Week 2 - Core Clinical Problems Flashcards
Criteria for Lactational amenorrhoea
Exclusively breast feeding
Less than 6/12 post natal
Amenorrhoeic
What effect does oestrogen have on the hypothalamus
Inhibits Gonadotropic Releasing Hormone
What substance inhibits release of FSH and LH
Progesterone
What risk factors do you need to be aware of before prescribing contraception
CV disease
Breast cancer
Osteoporosis
Before prescribing CHC, what should you do?
Take a history
BP & BMI
Check smear status
Legal limit for TOP
24 weeks
Legal limit for TOP for a foetus with an abnormality
Any time
Limits for TOP in Tayside
Surgical termination = 12 weeks
Medical termination = 19 weeks
What are the 2 types of surgical TOP and what are the timescale limits?
Vacuum aspiration: 6-12 weeks
Dilatation and evacuation: 13-24 weeks
What should you give the patient 72 hrs after the TOP (medical and other)?
Anti-D
Counselling
Contraception - DON’T GIVE PROGESTERONE DEPO INJECTION (as it reverses the effects of mifepristone)
What receptor sites does the HIV target?
CD4+
When testing for HIV what markers are you looking for?
Early stages - viral RNA and surface antigen (p24) will be raised
In the late stages (i.e. chronic disease) - antibodies against HIV will be raised
Give a good HIV test for an early infection
RITA
Give an advantage & disadvantage for the POCT HIV test
Adv - Simple (just a fingerprick specimen needed)
Disad - Not reliable in early infection stage
HIV Treatment
HAART - Highly active anti-retroviral therapy) = A combo of 3 drugs from at least 2 drug classes
3 drugs can include; Tenofovir, Emtricitabine, Efavirenz
What are the 3 targets for HIV drugs
Reverse transcriptase
Protease
Integrase
i.e. the drugs given are reverse transcriptase inhibitors or protease inhibitors etc
How to prevent transmission of HIV to a sexual partner or to the affected mothers baby?
PrEP = Pre-exposure Prophylaxis
It comes in the form of a pill called Truvada - contains tenofovir & emtricitabine
What is recommended for women to take prior to & during pregnancy?
Folic acid - 400ug pre-conception & 1st trimester
Vit D - 10ug throughout pregnancy & breastfeeding
Vit c - 70mg during pregnancy
Iron
What should pregnant women avoid?
Alcohol
Vit A
Too many calories (only need extra 300 calories in 3rd trimester)
Dodgy foods - soft cheese, undercooked meats, partially cooked eggs etc
By taking folic acid during pregnancy, what can be avoided?
Neural tube defects
What vaccines are given to MSM?
Hep A/ Hep B/ HPV
If someone has had sex with an HIV +ve person, what can they be given? (and in what time frame?)
Can have PEPSE - like a morning after pill for HIV Give HAART (3 antiretroviral) within 72 hrs
If someone has had sex with Hep B +ve person, what can they be given? (and in what time frame?)
HPV vaccine (taken 7 days after)
What method is used to look at in utero DNA?
Array CGH (aCGH)
