Female Care Flashcards
Diagnostic criteria for PCOS
We use the Rotterdam criteria
Need 2/3 for Dx
1- Polycystic ovary on ultrasound either( 12 or more follicles )or
(an increase in the overall volume more than 10cm3 )
2-clinical or biochemical signs of
hyperangrogenism
3- oligo- an ovulation

What cause increase ovary size ?
Insulin
PCOS commonly associated with family hx of ?
Diabetes 2
Mx of infertility in PCOS
- letrozole
- clomiphene
- metformin
Menstrual irregularity mx 
Initial treatment is hormonal contraception
- ocp is superior to metformin
- mirena

First-line therapy in mild hirsutism?  or acne ?
Oral contraceptives
A-medication with Moderate anti androgen affects can be used to for hirsutism? 
Spironolactone
Second -line therapy in mild hirsutism? or acne ?
Antiangrogen - spironoloctane
Mx of acute uterine bleeding ?
Haemodynamically stable 🩸?
- tamponade
- IV estrogen
- curettage
- artery embolization
🩸 stable ?
- ocp
- oral progestin
- IV tranexamic acid
All patients with abnormal uterine bleeding should be tested for?
Pregnancy and anaemia
Who is candidate for endometrial biopsy ?
 45 female with abnormal uterine 🩸 
First line imaging choice for you trying bleeding in most patients
Transvaginal ultrasonography 
Risk factor for endometrial cancer
(Major risk )
- unopposed estrogen (long term)
- lynch syndrome
- estrogen producing tumor
(Minor risk) Obesity Pcos Nulliparty Late menaupouse Tamoxifen use
Normal flora in the. Vagina ?
Lactobacilli
It is recommended to culture bacterial vaginitis ?
No
Do not obtain culture bc of polymictobial infection
In infectious vaginitis is recommended to also do nucleic acid amplification test ?
Trichomoniasis vagnitis
Bacterial vaginitis?
- 🐟 fishy odor , homogeneous discharge
- sign : no inflammation
Mx ? Metronidazole 5-7 days
\or
Clindamycin
Dx criteria for bacterial vaginitis ?
NEED 3/4 for accurate dx
1- thin homogeneous discharge
2- +ve whiff test ( amine odor)
3- clue cells on microscopy
4- vaginal PH>4.5
Candidiasis. V
PH<4.5
Negative whiff test
Thick white discharge
Vulvar itching , burnnig 🔥
No odor
Vulvar erythema and edema
Mx: Topical azole
Or /
Fluconazole
Trichomoniasis V
Green yellow discharge, frothy
Foul odor
- vagina pain + soreness
- strawberry 🍓 cervix
- SHOULD SCREEN 📺 for STD ⚠️
Mx? Metronidazole
Or tinidazole
Microscopic findings of infectious vaginitis
1- bacterial : clue cells
2- trichomoniasis: motile
3-candidiasis: pesudohypha
Fetal heart rate at ?
10-12 week
Fetal movement
20-24 week
When to do urine culture?
At 12-16 weeks
Fundal - height measurements?
At 20 weeks
Full term delivery
Preterm
Abortion/ miscarriage
1- 37-40 weeks
2-20-36 weeks
3- before 20 weeks
Aspirin prophylaxis recommendation for pregnant with a risk of pre-eclampsia
Should be started at 12weeks-28 weeks
Screening for gestational diabetes
At 24-28 weeks
Test to do at 35-37w
Group B strep
repeat urine analysis
and urine culture
CBC
