FEMALE HEALTH Flashcards
What investigations are used in early pregnancy
Urinary BHCG and serum HCG
Transvaginal US
What is the difference between the urinary and serum HCG?
urinary HCG - qualitative result (positive/negative),
- very sensitive, accurate and reliable
Serum HCG - quantitative test i.e. the amount of of HCG in serum
- useful ~4-8wks, serial tests 48hrs apart (normal rises of around >66%
- reaches a peak around 11weeks and then steadily declines
What are indications of TVUS?
diagnostic test in early pregnancy
- used to diagnose intrauterine pregnancy, viability, multiple pregnancy, ectopic pregnancy
- used also to diagnose miscarriage
what are the two main gonadotropins investigated?
FSH and LH
- measured in amenorrhoea, oligomenorrhoea and menopause
patterns of LF/FSH abnormalities?
- elevated - excess production = ovarian resistance and then ovarian failure/menopause
- reduced - lowered secretion - anorexia/pituitary failure
- normal - PCOS
what is the programme done to screen cervical cancer?
national cervical smear screening programme - detects cytological abnormalities in the PRE-CANCER phase
what are the potential results for a cervical smear?
- abnormal cells/ HRHPV +ve
2. normal cells
what is done is cervical smear is abnormal?
cytology
-outcomes can be
1) normal
- 3yr recall
2) mild/moderate/severe dyskaryosis
- colposcopy - confirms the diagnosis and the likely stage of CIN
what is hysteroscopy?
a procedure used to examine the inside of the womb/uterus
hysteroscopy indications?
investigate abnormal symptoms of problems
- unusual bleeding patterns
- repeated miscarriages
- infertility
diagnose/treat fibroids, polyps, displaced IUDs and adhesions
what is laparoscopy?
type of surgical procedure that allows access into the abdomen without making large incisions into the skin
- also referred to as keyhole surgery - minimally invasive surgery
small tube with a camera and light source - allows images of the abdomen and pelvis to be seen on a large monitor
Pros and Cons of laparoscopy?
PROS = shorter hospital stay/quicker recovery, less pain/bleeding post-op and reduced scarring
CONS = infection minor bleeding bruising - site of incision nausea and vomiting
What is colposcopy?
What are the indications of colposcopy?
simple procedure allowing visualisation of the cervix and the lower part of the womb
- confirms normal/abnormal cells on the cervix after smear
- allows targeted biopsies and treatment (removing cells) - LLTEZ
- cauterisation of ectropion or PCB
what is laparotomy?
possible complications?
surgical incision made into the abdominal cavity
- examine abdominal organs and diagnose any problems
- larger incision made compared to laparoscopy
Possible complications:
- infection
- formation of scar tissue in abdo cavity
what is a mammogram?
An X-ray of the breast - can often show abnormal areas of the breast
- 2 most common findings include = calcifications and masses
What is the breast cancer screening programme?
aged 50-71 - mammogram every 3yrs
- stops automatically at 71
What is a pre-natal US?
ultrasound scans during pregnancy
can be used to
- check the baby is developing as expected
- identify any birth defects or structural abnormalities
what is a cervical biopsy?
procedure to remove tissues from the cervix to test for abnormal or precancerous conditions or cervical cancer
often done after abnormalities are picked up from colposcopy
what is cervical ablation?
operation used to treat heavy periods
device is used to treat the endometrium - can be done whilst awake or under local anaesthetics or General anaesthesia
the endometrium is removed - reducing/stopping a women’s periods
What is CA-125 and its uses?
tumour marker most associated with ovarian cancer
not all cancers secrete CA-125 - false negatives
What can cause falsely raised CA-125?
- endometriosis
- menstruation
- pregnancy
- fibroids
- pelvic infections
- ascites
What are the BRCA1 &2 genes
hereditary gene errors that increase the risk of cancers
autosomal dominant pattern of inheritance
what can be done if BRCA1&2 genes are detected?
offer risk-reducing surgery = bilateral salpingo-oophorectomy
What Investigations are done in pre-eclampsia?
- blood pressure = HTN >140/90
- urine dip = proteinuria
- Bloods - slightly high Hb, Low platelets, relatively high urea: creatinine, high ALT/low albumin, increased PCR/ACR,
- US - poor fetal growth, reduced amniotic fluid and high resistance to umbilical vessels
What investigations are done in someone who has PMB?
- abdo/pelvic examinations
- TVUS - endometrial thickness (>4mm)
- OP endometrial biopsy or hysteroscopy and biopsy
