gynae Flashcards
Diagnostic thresholds for gestational diabetes:
Fasting glucose
2-hour glucose
Fasting glucose > 5.6mmol/L
2-hour glucose >7.8mmol/L
Targets for self monitoring of pregnant women (pre-existing and gestational diabetes):
(a) fasting
(b) 1 hour after meals
(c) 2 hours after meals
(a) fasting = 5.3
(b) 1 hour after meals = 7.8
(c) 2 hours after meals = 6.4
Hand foot and mouth disease
What pathogen causes it
Coxsackie A16
Rx = symptomatic only
Do not need to be off school with this
If cyclical mastitis (breast pain before period) pain has not responded to conservative measures, and is affecting the quality of life or sleep, then referral should be considered after what length of time?
And what 2 medications may help?
3 months
Bromocriptine and danazol
if guttate psoriasis covers greater than 10% of the body surface area then the patient should have what management
urgent referral for phototherapy consideration
Pregnancy induced HTN with proteinuria (>0.3g/day) = pre-eclampsia. What are the treatment options for gestational hypertension + pre-eclampsia prior to birth?
- If previously HTN - stop ACEi/ARB
- Start labetalol (first-line)
- Or nifedipine (if asthmatic) and hydralazine
- Pre-eclampsia - have aspirin 75mg OD from 12 weeks until birth of baby
Jaydess IUS coil is licensed for how many years
3 years
Mirena IUS coil is licensed for how many years
5 years
Kyleena IUS coil is licensed for how many years
5 years
Copper IUD coil is licensed for how many years
5-10 years
First line anti-emetic for hyper-emesis gravidarum
Oral cyclizine or promethazine
Hyperemesis gravidum is most common between what weeks
8-12 weeks
But may persist up to 20 weeks
What are 4 risk factors of hyperemesis gravidum
- Increased b-hCG levels - multiple pregnancies or molar pregnancy
- Nulliparity
- Obesity
- Family or personal history
What is associated with a decreased incidence of hyperemesis
Smoking
3 criteria for admission for nausea + vomiting in pregnancy
- Unable to keep down liquids/ oral antiemetics
- Ketonuria or >5% weight loss
- Comorbidity
What triad is present before the diagnosis of hyperemesis gravidarum
- 5% pre pregnancy weight loss
- Dehydration
- Electrolyte imbalance
ondansetron during the first trimester is associated with
small increased risk of baby having a cleft lip/palate
primary amenorrhoea age cut offs
failure to start period by 15 (with normal secondary sexual characteristics) or by 13 (with no secondary sexual characteristics)
secondary amenorrhoea is the cessation of menstruation for what timeframe
3-6 months with previously normal/regular periods
or 6-12 months in women with previous oligomenorrhoea
What is the most common cause of primary amenorrhoea
Gonadal dysgenesis
i.e. Turner’s syndrome
Gonadotrophins (LH/FSH) are raised in which primary amenorrhoea disease
Gonadal dysgenesis
i.e. Turner’s syndrome
gold standard investigation for endometriosis
laparoscopy
Management of endometriosis
- NSAIDs/paracetamol
- COCP or progestogens (Depo Provera)
- Secondary care can start GnRH analogues - which can induce psuedomenopause due to low oestrogen
- Surgery - laparoscopic excision
Management of menorrhagia if does not need contraception
Mefanamic acid 500mg TDS
Or Tranexamic acid 1g TDS
Or Norethisterone 5mg TDS short-term to rapidly stop menstrual bleeding