | Bilateral small pupils that react to accommodation but not light. Highly specific sign of neurosyphilis | |||||||||||||||||
7 | Balanitis circinata | Dermatologic manifestation of reactive arthritis (Reiter's Syndrome) => Slowly progressive annular dermatitis of the glans penis | |||||||||||||||||
8 | Bartholin's cyst | From blocked Bartholin's gand. May develop to a Bartholin's abscess. Definitive mangement = Marsupialization | |||||||||||||||||
9 | Best COCP to treat PCOS | Marvelon | |||||||||||||||||
10 | Categorisation of delayed labour | Power, Passage, Passenger. Second pregnancy => Must be the passenger | |||||||||||||||||
11 | Cause of anovulation in PCOS | Uncertain. Reduced gonadotrophin secretion due to inhibition by insulin? Arrested antral follicle development due to abnormal interaction of insulin and LH on granulosa cells? | |||||||||||||||||
12 | Cause of ectropion | Oestrogen (Puberty, COCP) | |||||||||||||||||
13 | Cause of late deceleration on CTG | Insufficient placental blood flow => Foetal hypoxia & acidosis. Maternal hypotension, Pre-eclampsia, Uterine hyper-stimulation. Indication for FBS/C-section | |||||||||||||||||
14 | Cause of strawberry cervix | Trichomonas vaginalis | |||||||||||||||||
15 | Causes of neonatal conjunctivitis | N. gonorrheae, Chlamydia or HSV-2 acquired from the birth canal during delivery. May cause blindness if untreated => Prophylactic eye drops after birth | |||||||||||||||||
16 | Causes of non-specific urethritis | Cytological diagnosis. Chlamydia (40%), Mycoplasma genitalium (25%), Ureaplasma urealyticum (15%), Trichomonas (10%), Herpes (1%), Non-infectious/No organism detected (30%) | |||||||||||||||||
17 | Causes of urethral discharge/dysuria | Gonorrhoea, Non-specific urethritis, UTI | |||||||||||||||||
18 | Cervical cancer management | Microinvasion => Cone biopsy. Stage 1b-2a => Wertheim's hysterectomy + RT. Stage 2b-4 => RT only | |||||||||||||||||
19 | Cervical cancer staging | 1: Cervix only. 2: Local extension (body of uterus, upper 2/3 of vagina). 3: Pelvic wall or Lower 1/3 of vagina (from urogenital sinus, not paramesonephric duct => different lymphatic drainage). 4: Bladder or Rectum | |||||||||||||||||
20 | Cervical cancer subtypes | SCC most common (from below). Also adenocarcinoma (from above) | |||||||||||||||||
21 | Cervical ectropion | Endocervical columnar epithelium protrudes out through the external os of the cervix and onto the vaginal portion of the cervix, undergoes squamous metaplasia, and transforms to stratified squamous epithelium. Indistinguishable from early cervical cancer => Pap smear/Biopsy | |||||||||||||||||
22 | Chancre characteristics | Painless, indurated, non-exudative. Heal spontaneously within three to six weeks. Can occur in the pharynx as well as on the genitals | |||||||||||||||||
23 | Characteristic appearance of genital warts | Cauliflower - Many lobules | |||||||||||||||||
24 | Chocolate cyst | Endometriotic cyst. Most important clinical manifestation of endometriosis | |||||||||||||||||
25 | Classification of ovarian tumours | 94% benign (epithelial cells tumours, functional cysts, teratomas, fibromas, endometriotic cysts). 6% malignant (cystadenocarcinoma, germ cell tumours, secondaries) | |||||||||||||||||
26 | Classification of uterine tumours | Benign (fibroid/myoma, polyp, endometrial hyperplasia, hydatidiform mole/trophoblastic disease), Malignant (endometrial carcinoma, choriocarcinoma) | |||||||||||||||||
27 | Clinical features of placenta praevia | Painless, bright red vaginal bleeding in 3rd trimester, often around 32 weeks. Malpresentation is found in 35% of cases | |||||||||||||||||
28 | COCP contraindications | Migraine with aura, VTE, VTE in a relative <40, Smoking, Liver tumour, Breast cancer, BP >160/95, BMI >40 | |||||||||||||||||
29 | COCP in epilepsy | Need a giant dose if on enzyme inducers. Can take double dose of 30 ug pill | |||||||||||||||||
30 | Colposcopy after borderline smear? | Only if 3 in a row | |||||||||||||||||
31 | Complete vs Partial hydatidiform mole | Complete => All chorionic villi are vesicular, No sign of embryonic development. Partial => Some villi are vesicular, whereas others appear more normal, Embryonic/fetal development may be seen | |||||||||||||||||
32 | Complications of breech delivery | Cord prolapse, Erb's palsy | |||||||||||||||||
33 | Contact tracing for female GU infections | Only for chlamydia, trichomonas, HIV. NOT for candidiasis, BV - Sexually associated but not transmitted | |||||||||||||||||
34 | Contraception after depo provera | Give on day 1-5 => Immediate protection. Otherwise condoms for 7 days | |||||||||||||||||
35 | Contraceptive side-effects | Oestrogenic mimic pregnancy (bloating, nausea, headache, breast tenderness) => Use a pill with less oestrogen. Progestogenic mimic PMT (moody, greasy skin) => Use a different progestogen | |||||||||||||||||
36 | Contraindication for POP | Current/past breast cancer, Gestational trophoblastic neoplasia, Liver disease, Enzyme inducers | |||||||||||||||||
37 | Corpus leuteal cyst | Benign ovarian tumour. Often secrete progesterone => Delayed menstruation/Heavy periods. Also pain. Key differential: Ectopic pregnancy | |||||||||||||||||
38 | Councelling for depo provera | Need to repeat every 12 weeks. Amenorrhoea is usual after 3rd injection. Return of fertility may take up to 1 year. Weight gain | |||||||||||||||||
39 | Cutoff for treatment of HTN in pregnancy | Diastolic >100 or Systolic >150. Don't treat if diastolic <100 as => Reduced placental function | |||||||||||||||||
40 | Degrees of tear in childbirth | 1st (surface scratch), 2nd (through bulbospongiosus), 3rd (through external anal sphincter => laxatives), 4th (through rectal mucosa) | |||||||||||||||||
41 | Depo-provera complications | Serious arterial disease, Acute liver disease, Hx of severe depression, Current medication for depression | |||||||||||||||||
42 | Description of pain in ovarian torsion | Often young (longer vascular pedicle). Sudden onset of sharp and usually unilateral lower abdominal pain. Comes in waves, as ovary twists. 70% of cases accompanied by nausea and vomiting. Death of ovary => Fever | |||||||||||||||||
43 | Diabetes and fetal congenital malformation | Big risk factor. HbA1c 10% => 1 in 4 risk | |||||||||||||||||
44 | Diagnosis and management of hydatidiform mole | Snowstorm appearance on USS. hCG may increase rapidly (more than double in 48 hrs) => Hyperemisis gravidarum. Evacuate uterus by uterine suction/curettage. Follow up until hCG is undetectable. Do not conceive for a year afterwards | |||||||||||||||||
45 | Diagnosis and management of uterine hyperstimulation | Long, forceful contractions => Late decelerations. Stop syntocinon and give salbutamol | |||||||||||||||||
46 | Diethylstilbestrol | Synthetic nonsteroidal oestrogen. Now banned - Associated with vaginal/cervical clear cell adenocarcinoma | |||||||||||||||||
47 | Differential diagnosis of breech presentation | Full bladder | |||||||||||||||||
48 | Differentials for Intrahepatic cholestasis of pregnancy | Preeclampsia, HELLP syndrome, Acute fatty liver of pregnancy | |||||||||||||||||
49 | Diseases caused by Treponema pallidum | Syphilis, bejel, pinta, yaws | |||||||||||||||||
50 | DNA origin in hydatiform mole | Complete is from pure sperm (usually 1, may be 2), with loss of maternal DNA => No fetal parts. Partial retains maternal DNA => 69,XXY | |||||||||||||||||
51 | Doxycycline in pregnancy. Use erythromycin instead | No. Calcium chelator => Weak bones, Weird teeth | |||||||||||||||||
52 | Early decelerations at 9 cm dilated | Head compression => Vagal response | |||||||||||||||||
53 | Emergency contraception | EllaOne (Selective progesterone receptor modulator, 5 days); Levonorgestrel (Second generation synthetic progestogen, 3 days); Copper coil | |||||||||||||||||
54 | Emergency contraception not effective | Days 14-19 (after ovulation). Have to use copper coil instead | |||||||||||||||||
55 | Failure of beta-HCG doubling | Ectopic pregnancy, Miscarriage. (Should normally double every 48 hrs) | |||||||||||||||||
56 | Failure rate of sterilisation | 1/2000 men. 1/200 women | |||||||||||||||||
57 | Female causes of infertility | Central (Thyroid), Ovaries (PCOS, POF, Androgen-secreting tumours, Cyst, Endometriosis), Tubes (PID, Adhesions), Lining (Progesterone loss => Sloughing), Vagina (Pain => Not enough sex) | |||||||||||||||||
58 | Female pelvis types | Gynaecoid, Android, Anthropoid, Platypelloid | |||||||||||||||||
59 | Fetal hydrops | Aneamia/Rh disease/Tumour => Increased fetal blood flow => Oedema in at least two fetal compartments (e.g. Subcutaneous, Pleural, Pericardial, Ascites) | |||||||||||||||||
60 | Fetal monitoring in uncomplicated delivery | Intermittant auscultation - Through contraction and for 1 min after | |||||||||||||||||
61 | Fetal mortality in severe PET | 20% | |||||||||||||||||
62 | FIGO staging for ovarian cancer | OPAL: 1 = Ovaries only, 2 = Pelvis (tubes, uterus), 3 = Abdomen, 4 = Mets | |||||||||||||||||
63 | Filshie Clip | Used for laparoscopic sterilization | |||||||||||||||||
64 | Fixed drug eruption in penis? | Tetracycline | |||||||||||||||||
65 | Frequency of cervical smear | First invitation at 25 (SCJ too high before), 3-yearly until 49, 5-yearly until 64 | |||||||||||||||||
66 | Genital symptoms of Behçet’s | Genitial ulcers (anus, vulva, scrotum) in 70-95% of cases. Usually painful and may scar | |||||||||||||||||
67 | Gestational trophoblastic disease | Group of pregnancy-related tumours arising from the trophoblast. One benign (hydatidiform mole), Four malignant (Invasive mole, Choriocarcinoma, Placental site trophoblastic tumour, Epithelioid trophoblastic tumour) | |||||||||||||||||
68 | hCG limit when you expect to see something on ultrasound | 1000 | |||||||||||||||||
69 | Hidden pregnancy | Can miss early pregnancy on scan (e.g. hidden behind rib cage). Check bHCG | |||||||||||||||||
70 | HIV testing timescales | p24 surface antigen test can be positive at 2 weeks, Antibody test can be positive at 1 month. Usually tested at 6 weeks with a final confirmatory test at 3 months | |||||||||||||||||
71 | How long can sperm survive in the genital tract? | 7 days. Consider if removing an IUD | |||||||||||||||||
72 | How soon can you do a pregnancy test? | From the first day of missed period / 21 days after last unprotected sex | |||||||||||||||||
73 | How to start POP | Can start at at time. Protected after 48 hrs | |||||||||||||||||
74 | How to stop COCP when planning pregnancy | Start folic acid immediately. Complete pack then aim to have one natural period prior to conception | |||||||||||||||||
75 | Infection causing male infertility | Mumps orchitis | |||||||||||||||||
76 | Intrahepatic cholestasis of pregnancy | Hormoes (esp. 3rd trimester) => Cholestasis => Itching, Deranged clotting, Fetal distress, Premature labour | |||||||||||||||||
77 | Iodine in colposcopy | Normal cells have lots of starch => Blue/black colour. Abnormal appear more white | |||||||||||||||||
78 | Key risk factors for infertility | Maternal age (esp. >35), Length of time trying | |||||||||||||||||
79 | Krukenberg tumor | Malignancy in the ovary that metastasized from a primary site, classically gastric adenocarcinoma. Frequently bilateral | |||||||||||||||||
80 | Landmark for safe vaginal delivery by ventouse | Head below the ischial spines | |||||||||||||||||
81 | Late risk of PCOS | Lifetime of anovulation => Lots of unopposed oestrogen => Endometrial carcinoma | |||||||||||||||||
82 | Male causes of infertility | Azoospermia (Occupation, Heat, Smoking, Varicocele, Infection), Timing, Surgery | |||||||||||||||||
83 | Malignant transformation of molar pregnancy | May transform to choriocarcinoma: Malignant, trophoblastic cancer, usually of the placenta. Characterized by early haematogenous spread to the lungs. Exquisitely sensitive to chemotherapy => 95% cure rate | |||||||||||||||||
84 | Management of abnormal cervical cytology results | Borderline OR mild dyskaryosis => Routine recall if HPV -ve (may regress) or Colposcopy referral if HPV +ve. Moderate/Severe dyskaryosis => Colposcopy | |||||||||||||||||
85 | Management of atrophic vaginitis | Topical oestrogens | |||||||||||||||||
86 | Management of gonorrhoea | Third generation cephalosporin (cefixime, ceftriaxone), Plus emiprical treatment for chlamydia (azithromycin). Abstinance for 1 week => Test of cure. Contact tracing | |||||||||||||||||
87 | Management of meconium-stained liquor | Not necessarily a sign of fetal distress in itself. However indication for continuous CTG monitoring with a quick recourse to fetal blood sampling in the presence of CTG abnormalities | |||||||||||||||||
88 | Management of ovarian carcinoma | Total abdominal hysterectomy with bilateral salpingo-oophorectomy. (Always remove the uterus). Staging is always done on the operating table | |||||||||||||||||
89 | Management of PET | Admit all cases. Prophylactic aspirin (vs stroke + DIC) from 12 weeks. Methyldopa/Labetolol (or nifedipine). Steroids if <34 weeks. Delivery at 37 weeks | |||||||||||||||||
90 | Management of tinnitus | Treat the underlying cause (Hearing aid), Retraining therapy (Low-noise generators), Medication (GABA agonists, Antidepressants) | |||||||||||||||||
91 | Maternal medical conditions predisposing to PET | HTN, migraine headaches, diabetes, kidney disease, rheumatoid arthritis, lupus | |||||||||||||||||
92 | Measuring engagement | Ulnar border on pelvic bone. How many fingers-worth of head are palpable over the pelvic brim = Degree of engagement | |||||||||||||||||
93 | Mechanism of copper coil | Prevents implantation => Use as emergency contraception - Esp. if mid-cycle when morning after pill won't work | |||||||||||||||||
94 | Medical management of ovarian cancer | Chemo sensitive, unlike most other gynae malignancies | |||||||||||||||||
95 | Meigs syndrome | Triad of ascites, pleural effusion and benign ovarian tumor. Classically on right side (Transdiaphragmatic lymphatic channels are larger in diameter on the right) | |||||||||||||||||
96 | Microscopic appearance of Neisseria gonorrhoea | Gram negative intracellular diplococci | |||||||||||||||||
97 | Mid-Luteal Serum Progesterone | Test 7 days after predicted day of ovulation (Day 21). >20 nM => ovulation; <20 nM => No ovulation | |||||||||||||||||
98 | Missed COCP advice | Missed one => Take now and continue as normal. Missed two => Take extra one now, then Condoms for 7 days / Emergency contraception if in first week / Run packs together if in last week | |||||||||||||||||
99 | Monitoring in VBAC | Always continuous CTG, to monitor for uterine rupture | |||||||||||||||||
100 | Most common cause of reduced variability on CTG | Fetal sleeping. Should last <40 mins |