Gynae Flashcards
What does the high vaginal charcoal swab test for?
BV, trichomonas, candida, group B strep
Where do you swab for gonorrhea and with what?
Endocervical charcoal swab
Where do you swab for chlamdydia?
Endocervical swab - break off into pot
How does the COCP work?
Supresses LSH and FH so that no ovulation occurs and thicken cervical mucus
Benefits of COCP
lower risk of ovarian and endometrial cancer
Risks of COCP
VTE, MI, stroke, breast cancer, cervical cancer
How does POP work?
inhibits some ovulation and thickens mucus, thins endometrium
What is the window of delay for POP?
3 hours (apart from Cerazette - 12)
Side effects of the depo
Irregular periods, weight gain, fertility delay 6 months, long term osterporosis
How immediate is depo?
Need condoms one week
How long can you have depo for?
Lasts 3 months, 3 years max - osteoporosis
How quickly does your fertility come back after depo?
Up to 6 months
How long does the IUD (copper) last?
5-10 years
How immediate is the IUD (copper)
Very - can be used as emergency contraception
What are the risks/side effects of the IUD (copper)?
Spotting, bleeding, menorrhagia, dysmenorrhea
What else can the IUS (mirena) be used for?
Menorrhagia, endometriosis, dyamenorrhea
Absolute contraindications to home birth
Full placenta praevia
transverse lie (C section needed)
premature
What is the diagnostic critieria for gestational diabetes
Fasting >5.6
2 hour >7.8
What strains does the HPV vaccine prevent against?
6,11,16,18
What age do you give HPV vaccine?
12-13
Degrees of perineal tears
1st degree - mucosa only
2nd - subcut tissue
3rd - external anal sphincter
4th - internal anal sphincter
Symptoms of endometriosis
Deep dysparaunia
Severe cyclical pain
Fertility problems
Bicornate uterus
heart shaped uterus
increased risk of recurrent miscarrage
Uterine fibroids typical presentation
30-50
Menorrhagia
Infertility
Placental Abruption
Sudden abdo pain 3rd
hypovolaemic shock
potentially no visible bleeding - can be contained in uterus
Complications of Diabetes in Pregnancy
Prem Miscarriage/stillborn Polyhydramnios Infection C Section
Complications of Smoking in Pregnancy
IUGR Miscarriage/still birth Premature Placental issues SIDS
Complications of Obesity in Pregnancy
NTD Gestational DM C Section HTN VTE
Diet advice for pregnancy
Vit D supplement if risk group
5aday and wash all before
Avoid uncooked meat, unpasteurised, caffiene
Features of FAS
Typical facial abnormalities
IUGR and FTT
Neuro developemental; learning disability, cognitive, behavioural problems
urogenital, cardiac, musculoskeletal, hearing
Facial anomalies of FAS
Microcephaly Flat phiitrum Thin upper lip Retrognathia Low nasal Micropthamia, short palpebral fissures Cleft palate
Facial anomalies of Downs
Brachycephaly Oblique palpebral fissures Epicanthic folds Iris speckes - Brushfieds spots ow set ears Flat nasal bridge High arched palate, protruding tongue
What does the heel prick test for?
6-8w PKU Congenital hypothyroid Sickle cell CF MCAD Homocystinuria MSUD Glutaric aciduria Isovaleric acidaemia
Tx for BV
Metronidazole
Features of BV
thin white discharge
clue cells
vaginal pH >4.5
whiff test
Features Trichomonas Vaginalis
Green frothy offensive
Strawberry cervix
Tx for Trichomonas Vaginalis
Metronidazole
Features of Chlamydia
thin mild odour discharge
dysuria
IMB
dyspareunia
Tx for chlamydia
IM cef and oral azithromycin
Premature Ovarian Failure definition
menopausal sx + elevated gonadotrophins (FSH, LH)
Causes of premature ovarian failure
Idiopathic
Chemo
Autoimmune
Radiation
MI management:
What drugs should everyone w/o CI be given?
aspirin
clopidogrel
LMWH
MI management:
Who do you give O2 to?
Sats
MI management:
When do you PCI?
MI management:
When ans how do you thrombolyse?
tPA (alteplase, tenecteplase)
ECG 90 after to look for 50% reduction in ST
if not then PCI
MI management:
Glycaemic control
insulin infusion to keep BM
VBAC
Ok if no prev rupture and less than 3 prev C sections
Higher risk of rupture if induced or prolonged
1 in 4 end in C section
Parity+Gravida
No of pregs carried to 24w (viability)
No of fetuses ever in uterus
Placenta praevia classic presentation
Painless bright red bleeding after 24w
Threatened miscarriage
Painless bleeding before 24w
Os closed
Missed miscarriage
dead fetus before 20w w/o sx of explusion
light bleeding
os closed
Inevitable miscarriage
heavy bleeding, clots and pain
os open
Incomplete miscarriage
not all products expelled
pain and bleeding
os open
