when can you have the implant inserted post partum
immediately following child birth
CI the implant
current breast cancer
Painful ulcer + Painful lymph nodes in LEDC:
Chancroid
Painful ulcer(s) + Painful lymph nodes:
Genital Herpes
Painless ulcer + Painful lymph nodes in LEDC:
LGV
Painless ulcer + Painless lymph node:
Syphilis (Tropenema)
chlamydia treatment in pregnancy
azithromycin, erythromycin or amoxicillin
1st + 2nd line meds chlamydia
1st= doxycycline 1 week
2nd= azithromycin or erythomycin or for 2 days (also good if not compliant)
investigation men + women- chlamydia
men= urine test
women= vulvovaginal swab
genital warts treatment
single keratanised= cryotherapy
multiple non keratinsed
1st= topical podophyllum
2nd= imiquimob
pregnant woman due cervical screen
-when can she get
3 months post partum
antenatal test results for Down’s
↑ HCG, ↓ PAPP-A, thickened nuchal translucency
when is Down’s screening offered
11- 13 + 6 weeks for combined test (HCG, PAPPA + NT)
if this is missed or inconclusive can do quadrouple test at 15-20 weeks (afp, unconjugate estradiol, HCG, inhibin A)
if woman has a ‘higher chance’ result for Down’s screening (combined or quadrouple) what is offered next
NIPT
-analyses small DNA fragments that circulate in the blood of a pregnant woman (cell free fetal DNA, cffDNA)
-cffDNA derives from placental cells and is usually identical to fetal DNA
-analysis of cffDNA allows for the early detection of certain chromosomal abnormalities
what risk is increased by adding progesterone to HRT?
-Breast cancer
-VTE
(2 legs + 2 boobs + 2 drugs)
how should genital herpes be treated
ORAL acyclovir
Management of placental abruption when the fetus is alive, <36 weeks and not showing signs of distress
Admit, monitor closely + admister steroids
Management of placental abruption when the fetus is alive, <36 weeks and showing signs of distress
immediate caesarean
Management of placental abruption when the fetus is alive, >36 weeks and not showing signs of distress
Vaginal delivery
Management of placental abruption when the fetus is alive, >36 weeks and showing signs of distress
immediate C section
A 32-year-old woman presents to the general practitioner with a lump in her right breast. She has no past medical or family history of note. On examination, there is a small, firm, non-tender lump in the upper left quadrant of the patient right breast. The remainder of the breast examination is unremarkable.
-next step?
Refer women aged >30 with an unexplained breast lump using a suspected cancer pathway referral
<30 non urgent referral
pre term rupture of membranes management
<34 weeks antenatal corticosteroids
<30/32 weeks Magnesium sulphate
can give prophylactic erythromycin
Deliver by 37 weeks plss
can someone with a prev C section + low transverse scar have vaginal birth
yes
planned VBAC is an appropriate method of delivery for pregnant women at >= 37 weeks gestation with a single previous Caesarean delivery
CI of vaginal birth
-previous uterine rupture
-classical caesarean scar
