lymphomagranulomavenereum - organism - stages - symptoms

- chlamydia trachomatis - step 1- painless genital ulcer - step 2-10 days to 6months later- lymphadenitis(painful lymphadenopathy), proctocolitis(painful defecation) and cervicitis(non-offensive vaginal discharge)

O&G Flashcards by Sidharth Praveen

emergency contraception <72 hours after UPSI

levonogestrel

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fetal varicella syndrome triad

1) eye defects
2) limb Hypoplasia
3) microcephaly`

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pregnant lady comes with chicken pox rash- what to do

start treatment of aciclovir, too late to check IG/give IG

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pregnant lady -contact with chicken pox, hx of chicken pox - what to do

check her IGg levels, if low needs top up

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emergency contraception <5 days >72 hours

IUcopper D- not mirena

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other benefits of COCP for young women

1) treats acne

2) treats irregular periods

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only useful contraceptive for HIV

condoms

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what virus causes warts on vulva and perineum in young women

HPV 6 and HPV 11

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high risk(PMHx DM, past history of large baby, >4.5kg BW, Fhx of GDM) of Gestational diabetes- what screening(

Glucose tolerance test at 20-28 weeks gestation

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missed miscarriage key finding

1) no bleeding , sometimes brown discharge

2) no fetal heart activity

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missed miscarriage management

watch and wait
misoprostol
ERCP

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complete miscarriage definition

any treatment

bleeding and complete passage of sac and placenta

- no need for D&C

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Threatened miscarriage

vaginal bleeding and cramping
cervix closed
watch and wait

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incomplete miscarriage

extremely heavy bleeding and cramps.

- USS showed products of conception

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inevitable miscarriage

increasing bleeding and cramps
rupture of membranes
CERVICAL OS IS OPEN- key difference between threatened

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70 year old with recurrent UTI and urgency- biopsy showed atrophic vaginitis(thinning of skin around urethra can cause this) treatment

oestradiol cream

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why cant you give warfarin to pregnant women

it is teratogenic- crosses into fetus

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why is pyelonephritis more common in pregnant women

pregnancy causes dilation of ureters and calyces

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symphysis pubis dysfunction key management

explain and reassure it will go away after birth.

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dichorionic pregnancy- need to look out for maternal anaemia-what ix

FBC- at 20-24 weeks to assess need for iron supplementation

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folic acid 5mg vs 400mcg

5mg- high risk- epileptics.

400mcg-normal

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lymphomagranulomavenereum

organism
stages
symptoms

chlamydia trachomatis
step 1- painless genital ulcer
step 2-10 days to 6months later- lymphadenitis(painful lymphadenopathy), proctocolitis(painful defecation) and cervicitis(non-offensive vaginal discharge)

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features of severe eclampsia(4)

severe headache
visual disturbances
epigastric pain
hyper-reflexia/clonus

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type of discharge with vaginal candidiasis

thick paste like cheesy discharge

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contraindications for progesterone only pill(2)

1) active liver disease | 2) active breast cancer

features of congenital rubella(quite a few)- brain size - heart - brain function - liver and spleen

- microcephaly- NOT hydrocephalus - cataracts - cardiac lesions - cerebral palsy - thrombocytopenia - jaundice, hepatomegaly and cerebral calcification

number of ulcers for syphillis

one single painless chancre- key way to differentiate from herpes

painless vaginal bleeding >28 weeks

placenta praevia

painful bleeding with shock

placental abruption

exaggerated pregnancy symptoms(severe hyperemesis) + large for dates _+ snowstorm appearance on USS

molar pregnancy/hydatidiform mole

septic pelvic thrombophlebitis

- pain and fever post-partum period - not respond to initial abx - responds to heparin + abx - needs CT/MRI for diagnosis

when is anti d given to rhesus negative mothers(3)

- at 28 weeks - at 32 weeks - after circulation contact-amniocentesis, miscarriage/ectopic pregnancy

key things to do for HIV positive pregnancies to reduce transmission

- advise not to breastfeed - <50copies/ml viral load can have a vaginal delivery. all others should have a c-section after 39 weeks - should start anti-retroviral therapy

- large pelvic mass that causes urinary urgency - vaginal bleeding and discharge - taking tamoxifen

- uterine leiomyosarcoma(malignant growth of myometrium muscle) - key way to differentiate endometrial CA- endo Ca does not have a mass presentation

CTG - pathological trace, Fetal blood sampling - ph- >7.10- foetal distress and hypoxia. plan

immediate delivery- c section if cervix is not fully dilated

baby with purulent discharge and lid swelling B/L

gonorrhoea

things to avoid for pregnant women with regards to the following: 1) toxoplasmosis 2) listeria

1) toxo- avoid changing cat litter | 2) listeria- avoid soft cheese, pate, unpasteurised milk

why is meconium released in utero? what to do?

- sign of fetal distress - deliver the baby- induction with continuous CTG - if CTG is abnormal will need c-section

what to do about a breech pregnancy with regards to delivery

- offer an elective c -section at 39-40 | - offer emergency if in labour

assisted delivery vs c-section- when to push for c-section

when cervix is not dilated to 10

what to do if not delivering after term

- membrane sweep and book for induction in maternity unit

uk peri natal mortality rate definition

the number of still births and early neonatal deaths per 1000 live births and still births

neonatal mortality rate

total number of neonatal deaths per 100 live births

PCOS biochemical markers(fsh/LH ratio)

LH:FSH ratio high( more cysts giving out LH) | menopause will have more LH

what is the commonest cause of maternal death in the uk

first-line rx for menorrhagia who is trying to get pregnant

tranexamic acid

first line treatment for dysmenorrhea associated with menorrhagia

mefenamic acid

RF for PMS

- hysterectomy with ovary conservation | - POP contraception

management of pms

- lifestyle changes | - COCP

what type of HRT still produces a monthly bleed

continuous oestrogen and cyclical progesterone

antibiotic class that is safe to give in pregnancy

- penicillins | - cephalosporins

HIV, prolonged rupture of membranes, retained products of conception, obesity, diabetes, manual removal of the placenta, extremes of productive age are risk factors for what post -partum.

Endometritis

endometritis is 10 times more common after?

C-section

symptoms of endometritis

fever, tachycardia, abdo pain, vaginal discharge and post partum haemorrhage accompanied by general malaise

Primary Post partum Haemorrhage - when - most common cause

upto 24 hours after delivery | Uterine atony

Secondary Post-partum Haemorrhage - when - most common cause and key investigation

- 24 hours-12 weeks post partum - retained placental tissue - USS

prophylaxis for preclampsia(reduces occurence, reduces perinatal mortality, reduces IUGR) when to start

Aspirin(from 12 weeks)

supplementation for pregnancy normal patient

folic acid 400mcg and Vit D 10mcg

CTG- worrying signs

late deceleration- foetal distress(asphyxia/placental insufficiency) Variable deceleration-cord compression baseline bradycardia(HR<100)-increased fetal vagal tone, maternal beta blockeir use Baseline tachycardia(HR>160)- maternal pyrexia, chorioamnionitis

unique signs of ovarian hyperstimulation syndrom

jaundice, ascites, anuria | severe- thromboemoblism, acute respiratory distress syndrome

baby blues management

reassurance

other complications of pre-eclampsia(extra-gynae)

intracerebral haemorrhage, | pulmonary oedema

after 20 weeks, symphysis-fundal height in cm= gestation in weeks

same gestation in weeks

grop b strep other name

streptococcus agalactiae

biggest issue with smoking in pregnancy

increased risk of pre-term labour

simple cyst follow up- premenopausal

repeat USS in 8-12 weeks

postmenopausal women - cysts

needs referral to gynaecology for assessment as a physiological cyst is unlikely

treatment of breastmilk related candida

- continue breastfeeding | - topical miconazole cream to nipple and oral mucosa of infant

commonest ovarian cyst

follicular cyst

hyperemesis gravidarum triad

1) 5% pre-pregnancy weight loss 2) dehydration 3) electrolyte imbalance

key issue with unopposed oestrogen

endometrial cancer

antenatal cytomegalovirus infection

cerebral calcification, microcephaly, sensorineural deafness.

parvovirus B19 antenatal infection

hydrops fetalis

O&G Flashcards

(73 cards)