Day before specialites Flashcards
APGAR- appearance
2= pink
1= blue extremities, pink body
0= blue
APGAR- pulse
2= over 100
1= under 100
0= no pulse
APGAR- resp effort
2= strong, crying
1= weak and irregular
0= none
APGAR- grimace
2= cries on stimulation, coughs, sneezes
1= grimaces
0= none
APGAR- tone (activity)
2= active movement
1= limb flexion
0= flaccid
What is the pain relief needed for ventouse vs forceps
Ventouse none major needed
Forceps requires epidural or pudendal nerve block
Time until…. in abdo hysterectomy
- discharge
- bed rest
- work
- sex
Discharge- 2-4 days
Bed rest- 4 days
Work- 2-4 if light duties, 4-6 weeks properly, 6-8 weeks if heavy lifting
Sex- 4-6 weeks
Time until…. in c-section
- discharge
- work
Discharge- 1-2 days
Work- 6-8 weeks including exercise
Time until…. in laparascopic hysterectomy
- discharge
- work
- discharge= 1-2 days
- work= 4-6 weeks
Time until…. in diagnostic or sterilisation laparascopy
- discharge
- work
Discharge- 6 hours
Work- less than 1 week
Time until…. in operative laparoscopy like cyst removal
- discharge
- work
Discharge- 6 hours same day
Work- 2-3 weeks
Time until…. in vaginal hysterectomy
- discharge
- work
Discharge- 24-48 hours
Work- 4 weeks
Time until…. in surgical miscarriage
- discharge
- work
discharge= same day
Work= 5-7 days
Time until…. in endometrial ablation
- discharge
- work
Discharge= 2 hours- bit longer if GA
Work= week
FIGO ovarian cancer staging
Stage I: Cancer is confined to one or both ovaries
- IA: Growth is limited to 1 ovary with no tumor on external surfaces
- IB: Growth is limited to both ovaries with no tumor on external surfaces
- IC: Tumor is either stage IA or IB, but with tumor on surface of one or both ovaries
Stage II: Cancer has spread to the uterus or other nearby organs
- IIA: Extension and/or metastases of cancer to the uterus and/or fallopian tubes
- IIB: Extension of the cancer to other pelvic tissues
- IIC: Tumor is at either stage IIA or IIB, but with tumor on surface of one or both ovaries
Stage III: Cancer has spread to the lymph nodes or abdominal lining
- IIIA: Tumor limited to the true pelvis
- IIIB: Metastasis of abdominal peritoneal surfaces ≤ 2 cm. in diameter
- IIIC: Peritoneal metastasis beyond the pelvis > 2 cm. in diameter
Stage IV: Cancer has spread to distant organs, such as the lungs or liver
Pathway for ovarian cancer in secondary care
RMI over 250- MDT
CT abdo pelvis
Laparotomic surgery
Management of ovarian cancer
Stage 1a and 1b= hysterectomy, BSO and infracolic omentectomy, samples of abdomen
1c= adjuvant chemo too
2 and above= fuck knows
Management of endometrial cancer
Mainstay is total hysterectomy, bilateral salpingo-oophorectomy and lymphadenectomy 1A
1B and above give radiotherapy
If want to preserve fertility- in 1A can do progestin and surveying every 3-6 months
Staging for endometrial cancer
Stage 1: The cancer is found only in the uterus or womb, and it has not spread to other parts of the body.
- 1A: The cancer is found only in the endometrium or less than one-half of the myometrium.
- 1B: The tumor has spread to one-half or more of the myometrium.
Stage 2: The tumor has spread from the uterus to the cervical stroma but not to other parts of the body
- 3: The cancer has spread beyond the uterus, but it is still only in the pelvic area.
- 3A: The cancer has spread to the serosa of the uterus and/or the tissue of the fallopian tubes and ovaries but not to other parts of the body.
- 3B: The tumor has spread to the vagina or to the tissue immediately next to the uterus called the parametrium.
- 3C1: The cancer has spread to the regional pelvic lymph nodes
- 3C2: The cancer has spread to the para-aortic lymph nodes with or without spread to the regional pelvic lymph nodes
Stage 4: The cancer has metastasized to the rectum, bladder, and/or distant organs.
- 4A: The cancer has spread to the mucosa of the rectum or bladder.
- 4B: The cancer has spread to lymph nodes in the groin area, and/or it has spread to distant organs, such as the bones or lungs
Management of cervical cancer
Stage 1- radical trachelectomy plus lymphadenectomy in A2, can do cone biopsy if wish to maintain fertility
Stage 2 and 3- chemo and radiation
Stage 4- radiation and chemo
