Women's Health Flashcards
(179 cards)
1
Q
Chicken pox >20 weeks
A
Oral Acyclovir or VZIG
2
Q
<20 weeks and not immune to Varicella
A
VZIG
3
Q
Risk for Hyperemesis
A
Twin pregnancy
4
Q
Draggy and heavy uterus
A
Urogenital prolapse
5
Q
Cervical excitation causes
A
PID and Ectopic pregnancy
6
Q
> 8 Bishops score
A
Vaginal birth likely
7
Q
<6 Bishops score
A
Vaginal birth unlikely and needs induction
8
Q
Chocolate cyst
A
Endometriotic cyst
9
Q
Most common ovarian cancer
A
Serous Carcinoma
10
Q
Simple cysts in young woman
A
follicular or corpus luteal
11
Q
Bladder palpable after urination
A
urinary overflow
12
Q
Signs of labor
A
Regular and painful uterine contractions, shedding mucos plus, ROM, shortening and dilation of cervix
13
Q
Stages of Labor Stage 1:
A
onset of true labor to when cervix is fully dilated
10-16 hours in primigravida
latent phase: 0-3 cm dilation
Active phase: 3-10 cm
14
Q
Stage 2 labor
A
From full dilation to delivery of fetus
Passive second stage: absence of pushing
Active second stage: maternal pushing
> 1 hour- ventouse extraction, forceps or C section
15
Q
Stage 3
A
from delivery of fetus to when the placenta and membrane have completely delivered
16
Q
Management of GBS
A
intrapartum Antibiotics such as Benzylpenicillin
17
Q
Breech babies at or after 36 weeks
A
USS at 6 weeks
18
Q
Reduce size of fibroid using
A
GNRH analogues
19
Q
Mefenamic Acid
A
treat dysmenorrhea and Heavy menstrual bleeding
20
Q
transxamic Acid
A
Menorrhagia and excessive blood loss
21
Q
Antiphospholipid syndrome
A
Recurrent miscarriage;
22
Q
Snow-storm appearance of uterus and abnormally large uterus and high hCG
A
Hydatiform mole
23
Q
Most common cause of post-coital bleeding
A
Cervical Ectropion
24
Q
Location of most ectopic pregnancy
A
Ampulla of Fallopian tube
25
Cocaine use is associated with (pregnancy)
Placental abruption
26
What ovarian tumour is related to Endometrial Hyperplasia
Granulosa cell tumour
27
Investigation of choice in Ectopic pregnancy
TVUS
28
Medical management of Miscarriage
Misoprostol
29
Known Previa going to labour prior to elective C-section
conduct an emergency c section
30
Spirometry in IPF- FEV1, FEV1/FVC and TLCO
FEV1 increased or normal
FEV1/FVC decreased
FVC decreased
31
Week when External cephalic version can be performed
36 week
| 37 if multiparous
32
Red degeneration
Fibroid degeneration during pregnancy, Low grade fever, pain, and vomiting
Managed with rest and analgesia, resolves in 4-7 days
33
Risks associated with Abruption
Maternal age, Multiparity and Advanced age
34
What is a galactocele
Women recently stopped breastfeeding; occlusion of a lactiferous duct; cystic lesion formed
35
1st line for management of Fibroids <3 cm
Levonorgestrel IUS
36
Breast tumour less then 4 cm
Wide local excision
37
Best imaging to diagnose Adenomyosis
MRI pelvis
38
Gold standard diagnosis for placenta previa
TVUS
39
Management of Post parturition Hemorrhage
1st line: IV syntocinon (oxytocin) or IV ergometrine
2nd line: carboprost
Surgical management: Intrauterine balloon tamponade - Uterine Atony is the cause
40
Pre-eclampsia Features
Eclampsia, fetal complications - IGR, prematurity, liver enzymes elevated, hemorrhage and cardiac failure
41
Ovarian torsion is associated with what sign on USS
Whirlpool sign
42
high risk pregnancy management
Aspirin 150mg daily from 12 week
43
High blood sugar in pregnancy
Fasting = 5.6 and 2 Hour =7.8
44
Placenta Accreta
Abnormal adherence by placental villi
45
Increta
Chorionic villi invade the myometrium
46
Pancreta
chorionic villi penetrate the uterine serosa and other organs such as bladder
47
Perineal tears
1st degree: vaginal mucosa torn
2nd degree: perineal muscles torn
3rd degree: Anal sphincter torn
4th degree: Rectum torn
48
Snowstrom Appearance on USS
Hyadtiform mole/ molar pregnancy
49
Investigation for miscarriage
TVUS
50
management of simple ovarian cysts
If asymptomatic - NO action
| >5 cm - surgery; CA-125
51
Early pregnancy, smoking, spotting, Pain
Ectopic pregnancy
52
C-section is a risk factor for what pain causing 3rd trimester condition
Placenta Praevia
53
Most common cause of post-partum hemorrhage
Uterine Atony
| 4 Ts tone tissue trauma and thrombin
54
Cord prolapse
Push the head and not the cord
| Immediate C-section
55
string on pearls on USS
PCOS
56
Abnormal smear and abnormal cytology
Colposcopy
57
Most common symptom associated with fibroids
Heavy menstrual bleeding/ Menorrhagia
58
Oligomenorrhia + Subfertility + Hirstuism + USS - beads on string
PCOS
59
Ectropion is commonest cause of
Post-coital bleeding
60
Most significant risk of vaginal birth after C-section
Uterine Rupture
61
Placenta praevia going for preterm birth
Emergency C-section ASAP!!!
62
Eclampsia treat with
MGSO4 (immediate) + C-section
63
Oligohydraminos cause
poor functional fetal kidneys
64
Polyhydraminos Cause
duodenal atresia and maternal diabetes
65
Thin and unilocular cyst is linked to
Simple cysts
66
Surfactant lung disease risk factors
Male sex; diabetic mother, C-section and 2nd premature twin
67
Investigation of PROM
Speculum exam
68
Hyperreflexia is an important symptom of
Pre-eclampsia
69
When should Vitamin K be given in epilepsy in a pregnant woman
36 week onwards
| Carries a risk of hemorrhagic disease of the newborn
70
HIV is screened at booking scan - True or false
True
71
Combined test for Downs
Nuchal translucency, HCG, PAPP-A
72
Triple test for downs
Combined + AFP + oestriol and inhibin A
73
Quadruple
HCG, estriol, AFP, Inhibin A
74
Pulmonary hypertension, hypoxia, amniotic fluid and fetal matter in maternal lungs, collapse, respiratory distress, central cyanosis, DIC
Amniotic fluid embolism
75
10-13 weeks antenatal timetable
Booking scan- Advice, smoking, alcohol, folic acid, Bloods, rhesus status, HIV test, syphilis, Hepatitis screen.
Dating scan - USS
Down's Screening
76
18-20 weeks antenatal timetable
Anomaly scan
77
24 weeks antenatal timetable
SFH measure
78
28 weeks
Anti-D for rhesus negative mothers
| GTT
79
36 weeks
identify presentation
80
Risk for preterm labor
Acute illness, low BMI, Multiple pregnancy, polyhydraminos, PROM, cervical surgery, smoking, uterine abnormality
81
Management of shoulder dystocia
Episiotomy, Mcrobert's, suprapubic pressure, internal rotation
82
Miscarriage and antiD
RH-ve mother and >12 weeks gestation
83
Surgical treatment of ectopic
Laparoscopic salpingectomy of affected tube
salpingostom if contralateral tube is absent or damaged
Laparotomy if unstable
84
1st trimester surgical Termination
Vaccum aspiration
85
2nd trimester termination
dilatation and evacuation
86
Endometrial cancer risks
Obesity, tamoxifen, HRT, increased estrogen, Lynch syndrome
87
Dysmenorrhea, deep dyspareunia, chronic pelvic pain, and ovulation pain; subfertility, dyschezia
Endometriosis
88
Menorrhagia causes
Fibroids, coagulopathy, pelvic cancers
89
Treatment of fibroids
Submucosal: trans-cervical resection
Intramural and subserosal: myomectomy
Hysterectomy
uterine artery embolization
90
PPH management
Oxytocin
91
Main lymph drainage of ovary
Para-aortic nodes
92
Mittelschmerz
mild suprapbic pain due to ovulation; subsides in 1-2 days
93
When should a referral made for no fetal movements in pregnancy
24 weeks
94
Management of Atrophic vaginitis
Moisturiser, water based lubricant and topical estrogen therapy
95
Most common site for Ectopic pregnancy
Ampulla in Fallopian tube
96
Why does ectopic pregnancy cause Shoulder tip pain
Ruptured contents in the abdomen causes irritation of the diaphragm
97
Risks for an ectopic pregnancy
Previous ectopic; IUD use, chronic inflammation, tubule surgery, progesterone only pill and IVF
98
Investigations in Ectopic pregnancy
First line: beta HCG and urinalysis
| Gold standard: Transvaginal USS
99
Viable pregnancy in ectopic
HCG will double every 48 hours
100
What are the indications for expectant management in ectopic
```
Size <35mm
Unruptured
Asymptomatic and no heart beat
Serum bHCG <1000
Compatible with another intrauterine pregnancy
```
101
Indication for medical management with Methotrexate in ectopic pregnancy
```
Size <35 mm
Unruptured
No pain
No fetal heart beat
<1500 hcg
```
102
Surgical management of ectopic by Laparoscopic or laparotomy - indications
```
Size >35 mm
Ruptured
Pain
Visible fetal heartbeat
>1500 hCG
```
103
Endometrioma in ovary is called
Chocolate cysts
104
Chronic pain, dysmenorrhea, deep dyspareunia, sub-fertility
Endometriosis
105
Gold standard diagnosis for endometriosis
Laparoscopic surgery
106
Management of endometriosis
NSAIDs/ paracetamol - 1st line
COCP or progestrins such as medroxyprogesterone acetate
Fertility priority
GNRH analogues
Laparoscopic excision and laser treatment
107
When does red degeneration of a fibroid occur
During pregnancy
108
Menorrhagia, iron deficiency, cramping abdominal pains and menstruation, subfertility, polycythemia
Fibroids
109
Diagnosis of fibroids
transvaginal USS
110
Medical and surgical treatment of fibroids
Progesterone tablets, GnRH analogues
Surgical: Myomectomy, hysteroscopic endometrial ablation, uterine artery embolization
111
Management of menorrhagia secondary to fibroids
Levonorgestrel Intrauterine system - IUS
| NSAIDs such as Mefenamic acid, tranexamic acid, COCP
112
Bleeding from a closed cervical, does not result in a miscarriage
Threatened miscarriage
113
Bleeding from an open cervix, abdominal cramps, uterine contents visible during pelvic examination, heavy bleeding
Inevitable miscarriage
114
Open cervix, passing of uterine contents, Not all products are yet expelled and the OS is open and bleeding
Incomplete miscarriage
115
Uterine cavity is empty
Complete miscarriage
116
No symptoms of expulsion, fetus is not viable
Missed miscarriage
117
Diagnosis of miscarriage
TVUS
Pelvic exam
HCG levels
118
Treatment of missed, incomplete and inevitable miscarriage
Vaginal Misoprostol
vacuum aspiration or suction curettage
Dilation, curettage and uterine aspiration
119
Expectant miscarriage management
Wait and watch - 7 to 14 days
High risk patients: Coagulopathy, later first trimester
Previous adverse events and infection
120
Commonest type of ovarian cyst
Follicular cyst
121
These cysts are only seen during pregnancy
Theca lutein cysts
122
Most common ovarian tumour in young women (under 30)
Dermoid cysts (likely to cause torsion)
123
Most common benign epithelial tumour
Serous cystadenoma
124
Which cyst on rupture can cause pseudomyxoma peritonei
Mucinous cystadenoma
125
Diagnosis of ovarian cysts
Abdominal USS, MRI, CA-125, histology USS guided
126
>5 cm ovarian cyst
Laparoscopically removed
127
What is the ratio of LH and FSH in PCOS
LH > FSH 2:1
128
Decreased SHBG, Raised free testosterone; insulin resistance, raised testosterone and Estrogen
PCOS
129
Diagnosis of PCOS
Anovulation (primary)
Hyperandrogenism
PC ovary >12 on TVUS
130
What is an endometrial complication of PCOS
Endometrial hyperplasia
131
Acanthosis nigricans
Skin patches related to PCOS
132
Management of PCOS
OCPs and Co-cyprindiol
Topical eflornithine
Fertility - Clomiphene and met Forman
Ovarian drilling - surgical
133
Prevention of Anemia in pregnancy
60 mg iron and 400 mcg folic acid until 12 weeks
| 5 mg if high risk pregnancy - NTD, SCD
134
Descent of umblical cord through cervix along with or past the presenting part in PROM
Cord prolapse
135
Risks of cord prolapse
Artificial ROM, breech position, polyhydramnios, congenital anomalies and previous cord prolapse
136
Management of cord prolapse
push the head not the cord
Bladder filling
exaggerated Sims position
C-section if not dilated
137
Placental hormones that can relate to gestational diabetes
Growth hormone, CRH, Placental lactogen
138
Risks for GD
Increased maternal age, obesity, previous macrosomia, FH, PCOS, South asian
139
GD screening occurs at
24 to 28 weeks
140
>7 mmol/L fasting glucose (normally 5.6)
Insulin should be started
141
Pre-existing diabetes
High risk preganancy and treat with folic acid 5 mg, glycemic control and 20 w anomaly scan
142
What vitamin is recommended in AEDs taking mothers babies
Vitamin K
143
LFTs in Obstretic cholestasis
High bilirubin, ALT, AST and bile acids - 10-100 times
144
Management of obstretic cholestasis
Ursodeoxycholic acid
Vitamin K
37 week induction of labour
145
when placenta lies near the OS
Placenta Previa
146
Risk factors for previa
Endometrial scarring - Previous C-section, increased parity and prior Curettage, smoking, multiple gestation and high altitude
147
Painless PV bleeding, shock, non-tender uterus,
Previa
148
Accreta
abnormal placental implantation into the uterus by placental villi
149
Increta
Chorionic villi invade the myometrium
150
Percreta
Involves uterine serosa and other organs
151
Diagnosis of Previa and other placental abnormality
Tranvaginal USS
MRI- Accreta
152
Management of previa
repeat USS at 34 weejs
| at 37 week C-section
153
Painful 3rd trimester bleeding, tender tense uterus, coagulation problems, Anuria, pre-eclampsia
Placental abruption
154
confirmation of placental abruption diagnosis
USS - retroplacental blood clot or collection
155
<36 weeks and alive fetus in abruption
Distress- c-section
| no distress- steroids
156
>36 weeks in abruption
Distress- C-section
| no distress- vaginal induction
157
Fetus dead in abruption
Vaginal delivery
158
Commonest cause of PPH
Uterine atony
159
Risk factors to PPH
previous PPH, prolonged labour, pre-eclampsia, increased age, polyhydramnios, placental abnormalities such as previa and accreta
160
Management of PPH
```
Oxytocin aka syntocin
Syntometrine: oxytocin + Ergot drugs
Uterine massage
Surgical: intrauterine balloon tamponade - uterine atony
B- lynch suture
```
161
Secondary PPH occurs
between 24 hours to 12 weeks
162
Triad of pre-eclampsia
Hypertension + proteinuria + oedema
163
HELLP syndrome
Hemolysis, elevated liver enzymes and low platelets
164
Risk reduction in pregnancy - hypertension
>1 high risk factor or >2 moderate risks - Aspirin 75 to 150 mg daily from 12 weeks until the birth
165
Medications in Gestational hypertension
Labetalol 1st line
| Nifedipine is asthmatic
166
Antibiotics that can be used in Pregnancy
Trimethoprim cant be used in 1st trimester
Amoxicillin and nitrofurantoin
do not use nitrofurantoin in last trimester
treat for 7 days
167
What is the classic feature of vasa previa
Fetal bradycardia
168
Risk factor for vasa previa
placenta previa, multiple pregnancy, iVF
169
Screen for VCI
vasa previa - velamentous insertion of the cord; no wharton's jelly
170
Treat dysmenorrhea
Nsaids such as mefenamic acid
| COCP 2nd line
171
Whirlpool sign
Torsion
172
how mant visits in first pregnancy
10 antenatal visits
173
How many in non-first pregnancy
7 antenatal visits
174
18-21 weeks what happens in antenatal time period
Anomaly scan
175
first dise of anti-D prophylaxis
28 weeks
176
2nd dose of anti-d
34 week s
177
Offer external cephalic version
36 week s
178
latent phase of stage 1
0-3 cm dilation
179
active phase of stage 1
3-10 cm dilation
