Professional and Linguistic Assessments Board (PLAB) Obstetrics, Gynaecology and Sexual Health Syllabus

Obstetrics, Gynaecology and Sexual Health syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Obstetrics, Gynaecology and Sexual Health in Professional and Linguistic Assessments Board (PLAB), not a summary of it.

1. 1

   Antenatal Care

   4 topics

   • Booking and Routine Care
     • Antenatal schedule and screening
     • Folic acid and lifestyle advice
   • Hypertensive Disorders of Pregnancy
     • Pre-eclampsia and eclampsia
     • Magnesium sulphate and delivery timing
   • Gestational Diabetes
     • Screening and diagnosis
     • Glycaemic management
   • Antepartum Haemorrhage
     • Placenta praevia
     • Placental abruption
2. 2

   Labour and Postnatal Care

   4 topics

   • Normal Labour
     • Stages of labour and partogram
     • Fetal monitoring and CTG interpretation
   • Obstetric Emergencies
     • Postpartum haemorrhage
     • Shoulder dystocia
     • Cord prolapse
   • Postnatal Complications
     • Sepsis and endometritis
     • Postnatal mental health
   • Early Pregnancy Problems
     • Miscarriage management
     • Ectopic pregnancy
     • Hyperemesis gravidarum
3. 3

   Gynaecology

   4 topics

   • Menstrual Disorders
     • Heavy menstrual bleeding
     • Amenorrhoea and PCOS
     • Dysmenorrhoea and endometriosis
   • Menopause
     • Symptom assessment
     • Hormone replacement therapy
   • Pelvic Pathology
     • Fibroids
     • Ovarian cysts and torsion
     • Pelvic inflammatory disease
   • Gynaecological Cancers
     • Cervical screening programme
     • Endometrial and ovarian cancer red flags
4. 4

   Contraception and Sexual Health

   4 topics

   • Contraceptive Methods
     • Combined and progestogen-only methods
     • Long-acting reversible contraception
     • UKMEC eligibility criteria
   • Emergency Contraception
     • Copper IUD and oral options
     • Counselling and timing
   • Sexually Transmitted Infections
     • Chlamydia and gonorrhoea
     • Syphilis and HIV testing
     • Partner notification
   • Sexual and Reproductive Counselling
     • Unintended pregnancy options
     • Fraser guidelines and consent

Obstetrics, Gynaecology and Sexual Health flashcards for Professional and Linguistic Assessments Board (PLAB)

25 of 62 cards from the Obstetrics, Gynaecology and Sexual Health deck — real questions with worked answers.

1. What blood test screening is offered at the booking visit (8-12 weeks) in routine UK antenatal care?

   FBC, blood group and rhesus status, red-cell antibodies, haemoglobinopathies (sickle/thalassaemia), and infection screening for HIV, hepatitis B, and syphilis. Rubella susceptibility is no longer routinely tested.

2. When is the combined test for Down's syndrome offered, and what does it measure?

   Offered at 11-13$^{+6}$ weeks. It combines nuchal translucency on ultrasound with serum $\beta$-hCG (raised) and PAPP-A (low), plus maternal age.

3. What dose of folic acid is recommended pre-conception and in the first 12 weeks, and which women need the higher dose?

   Standard $400\ \mu g$ daily. High-risk women (previous NTD, diabetes, on antiepileptics, BMI $\geq 30$, sickle cell) take $5\ mg$ daily.

4. Define gestational hypertension (pregnancy-induced hypertension).

   New hypertension ($\geq 140/90\ \text{mmHg}$) arising after 20 weeks' gestation without significant proteinuria.

5. What three features define pre-eclampsia?

   New-onset hypertension after 20 weeks PLUS one or more of: proteinuria, maternal organ dysfunction (renal, liver, neurological, haematological), or uteroplacental dysfunction (fetal growth restriction).

6. What is the first-line antihypertensive for pre-eclampsia/gestational hypertension in the UK?

   Labetalol. Alternatives are nifedipine (modified-release) and methyldopa. ACE inhibitors and ARBs are contraindicated in pregnancy.

7. What is the definition of eclampsia and its treatment?

   Tonic-clonic seizures in association with pre-eclampsia. Treated with intravenous magnesium sulfate (loading dose $4\ g$ over 5-10 min, then infusion $1\ g/h$), plus blood-pressure control and delivery.

8. List the components of HELLP syndrome.

   Haemolysis, Elevated Liver enzymes, Low Platelets. It is a severe variant of pre-eclampsia.

9. What prophylaxis reduces the risk of pre-eclampsia in high-risk women, and from when is it taken?

   Aspirin $75\text{-}150\ mg$ daily from 12 weeks until birth.

10. What is the sign of magnesium sulfate toxicity, and how is it reversed?

    Loss of deep tendon (patellar) reflexes is the earliest sign, followed by respiratory depression. Reversed with intravenous calcium gluconate.

11. Which women are screened for gestational diabetes and by what test?

    Women with risk factors (BMI $> 30$, previous macrosomic baby $\geq 4.5\ kg$, previous GDM, family history, high-risk ethnicity) are offered a 75 g oral glucose tolerance test at 24-28 weeks (or earlier if previous GDM).

12. State the NICE diagnostic thresholds for gestational diabetes on OGTT.

    Fasting plasma glucose $\geq 5.6\ \text{mmol/L}$ OR 2-hour plasma glucose $\geq 7.8\ \text{mmol/L}$.

13. What is the first-line management of gestational diabetes if fasting glucose is below 7 mmol/L at diagnosis?

    A trial of diet and exercise for 1-2 weeks; if targets are not met, add metformin, then insulin if still inadequate.

14. At what fasting glucose level at diagnosis of GDM is insulin started immediately?

    Fasting glucose $\geq 7\ \text{mmol/L}$ warrants immediate insulin. Between $6\text{-}6.9$ with complications (macrosomia/hydramnios), insulin is also offered.

15. Define placenta praevia and its classic clinical presentation.

    Placenta lying wholly or partly in the lower uterine segment. Presents with painless bright-red vaginal bleeding, often after 28 weeks; the uterus is soft and non-tender.

16. Define placental abruption and its classic presentation.

    Premature separation of a normally sited placenta. Presents with painful vaginal bleeding (may be concealed) and a tense, tender, 'woody-hard' uterus; fetal distress is common.

17. Why is digital vaginal examination contraindicated in antepartum haemorrhage until placenta praevia is excluded?

    It can provoke catastrophic haemorrhage if a low-lying placenta is present. Placental site must be confirmed by ultrasound first.

18. What is vasa praevia and its danger?

    Fetal vessels run through the membranes over the cervical os, unsupported by placenta or cord. On membrane rupture they tear, causing rapid fetal exsanguination (fetal, not maternal, blood loss).

19. What defines the latent and active first stage of labour?

    Latent phase: painful contractions with cervical change up to 4 cm dilatation. Active first stage: from about 4 cm to full (10 cm) dilatation, typically progressing $\sim 0.5\text{-}1\ \text{cm/h}$.

20. Describe the three stages of labour.

    First stage: onset of established labour to full dilatation (10 cm). Second stage: full dilatation to delivery of the baby. Third stage: delivery of the baby to delivery of the placenta and membranes.

21. What are the seven cardinal movements of labour?

    Engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and expulsion.

22. On a partogram, what do the 'alert' and 'action' lines indicate?

    The alert line marks expected minimum progress ($1\ \text{cm/h}$); crossing it signals slow progress. The action line (drawn to the right of alert) triggers intervention/escalation when crossed.

23. What is the immediate management of shoulder dystocia (first-line manoeuvre)?

    McRoberts manoeuvre: hyperflexion and abduction of the maternal hips, plus suprapubic pressure. Call for help and avoid fundal pressure.

24. List the four 'T' causes of primary postpartum haemorrhage.

    Tone (uterine atony, most common), Trauma (lacerations), Tissue (retained placenta), and Thrombin (coagulopathy).

25. Define primary postpartum haemorrhage.

    Blood loss of $\geq 500\ mL$ from the genital tract within 24 hours of delivery. Loss $> 1000\ mL$ or with shock is a major PPH.

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