Reproduction Flashcards
(28 cards)
What investigation is UNRELIABLE in pregnancy
D-dimer
What investigations would be used to diagnose a DVT/PE in a pregnant/postnatal woman
- ECG
- Leg Dopplers
- CXR +/- VQ scan or CTPA (CT Pulmonary Angiogram) [radiation risk during pregnancy and breast feeding]
What investigations would you carry out for female infertility
-Rubella immunity
-Chlamydia
-TSH
-Mid luteal progesterone, 7 days prior to expected period (if periods are regular)
-If periods are irregular day 1-5;
FSH
LH
PRL
TSH
Testosterone
-Pelvic ultrasound
-Tubal patency test
What investigations would you carry out for male infertility
Semen analysis
How to diagnose Polycystic Ovary Syndrome (PCOS)
- Testosterone level
- Ultrasound
- Hirsutism (clinical diagnosis)
Investigations for Azoospermia
- Testosterone level
- Karyotype
- PRL (prolactin)
- CF Screen (cystic fibrosis)
- FSH (Follicle-stimulating hormone)(gonadotropin)
- LH (Luteinizing hormone)
What is measured to confirm pregnancy
Beta-human Chorionic Gonadotropin (B-hCG) in urine
Investigations to confirm ectopic pregnancy
- US
- Serum B-hCG levels (may need to serially tack levels
- Serum progesterone levels
What would be seen on an Ultrasound scan of an ectopic pregnancy
- No intrauterine gestational sac
- May see adnexal mass
- Fluid in pouch of Douglas
How to diagnose placenta praevia
US to locate placental site
3 ways of confirming significant proteinuria
- Dipstick test: Urine protein estimation >1
- Spot urinary protein: Creatinine ratio >30 mg/day
- 24hrs urine protein collection >300 mg/day
What investigations would be carried in pre-eclampsia
- Blood investigations: FBC (for haemolysis), LFT’s, Renal function tests (serum urea, creatinine, urate), coagulation test if indicated
- Foetal investigation: Scan for growth + Cardiotocography (CTG)
How to screen for GDM
If risk factors are present
- Offer HbA1c at booking (first antenatal scan)
- If HbA1c >43 mmol/L do OGTT
- If OGTT normal repeat it at 24-28 weeks
-Can also offer a OGTT at 16 and repeat at 28 weeks is significant risk factor present (e.g. previous GDM)
3 investigations for UI
- Urinalysis, Multistix +/- MSSU
- Post voiding residual volume assessment, Only if symptoms of voiding difficulties
- Urodynamic, ONLY if surgical treatment is contemplated
Investigations for primary amenorrhea
- FSH
- LH
- Prolactin (PRL)
- Testosterone and oestrogen
- Pelvic US
Investigation for menstrual problems
- FBC (if menorrhagia)
- Endometrial biopsy (mainly >45/persistent IMB/high risk)
- Chlamydia (esp. IMB, PCB, <25, new partner)
- Pregnancy test
- Ultrasound
Investigations for endometriosis
- Laparoscopy
- MRI
- US
How to diagnose adenomyosis
-Histology of uterine muscle (NOT ENDOMETRIAL BIOPSY)
-Probably US, laparoscopy, hysteroscopy
MRI may suggest diagnosis but limited availability
How fibroids are diagnosed
- Clinical exam
- US
- Hysteroscopy
Exams and investigations for secondary amenorrhoea
- BP + BMI
- Hirsutism, acne, striae
- Enlarged clitoris/deep voice
- Abdo + bimanual exam
- Pelvic US
- Urine dipstick (for glucose) + urine pregnancy test
- FSH
- LH
- Thyroid function tests
- Prolactin
- Oestradiol + Testosterone
What is a DEXA scan used for and what does it stand for
- Dual Energy X-ray Absorptiometry
- Bone density
Investigations for POP
- USS/MRI, allow identification of fascial defects
- Urodynamics, concurrent UI or to exclude Occult SI
- IVU or Renal USS, If suspicion of ureteric obstruction
Investigations for vulvovaginal candidosis
Gram stained preparation (low sensitivity)
Culture (low specificity)
Type of culture used to diagnose vulvovaginal candidosis
Sabouraud’s medium
