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Flashcards in repro Deck (30)
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1

obstetric abdominal examination: inspection

scars
striae gravidarum
linea nigra

note for swelling of uterus from end of the bed

2

obstetric abdominal examination: palpation

upper and lateral edges of mass
feel for fetal poles (head and breech) to find lie
use side of hands to find highest point of uterus (fundus)

3

obstetric abdominal examination: measuring fundal height

after 20wks
tape measure face fown, measure to top of symphysis pubis

fundal height should be equivalent to gestation in weeks +/-3cm

4

obstetric abdominal examination: feel for presenting part

place both hands at base of uterus, above pubic bone - warn of possible discomfort

ballot the head gently or note if not possible

5

obstetric abdominal examination: feel for engagement

after 36wks

estimate how much of head is still palpable on abdominal examination

6

obstetric abdominal examination: auscultation

listen for fetal heart over baby's anterior shoulder

7

female sexual health + repro history qs

-menstrual Hx: age first/last, length + pattern cycle, intermenstrual or post-coital bleeding
-LMP
-dysmenorrhea, menorrhagia
-pelvic + sexual infections: discharge, pelvic pain, dyspareuria, rash, ulcers
-cervical smear hx
-obstetric hx: parity, gravity, terminations, miscarriages
-infertility: duration of trying to conceive, frequency UPSI
-past + present use contraception
-incontinence: stress + urge
-sexual history: current/prev partners, type of sex, high risk partners

8

male sexual and repro history qs

-erectile dysfunction: how long, can they develop erection, can they have sex
-premature or delayed ejaculation
-urinary symptoms: dysuria, frequency, nocturia, dibbling, flow
-penile discharge
-testicular swelling, pain, rash
-penile rash, ulcer, lump
-if infertility: duration of time trying to conceive, frequency UPSI
-sexual history: current/prev partners, protection, high-risk partners, prev STI

9

gravidity

number of times a woman has been pregnant, regardless of outcome

10

parity

total number of times a woman has given birth to a child with a gestational age 24wks+
regardless of whether child was born alive or not

11

gynae causes of abdo/pelvic pain

ectopic pregnancy
PID
endometriosis
ruptured ovarian cyst

12

gynae causes of post-coital bleeding

cervical Ca
gonnorhea
chlamydia
vaginitis

13

gynae causes of intermenstural bleeding

contraception
ovulation
misscarriage
gonnorhea
chlamydia
malignancy
uterine fibroids

14

gynae causes of post-menopausal bleeding

vaginal atrophy
HRT
malignancy

15

gynae causes of abnormal vaginal discharge

BV
chlamydia
gonorrhea

16

gynae causes of dyspareunia

endometriosis
chlamydia
gonorrhea

17

gynae causes of vulval skin changes + itching

gonorrhea
thrush

18

determining whether vaginal discharge is normal or abnormal

volume - change in amount

colour - green, yellow, blood-stained

consistency - thickened, watery

smell

19

menstrual hisotry

-duration of periods
-frequency of periods/length of cycle
-volume of blood - heavy/light
-dysmenorrhoea
-date LMP
-age at menarche
- menopause if relevant

20

what to ask about current pregnancies

gestation
any symptoms - nausea, vomiting, backpain
complications - pre-eclampsia, cervical neck incompetence
-recent scan results

21

what to ask about previous pregnancies

age of kids
birth weight
mode delivery
complication: antenatal, perinatal, postnatal
if relevant, are they breastfeeding - contraindication to COC

22

causes of reduced fetal movements

fetal distress
early fetal demise

23

obstetric causes vaginal bleeding

placenta praevia
placental abruption

24

typical clinical features of pre-eclampsia

headache
visual disturbance
epigasric pain
oedema

25

previous obstetric history

gravidity and parity

term pregnancies: gestation at delivery, birth weight, mode of delivery, complications, assisted reproduction

stillbirth
misscarriages
terminations
ectopic pregnancies

26

asking about last sexual contact

when was it?
was it consensual?
regular or casual partner
partner demographics - sex and nationality
type of sex involved
contraception used and consistency of usage
other sexual partners in past 3mo

27

pelvic bimanual examination: inspection of vulva

hair distribution
ulcers
vaginal discharge
masses e.g. bartholin's cysts
swelling
prolapse

28

pelvic bimanual examination: palpation

walls of vagina - irregularities, masses
cervix - consistency, pain
uterus - smooth, nodular, tenderness, mobility
adnexa (R + L lateral fornices) - feel for any masses

29

vaginal speculum exam: visualise cervix

cervical os - if open may indicate miscarriage
look for erosions around os
cervical masses
ulceration
abnormal discharge

30

indications for pelvic examination

to assess pathology related to external genitalia, vaginal walls, cervix, uterus and adnexa

to perform e.g. high vaginal or endocervical swabs, cervical cytology

in labour to assess dilatation of cervix, rupture of membranes and to assess progress in labour