Obs Flashcards
(27 cards)
What are the types and symptoms of fibroids?
intramural - most fibroids submucosal subsercosal Make periods heavier or longer Fertility and pregnancy problems - if >5cm into uterine cavity pelvic pain
What is the treatment of fibroids?
Only treated if symptomatic Tranexamic acid, NSAIDs, GnRH agonists coil, COCP Ablation Transcervical resection of fibroids
What are the tests and treatment for endometrial hyperplasia?
Tests - endometrial biopsy, hysteroscopy, transvaginal US
TREAT - mirena coil, progesterone tablets
Do regular biopsies to monitor progression to carcinoma
Why does a high BMI increase risk of endometrial hyperplasia and cancer?
androgens are converted to eostrogen within adipose tissue
What are the 2 types of endometrial hyperplasia?
simple - 5% risk of progression to carcinoma in 20 years
Complex with atypia - 28% risk of progression
What are the risk factors for endometrial hyperplasia and its symptoms?
RF - BMI >35, high oestrogen, PCOS, tamoxifen, DM, nulliparity
Symptoms - abnormal bleeding e.g. intermenstrual
What is the difference in symptoms between endometrial and cervical polyps?
endometrial - intermenstrual bleeding
cervical - mucus discharge, postcoital bleeding
What are 3 causes of intermenstrual bleeding?
endometrial or cervical polyps PCOS tumours contraception fibroids hormone imbalance
What is a risk factor of endometriosis polyps and how would you diagnose it?
risk factor - high estrogen e.g. high BMI
hysteroscopy
What are the amin symptoms of endometriosis and hwo would you test for it?
chronic pain - cyclic, dyspurinia Dysmenorrhea infertility US, CA125 only laproscopy is diagnostic
What are the main differentials of endometriosis?
adenomysosis - pain
fibroids - pain, infertility, bleeding
endometriosis - pain and infertility
What are 3 acute and 3 chronic causes of pelvic pain?
Acute - ectopic pregnancy, miscarriage, ovarian cyst, ascending UTI
Chronic - adenomyosis, endometriosis, fibroids, PID, adhesions, IBS
What is criteria for diagnosis of PCOS?
2 of
- oligo/amennorhea
- hyperandrogenism - clinical or biochemical
- polycystic ovaries in US
What is it?
Unilateral pelvic pain, vaginal bleeding, cervical excitation, abdominal tenderness, adnexal mass
Ectopic pregnancy
How would you test for ectopic pregnancy?
TVUS - empty cavity, extra-adnexal mass, free pelvic fluid, beta hCG increasing, low progesterone
What is it?
Vaginal bleeding, clots, abdo cramps, GI upset, abdo tenderness
miscarriage
How would you test for miscarriage?
TVUS - no obvious yolk sac, foetal pole or cardiac activity
Doppler - no heartbeat
Beta hCG decreasing
What is it?
Early pregnancy, vaginal bleeding, abdo cramps, closed os
subchorionic haemorrhage
What is it?
Pelvic girdle pain worsened by movement, clicking or grinding
Symphysis pubis dysfunction
How would you test for hyperemesis gravidarum?
inflammatory markers (normal), urinalysis glucose, TFT, PTH, LFT, cortisol, aldosterone
What is it?
sudden onset dark bleeding, moderate abdo pain, tender rigid uterus, hypotension
placental abruption
What is it?
Sudden onset vaginal bleeding, severe abdo pain, bradycardia, hypotension
Uterine rupture
What is it?
Sudden onset bright red vaginal bleeding, can stop spontaneously, soft non-tender abdo
Placenta previa
What is it?
Sudden onset vaginal bleeding after ROM, painless
Vasa previa
