Womens Health Flashcards
(85 cards)
Difference between sex and gender?
Sex is the biological classification of male or female through external genitalia and chromosomal makeup
Gender is social and/or cultural conformities and individual ideology
main types of gynaecological malignancies?? (4)
Vulval
Cervical
Endometrial
Ovarian
Risk factors for vulval cancer
- VIN
- Melanoma or lichen sclerosis
- Recurrent HPV infections
- Paget’s disease
Cervical cancer RFs?
Smoking
CIN
Recurrent HPV
Immunocompromised (immunosuppressants, HIV, transplants)
COCP - due to no use of condom
Endometrial cancer RFs?
Obesity, T2DM, HTN
Smoking, alcohol, bad diet
Family history
Previous history with other gynaecological cancers or breast cancers
Early menarche - late menopause
Ostrogen only HRT
Nulliparous
Ovarian cancer RFs
Smoking obesity
Family history
Breast cancer or tamoxifen use
Nulliparous
Early menarche-late menopause
Age
Talcum powder pre 1975 and asbestos exposure
Cervical Screening explained
Introduced 1988
Women aged 25-64
25-49 = every 3 years
50-64 = every 5 years
HIV/CIN +ve = annually
Rescheduled if:
- PID
- Bleeding
- Less than 12 weeks postpartum
Don’t need if:
- cancer referral required
- virgin
Process:
1. Speculum and HSV brush
2. Swab placed in liquid
3. Microbiologist take look if +ve —> cytology
4. If dyskaryosis seen on cytology then colposcopy and biopsy
figures around the effects of cervical examinations?
4,500 lives saved per year, 5% abnormalities found, stats dropped between 1988-1999
Who’s included in a gynaecological MDT
MDT coordinator
- GP
- Gynaecologist/consultant
- radiologist
- histopathologist
- specialist nurse
Extended:
- OT
- dietician
- palliative care if needed
- chaplain if needed
- social worker if needed
What is the 5 main purposes of an MDT
- Discuss new cases/diagnoses
- Make management plan for patient and communicate
- Options for support in terms of dedicating specialist nurses to patients
- Review guidelines and audit
how many antenatal visits should be done?
10 or 7 if previous babies have been had
Describe the calendar of antenatal screens/checks in an “average” woman
8-10 weeks = booking visit (mental health, PMHx, SHx, gynae and obstetric and surgical Hx THEN drug history - following vitamin D and folic acid, blood test for Hep B, HIV, blood group, rhesus factor, anaemia)
BP, WEIGHT AND URINAnalysis is done pretty much all the time to screen for bacturia
12 weeks = USS
11-13+6 = combined test
16 weeks = USS to discuss test and FBC for anaemia for oral iron tablets
18+ anomaly scans (14-20 = triple or quadruple tests)
What is in a combined test
Nuchal translucency (USS)
PAPPA & free floating b-hCG (bloods)
What is in a triple test?
Free floating b-hCG
Serum oestriol
Alpha-feta protein
What is in a quadruple test?
Alpha-feta protein
Free floating b-hCG
Inhibin A
Serum oestriol
Benefits of antenatal screen?
- Allows patients to educate themselves and feel fully informed moving forward
- Allows advanced preparation if keeping baby (household changes etc)
- Allows support group connections
- Reassurance for those at risk or low risk
Negatives of antenatal screening
Just a screening test = could be false positive
Miscarriages
Results for downs on antenatal tests?
HIGH = beta h-CG & inhibin
LOW = PAPPa& alpha-fetoprotein & serum oestriol
>6mm NT
Supplements for pregnant women?
400mcg of folic acid 3 months prior-12 weeks gestation
5mg of folica acid 3 months prior - 12 weeks gestation
10mcg vitamin D daily through pregnancy and post
Iron tablets if Hg <11
Vitamin A = teratogenic caution
What is FGM
Female genital mutilation act 2003
What is the FGM act?
Illegal in uK
Illegal to aid and abet in uK
Illegal to send over for FGM
Labioplasty only if preserves mental and phsyical health of a child/woman
4 types of FGM
1 - clitoral removal
2 - clitoral and labial removal
3 - closure
4 - burning stitching or piercing of clitoris
IVF on the NHS?
Offered for 3 cycles if meet specific criteria:
- <40 if 40-42 or 40 mid treatment only 1 cycle done
- 2 years of trying without contraception
- 12 cycles of alternative fertility treatment clomifene done
Some CCGs look at weight smoking and drinking status too
Still birth?
Rates 4.6 - death of a baby antenatally or within 24 hours of life