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Reproduction Flashcards

(53 cards)

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1
Q

What drugs are Teratogenic

A

-Warfarin

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2
Q

Treatment of DVT/PE during pregnancy

A

Low molecular weight heparin (LMWH)

[WARFARIN IS TERATOGENIC]

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3
Q

Management of Maternal Sepsis

A

-Prompt IV administration
-Full septic screen;
Blood cultures, LVS, MSSU, wound swabs
-Antipyretic measures
-Fluids

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4
Q

How to induce ovulation

A

-Clomifene

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5
Q

How does Clomifene work

A

-Binds to oestrogen receptors which causes the pituitary to release gonadotropins

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6
Q

Side effects of Clomifene

A
  • Vasomotor (hot flashes)

- Visual

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7
Q

Treatment for Azoospermia

A

-Surgical retrieval of sperm
Micro-epididymal sperm aspiration
Testicular sperm extraction

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8
Q

Treatment of Ectopic Pregnancy

A
  • Methotrexate, single IM into buttocks
  • Surgical removal of fallopian tube
  • Expectant management, if pregnancy is small it may dissolve by itself
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9
Q

Caution after receiving methotrexate

A
  • Avoid alcohol, methotrexate + alcohol = liver damage

- Reliable contraception for 3 months after, as methotrexate will harm the foetus

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10
Q

If prescribing Isotretinoin, to a woman of child bearing age, what 2 things must also be done with regards to the patient, according to the BNF

A
  • Monthly pregnancy checks

- Use at least one (preferably 2) methods of contraception

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11
Q

When should you avoid using Trimethoprim for a UTI

A

BNF says avoid during 1st trimester

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12
Q

Baby JR

  • 3 weeks old
  • Breast feeding
  • Mother has lower back pain

What can she safely take

A
  • Paracetamol + Ibuprofen, BNF notes amounts too small to be harmful in breast milk (though some manufacturers state avoid ibuprofen)
  • Codeine USUALLY too small to be harmful, but maternal metabolism very variable so risk of morphine OD in baby
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13
Q

Management of an ectopic pregnancy

A
  • Medical = Methotrexate
  • Surgical = Mostly laproscopical salpingectomy/salpingotomy (removal of fallopian tube)
  • Conservative = If pregnancy is small enough it may dissolve by itself
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14
Q

Management of placenta praevia

A
  • Caesarean section

- Watch for post partum haemorrhage (PPH)

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15
Q

Management for antepartum haemorrhage

A

-Will vary from expectant treatment to attempting vaginal delivery to caesarean section
-Depends on;
Amount of bleeding
Condition of mother + baby
Gestation

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16
Q

Management of preterm delivery

A
  • Consider possible cause (abruption, infection)
  • <24-26 weeks, Generally regarded as very poor prognosis
    -Cases considered viable;
    Consider tocolysis to allow steroid transfer,
    Steroids unless contraindicated
    Transfer to NICU
    Aim for vaginal delivery
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17
Q

Treatment for chronic hypertension in pregnancy

A
  • Beta-blockers (Labetalol)
  • Calcium channel blocker (Nifedipine)
  • Centrally acting antihypertensive drugs (Methyldopa)
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18
Q

Treatment of eclamptic seizures

A

Magnesium sulphate bolus + IV infusion

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19
Q

Prophylaxis for pre-eclampsia in subsequent pregnancies

A

Low dose aspirin, from 12 weeks till delivery

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20
Q

Treatment for diabetes during pregnancy

A

Can continue with oral metformin but may need to change to insulin for tighter glucose control

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21
Q

Management of GDM

A

Control blood sugars with;

  • Diet
  • Metformin/insulin if sugars remain high
  • 6-8 weeks post delivery check OGTT
  • Yearly check of HbA1c (due to higher risk of developing overt diabetes)
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22
Q

4 methods of management for UI

Study These Flashcards
A
  • Lifestyle changes
  • Medical treatments
  • Physiotherapy
  • Surgery
23
Q

Describe the mechanism of SUI and treatment for it

Study These Flashcards
A

-SUI occurs when intra-abdo pressure exceeds urethral pressure, resulting in leakage
-Urethral closure pressure is increased by;
Pelvic floor muscle training
Surgery
Pharmacological agents

24
Q

4 lifestyle changes for UI treatment

Study These Flashcards
A
  • Smoking cessation
  • Weight loss
  • Healthier diet
  • Stop drinking alcohol and caffeine
25
3 components pelvic floor muscle training (PFMT)
- Reinforcement of cortical awareness of muscle groups - Hypertrophy of existing muscle fibres - General increase in muscle tone and strength
26
Pharmacological treatment for SUI (moderate to severe) and who should receive it
- Duloxetine (should still include PFMT) - If PFMT has failed or would be enhanced with Duloxetine - After failed surgery or those unfit for or not interested in surgery
27
3 surgical treatments for SUI
- Colposuspension - Mid-urethral sling - Retro-pubic TVT (Tension-free Vaginal Tape) TVT has now replaced Colposuspension as 1st choice surgical treatment of SUI 8 year 80% cure rate
28
4 lifestyle changes to treat OAB
- Normalise fluid intake - Reduce caffeine - Smoking cessation - Weight loss
29
Pharmacological treatment of OAB
``` Antimuscarinic Drugs (type of anticholinergic drug) E.g. Oral Solifenacin ```
30
2 recent treatments for OAB
- Botox | - Neuromodulation (Needle stimulation s2-4, reflex inhibition of detrusor muscle, cheap and minimally invasive)
31
Treatment for Polycystic Ovaries Syndrome (PCOS)
- Oral contraceptive pill | - Weight loss
32
Menorrhagia treatment
-Progesterone only pill or Combined oral contraceptive -Tranexamic Acid (Antifibrinolytic)(pregnancy category B)
33
Management of vulvovaginitis
- Improved hygiene (may be curative) - Treatment is indicated if there it is chronic or there's difficulty urinating - Lubrication of the labia with a bland ointment - Topical oestrogen - Surgical separation is rarely necessary
34
Management of a vaginal discharge
- Culture to identify causative organism - Urinalysis to rule out cystitis - Review proper hygiene - Perianal exam with transparent tape to test for pinworms - If persistent discharge, exam under general anaesthetic is indicated to rule out foreign body
35
Treatment of endometriosis
-Medical Progesterone or combined pill GnRH analogues (Leuprorelin) -Surgical Excision of deposits from peritoneum/ovary Diathermy/laser ablation of deposits Hysterectomy AND Oophorectomy May recur after Rx
36
Treatment of adenomyosis
- Mirena may help (IUD containing progestin) - Medical Rx often fails - Hysterectomy
37
Fibroids treatment
- Myomectomy - Standard menorrhagia Rx (if cavity not too distorted) - GnRH analogues - Anti-progestogen - Uterine artery embolisation - Hysterectomy
38
Menorrhagia treatment
- Tranexamic acid - Combined oral contraceptive pill - Injected progestogen
39
Treatments for DUB
-Fertility conserving treatment Menfenamic acid Combined oral contraceptive pill Progesterone IUD (Mirena) -If family complete Endometrial ablation Hysterectomy
40
Prevention + treatment of osteoporosis
- Weight bearing exercise - Adequate Ca + Vit D - HRT - Bisphosphonates - Calcitonin - Monoclonal antibody to osteoclasts (Denosumab)
41
Benefit of transdermal HRT vs oral
Transdermal avoids first pass metabolism, reducing risk of VTE
42
Treatment of Polycystic Ovary Syndrome (PCOS)
- Weight loss/exercise - Combine hormonal contraception (Antiandrogen) - Endometrial protection (progesterone, mirena IUS) - Fertility Rx metformin/clomiphene
43
Treatment for POP
- Physiotherapy (PFMT) - Pessaries (silicone is favoured) - Surgery
44
Treatment of axilla in breast cancer with +ve sentinel lymph node
-Remove them all surgically (axillary clearance) or -Radiotherapy to all nodes in the axilla
45
3 methods of treatment for micrometastases
- Hormone therapy - Chemotherapy - Targeted therapies
46
Type of hormone therapy given if premenopausal
Tamoxifen for 5 years
47
Type of hormone therapy given if postmenopausal
- Tamoxifen for 5 years (if excellent prognosis) - Aromatase inhibitor for 5 years (if poorer prognosis) (intermediate prognosis tamoxifen for 2yrs + AI for 3yrs)
48
2 types of chemotherapy drug used to treat micrometastases
- Anthracyclines | - Taxanes
49
Drug used in anti-her2 therapy
Trastuzumab (monoclonal antibody against Her2 receptor
50
Drug class and 2 examples for the treatment of vulvovaginal candidosis
- Azole antifungals - Clotrimazole (500mg PV once) - Fluconazole (150mg PO once)
51
2 drugs and their mode of delivery to treat bacterial vaginosis
- Metronidazole, Oral(avoid alcohol) or vaginal gel | - Clindamycin, Vaginal
52
Treatment for congenital hypothyroidism (CHT) and when should it start by
- Thyroxine tablets | - 21 days of age
53
Emergency treatment for Medium Chain Acyl-CoA Dehydrogenase Deficiency (MCADD)
Glucose polymer (maxijul) + IV dextrose

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