Emergency causes of abdominal pain in females Flashcards
Abdo pain causes in early pregnancy
Miscarriages
Ectopic pregnancy
Abdo pain causes in late pregnancy
Labour
Infection (chorioamnionitis)
Placental abruption
Uterine rupture
Abdo pain causes anytime in pregnancy
Degeneration of a uterine fibroid
Non pregnancy relates problems in females causing abdominal pain
Menstrual cycle
Pelvic inflammatory disease
Ovarian and Fallopian tube cyst accidents (rupture, bleeding, torsion)
Ovarian, hyper-stimulation syndrome
Endometriosis
Complications of uterine fibroids (torsion, pedunculated, prolapse)
Initial assessment in examinations
General Abdomen Pelvic exam (speculum before digital)
Investigations to undertake in initial assessment
- vaginal swabs for infection
- Urine tests (urinalysis and MSU for Microscopic culture)
- Blood tests (FBC, WCC, beta HCG, CRP, blood group)
- Ultrasound (abdo and pelvis)
Symptoms and signs of a miscarriage
Amenorrhea
Positive pregnancy test
Vaginal bleeding preceding abdo pain
Cervix may be dilated with products pf the pregnancy in the vagina
Management of a miscarriage
Pain relief
Expectant
MEdical (misoprostol)
Surgical (suction evacuation of the uterus)
Symptoms and signs of ectopic pregnancy
Amenorrhea and positive pregnancy test
Abdo pain (often unilateral)
Vaginal bleeding after pain
Shoulder tip pain (red flag)
Management of ectopic pain
Pain relief
Expectant
Medical (methotrexate)
Surgical (laparoscopy)
Signs of an infection in late pregnancy (chorioamnionitis)
General uterine pain and tenderness
Raised temp
TAchycardia
Yellow vaginal discharge
Management of chorioamnionitis
pain relief
Antibiotics
Deliver baby
Clinical feature of placental abruption
Constant uterine pain and tenderness
Vaginal bleeding
Woody hard uterus
Management of placental abruption
Resuscitate, pain relief, deliver baby
Clinical feature of uterine rupture
Constant uterine pain and tenderness
Contractions cease
Management of uterine rupture
Resuscitate
Pain relied
Abdo surgery
Deliver baby
Symptoms of degeneration of a uterine fibroid
History of uterine fibroids
Pregnancy
Uterus larger than expected gestational age
Tender firm area on uterus
Treatment of uterine fibroid
Pain relief
Symptoms of pelvic inflammatory disease
Abdo pain VAginal discharge Raised temp Raised pulse rate Recent causative incident (e.g. unprotected sex or uterine instrumentation)
Management of PID
Pain relief
Antibiotics
Surgery to drain any pelvic abscesses
Can ovarian and Fallopian tube cyst accidents happen in pregnancy
YEs
What is ovarian hyper-stimulation syndrom
Where women going through fertility treatment get hormones and their body produces too many eggs/cysts
Management of ovarian and Fallopian tube cysts accidents (rupture, torsion)
Pain relief
Expectant management or surgery to remove cyst
Exclude cancer (USS and tumour markers)
Symptoms of ovarian hyper-stimulation syndrome
Abdo pain and distension, N&V
Recent history of fertility treatment
Management of ovarian hyper-stimulation syndrom
Pain relief Anti-emetics Close monitoring Fluid balance Thrombosis prevention
Signs of endometriosis
Abdo pain
Heavy and painful menstrual bleeding
Painful sex
Management of endometriosis
Pain relied
Hormones (combined pill, progesterone IuCD, surgery)
Signs of uterine fibroids
Inilateral or central colicky pain
Management of uterine fibroids
Pain relief
Surgical removal
