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Year 4 - Womens Health > Gynaecological Abnormalities And Pregnancy Loss > Flashcards

Gynaecological Abnormalities And Pregnancy Loss Flashcards

(55 cards)

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1
Q

What is endometriosis

A

Where endometrium cells migrate spontaneously or due to reasons implant and cause prolifertion of endometrium fibroids in that area

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2
Q

Where does endometriosis usually occur?

A

Ovaries and ligaments

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3
Q

Can peritoneal cells transform into endometrial cells?

A

Yes

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4
Q

First line of treatment for endometriosis?

A

Paracetamol/nsaids

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5
Q

Secondary line of tx for endometriosis

A

COCP/POP

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6
Q

when is COCP for endometriosis tx contraindicated

A

Migraine with aura

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7
Q

What is GnRH analogue

A

Induce a menopausal state third line tx for endometriosis

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8
Q

Last tx for endometriosis

A

Laparoscopic excision or ablation

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9
Q

What is a common site of ectopic pregnancy

A

Ampulla

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10
Q

What tests are used to verify ectopic pregnancy

A

Pregnancy test positive and TVUS

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11
Q

What 3 types of management is used for ectopics

A
  1. Expectant - close monitoring over 48hrs if b-hCG rises or Sx manifest interventions performed
  2. Medical - methotrexate + follow up
  3. Surgical - salpingectomy for no risk for infertility, salpingotomy for risk of infertility
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12
Q

When is an open salpingectomy used

A

Emergency cases with ruptured fallopian tube

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13
Q

<35mm unruptured and asymptomatic with hCG <1000?

A

Expectant management of ectopic pregnancy

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14
Q

<35mm unruptured no significant pain hCG <1,500 ?

A

Medical management of miscarriage

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15
Q

> 35mm, ruptured?, pain, visible HB, HCG >5,000 ?

A

Surgical.

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16
Q

5 categories of miscarriages?

A
  1. Threatened
  2. Inevitable
  3. Incomplete
  4. Complete
  5. Missed
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17
Q

Bleeding less than menstruation, close cervical os, slight/no pain before 24 weeks (6-9)

A

Threatened

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18
Q

Missed (delayed) miscarriage

A

Light vaginal bleeding, pregnancy symptoms disappear, no pain, closed cervical os,

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19
Q

What’s an inevitable miscarriage

A

Heavy bleeding clots pain and open os

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20
Q

What’s an incomplete miscarriage e

A

Not all products expelled, pain, bleeding open os

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21
Q

Loss of internal labial margin, redness and soreness, scaling?

A

Lichen sclerosis

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22
Q

What’s adenomyosis

A

Endometrial tissue within myometrium

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23
Q

Describe the physiology of micturition

Study These Flashcards
A

2 phases: 1. Storage 2. Voiding - uses pontine continence centre - spinal continence - hypogastric nerve - detrusor muscle relaxation and internal sphincter constriction for storage.

Uses pontine micturition centre - spine - pelvic nerves - contraction of detrusor muscle and relaxation of internal sphincter voluntary external sphincter depending on what you want

24
Q

What acts on the bladder to cause relaxation

Study These Flashcards
A

Acetylcholine

25
What can cause increase risk of voiding
Anticholinesterases Diabetes Caffeine Alcohol
26
What is receptive relaxation
Intra vesicle pressure is lower than the urethral pressure
27
How long does the voiding phase last?
20-25ml/s fo men, 25-30ml/s for women
28
how much urine do you need to void?
400ml
29
What is urodynamics testing?
Pressure difference measurement between rectum and bladder.
30
How is urodynamics testing conducted
Thin catheter in front and back passage
31
When is urodynamic testing used?
Women with overflow incontinence or those where first line urge incontinence treatments aren’t working
32
What’s measured on a urodynamic test?
Post voiding pressure Leak point pressure (pressure needed to leak) Flow rate Custom entry (bladder contraction pressure)
33
What is stress incontinence
Urine leakage due to weak pelvic floor muscles
34
What 4 things can cause stress incontinence?
1. Pregnancy 2. Coughing 3. Laughing 4. Sneezing
35
What is urge incontinence
Overactivity of the bladder muscle
36
What causes urge incontinence
1. Alcohol 2. Caffeine 3. Medications 4, UTI
37
What causes overflow incontinence
1. Bladder stones 2. Chronic urinary retention 3. Anticholinergic medication 4. Urodynamics neeed
38
What is overflow incontinence?
Urine leakage due to bladder being overfilled
39
When is pelvic floor exercises indicated?
Stress incontinence
40
When is bladder retraining indicated?
Urge incontinence
41
What is classed as heavy menstrual bleeding?
Blood loss of over 80ml
42
What is normal blood loss for periods?
40ml
43
3 criteria for menorrhagia
Changing pads every 1-2 hours Bleeding more than 7 days Large clots
44
What causes menorrhagia (4 subcategories)
1. Disorders (diabetic, hypothyroid, bleeding and connective tissue disorder) 2. Medication (anticoagulation, contraception) 3. Abnormalities (PCOS, fibroids, PID) 4. Dysfunctional bleeding or extreme of reproductive age
45
What subcategories are there for causes of heavy menstrual bleeding /
1. Conditions 2. Medications 3. Problems/abnromlaities 4. General issue/natural
46
What is chronic pain defined as?
Pain that is usually continuous and dull that is suggested to affect mental health more that lasts longer than 6 moths
47
What is acute pain defined as?
Sharp severe immediate pain that usually has sudden-short onset and is usually recent or new and less than 2 weeks/6months
48
what is important in distinguishing pelvic pain? Describe steps taken (7)
1. History/collateral history 2. Sats 3. Abdo and I manual pelvic exam 4. STI screen (HVS, chlamydia/gonorhhoea) 5. TVUS/MRI (endo/adenomyosis/fibroids) 6. Diagnostic laparoscopy 7. CA125 (cancer and endometriosis/fibroids)
49
3 non GUM causes of pelvic pain
Appendicitis IBS IBD
50
3 Basic screening modalities used in pelvic pain
TVUS, mri, ct sometimes and laparoscopy
51
What is the clinical criteria needed to make an endometriosis diagnosis? (5+1)
Infertility and 1 more of these: - chronic pain for more than 6 months - period pain that affects ADLl - period related GI problems (diarrhoea/vomiting/constipation) - period related excessive bleeding/toilet pain etc - deep pain during sex
52
What investigative steps are taken for suspected endometriosis
1. History 2. Abdo and pelvic exam 3. TVUS 4. Laparoscopy
53
What’s a tell tale sign of adenomyosis?
Enlarged, boggy uterus
54
how would you investigate adenomyosis?
TVUS, MRI alternative
55
How would you treat/manage adenomyosis?
1. Symptomatic treatment such as TXA 2. GnRH agonists 3. Uterine artery emobolism 4. Hysterectomy

Year 4 - Womens Health (10 decks)

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