Gen Med deck 2 Flashcards
pro’s of breast feeding
Baby
- Perfect nutrition for first 4-6months,
- supplementary nutrition until 1 year,
- baby receives biologically adequate food/easy digestion,
- boost immunity of baby
Mother
- stimulate postpartum uterine involution,
- helps normalisation of mother’s weight,
- protects against breast cancer,
- strengthens psychological relationship between mother and child
Immunisation contraindications
- Unexplained encephalopathy after a previous pertussis containing vaccine
- Anaphylaxis after a previous dose
- Immunodeficiency – for live vaccines
- evolving neurological diseases
- temperature above 38.5
Immunisation local/general side effects
Local: Itchiness, redness, swelling at site injection,
General: Slight temperature, headache, loss of appetite, allergic reaction
what is febrile syndrome
according to temp
- Subfebrile: below 38
- moderate: up to 39
- high: 39-40
- very high: above 40
according to duration
- transient/ephemeral= 1-3 days
- acute =up to 15
- subacute: up to 6w
- chronic: >6w
Febris
Continua =day/night fluctua <1° by spotted fever
remitens = day/night fluctua >1° by infectious mononucleosis),
intermitens =minimum lower than normal and max in high
values by malaria
- *undulans** gradual rise in temp and gradual drop day to day by
- *brucellosis**
reccurens: afebrile periods between febrile days by recurrent typhoid
WHO : definition of reproductive health
Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.
what does reproductive health consist of
Sexual Health (Contraception, reproduction)
STDs (prophylaxis/treatment)
Puberty & development
Family planning,
Prenatal/postnatal consultations
Screening of diseases of breast/uterus
Reproductive health definition
State and condition free of disease and disturbances in reproductive system in both sexes
Assisted reproductive technologies
1 artificial insemination 2Invitro fertilisation 3intracellular sperm injection
Women’s consultation consists of?
- Regular observation to check normal development of pregnancy
- prevention & early diagnosis of gynaecological diseases/anomalies in development with prophylactic check-ups and cervical smear test
- health promotion for hygiene of sexual organs, reproductive life & sexual life
what is a High risk pregnancy
Over 35yrs, alongside comorbidities, previous miscarriages, IVF, twins
Monitoring of pregnancy by GP and by specialist
How to trace pregnancy by months
First visit
- take history of risk factors (Age, comorbities, complications in previous preg)
- gynea status ; rpt at mo 4 and PRN
- US- rpted at 16-20th wk
- blood typing: rh + abo
- vag secretion tests for microbio rpt in 9th mo
- HIV, SYPHILLIS, HEP B, pap smear testing
- determination of expected term of delivery
first trimester tests = 1x/ month and 2x month 9 and 10
- BP
- blood type
- clinical lab
- blood: Hb, RBC,WBC,ESR, MCV, MCH,
- urine: urobilinogen, ketones
- Gynaecological status: first visiT, month 4, PRN
- anthropometric assess (height, body weight, external pelvimetry)
- Foetal cardiac function: 1X in month 5,6,7 and twice month 9,10
Clinical lab: once in first trimester and lunar month 5, 8, 10
- blood
- Hb, RBC,WBC,ESR, MCV, MCH,
- blood type and Rh factor at first visit or some point in first trimester
- Glucose, Urine (urobilinogen, ketones)
- HIV testing, prophylactic cervical smear, syphilis test, hep B test-> in primary visit
- Vaginal secretion & microbiological investigations in first visit 9th mo
post natal till 42 days
- bloods 1x
- BP
- uterine involution,
- genital bleeding,
- mental status,
- mammary gland exam twice up to 42nd postnatal day( 7dy birth +30 dy after delivery
what is Cervical Cancer
Caused by HPV, Herpes simples type 2, ebstein-barr virus.
PAP I- no abnormality.
PAP II- cervicitis or metaplasia, followup smear.
PAP III- severe inflame, degenerative chnge,colposcopy.
PAP IV- severe dysplasia o r CIS, biopsy.
PAP V- invasive carcinoma
Natural contraception
- *Calendar method-** restraining from sex for 4 days before and after ovulation
- *Basal body temp**- restrain 5 days before & 3 days after BBT raised by 0.2-0.5°C
- *Cervical Mucosa method**- based on changes cervical mucosa during menstrual phases
- *Symptomatic thermal method**- BBT is checked, cervical discharge and changes in
- *menstrual phases** (abdominal pain, ovulatory bleeding, breast tension)
- *After delivery** up to 45 days if not breastfeeding or up to 6weeks if breastfeeding
Advantage: Dont affect health, no risk, no secondary effects, low cost, lead
what is Intrauterine pessary
A foreign body preventing fertilisation of ovum and implantation of embryo, by acting upon movement of sperm from vagina to tubes.
Insert during menstruation or up to 12th day of menstruation or 4 weeks after delivery or immediately after- 5 days post abortion
Advantage: fast efficiency, economic, no interfere with sex or breastfeeding
Disadva: require perfect health of reproductive system, increased bleeding in first 3m
