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Complex care 2 > Module 8 > Flashcards

Module 8 Flashcards

1
Q

Antiepileptic drugs
Generic name
Trade Name:
Category in pregnancy:

A

Carbemazepine and lamotrigine
Tegretol and lamictal
Ampicillin cat B,

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2
Q

maternal mortality rate

A

5.5 per 100,000 women giving birth in 2020

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3
Q

most common cause maternal mortality rate

A

motor vehicle trauma and cancer

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4
Q

ovarian cysts - symptoms

A

pain, abdominal discomfort-fullness, indigestion, early satiety, urinary urgency, urge to defecate, painful bowel movements, painful sex or none

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5
Q

ovarian cysts - diagnosis

A

palpation, USS, MRI, CT scan

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6
Q

bartholins cysts

A

obstruction of the bartholin’s glands on either side of the vaginal opening causing fluid build up, usually painless but may become infected requiring surgical draining under GA and hospital admission with IV ABX

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7
Q

gynaecological conditions

A

Endometriosis
Structural anomalies
Batholin’s cyst
Uterine fibroids
ovarian cysts
PCOS
Genital tract infections
Abnormal cervical screening
Recurrent UTI
Incontinence
Cancer
cervical cancer
breast cancer
ovarian neoplasia (cancer)
ectopic pregnancy
fistuale/FGM

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8
Q

uterine fibroids

A

Non-cancerous growth on the uterus wall
Generally don’t affect fertility
May complicate pregnancy and labour, risks for fetal malpresentation, labour dystocia, LSCS and PPH
Symptoms menstrual changes, aetiology unknown

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9
Q

cancer affects …

A

approx 1 in 2000 pregnancies

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10
Q

most common cancers in pregnancy

A

melanoma 1:1000,
breast 1:3000,
cervical 1:4500,
hodgkin lymphoma 1:1000-6000,
ovarian 1:8000

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11
Q

estrogen is thought to be

A

an established growth factor in cancers and therefore accelerated disease occurs in pregnancy

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12
Q

elective pre-term labour cancer

A

32-34 weeks
is often favoured by medical staff and the woman, so her condition can be assessed and more appropriate treatments can be administered such as radiation and cytotoxic drugs

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13
Q

cervical cancer - HPV

A

human papillomavirus is the cause of both invasive cervical cancer and the premalignant change in the cervical epithelium. HPV is transmitted sexually but not considered a STD.

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14
Q

risk factors of HPV/cervical cancer

A

multiple sexual partners, experiencing sex at an early age, sex with a male partner who has had multiple partners, oral contraceptive pill more than 4 years.

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15
Q

stage 1 cervical cancer

A

carcinoma confined to the cervix

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16
Q

stage 2 cervical cancer

A

carcinoma is beyond the cervix into surrounding tissue

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17
Q

stage 3 cervical cancer

A

carcinoma extends to the pelvic wall

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18
Q

stage 4 cervical cancer

A

carcinoma beyond the pelvis involvement of bladder and rectum or distant organs such as lungs

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19
Q

breast cancer stage 0

A

non invasive not in surrounding tissue

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20
Q

breast cancer stage 1

A

invasive where tumour measures less than 2 cm with no lymph node involvement

21
Q

breast cancer stage 2

A

measures a minimum of 2 cm and maximum of 5 cm or has spread to the lymph nodes in the axilla of the affected breast

22
Q

breast cancer stage 3A

A

size greater than 5 cm or lymph node involvement

23
Q

breast cancer stage 3B

A

tumour has spread to the breast skin, chest wall or internal mammary lymph nodes

24
Q

breast cancer stage 3C

A

tumour of any size, spread to the clavicle with lymph node involvement

25
Q

breast cancer stage 4

A

any size, spread to both lymph nodes and distant organs

26
Q

signs and symptoms of breast cancer

A

fatigue, anaemia, anorexia, depression, sepsis, pain or metastasis

27
Q

consultation after treatment breast cancer

A

Pregnancy after treatment should be in consultation with oncologist, breast surgeon and obstetrician, wait at least 2 years after treatment

28
Q

ovarian neoplasia (cancer) stage 1

A

limited to ovaries

29
Q

stage 2 ovarian cancer

A

involving one or both ovaries with pelvic extension

30
Q

stage 3 ovarian cancer

A

involving one or both ovaries with peritoneal deposits outside the pelvis

31
Q

stage 4 ovarian cancer

A

involving one or both ovaries not limited to the pelvis

32
Q

stage 4 ovarian cancer

A

involving one or both ovaries not limited to the pelvis

33
Q

how many weeks to expedite delivery for ovarian cancer

A

32 weeks to minimise delay in treatment

34
Q

neurological disorders

A

epilepsy
multiple sclerosis
bells palsy
cerebrovascular disease and stroke

35
Q

epilepsy

A

characterised by recurrent seizures

36
Q

seizure triggers

A

stress, anxiety, lack of sleep, lack of feed, excess alcohol, binge drinking, drugs, dose of antiepileptic drugs, flickering lights, illness and health condition, antidepressants and antihistamines, hormonal changes

37
Q

epilepsy affects

A

0.5% of pregnancies

38
Q

pre-conception care epilepsy

A

folic acid supplementation, counselling to review current medications, explain risk of fetal defects, review of hx, reduce medication where possible, 5mg of folic acid 12 weeks before pregnancy and continue until the end of the first trimester due to the increase risk of folate deficiency, antenatal screening, Vitamin K, consider seizure risk for labour and pain relief, encourage breastfeeding, safety advice in the postnatal period

39
Q

complications epilepsy

A

status epilepticus (>30 min), sudden unexpected death, trauma, maternal mortality.

40
Q

epilepsy management

A

obstetric management, seizure control, congenital malformation, folic acid supplementation, antenatal screening, Vitamin K supplementation, no pethidine

41
Q

multiple sclerosis

A

chronic inflammatory autoimmune disease
of the CNS that mostly affects women and those in the childbearing age group
Characterised by destruction of the myelin sheaths (lesions) in the brain and spinal cord and has a variety of classification types e.g. relapsing-remitting, primary progressive

42
Q

ms effect on pregnancy

A

pregnancy has a protective
benefit against relapses, however increased chance of relapses postnatally when physical and emotional stressors are greater and results in immune activation

43
Q

meds for ms

A

Immunomodulatory agents (IMAs) e.g. beta interferon and glatiramer (Copaxone) are not recommended in pregnancy and lactation

44
Q

bells palsy

A

An idiopathic inflammatory reaction involving the facial nerve and resulting in facial paralysis
Three times more common in pregnant women than those of similar age
May be caused by oedema, hypertension or secondary to infection
Most cases resolve without treatment
Treatment eye care, high dose steroids, emotional support

45
Q

cerebrovascular disease and stroke 3 categories

A

ischaemic (from decreased blood flow), thrombotic (a venous event), haemorrhagic (subarachnoid haemorrhage due to a ruptured blood vessel)

46
Q

signs and symptoms of cerebrovascular disease and stroke

A

abrupt onset of neurological symptoms and needs urgent medical review

47
Q

risk factors cerebrovascular disease and stroke

A

hypertension, heart disease, previous ischaemic attacks, diabetes, vasculitis, smoking, obesity, excessive alcohol, over 35, thrombophilia, dehydration, infection, smoking, operative delivery, 6 or more pregnancies, ⅔ have no risk factor

48
Q

complications of cerebrovascular disease and stroke

A

can result in death or permanent disability, dizziness, weakness, numbness, paralysis, headache, slurred speech, partial vision loss
Preconception care review prior to pregnancy where a hx is present, titrate aspirin up, cease warfarin and change to heparin, consult with haematology, support and reassurance

49
Q

labour care cerebrovascular disease and stroke

A

regular obs, TEDs, hydrate and mobilise, supportive care

Complex care 2 (9 decks)

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