Obstetrics and Gynaecology Flashcards

A 50-year-old presents with vulval itching and a persistent white plaque. What is the most appropriate next step?

Answer: Vulval biopsy

A persistent vulval plaque requires biopsy to exclude lichen sclerosus or vulval carcinoma.

Which contraceptive method is most appropriate for a breastfeeding woman 4 weeks postpartum?

Answer: Progestogen-only pill or implant

Progestogen-only methods are preferred in breastfeeding as oestrogen may reduce milk supply and increase VTE risk.

A 26-year-old has a smear showing low-grade squamous intraepithelial lesion with positive high-risk HPV. What is the usual next step?

Answer: Colposcopy

Abnormal cytology with high-risk HPV is referred for colposcopy to directly assess the cervix.

A woman presents with secondary amenorrhoea, galactorrhoea and headaches. Which investigation is most appropriate?

Answer: Serum prolactin and pituitary imaging

Galactorrhoea with amenorrhoea and headaches suggests a prolactinoma, assessed by prolactin levels and pituitary MRI.

What is the recommended timing for routine anti-D prophylaxis in a rhesus-negative pregnant woman without sensitising events?

Answer: At around 28 weeks (and at 34 weeks if two-dose regimen)

Routine antenatal anti-D prophylaxis is given at around 28 weeks (with a second dose at 34 weeks in two-dose regimens).

A 35-year-old with infertility has confirmed bilateral tubal blockage. What is the most appropriate treatment to achieve pregnancy?

Answer: In vitro fertilisation (IVF)

Bilateral tubal blockage bypasses the tubes, so IVF is the treatment of choice for conception.

A woman at 38 weeks has spontaneous rupture of membranes with green-stained liquor. What does this indicate?

Answer: Meconium-stained liquor requiring closer fetal monitoring

Green liquor indicates meconium passage, which may signal fetal compromise and warrants continuous monitoring.