Acute Gynae Flashcards
What are investigations for unilateral abdo pain in female with suspicion of ectopic?
FBC, G&S, USS - FAST scan versus transvaginal
What is presentation of ectopic pregnancy? (8)
shoulder tip pain, bleeding, LMP, dyschezia, vomiting and diarrhoea, faint, hypotensive, tachycardia
Ectopic pregnancy risk factors (7)
previous ectopic, tubal damage, IUS/IUD, smoking, infertility, infertility treatment, odler reproductive age
Initial management of ectopic
resus, ABCDE
What are surgical managements options for ectopic
laparoscopic, laparotomy, salphingectomy, salphingotomy, anti D if necessary
Pregnancy of unknown location presentation in terms of HCG levels?
static HCG - if goes down then failing, if static then unknown location, if rising then normal pregnancy. , clinically well
What are management options for PUL?
expectant management, medical: methotrexate, consider surgical
Cyst presentation (4)
sudden onset unilateral fossa pain,
faint,
tachycardia,
normotensive
Cyst investigations? (3)
Bloods (FBC, CRP, G&S), palpable mass on vaginal exam, transvaginal ultrasound
Torsion is more likely with a cyst of what size?
more likely with a cyst >5cm
What percent of ovarian torsion are caused by dermoid cysts?
10%
What percent of adnexal torsions occur in children?
25%
Premenopausal ovarian torsion most likely ____ whereas postmenopausal ovarian torsion most likely ___
benign, malignant (shouldn’t be producing follicles)
Ovarian torsion treatment (5)
resus and ABCDE, laparoscopy/laparotomy, detorsion, cystectomy, oophrectomy (if necrotic)
Cyst accident presentation? (6)
sudden onset unilateral fossa pain, may be precipitated by sex, sports or spontaneous, tachycardic, hypotensive, apyrexial, HCG negative
Cyst accident investigations?
Bloods (FBC, CRP, G&S), peritonism, ultrasound