O&G Flashcards
Heavy menstrual bleed
PALM COEIN
Polyp Adenomyosis Leiomyoma (fibroid) Malignancy - cervical, endometrial Coagulopathy - Von Willebrand, thrombocytopenia Ovulation - PCOS, hypOthyroidism Endometriosis Iatrogenic - IUD/IUS, OCP Not classified
Primary amenorrhoea
Without breast development:
- Kallman syndrome
- Turner syndrome
- 17-hydroxylase deficiency (CAH)
With breast development:
- Imperforate hymen
- Chromosomal abnormalities
- Cervical / mullerian agenesis
Secondary amenorrhoea
Pregnancy Hypothalamic - anorexia, stress, excessive exercise (athletic women) PCOS Prolactinoma Hyperthyroidism Progesterone / POP / Nexplanon Premature ovarian failure / Menopause Asherman’s syndrome Sheehan’s syndrome
Abdominal pain in pregnancy
Early (1st trimester): - Ectopic pregnancy - Miscarriage Late (2nd/3rd trimester): - Braxton Hicks contractions - Labour - Pre-eclampsia - Placental abruption - Uterine rupture - Red degeneration of fibroid
Dysmenorrhea
Common: - Primary dysmenorrhea - PID - Endometriosis - Adenomyosis - Fibroids - Uterine polyps Uncommon: - Ovarian cyst with haemorrhage / torsion - Copper IUD - Asherman’s syndrome
Dyspareunia
Common: - STI / PID - Vaginal atrophy - Endometriosis - Adenomyosis - Fibroids Uncommon: - UTI - Bartholin cyst / abscess - Imperforate hymen - Psychosexual disorders
Calf swelling in pregnancy
Physiological oedema
DVT
Pre-eclampsia
Cellulitis
Bleeding in pregnancy
Early: - Implantation - Ectopic - Miscarriage Late: - Labour - Placenta praevia - Placental abruption - Vasa praevia
Postmenopausal bleeding
- Atrophic vaginitis (most common)
- Endometrial cancer
- Endometrial hyperplasia
- Polyps
- Exogenous oestrogen / HRT
- Cervical, Vulval, ovarian cancer
Intermenstrual bleeding
- Polyps
- Cervical ectropion
- Endometriosis
- Adenomyosis
- Ovarian cyst
- Chronic pelvic infection / PID
- Fibroids
- Breakthrough bleeding (contraception)
- Ovarian/cervical/endometrial cancer
Postcoital bleeding
- Trauma
- Cervical polyp
- Cervical ectropion
- Cervical cancer
- Cervicitis / vaginitis
Vaginal discharge
- BV
- Trichomoniasis (green, frothy)
- Candida (cottage cheese)
- Chlamydia
- Gonorrhoea
- Atrophic vaginitis
Chest pain in pregnancy
- Pulmonary embolism
- Amniotic fluid embolism
- GORD
- MI
- Aortic dissection
Dyspnoea in pregnancy
- Physiological breathlessness of pregnancy (more common in 3rd)
- Anaemia (more common in 3rd)
- PE
- Hyperventilation
- Asthma
- Pneumonia
- Pneumothorax (most common after vaginal delivery)
Maternal collapse in pregnancy
- VTE: DVT/PE/stroke
- Amniotic fluid embolism
- Cardiac (MI, aortic dissection, cardiomyopathy)
- Sepsis
- Eclampsia
- Hypovolaemia - APH/PPH, placental abruption, uterine rupture, any PV bleed
- Drugs (Magsulf, illicit, anaesthesia toxicity)
Vulval pain / Vulvodynia
Acute:
- Infection (candidiasis, herpes, STI, Bartholin abscess)
- Inflammation (lichen sclerosus, lichen planus, soap/clothing irritation)
- Malignancy (VIN, vaginal cancer)
Chronic:
- Nerve damage (prev. Surgery, childbirth, trapped nerves)
- Persistent thrush
- Vaginal dryness / menopause
Vomiting in pregnancy
- Physiological N&V (1st trimester)
- Hyperemesis gravidarum (molar pregnancy, multiple pregnancy)
- Gastroenteritis, appendicitis
- Pyelonephritis / UTI, ovarian torsion
- Pre-eclampsia
- Acute fatty liver of pregnancy
- DKA
Reduced Fetal Movements
- Physiological (fetus sleeping, position, distractions, maternal obesity) Maternal: - Maternal sedating drugs (BDZ, smoking, alcohol, narcotics) - Steroids (for lung maturity) - Oligo/Polyhydramnios - Maternal comorbidities (anaemia, hypothyroidism, metabolic dx) Fetal: - Congenital abnormalities (neuro, MSK) - Hydrops fetalis - Intrauterine death Placenta: - Anterior placenta - Placental insufficiency / IUGR
Fever in pregnancy
Infection - Viral/bacterial infections (TORCH), STIs, UTI, chorioamnionitis, GBS, listeriosis
Non-infective - VTE, SLE/RA, drug administration (prostaglandins), red degeneration of fibroid
Fever in puerperium
ENDOMETRITITS Retained products of conception Wound infection UTI Mastitis / abscess VTE Atelectasis
Fetal distress in labour
Maternal: - APH / vasa praevia - Epidural anaesthesia - Umbilical cord prolapse - Placental abruption - Uterine rupture - Obstetric cholestasis - Pre-eclampsia/eclampsia - Uterine hyperstimulation Fetal: - Malposition / malpresentation - Shoulder dystocia - Cord entanglement (ECV, multiple pregnancy) - Oligohydramnios
Shoulder dystocia
- Cephalopelvic disproportion
- Maternal diabetes / GDM
- Fetal macrosomia
- High maternal BMI
- Post-term pregnancy
- Prolonged labour
- Instrumental delivery
Uterine rupture
- VBAC
- Previous gynae surgery
- Induction of labour / oxytocin
- Malpresentation
- Obstructed labour
- Instrumental delivery
Cord prolapse
- PROM/PPROM
- Preterm labour
- Multiple pregnancy
- Polyhydramnios
- Malpresentation
- ARM
