20 Must-Know Obstetrics And Gynaecology Flashcards NEET PG 2025

FLASHCARD 1 

Ovulation

Ovulation of the follicle around the 14th day of the menstrual cycle

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Oocytes will be released into the fallopian tube.

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Shrinkage of the follicle forms the corpus luteum (Yellow color body)

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The Corpus luteum will produce progesterone.

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Progesterone will make the endometrial glands secretory.

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Fertilization will occur at the site of the ampulla.

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The embryo will reach the uterine cavity on 3rd to 4th day.

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Implantation occurs on the 6th day after ovulation or fertilization – earliest

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It can also occur from the 6th to the 10th day of ovulation (20 to 24 days of the menstrual cycle)

 Follicular Stimulating Hormone 

• Normal level: 2 to 6 IU
• Purpose: Produce Estrogen
• Suggestive of menopause: >10 IU
• Diagnostic of menopause: >40 IU
• Premature ovarian failure: FSH >40 IU in <40 years

FLASHCARD 2

Menstrual Cycle Chart

• Cycle starts with bleeding – Day 1
• Initially, FSH is high, decreases in mid, and again increases at last
• Heartbeat of infant: 5 weeks and 3 days
• FSH: Recruit 7 or 8 Antral follicles
• Low FSH will maintain the growth of one follicle (Size 15 to 20 mm)
• Estrogen levels will be increased (150 to 200 pg)
• So it is known as the proliferative phase
  • Other Name: Follicular Phase
• LH surge will occur as the estrogen gives singles to the brain
• Follicle will become shrink and become corpus luteum
• Corpus luteum will produce the progesterone
  • The size of the glands is not increased
• Hence, it is known as the secretory phase
  • Other Name: Luteal Phase
• Corpus luteum also secrete some amount of estrogen
• Corpus luteum reduces in function by day 24 and is lost by day 28.
• That endometrium will degenerate and shed.

Menstrual Cycle: Of Sexually Active Women

Implantation of the embryo will occur on the 6th day after ovulation or fertilization

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The embryo is implanted in the secretory endometrium

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Corpus luteum will work only for 10 days

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Early cells of the placenta: Syncytiotrophoblasts will produce the HCG

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Human chorionic gonadotropin will protect the corpus luteum from degeneration

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It helps to maintain the pregnancy

FLASHCARD 3

Progesterone Challenge Test

FLASHCARD 4

Sonographic Criteria for PCOS

• It has no cyst
• Enlarged ovary with a chain of small follicles i.e. necklace of chain appearance.
• Shape: ring of pearl
• Presence of 20 or more Follicles in either ovary measuring 2 to 6 mm in diameter (Less than 9 mm): Antral size follicles
• Thick stroma
• Increased ovarian volume: >10 ml
• A single ovary meeting these criteria is sufficient to affix the PCOS morphology

Syndrome of PCOS

• Anovulation is associated with infertility
• Periods after 35 days: Oligomenorrhea
• Missing 3 regular cycles of menstruation: Amenorrhea

Quick Revision of PCOS

• FSH is very low
• Estrogen is increased
• Sends positive feedback to the brain
• As a result, LH levels will be increased
• Progesterone is low, no secretory action
• Proliferation occurs continuously

FLASHCARD 5

Symptoms of Ca Cervix

• Most common is post-coital or post-menopausal bleeding
• Pyrometra causing dirty, foul, smelling discharge
• Uremia: Most common cause of death

Staging of Ca Cervix

FLASHCARD 6

Ca Endometrium Staging

Ca Endometrium Management

• Rule out any local lesions
• After the physical examinations, and observe all the local lesions
• If there are no local lesions, 1st step is office endometrial biopsy using a pipelle
  • Easy procedure
  • 90% sensitive
• Fractional curettage (D&C)
  • Assess all the fractions of the uterus
  • 95-99% sensitive
• Hysteroscopy biopsy
  • 100% sensitive
  • Best method
• TVS: good adjunctive procedure
  • In postmenopausal women, endometrium
• Common site of the recurrence of ca endometrium is : vault of the vagina
  • 1st line treatment of recurrence is progesterone therapy
  • Radiation is the best treatment for recurrence.

FLASHCARD 7

Dysgerminoma 

• Most common germ cell malignancy: 40-45%
• Only bilateral germ cell malignancy in 10-15% of cases
  • Large fleshy tumour
• Frequently associated with hypercalcemia
• 5% associated with dysgenic gonads
  • Turner syndrome
• Seminoma-type cells
  • Large polygonal cells with clear cytoplasm and dark nucleoli and back-to-back arrangements
• Increases LDH, placental alkaline phosphatase, and even HCG, but not Alfa fetoprotein.

FLASHCARD 8

Adenomyosis

• It is referred to as endometriosis interna, endometriosis occurring within the muscle layer.
• Hysterectomy specimen examination
  • Lakes of uterine blood are found in uterus muscles
  • Hyperplasia of uterine muscle.

FLASHCARD 9

Staging of Prolapse based on POP-Q

Stage of Prolapse

Extent of prolapse in relation to hymen

Prolapse above the hymen: Negative Numbers

Prolapse below Hymen: Positive Numbers

Stage 0:  No Prolapse

Stage I: The most distant portion of prolapse descends to a point less than 1cm above the hymen

Stage II:  Maximum Descent is within 1 cm of Hymen

Stage III : Prolapse extends more than 1 cm beyond hymen but no more than 2 cm of Total Vaginal length

Stage IV : Complete eversion of vagina or descent within 2 cm of the vaginal length

FLASHCARD 10

Types of pills

Four generations: based on types of progesterone

• 1st generation · Norethindrone, lynestrenol, Norethisterone
• 2nd generation · Etonogestrel, Norgestrel
• 3rd generation · Desogestrel, Gestodene, Norgestodene
• 4th generation : Drosperinone (potent progestogenic-antimineralocorticoid- anti androgenic)

Protocol for Starting the Pills

• Regular cycles: 1st to 5th day of periods
• Breastfeeding: After 6 months of Exclusive B.F.
• After delivery & not breastfeeding:  After 4 weeks of delivery
• Post-abortion:  From immediately to 7 days after
• After Emergency Contraception:  Same Day! Don't have to wait for the next period!

Emergency Contraception

• If women doesn't want to have children: Combined oral contraceptive pill/IUCD
  • If women have children, are pregnant and don't want children anymore: Medical termination of pregnancy.
• If a woman had intercourse and has not taken contraception where she is too early for abortion: Interception of a pregnancy (Emergency contraception) within 72 hours of unprotected intercourse.

FLASHCARD 11

Male Sterilization : Non-Scalpel Vasectomy (NSV)

• Tools
• Anesthesia is given, and 1 stab incision is given
• A stab incision is created by the sharp artery forceps
• Stabilizing the Vas by ring forceps
  • Babcock's forceps is used for tubal ligation in females
• Can be done in 5-7 minutes
• A simpler procedure
• After the vasectomy, the man is not sterile until the path is not emptied of sperm (3 months or 20 ejaculates)
• Later, semen analysis is done (Azoospermia)
• Safe procedure

FLASHCARD 12

ESHRE Classification of Mullerian Defects

FLASHCARD 13

Hypertension in Pregnancy

FLASHCARD 14

Treatment of  Gestational Hypertension and Pre-Eclampsia

• Labetalol: DOC ( can be given up to 2400 mg/24hrs)
• Methyldopa: Previous drug of choice, a prodrug 250-500mg QID
• Nifedipine: 5-10 mg TID upto 80 mg/24hrs
• Prazosin: 2.5mg OD or BD
• Hydralazine: 25mg per day
• Contraindicated Drugs:
  • ACE Inhibitors:
    • Hypocalvaria
    • Renal agenesis
    • Oligoamnios
  • β - Blockers
  • Frusemide
  • All the above three drugs are known to cause IUGR.

FLASHCARD 15

Problems with Diabetes in Pregnancy

FLASHCARD 16

Treatment of abortion: 1st trimester

Dual marker at 12 weeks:

• PAPP-A - pregnancy-associated plasma protein A reduces
• HCG - increases

NT NB scan at 12 weeks

• Nuchal translucency > 3 mm - increased risk
• Absent nasal bone or short-increased risk

Triple marker at 16 weeks

• UE3 - unconjugated estriol reduced
• AFP - reduced
• HCG - increased

Quadruple marker at 16 weeks

• Triple + inhibin
• Inhibin high

FLASHCARD 17

Placenta Previa

• Incidence - 1 in 300-400 pregnancies
• Associated with
  • Multiparity
  • Twin gestation
  • Large placenta
  • Previous cesarean section
  • Placenta accreta
  • Previous hysterotomies, myomectomies

FLASHCARD 18

Causes of PPH Postpartum Hemorrhage

FLASHCARD 19

Uterine Devascularization

FLASHCARD 20

Overview of Physiological Change in Pregnancy

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