Women's key facts Flashcards
(72 cards)
What is the difference between stress and urge incontinence?
Stress - leakage occurs when coughing or laughing.
Urge - Frequency with sudden rushes to the toilet.
What is the first line treatment for stress and urge incontinence?
Stress - Pelvic floor exercises for at least 3 months
Urge - Bladder retraining.
What is the second line (medical) management for stress and urge incontinence?
Stress - Duloxetine (SNRI)
Urge - Oxybutynin (anticholinergic)
What are the initial investigations for incontinence?
Bladder diary
Urine dipstick (UTI?)
Urodynamics (if no response to treatment)
What is a:
Uterine prolapse
Vault prolapse
Cystocele
Rectocele
Uterine prolapse - Uterus descends into the vagina
Vault prolapse - after a hysterectomy, the top of the vagina descends into the vagina
Cystocele - the bladder prolapses backwards into the vagina through the anterior vaginal wall
Rectocele - the rectum prolapses forwards into the vagina through the posterior vaginal wall.
What are the key risk factors for vaginal prolapse?
- Multiparity
- Obesity
- Traumatic delivery
- Menopause
- Advanced age
- Chronic coughing or constipation
What is the key initial investigation for prolapse?
Speculum examination
How is prolapse graded?
Grade 1 - the uterus is more than 1cm away from the opening of the vagina.
Grade 2 - the uterus is within 1cm of the introitus (above or below)
Grade 3 - the uterus is more than 1cm from the introitus, but not fully descended
Grade 4 - the uterus is fully everted and descended
What is the conservative management for a uterine prolapse?
Pelvic floor exercises
Incontinence pads
Weight loss
Reduce caffeine
Oestrogen cream
What can be inserted to help manage prolapse?
A vaginal pessary - adds support to the pelvic organs to help with prolapse
What is the definitive management for pelvic organ prolapse?
Surgery
What are the key risk factors for perianal tear?
First pregnancy
Macrosomia
Shoulder dystocia
Instrumental delivery
How is a perianal tear graded?
Grade 1 - just involves the vagina
Grade 2 - involves the vagina and the perianal muscles
Grade 3 - involves the anal sphincter:
- 3a - involves less than 50% of the external sphincter
- 3b - involves more than 50% of the external anal sphincter
- 3c - involves the internal anal sphincter.
Grade 4 - involves the rectal mucosa.
What is the management for a perianal tear (grade dependant)?
Grade 1 - repairs on own.
Grade 2 - repair with sutures on the ward.
Grade 3 or 4 - requires suturing in theatre.
What timeframe is the copper coil suitable for emergency contraception?
- 5 days after unprotected sexual intercourse
What timeframe is levonorgestrel suitable for?
Must be taken within 72 hours of unprotected sexual intercourse.
What timeframe is ulipristal acetate (EllaOne) suitable for?
Must be taken within 5 days of unprotected sexual intercourse.
What are the categories of C-section and what are the timeframes for each?
Cat 1 - within 30 mins
Cat 2 - within 75 mins
Cat 3 - Delivery is required but mother and baby are stable.
Cat 4 - elective C-section
What medication is given to treat HER2 positive breast cancer?
Trastuzumab
How is estimated day of delivery calculated?
Add one year and seven days to the first day of the last menstrual period, and then subtract three months.
What are some common risk factors that indicate thromboprophylaxis after giving birth?
What drug is given?
Give LMWH
- Previous VTE
- Age over 35
- BMI over 30
- Smoking
- Multiple pregnancy
- Pre-eclampsia
- C-section
- Prolonged labour
- Preterm birth
- Stillbirth
- Postpartum haemorrhage.
What hormone should be checked to check for ovulation and when?
Check progesterone 7 days before the end of the cycle
e.g. 28 day cycle check at 21 days.
What is the likely history for fat necrosis of the breast?
Breast trauma followed by a firm/hard irregular lump in the breast.
What are the three components of triple assessment of any breast lump?
- Clinical examination
- Imaging (mammography and/or USS)
- Tissue sampling/biopsy.
