Clinical Flashcards
List a couple of areas in a gynaecological history that differ than a standard history?
Sexual history
Obstetric history
What specific questions are also important to ask about in a gynae history?
- Last menstrual period
- Cycle
- Contraception
- Last smear
What specific conditions can be asked about in a gynae history?
- Menorrhagia
- Prolapse
- Pelvic pain
- Early pregnancy bleeding
What consideration must be taken in a gynae examination?
Intimate examination - sensitivity (chaperone etc)
What two types of speculum may be used?
Cuscos
Sims
What type of examination should be done prior to a vaginal examination?
Abdominal examination
What should be examined in a vaginal examination?
- Position of uterus
- Size of uterus
- Mobility of uterus
- Adnexal masses
- Tenderness/cervical excitation
What is the term for the number of pregnancies reaching viable gestational age in an obstetric history?
Parity
List some relevant information in past obstetric history?
- All previous pregnancies and outcomes
- Date
- Type of delivery
- Live births/still births
- Weight and sex of baby
- Any problems encountered during pregnancy/delivery/postnatally
What is included in an obstetric examination?
General exam including BP
Abdominal exam
Fetal Heartbeat
Urine
Where is fundal height measured?
Top of fundus to pubic symphisis
What are the types of ways in which the baby can lie in the uterus?
Longitudinal/oblique/transverse
What are the types of ways in which the baby can present in the uterus?
Cephalic/breech/transverse
What hormone forms the basis of pregnancy tests?
B-hCG
Only produced from trophoblast cells. If positive, placental cells are present
When does a threatened miscarriage progress to inevitable?
If the cervix has already begun to dilate
What risk is associated with incomplete abortion/miscarriage?
Risk of ascending infection
-Septic abortion
List some examples of neonatal morbidity associated with prematurity?
- Respiratory distress syndrome
- Intraventricular haemorrhage
- Cerebral palsy
- Nutrition
- Temperature control
- Jaundice
- Infections
- Visual impairment
- Hearing loss
What are some clinical features of Down’s Syndrome?
Epicanthic folds
Single palmar crease
Broad nostrils
Duodenal atresia
What may be suspected if lack of fetal heart movement is seen on a scan in pregnancy?
Intrauterine Death (IUD)
Where would a baby be admitted to after birth in a mother that is an intravenous drug user?
Neonatal unit to be treated for withdrawal
What is APGAR scoring used for?
APGAR is a scoring system for the clinician to tell how well the baby tolerated birthing process/how it is coping outside the womb.
What components are measured in APGAR?
Activity Pulse Grimace response Appearance Respiration
What should be used to screen for Gestational Diabetes?
HbA1c estimation
Oral Glucose Tolerance Tests
Which women may benefit from screening for ovarian cancer?
High risk women
- cancer gene mutation carriers
- 2 or more relatives
What would be involved in a screening for ovarian cancer?
Pelvic examination
- US scanning of ovaries
- CA 125
