OBG Flashcards
(30 cards)
Leucorrhea
Excessive normal vaginal discharge
Relation of vaginal secretion with endogenous estrogen levels
rising estrogen –> abundant secretory activity of endocervical glands and superficial vaginal epithelium becomes rich in glycogen
Conditions where there is increased vaginal secretion d/t increased estrogen
- Puberty
- Menstrual cycle
- Pregnancy
- Sexual excitement
Strawberry cervix is seen in
Trichomonas vaginitis
Clue cells are seen in
Bacterial vaginosis
Most common cause of puberty menorrhagia
Anovulation
Anovulatory cycles –> unopposed estrogen —> endometrial hyperplasia –> prolonged and heavy periods
Causes of puberty menorrhagia
- Endocrine dysfunction:
PCOS
Hypo/hyperthyroidism - Hematological causes:
Idiopathic thrombocytic purpura
Von Willibrand disease
Leukemia - Pelvic causes:
Fibroids
Sarcoma botryroides
Estrogen producing ovarian tumors
Treatment of pubertal menorrhagia
Reassurance
Correction of anemia
In refractory cases- progestogens (Medroxyprogesterone acetate or norethisterone) 5mg thrice daily till bleeding stops
Bleeding stops by 3-7 days; medications continues till 21 days
In emergency, conjugated equine estrogen 20-40 mg IV given every 6-8 hrs
SRY region is located in
Short arm of Y chromosome
SRY gene produces protein called
testis determining factor
causes gonads to develop into testis
Clue cells are
epithelial cells covered by bacteria
seen in bacterial vaginosis
Bacterial vaginosis is caused by
Gardnerella vaginalis
Hemophilus vaginalis
Mobiluncus curtisii
Mycoplasma hominis
Amsel’s criteria is
for diagnosing bacterial vaginosis
3 out of 4 should be present
1. Thin, white homogenous vaginal discharge
2. Fishy odor accentuated by adding 10% KOH- Whiff test
3. pH > 4.5
4. Clue cells
Treatment of bacterial vaginosis
Oral metronidazole 500mg BD for 7 days
OR
Ampicillin 500 mg or Cephalosporin 500 mg BD for 7 days
HRT decreases the risk of
Colon cancer
Therapeutic Indications for HRT
Therapeutic:
- Gonadal dysgenesis in adolescents
- Symptomatic patients with estrogen deficiency
Prophylactic indications for HRT
- High risk cases for menopausal complications such as cardiovascular disease, osteoporosis, colonic cancer, stroke, Alzheimer’s disease
- Premature menopause- either by surgery or spontaneous
- Menopause d/t chemotherapy or radiotherapy especially after alkylating agents
- Women who demand HRT as prophylaxis
Contraindications of HRT
- Undiagnosed abnormal genital bleeding
- Known, suspected or H/o breast cancer
- Known or suspected venous thromboembolism
- Known or recent (1 year) arterial thromboembolic disease
- Known/ suspected estrogen dependent neoplasia
- Uterine fibroids (they will increase in size)
- Hypersensitivity to ingredients
- Known or suspected pregnancy
- Liver dysfunction or gallbladder disease
Uses of HRT
- Dyspareunia, libido
- Cardiovascular disease
- Osteoporosis
- Alzheimer’s
- Short term hot flushes; vasomotor symptoms
- Urethral syndrome
Risks of HRT
- Endometrial cancer
- Breast ca
- Ovarian ca
- Thromboembolism
- Liver dysfunction, gall bladder stones
- Lipid profile dysfunction
Hydrops diagnosis
Either 2 or more fetal effusions- pleural, pericardial, ascites- or one effusion plus anasarca
Types of Hydrops
Immune- associated with red cell auto immunization
Non immune
Pathogenesis of hydrops
-Increased hydrostatic pressure/ central venous pressure
-Decreased colloid oncotic pressure
-Enhanced vascular permeability
Cardiovascular causes of Hydrops
- Structural defects- Ebstein anomaly, Tetralogy of Fallot with absent pulmonary valve, hypoplastic left or right heart, premature closure of ductus arteriosus, AV malformations (vein of Galen malformation)
- Tachyarrhythmias
- Cardiomyopathies
- Bradycardia as seen in heterotaxy syndrome with endocardial cushion defect or with anti-Ro/La antibodies
