Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 3a > Women’s Health > Flashcards

Women’s Health Flashcards

(147 cards)

Start Studying
1
Q

Interpreting CTG

A

DRCBRAVADO
Define Risk
Contraction
Baseline Rate
Accelerations
Variability
Deceleration
Overall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define and describe the different types of decelerations

A
  1. Early - Relative to contraction the deceleration is early. Normal because baby head is squeezed triggering vagal stimulation.
  2. Late - Pathological
  3. Variable - Cord compression. Cord is 2 arteries and 1 vein. When compressed vein compresses first and then arteries. When pressure released arteries rebound and then vein. The down and up nature of the graph depicts this.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define antepartum haemorrhage (APH)

A
  1. Vaginal bleeding
  2. Between 24w and birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ix for APH

A
  1. Abdo exam
  2. Speculum exam
  3. Bloods
    • Group + save
    • Crossmatch
    • Coag screen
    • Kleihauer test (in Rh-ve women)
  4. USS (exclude placenta praevia)
  5. CTG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of APH

A
  1. Obtain IV access
  2. Monitor for concealed haemorrhage
  3. Antenatal corticosteroids between 24-34w of gestation if risk of preterm birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a booking appt

A
  1. Comprehensive health assessment
  2. Before 10w gestation
  3. Identify women who require additional support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ix in booking appt

A
  1. Comprehensive histories of:
    • Medical
    • Psychiatric
    • Surgical
    • Obs + gynae
    • Social
  2. Height, weight, BMI
  3. Urinalysis
  4. BP
  5. Full bloods
  6. Test for sickle cell and thalassaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Indications for elective c-section

A
  1. Previous c-section
  2. Symptomatic after previous perineal tear
  3. Placenta praevia
  4. Vasa praevia
  5. Multiple pregnancy
  6. Uncontrolled HIV
  7. Cervical cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Indications for emergency c-section

A
  1. Category 1 - Immediate threat to life of mother and baby. Decision to delivery time = 30 mins
  2. Category 2 - No imminent threat to life but required urgently due to compromise of mother or baby. Decision to delivery = 75 mins
  3. Category 3 - Delivery required but mother and baby stable
  4. Category 4 - Elective c -section
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define breech presentation

A

Fetal position where buttocks or feet are near cervix and head near fundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management of breech presentation

A
  1. External Cephalic Version (ECV) at 36w for primiparous
  2. ECV at 37w for multiparous
  3. C-section
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

State absolute contraindications to ECV

A
  1. C-section already indicated
  2. APH within last 7d
  3. Non-reassuring CTG
  4. Major uterine abnormality
  5. Placental abruption or placenta praevia
  6. Ruptured membranes
  7. Multiple pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define chorioamnionitis

A
  1. Bacterial infection
  2. Affects membranes surrounding fetus
    • Amniotic sac
    • Amniotic fluid within uterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sx of chorioamnionitis

A
  1. Fever
  2. Abdo pain
  3. Offensive vaginal discharge
  4. Preterm rupture of membranes
  5. Maternal + foetal tachycardia
  6. Uterine tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of chorioamnionitis

A
  1. IV broad spec Abx: BenxylP, Metro, Genta
  2. early delivery if necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

State the complications of diabetes in pregnancy

A
  1. Macrosomia
    • unusually large birthweight (>4kg)
    • Increase risk of shoulder dystocia
  2. Pre-term delivery
    • may lead to respiratory distress syndrome
  3. Hypoglycaemia in baby
    • Due to continued high foetal insulin levels even after birth
  4. Increased risk of T2DM later in life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sx of Down’s

A
  1. Facial features
    • Upward-slanting palpebral fissures
    • Protruding tongue
    • Small low set ears
  2. Short stature
  3. Learning difficulties
  4. Congenital heart defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Ix for Down’s screening

A

Screening test between 10w and 14w for:
- Trisomy 13
- Trisomy 18
- Trisomy 21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Summarise Down’s screening

A
  1. Combined test
    • Nuchal translucency using USS
    • PAPP-A hormone (reduced)
    • beta-hCG (raised)
  2. Triple test if woman presents post 13w
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define pre-eclampsia

A
  1. Placental condition
  2. Affects pregnant women from 20w
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Sx of pre-eclampsia

A
  1. Hypetension
  2. Proteinuria
  3. Peripheral oedema
  4. Severe headache
  5. Drowsiness
  6. Visual disturbances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

State the maternal complications in pre-eclampsia

A
  1. Eclampsia
    • Seizure due to cerebrovascular vasospasm
  2. Organ failure
  3. Disseminated intravascular coagulation (DIC)
  4. HELLP syndrome (Haemolysis (H), elevated liver enzymes (EL), low platelets (LP))
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

State foetal complications of pre-eclampsia

A
  1. Intrauterine growth restriction
  2. Pre-term delivery
  3. Placental abruption
  4. Neonatal hypoxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ix for pre-eclampsia

A
  1. BP measurement
  2. Urinalysis (confirm proteinuria)
  3. Bloods
    • Kidney function
    • Liver function
    • Clotting status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Management of pre-eclampsia
1. Aspirin as prophylaxis - 12w to birth for women with 1x high risk factor or 2 or more moderate risk factors 2. Anti-hypertensive - Labetalol 3. Magnesium sulphate prophylaxis for eclamptic seizures
26
Define ectopic pregnancy
embryo implanting and growing outside the uterine cavity
27
Sx of ectopic pregnancy
1. Pelvic pain - may be unilateral ipsilateral to ectopic 2. Shoulder tip pain - if ectopic bleeds, blood irritates diaphragm -> shoulder top pain 3. Abnormal vaginal bleeding 4. Haemodynamic instability 5. Cervical tenderness (Chandelier's sign)
28
Ix for ectopic pregnancy
1. Pregnancy test to confirm 2. Transvaginal USS to locate
29
Management of ectopic pregnancy
1. Conservative management - For minimal to no Sx - Close follow-up with repeat B-hCG; if do not decrease -> active management 2. Medical management - One off dose of methotrexate - Criteria for methotrexate: - Low hCG level - Ability to attend follow up - Adherence to avoiding pregnancy for a period post treatment - If initial dose fails, 2nd dose or surgical 3. Surgical management - Salpingectomy
30
Summarise management of epilepsy pre-pregnancy
1. Aim for lowest effective dose monotherapy 2. Levetiracetam and lamotrigine safest options 3. AVOID SODIUM VALPROATE 4. If no fits in last 2y - consider stopping all meds 5. 5mg/day folic acid from pre conception -> end of 1st trimester
31
Summarise management of epilepsy in antenatal pregnancy
1. Monitor plasma anti-epileptic drug levels regularly 2. Foetus monitor throughout pregnancy 3. Vit K therapy from 36w due to reduced foetal clotting factor production 4. If seizures during labour -> benzos asap to terminate seizures avoid maternal and foetal hypoxia
32
Define fibroids
benign smooth muscle tumours originating from myometrium of uterus
33
Sx of fibroids
1. Often asymptotic 2. Menstrual dysfunction 3. Infertility if large
34
Ddx for fibroids
1. Endometrial polyps - Irregular menstrual bleeding + spotting 2. Endometriosis - Dysmenorrhea - Deep dyspareunia (painful sex) - Chronic pelvic pain - Infertility
35
Ix for fibroids
1. Trans-vaginal USS 2. Biopsy
36
Management of fibroids
1. Non surgical - NSAIDs - Anti-fibrinolytics - COCP - Mirena coil 2. Surgical
37
Define 1st stage of labour
- Regular uterine contractions -> cervix dilated to 10cm - further divided into: - Latent phase: 0-3 cm - Active phase: 3 - 10 cm - Dilation rate: 1cm/2h primiparous, 1cm/1h multiparous
38
Sx of 1st stage of labour
1. Regular, painful contractions 2. Progressive cervical dilation 3. Blood stained mucus called ‘show’ 4. Rupture of membranes 5. Descent if foetal head into pelvis
39
Ddx for 1st stage of labour
1. Braxton Hicks contractions - Irregular, non-progressive contractions - Do not result in cervical dilation 2. Preterm labour - <37w gestation
40
Define genital candidiasis (yeast infection)
1. Inflammation of vagina + vulva 2. Candida Albicans 3. Recurrent: 4 or more symptomatic episodes / year + 2 episodes confirmed
41
Rf for Candida infection
1. Pregnancy 2. Abx use 3. Immunosupression
42
Sx of candida infections
1. Women - Itching - White curdy discharge - Sour milk odour 2. Men - Soreness - Pruritis
43
Ddx of candida infection
1. Bacterial vaginosis - Greyish white - Fishy odour - Absence of significant inflammation 2. Trochomoniasis - Yellow-green frothy discharge - Dysuria - Itching 3. Chlamydia/ gonorrhoea - Pelvic pain + bleeding
44
Tx of candida infection
1. Oral (-azoles) - Fluconazole 2. Intravaginal - Clotrimazole pessary 3. Vulval - Topical clotrimazole cream
45
Define gestational Diabetes mellitus (GDM)
1. Glucose intolerance 2. Fasting blood glucose > 5.6 mmol/L 3. 2h plasma > 7.8 mmol/L
46
Rf for GDM
1. High 2TDM prevalence ethnic backgrounds 2. PMH of GDM 3. Prior delivery of macroscopic babies (>4.5kg) 4. Maternal obesity (BMI > 30)
47
Sx of GDM
- Usually no noticeable Sx - Some may experience: - Polyuria - Thirst - Fatigue
48
Foetal complication of GDM
1. Macrosomia (>4kg) - Increased risk of shoulder dystopia, birth injuries, emergency c-section 2. Sacral agenesis 3. Neonatal hypoglycaemia due to high insulin 4. Baby developing T2DM
49
Maternal complication of GDM
- Increased risk of hypertension and pre-eclampsia - T2DM - GDM in subsequent pregnancies
50
Tx of GDM
1. Lifestyle changes - If target not met within 2w, offer metofrmin 2. If fasting glucose >7mmol/L insulin therapy
51
Define GBS
1. Group B Strep infection 2. Bacterium carried asymptomatically in GU tract for ~25% pregnant women
52
Sx of GBS in newborn
1. Sepsis 2. Pneumonia 3. Meningitis
53
Tx of GBS
Intrapartum Abx prophylaxis: IV Penicillin during labour and delivery
54
Define HELLP syndrome
1. Complication of pregnancy characterised by: - Haemolysis (H) - Elevated liver enzymes (EL) - Low platelets (LP) 2. Manifests in 3rd trimester
55
Sx of HELLP syndrome
1. Headache 2. N+V 3. Epigastric pain 4. RUQ pain 5. Blurred vision
56
Complications of HELLP syndrome
1. Maternal complications - Organ failure - Placental abruption 2. Foetal complications - Intrauterine growth restriction - Preterm delivery - Neonatal hypoxia
57
Define Haemolytic Disease of Newborn (HDN)
1. Immunological condition 2. Rh- negative mother sensitised to Rh+ RBCs of baby in utero
58
Sx of HDN
1. Hydrops foetalis - Appears as foetal oedema in at least 2 compartments on antenatal USS 2. Yellow amniotic fluid due to excess bilirubin 3. Neonatal jaundice 4. Foetal anaemia 5. Hepatomegaly or splenomegaly
59
Ddx of HDN
1. G6PD deficiency - Same Sx but EPISODIC
60
Ix of HDN
1. Direct Antiglobulin Test (DAT) 2. USS to detect foetal oedema 3. LFTs
61
Tx of HDN
1. Intrauterine transfusions if severe anaemia in foetus 2. Early delivery if severe
62
Define Tocolytics
- Drugs used to suppress contractions and therefore labour - Used in pre term labour
63
State indications for induction of labour
1. Post date: >41w gestation 2. Preterm pre labour rupture of membranes 3. Intrauterine foetal death 4. Abnormal CTG 5. Maternal conditions like pre-eclampsia
64
State contraindications to labour induction
1. Previous vertical incision during c-section 2. Multiple lower uterine segment C-sections 3. Transmissible infections 4. Placenta previa 5. Vasa previa
65
How is labour induced?
1. Membrane sweep - Insert gloved finger into external os - Separate membrane from cervix 2. Vaginal prostaglandins (PGE2) - Used to ripen cervix and induce contractions 3. Amniotomy - Artificial rupture of membranes 4. Balloon catheter - Mechanically dilate cervix
66
What is the Kleihauer test?
- Diagnostic procedure - Quantify volume of foetal Hb present in maternal circulation
67
Define vasa praevia
- Unprotected foetal vessels run close to/across internal cervical os - Makes them prone to rupture during membrane rupture - Can result in foetal haemorrhage
68
Sx of vasa praevia
Triad of: 1. Painless vaginal bleeding 2. Rupture of membranes 3. Foetal bradycardia
69
Ddx of vasa praevia
1. Placenta praevia - NO foetal bradycardia or death 2. Abruptio placentae - abdo pain - Uterine tenderness and rigidity
70
Ix for vasa praevia
Transabdominal/transvaginal ultrasonography
71
Tx of vasa praevia
C-section prior to rupture of membranes
72
State the types of foetal presentations
1. Cephalic - Baby’s head palpable at base of abdomen 2. Breech - Frank - Buttocks first + legs in extension (most common) - Complete - Buttocks + crossed legs - Footling - feet first (common pre term) - Kneeling - knees first 3. Shoulder - Transverse lie 4. Compound - 2 parts of baby presdenting simultaneously (e.g. Head and hand)
73
What are twin pregnancies classified by?
1. Zygosity - Number of zygotes 2. Chorionicity - Outer sac 3. Amnionicity - Inner sac
74
Summarise monozygotic pregnancy
1. Identical twins 2. Depending on stage at which split occurs: - Dichorionic + diamniotic (2 different sacs) - Monochorionic + diamniotic (same outer sac, different inner sacs)
75
State the 1st line tocolytic agent
Nifedipine
76
Contraindications for tocolysis
1. Gestation >34w 2. Cervical dilation >4cm
77
Define the 3rd stage of labour
1. Stage between delivery of foetus and delivery of placenta + foetal membranes 2. 30-90 mins naturally or 5-10 mins with oxytocin
78
Sx of 3rd stage of labour
1. Gush of blood from vagina 2. Lengthening of umbilical cord 3. Ascension of uterus in abdomen
79
State the supplements recommended in pregnancy
1. Folic acid 400 mcg/day - Pre term -> 12w gestation 2. Vit D 10 mcg (400 units)/day - Throughout pregnancy and breastfeeding
80
Define Spina bifida
1. Neural tube defect 2. Incomplete development of spinal column 3. Herniation of the spinal cord
81
State the 3 types of Spina bifida
1. Spina bifida occulta - Incomplete fusion of vertebrae - NO herniation of spinal cord 2. Meningocele - Incomplete fusion of vertebrae - WITH herniation of meningeal sac containing CSF 3. Myelomeningocele - Incomplete fusion of vertebrae - WITH herniation of meningeal sac containing CSF AND spinal cord
82
Define shoulder dystocia
1. Type of obstructed labour 2. Following delivery of foetal head, anterior shoulder impacted behind maternal pubic symphysis
83
Define the 2nd stage of labour
Stage from desire to push to repositioning of foetus in prep for birth
84
State Rf for PPH
1. Previous PPH 2. BMI >35 3. Multi pregnancy 4. Parity >4 5. Macrosomia
85
Define rhesus isoimmunisation
1. Rh- mother with Rh+ baby 2. If any foetal RBCs enter maternal circulation, mother form anti-D antibodies 3. Maternal anti-D antibodies can cross placenta in subsequent pregnancies for future Rh+ baby - Cause Rh haemolytic disease
86
What are sensitisation events?
Rh+ foetal blood crossing placenta into maternal circulation
87
State complications of anti-D sensitisation
Incompatibility in pregnancy + haemolysis in future pregnancies
88
Tx for rhesus isoimmunisation
- Anti-D antibodies given to: - patients who have experienced sensitising events - All non-sensitised Rh- mothers at 28w - Anti-D antibodies prophylaxis only
89
Management of pre term labour (before 37w)
1. Corticosteroids - accelerate foetal lung maturation 2. IV Abx if risk or history of GBS - Penicillin if no allergy 3. Tocolytic agents (Nifedipine) to delay labour
90
Define pregnancy of unknown origin
+ve pregnancy test but no signs of intrauterine or extrauterine pregnancy on transvaginal USS
91
Aetiology of pregnancy of unknown origin
1. Early viable or failing intrauterine pregnancy 2. Complete miscarriage 3. Ectopic pregnancy
92
Sx of pre labour rupture of membranes at term (PROM)
1. Foul smelling or greenish amniotic fluid 2. Maternal fever 3. Reduced foetal movements
93
Tx of PROM at term
Induce labour if doesn't commence spontaneously within 24h of PROM
94
Define PPH
Loss of at least 500mL of blood within first 24h of delivery
95
Tx of PPH
1. ABCDE 2. Consider major haemorrhage protocol 3. 2x large bore cannulas 3. MEDICAL: Oxytocin, tranexamic acid 4. SURGICAL: Intrauterine balloon tamponade, B-lynch suture
96
Define polyhydramnios
Excess amniotic fluid
97
Sx of polyhydramnios
1. Tense/large uterus 2. Difficulty feeling foetal parts on palpation
98
Complications of polyhydramnios
1. Maternal resp compromise due to increased pressure on diaphragm 2. Inreased risk of UTI due to increased pressure on urinary system 3. Worsening reflux, constipation, oedema and sretch marks
99
Define placental abruption
1. Premature separation of placenta from uterine wall during pregnancy 2. -> maternal haemorrhage
100
Sx of placental abruption
1. Abdo pain 2. Woody uterus 3. Contractions 4. Vaginal bleeding (some cases can be concealed -> no bleed) 5. Reduced foetal movement + abnormal CTG
101
Risk factors of placental abruption
1. Trauma 2. Pre-eclampsia or hypertension 3. Multiparity 4. Polyhdramnios 5. Substance abuse during pregnancy (smoking and cocaine)
102
Tx of placental abruption
1. ABCDE 2. Emergency delivery if maternal and/or foetal compromise detected 3. Induction of labour preferred no foetal or maternal compromise 4. GIVE ANTI-D WITHIN 72H OF ONSET IF MOTHER RH-
103
Define placenta praevia
Low lying placenta that may cover cervix
104
Sx of placenta praevia
1. Painless bright red vaginal bleeding after 24w 2. Malpresentation of foetus
105
Ix for placental praevia
1. Painless bleeding after 13w -> transvaginal USS to exclude PP 2. No routine screening in low risk in UK
106
Tx of PP
1. Bleeding with unknown placental position - ABCDE - Urgent transvaginal USS if stable - Immediate c-section if uncontrolled bleeding 2. Bleeding with known placenta praevia - ABCDE - Emergency C-section if not stabilised - Corticosteroids if between 24-34w (risk of preterm labour
107
Define the types of perineal tears
1. 1st degree - Limited to the superficial perineal skin or vaginal mucosa 2. 2nd degree - Extends to perineal muscle and fascia BUT anal sphincter intact (episiotomy classified as 2nd degree) 3. 3rd degree - 3a: <50% of the thickness of the external anal sphincter is torn - 3b: >50% of the thickness of external anal sphincter torn but internal sphincter intact - 3c: External and internal anal sphincter torn but anal mucosa intact 4. 4th degree - Perineal skin, muscle, anal sphincter and anal mucosa torn
108
State pathogens that cause Pelvic Inflammatory Disease (PID)
1. Chlamydia trachomatis 2. Neisseria gonorrhoeae
109
Define oligohydramnios
Lower than normal volume of amniotic fluid
110
Sx of aligohydroamnios
1. Lack of space -> foetal compression - Clubbed feet - Facial deformity - Congenital hip dysplasia 2. Lack of amniotic fluid - Pulmonary hypoplasia
111
Sx of obstetric cholestasis
1. After 24w 2. Accumulation of bile acids 3. Pruritus 4. RUQ pain 5. Jaundice 6. Loss of appetite
112
Tx for obstetric cholestasis
1. Chlorphenamine + Vit K 2. Early delivery planning 3. Off - license use of UDCA
113
State Naegele's rule
(1st day of LMP + 1y7d)-3m = EDD (Expected Date of Delivery)
114
Define molar pregnancy
1. Gestational trophoblastic disease 2. Imbalance of paternal and maternal chromosomes
115
Sx of molar pregnancy
1. Vaginal bleeding 2. Nausea 3. Hyperemesis gravidarum (severe vomiting before 20w)
116
State the 4 types of miscarriage
1. Threatened miscarriage 2. Inevitable miscarriage 3. Complete miscarriage 4. Missed miscarriage
117
Define threatened miscarriage
1. Mild Sx of bleeding 2. Foetus retained within uterus as cervical os is closed
118
Inevitable miscarriage
1. Heavy bleeding + pain 2. Foetus intrauterine but cervical os open
119
Complete miscarriage
1. Intrauterine pregnancy that has fully miscarried 2. All products of conception expelled 3. Uterus empty + cervical os closed
120
Missed miscarriage
1. Uterus contains foetal tissue 2. Foetus no longer alive 3. Missed due to asymptotic + closed cervical os
121
Tx for miscarriage
MEDICAL 1. Missed miscarriage: - 200mg mifepristone - 48h later 800 mcg misoprostol (vaginal, oral or sublingual) 2. Incomplete miscarriage: - 600-800 mcg misoprostol (vaginal, oral or sublingual) SURGICAL 1. Manual vacuum aspiration under local 2. Surgical management under general
122
Define meconium
1. Initial faeces passed by newborn 2. Sometimes expelled into amniotic fluid before birth -> meconium stained liquor
123
Define meconium aspiration syndrome
Passage of meconium into foetal lungs -> blockage + inflammation
124
Sx of meconium aspiration syndrome
1. Meconium stained liquor during rupture of membranes or birth - greenish/yellowish 2. Green staining of infant's skin, nail beds or umbilical cord 3. Resp distress in newborn 4. Crackles on ausc. of foetal lungs
125
Tx of meconium aspiration syndrome
1. Gentle suction mouth + nose 2. Abx 3. Transfer to neonatal ICU
126
Outline cervical screening
1. All women 25-64 2. Sample taken and tested for HPV 3. 24-49 every 3y 4. 50-64 every 5y 5. Identify pre - cancerous dyskaryotic cells
127
State outcome of +ve HPV test during cervical screening
Referred for cytological testing -> +ve = colposcopy referral -> -ve = Repeat HPV in 12m then 24m if still +ve. If remains +ve then -> colposcopy
128
What type of cancer cell is cervical cancer?
SCC
129
Sx of cervical cancer
1. Vaginal discharge 2. Bleeding 3. Vaginal discomfort 4. Urinary/bowel habit changes 5. Suprapubic pain
130
Ix for cervical cancer
1. Speculum 2. Bloods - FBC (anaemia) - LFTs (liver involvement) - U&Es (renal involvement) 3. CT for staging 4. Colposcopy
131
Tx of cervical cancer
Maintain fertility 1. Small cancers - conisation with free margins 2. Radical trachelectomy - Removal of cervix, upper vagina and pelvic lymph nodes NOT maintaining fertility 1. Laparoscopic hysterectomy + lymphadenectomy 2. Invasive, infiltrating and early metastatic cancer - Wertheim's hysterectomy - Removal of uterus, primary tumour, pelvic lymph nodes, upper 1/3 of vagina
132
General principle of female contraception
1. Thickening of cervical mucus 2. Thin the endometrial lining 3. Prevent ovulation (COCP)
133
Contraindication for contraception
1. Known pregnancy 2. HYT SBP >160 or DBP >100 3. Smoker with >15 cigarettes age>35 4. IHD 5. Stroke/ vasc disease
134
Management of dysmenorrhoea
1. Tranexamic acid 2. Contraception
135
Summarise emergency contraception
1. Levonorgestrel (Levonelle) - Within 72h - Prevent ovulation + implantation (ellaOne) 2. Ulipristal acetate - Within 120h - Prevent ovulation 3. Copper IUD (ParaGard) - Within 120h - Prevemy implantation
136
Define endometriosis
Growth of endometrial tissues outside the uterine cavity
137
Sx of endometriosis
1. Dysmenorrhoea 2. Dyspareunia (pain during intercourse) 3. Subfertility
138
Dx of endometriosis
Diagnostic laparoscopy
139
Tx of endometriosis
1. Analgesia 2. HRT: COCP (unsuitable if endometriosis causing infertility) 3. Ablation or excision of lesions
140
Define vaginal prolapse
1. Displacement of pelvic structures from normal position 2. Towards or through vaginal opening
141
Tx of vaginal prolapse
1. Pelvic floor exercises 2. Pessary 3. Surgical intervention
142
Sx of ovarian cyst rupture
1. Can be asymptomatic 2. Acute unilateral pain 3. Bloating + early satiety
143
Ddx for ovarian cyst rupture
1. Ovarian torsion - Sudden severe pain - N+V 2. Ectopic pregnancy - Abdo pain - Amenorrhea - Vaginal bleeding 3. Appendicitis - Navel -> RLQ pain - Loss of appetite - N+V
144
Sx of ovarian torsion
1. Sudden onset abdo pain 2. N+V 3. Palpable adnexal mass
145
Tx of ovarian torsion
Surgical - Detorsion - Salpingo-oophorectomy if ovary necrosed
146
Sx of PCOS
1. Oligomenorrhoea 2. Hirsutism (male pattern hair growth) 3. Acne 4. Subfertility
147
Tx of PCOS
1. Medical (not planning pregnancy) - COCP - Co-cyprindol - Metformin 2. Medical (wishing to conceive) - Clomiphene - Metformin

Phase 3a (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions