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JL Reproduction and Sexual Health > Week 4 part 3 > Flashcards

Week 4 part 3 Flashcards

1
Q

When does bleeding in early pregnancy occur?

A

less than 24 weeks

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2
Q

Bleeding from the genital tract after 24 weeks gestation?

A

Antepartum haemorrhage

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3
Q

Are preeclampsia and hypertension risk factors for placental abruption?

A

Yes

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4
Q

Name a cause of couvelaire uterus?

A

Placental abruption

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5
Q

Uterine tenderness/wooden hard?

A

Placental abruption

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6
Q

Sudden-onset abdominal pain, vaginal bleeding, and uterine tenderness. Also abnormally freuqent contractions and uterine hypertonus?

A

Abruption

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7
Q

Placenta is partially or totally implanted in lower uterine segment?

A

Placenta previa

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8
Q

Painless, ‘causeless’ recurrent 3rd trimester bleeding? Uterus is soft and non tender

A

Placenta previa

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9
Q

How do you diagnose placenta oprevuia?

A

Ultrasound (20 week scan) - do not perform vaginal exam until you exclude it

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10
Q

Placenta invades myometrium?

A

Placenta accreta - percreta (placenta has reached serosa). Associated with sever ebleeding, PPH and may end up with hysterectomy

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11
Q

With placenta praevia - if ther has been prior bleeding in pregnancy or suspected/confirmed placenta accreta how is baby delivered?

A

Caesarea section at 37 weeks

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12
Q

With placenta preavia are steroids given?

A

Yes - promote fetal lung surfactant production (e.g. betamethasone)

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13
Q

Greater than 500ml blood loss post partum?

A

PPH

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14
Q

4 t’S OF pph?

A

Tone - 70%
Trauma - 20%
Tissue -10%
Thrombin - <1%

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15
Q

What is the initial management of PPH?

A
  1. Uterine massage
  2. 5 units IV syntocinon stat
  3. 40 units syntocinon in 500ml Hartmanns
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16
Q

Management of persistent PPH

A

Catheter

500microg ergometrine IV

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17
Q

Deepest layer of pelvic floor?

A

Pelvic diaphragm

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18
Q

What two muscle groups make up pelvic diapgrahm?

A

Levator ani
+
Coccygeus

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19
Q

Forms most of pelvic diaphragm?

A

Levator ani

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20
Q

What are three muscles making up levator ani/

A
  1. Iliococcygeus
  2. Pubococcygeus
  3. Puborectalis
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21
Q

Name 4 pelvic ligaments?

A
  1. Uterosacral
  2. Transverse cervical
  3. Lateral ligament of bladder
  4. Lateral rectal ligaments
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22
Q

What lies below fascia covering inferior aspect of pelvic diaphragm, and lies above perineal membrane?

A

Deep perineal pouch - conatains part of urethra, bulbourethral glands, NVB for penis/clitoris, extensions of ischioanal fat pads and muscles

23
Q

What in males, contains bulb - corpus spongiosim, crura - corpus cavernosum. associated muscles - bulbospongiosus and ischiocavernosus?

A

Superficial perineal pouch - male

24
Q

What in females, contains female erectile tissue and associated muscles: clitoris and crura - corpus cavernosum, bulbs of vestibule - paired, associated muscles - bulbospongiosus and ischiocavernosus

A

superficial perineal pouch - female

25
Lump in vaginal wall?
Prolapse - vaginal
26
Dragging sensation, feeling of lump, urinary incontinence?
Uterine prolapse
27
Predominant locations and role of muscarinic receptor subtypes: M1
Brain (cortex, hippocampus); salivary glands | Cognitive functioning and memory; saliva secretion
28
Predominant locations and role of muscarinic receptor subtypes: M2
Heart, brain, smooth muscle | Regulation of heart rate and heart rate flexibility; behavioural flexibility
29
Predominant locations and role of muscarinic receptor subtypes: M3
Smooth muscle, glands, eye | Smooth muscle contraction; gland secretion; iris contraction
30
Predominant locations and role of muscarinic receptor subtypes: M4
Brain (forebrain, striatum) | Modulation of several important dopamine-dependent behaviours
31
Predominant locations and role of muscarinic receptor subtypes: M5
Brain (substantia nigra); eye | Regulation of striatal dopamine release
32
Stress urinary incontinence?
leakage of urine during raised intra-abdominal pressure
33
leakage associated with urgency, usually with detrusor activity
Overactive bladder
34
What test is useful to differentiate between stress urinary incontinence and overactive bladder in patients whom surgery considered?
Urodynamics
35
a method by which the pressure/volume relationship of the bladder is measured during filling, provocation and during voiding
Cystometry
36
Drug for stress urinary incontinence
Duloxetine
37
Drug for overactive bladder?
Oxybutynin
38
1st degree uterine descent?
In vagina
39
2ND degree uterine descent?
In interiotus
40
3rd degree uterine descent?
Procidentia (entiryl outside vagina)
41
What has prolapsed if it is an enterocele prolapse?
Pouvh of douglas cobtaining small bowel
42
What type of prlapse: stress urinary incontinence, urinary retention, recurrent UTI?
Cystourethrocele
43
What typeof prolapse? Backache, ulceration if procidentia/everted?
Uterine/vault prolapse
44
What type of prolapse - constipation, dyschezia?
Rectal
45
When is the nadir reached in pregnancy for BP/
22-24 weeks
46
What are the two stages in pathogenesis of preeclampsia?
1. aBNORMAL placental perfusion | 2. Maternal syndrome
47
What can be used to predict pre-eclampsia?
Maternal Uterine Artery Doppler 20-24 weeks
48
Treatment of hypertension in pregnancy: METHYLdopa contraindication?
Depression
49
Treatment of hypertension in pregnancy: labetalol contraindication?
Asthma
50
Tonic-clonic (grand mal) seizure occuring with features of pre-eclampsia
Eclampsia - most common post partum 44%, more common in teenagers
51
What hypertensives are given for eclampsia?
IV Labetalol | IV hydralazine
52
How are seizures treated in eclampsia?
Magnesium sulphate
53
What is main cause of death in eclampsia?
Pulmomary oedema
54
whats is given in low dose to high risk woemn for preeclampsia?
Aspirin- commence before12 weeks

JL Reproduction and Sexual Health (18 decks)

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