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Y3 Reproductive > 1st Trimester Conditions > Flashcards

1st Trimester Conditions Flashcards

1
Q

Differentials for ______: miscarry, ectopic, molar, chorionic haematoma, implantation bleed, UTI, hemorrhoid, bowel malignancy, chlamydia, gonococcus, cervical polyp, trichomoniasis, BV, forgotten tampon

A

1st trimester bleeding

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2
Q

Implantation bleeding occurs _____ days post ovulation, is of a _____ amount, is _____ colour and occurs [is/isn’t] associated with the normal S+S of pregnancy

A

Implantation bleeding occurs 10 days post ovulation, is of a SMALL amount, is BROWN colour and occurs IS associated with the normal S+S of pregnancy

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3
Q

What is the management of implantation bleeding/

A

Watchful waiting

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4
Q

What is the pathology of a chorionic haematoma?

A

Blood between endometrium and embryo

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5
Q

Chorionic haematomas are not associated with miscarriages. T or F

A

False, cause a threatened miscarriage

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6
Q

Chorionic haematomas are usually self-limiting. T or F

A

True

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7
Q

How do chorionic haematomas present?

A

1st trimester bleeding + cramping

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8
Q

Bleeding in early pregnancy is before what week gestation?

A

24

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9
Q

Listeria, rubella, toxoplasmosis and CMV all have what in common in relation to the 1st trimester?

A

Can cause miscarriages

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10
Q

What chronic systemic conditions can cause in miscarriages?

A

APS, SLE

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11
Q

What is the general pathology of miscarriages?

A

Placenta / chorion bleeding or dysfunction causes fetal hypoxia and/or demise

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12
Q

What is the commonest PC in miscarriages?

A

Cramp

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13
Q

What investigations are done for a patient in her 1st trimester presenting with a suspected miscarriage?

A

Speculum to classify

US (see empty uterus)

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14
Q

What is the classification of miscarriages?

A 
Threatened
Inevitable
Incomplete
Complete
Early fetal demise
Anembryonic
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15
Q

What is a threatened miscarriage?

A

Os closed

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16
Q

What is an inevitable miscarriage?

A

Products sited at open os

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17
Q

What is an incomplete miscarriage?

A

Part lost already

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18
Q

What is a complete miscarriage?

A

Uterus empty, products in vagina

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19
Q

What is an anembryonic miscarriage?

A

No fetus, empty sac

20
Q

How many miscarriages has a women had for them to be referred to as recurrent miscarriages?

A

3

21
Q

What is the management of a miscarriage?

A

Assess haemodynamic stability, FBC, G&S

22
Q

What tests are done for recurrent miscarriages?

A

Anti-cardiolipin Ab
B2-glycoprotein
Homocysteine
Karyotype

(For SLE, APS)

23
Q

What is an ectopic pregnancy?

A

Implantation occurs out with uterus

24
Q

What is the commonest location of ectopics?

A

Ampulla

25
Q

Is bHCG positive in ectopics?

A

Yes

26
Q

What is the risk in ectopics and is it common?

A

Rupture causes potentially fatal haemorrhage

Common

27
Q

How does an ectopic present?

A

Dull ache - stabbing abdo pain
Bleeding
Shoulder tip pain
Rupture

28
Q

How does an ectoptic pregnancy rupture present?

A

Haemodynamic instability
Acute abdo peritonism
Dizzy / collapse

29
Q

What is the management of an unruptured ectopic with low bHCG levels?

A

Methotrexate

30
Q

What condition of the 1st trimester is referred to as trophoblastic disease?

A

Molar pregnancy

31
Q

What is the pathology of molar pregnancies?

A

Nonviable fertilised egg implants, placenta overgrowth, swollen chorionic villi + fluid

32
Q

How is a molar pregnancy classified?

A

Complete and partial

33
Q

What is a complete molar pregnancy?

A

2 sperm fertilise

34
Q

What is the genotype of a complete mole?

A

Diploid 46 XX or 46 XY

35
Q

What is a partial molar pregnancy?

A

1 sperm reduplicated itself
OR
2 sperm fertilise egg

36
Q

What is the genotype of a partial mole?

A

Triploid 69 XXY

37
Q

Is there a fetus in a complete mole?

A

No

38
Q

Which type of molar pregnancy has a 2.5% choriocarcinoma risk?

A

Complete

39
Q

What sign is seen on ultrasound in a complete molar pregnancy?

A

Snowstorm appearance (multiple placental vesicles)

40
Q

Would SFD or LFD happen in a molar pregnancy?

A

LFD

41
Q

How would a molar pregnancy present?

A

LFD, bleeding, hypermeresis

42
Q

What is the management of a molar pregnancy?

A

Surgical + IJ anti-D

43
Q

Define hyperemesis gravidum

A

Excessive 1st trimester nausea and vomiting that alters QOL

44
Q

Hyperemesis gravidum is a diagnosis of exclusion. T or F

A

True

45
Q

What is the 1st line Mx for hyperemesis gravidum?

A

Antiemetic:
Cyclizine IM/IV
OR
prochlorperazine IM/IV

46
Q

What is the management of protracted hyperemesis gravidum causing recurrent admissions?

A

PO CCS

47
Q

Whats the difference between a stillbirth and a miscarriage?

A

Miscarriage 0-24wk

Stillbirth >24wk

Y3 Reproductive (28 decks)

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