last min gynae Flashcards by Lucy Miller

Inhibin selectively inhibtis

FSH

How well did you know this?

Not at all

Perfectly

thec cells produce andogens from cholesterol by

How well did you know this?

Not at all

Perfectly

drop in what causes dom follicle

FSH

How well did you know this?

Not at all

Perfectly

whats most likely to be the dom follcile

high conc of FSH induced LH receptors

How well did you know this?

Not at all

Perfectly

inhibin acts to decrease

FSH

How well did you know this?

Not at all

Perfectly

androgens rise during ovulation - thought to be important in libido

How well did you know this?

Not at all

Perfectly

LH surge is the best predictor of imminent ovulation and this principle is used in ovulation predictor tests.

How well did you know this?

Not at all

Perfectly

ovulation occurs when

12 hours after the Lh surge

How well did you know this?

Not at all

Perfectly

high levels of porgesteron during teh – phase supress LH and FSH

luteal

How well did you know this?

Not at all

Perfectly

decrease in what causes menstruation

progesterone

How well did you know this?

Not at all

Perfectly

7 day before period progesterone

assesses ovualtion

How well did you know this?

Not at all

Perfectly

when is the endometrium in the proliferating vs secretory pahse

follicular phse - proliferatin
luteal - secretory

How well did you know this?

Not at all

Perfectly

is the formation of a specialised glandular epithelium and is an irreversible process and apoptosis occurs if there is no embryo implantation.-

decidualisation

How well did you know this?

Not at all

Perfectly

menstruation is how long after ovualtion

How well did you know this?

Not at all

Perfectly

mefenamic acid is a

prostaglandin inhibitor - act by increasing the ratio of vasconcstrictor to vasodilator ratio

How well did you know this?

Not at all

Perfectly

Nsaids such as mefenamic acid is contraindicaed if hsitory of

duodenal ulcers or severe asthma

How well did you know this?

Not at all

Perfectly

why GnrH analogue bad long temr

osteoporosis - however can combine with HRT

How well did you know this?

Not at all

Perfectly

GNRH decrease

FSH and LH

How well did you know this?

Not at all

Perfectly

examples of gnrh analogues

buserelin and goserelin

How well did you know this?

Not at all

Perfectly

most common reasons for cervical ectropion

preg or pill

How well did you know this?

Not at all

Perfectly

women with PMB over what age should have 2 week by US for endometrial cancer

How well did you know this?

Not at all

Perfectly

most common cause of post menstual bleedig

atrophic vaginits

How well did you know this?

Not at all

Perfectly

exception to doing US for if got post mentrual bleeding

if on tamoxifen - as they will have a thickened endometrium so need direct visualisation by hysterocscopy and endoemtrial biopsy

How well did you know this?

Not at all

Perfectly

first line for endometrial hyperplasia

MIRena

How well did you know this?

Not at all

Perfectly

LH and FSH in PCOS

LH are very high and FSH are low or normal

clomifene works by

blcokign oestrogen negative feedback so more gnrh and more FSH and LH

best thing for acne in PCOS

Co-cyrprindol (diannette)

dysmenorrhoea

excessive pain during menstrual period

primary dysmenorrhoea - usually appears 1-2 years after menarche

secondary dysmenorrhoea- starts many yeats after starting menarceh

uterus appears large and globualr

adenomyosis

endometrium in muscle layer of uterus

adenomyosis

nsaids such as mefenamic acid and ibuprofen are first line for

dysmenorrohoea

absent uterus

mullerian agenesis

mx for kallamn

HRT

ashermann syndrome

secondary to endometrial infection or durgery - secondary amenorrheoa

climateric is

time around the beginning of the menopause

mx can be avoid what in start of menopause

spicy foods

main medical mamagement for troublesome menopasue symptoms

HRT

oestrogen only hrt given if not got

uterus

hrt oestogen patches avoisd

first past metabolism

when given continous vs cyclical hrt

contunous - menopausal cyclical - perimenopsual who still get pridso

what decreases risk HRT causing endoemtrial cancer

adding progesterone if got a uteurs

Suspected pregnancy Breast cancer Endometrial cancer Active liver disease Uncontrolled hypertension Known VTE Known thrombophilia e.g. factor V leiden otosclerosis

absolute contrainicatiosn to HRT

cigarette appearance

lcihen scleorus

what is common in lichen sclerosus

splitting of the skin and often leads to superficial dyspareunia

mx of lcihen sclerossus

high dose steriods and emollient s-- dermovate (topical steriod)

pagets disease is often a sign of

malignancy elsewhere in teh body

mucin in epdeirmis in

pagets

Benign ovarian cysts are < 5cm in maximum diameter, are physiological and tend to resolve over 2-3 menstrual cycles.

what tumour markers recommeded for all pre menopausal woman with compelx ovarian cyst

ca125, afp, beta hcg

It is the most common benign ovarian tumour in women <30years

dermoid cysts- as they tend to be big they are more likely to present with torsion

if mucinois cysts rupture they can cause

pseudomyxoma peritoneii

tender nodualrity on posterior fornixx

endometriosis

us shows whirpool sign

ovarian torsion

average labour for first time mums is

10hrs and for multi parous women is 5.5

1st stage of labour

no more than 12hrs in 1st time mum or 10 in second

early latent phase

dilates up to 4cm

cord isnt clamped until

pulsations have ceased

There are 3 classic signs to indicate separation of the placenta and membranes: The uterus contracts, hardens and rises Umbilical cord lengthens permanently There’s a gush of blood variable in amount Placenta and membranes appears at introitus.

increased hyaluronic acid causes cervix to ripen

enagment -

passage of widest diamter of the presenting part below the pelvic inlet

need to catheterise before using froceps as bladder needs to be empty

chignon

swelling on babys head

caput succdenaemum

present at brith

what haematoma develops several hours after birth

cephalohaemtoma- swelling is firm

caput succedaneum

- often occurs due to pressure of the presenting part agaginst the cervix - soft puffy swellign

how to induce labour if memebranea are intact

prostaglandin E2 - pessary most commonly used

negative nuber if above spine

women on anticonvulsants can only take

opiates

patietn controleld - pethidine, morphine and remifentatanil (very fast acting and good) -last one

ferguson refex - increased uterine contraction due to oxytocin

continous electrical fetal monitoring done if

below 37 or after 42

A terminal bradycardia is when the baseline fetal hear t rate drops to below 100beats per minute for more than 10minutes. A terminal deceleration is when heart rate drops and does NOT recover for more than 3 minutes.

indicators for emergency c section

early decelartion often due to

head compression

fetal sleeping - reduced varaibility usually lasts no longer than

40 misn

variable deceleration idnciates

cord compression=Cord compression which initially compresses the umbilical vein causing acceleration which is a healthy response. The occlusion of the umbilical artery results in a rapid deceleration. When pressure on the cord is reduced, another acceleration occurs and baseline rate returns.

mx of variable deveeraltions

change position of mother

sinusoidal pattern on partogram

urgent c section

early deceleration are physiological

variable deceleration

change position of mother

amnioscope detects

fetal Ph

reversible causes of death that can be added to the list in preg

eclampsia and intracranial haemorrhaeg

most common cause of maternal cllapse - ahemorrhage

most common cause of direct maternal death - thromboemmbolism

aortic dissection can have

wide pusle pressure

ejection systolic murmurs are common in preg

malg sulphate drug toxicity in presence of renal impairemnt

in cpr if cardaic output not restored after 3 mins of cpr then do

c secction