O&G Flashcards
Post coital bleeding
Infection Cervical ectropion Cervical polyps Endometrial polyps Vaginal cancer Trauma
Intermenstraul bleeding
Physiological ▪️1-2% spot around ovulation ▪️hormonal fluctuation in peri menopause - diagnosis of exclusion Pregnancy related ▪️ectopic pregnacy ▪️gestational trophoblasts disease Vaginal cause ▪️adenosis ▪️vaginitis - uncommon premenopause ▪️tumours Cervical cause ▪️infection: chlamydia, gonorrhoea ▪️cancer - bleeding is post coital ▪️cervical ectropion ▪️condylomata acuminata of the cervix Uterine cause ▪️fibroids - although more likely to cause menorahagia ▪️endometrial polyps ▪️️cancer: endometrial adenocarcinoma, adenosarcoma, lieomyosarcoma ▪️adenomyosis ▪️endometritis Oestrogen secreting ovarian cancers Iatrogenic ▪️tamoxifen ▪️smear or ️cervical treatment ▪️missed OCP ▪️drugs altering clotting parameters ▪️
Chronic pelvic pain
Gynaecological cause - often oestrogen dependant so rare post menopause ▪️endometriosis ▪️adenomyosis ▪️Fibroids ▪️PID ▪️adhesions Urological ▪️interstitial cystitis ▪️chronic urethritis ▪️urinary tract calculi Gastrointestinal ▪️IBS ▪️diverticular disease Psychiatric/psychological Pelvic congestion syndrome Myofascial syndrome
Primary amenorrhoea
Secondary sexual characteristics present
▪️constitutional delay
▪️️️️genitourinary malformation: imperforate hymen, absent uterus or vagina
▪️testicular feminisation
Secondary sexual characteristics absent
▪️hypothamic failure: chronic illness, excessive exercise, stress, anorexia NERVOSA,
▪️kallman syndrome
▪️hyperprolactiemia
▪️gonadal failure: turners syndrome
▪️congenital adrenal hyperplasia
Secondary amenorrhoea
Pregnancy Lactation Menopause Premature ovarian failure Depot and implant contraception Asherman's syndrome BMI - below 19 Pitutuary disease and ️hyperprolactiemia ▪️Drugs: phenothiazine, Metrocoplimide ▪️Sheehan syndrome Post pill amenorrhoea Signs of androgen excess ▪️PCOS ▪️Cushing syndrome ▪️late onset ️congenital adrenal hyperplasia ▪️adrenal or ovarain carcinoma
Menorahagia
Fibroids ️endometrial polyps ️Adenomyosis ️Endometrial hyperplasia ️PID ️Endometrial carcinoma Dysfunctional uterine bleeding Systemic disease ▪️hypothyroidism ▪️liver or kidney failure ▪️obesity ▪️bleeding disorder Iatrgoenic ▪️IUCD ▪️anticoagulant
Vaiginal discharge
Non-infective ▪️physiological ▪️️cervical polyps and ectopy ▪️vulval dermatitis ▪️erosive lichen planus ▪️gential tract malignancy Non-sexually transmitted infection ▪️bacterial vaginosis ▪️candida infection Sexually transmitted infections ▪️chlymidia ▪️gonorrhoea ▪️trichimonas
Vomiting in pregnancy
Pregnancy related
▪️hyperemis gravidarum
▪️multiple pregnancy
▪️gestational trophoblastic disease
Non preganacy related
▪️gastrointestinal e.g. gastroenteritis,appendicitis hepatitis obstruction
▪️neurological e.g. Migraine, raised ICP
▪️UTI
▪️ENT E.g labyrinthitis, meunière disease
▪️metabolic and endocrine disease e.g uremia, hypercalcemia, DM
▪️️Drugs
Bleeding in pregnancy
Implantation bleeding Threatened miscarriage Miscarriage Ectopic pregancy Gestational trophoblastic disease Demise of twin
Painfull vulvial selling
Bartholin cyst
VIN
Vulval malignancy
Cellulitis
Small for dates
Small for gestational age - Consitiuonal ▪️low maternal height and weight ▪️nulliparity ▪️Asian ethnicity ▪️female fetal gender IUGR ▪️pre- exisiting maternal disease e.g autoimmune and renal disease ▪️maternal pregnancy complications such as pre-eclampsia ▪️️multiple pregnancy ▪️smoking and drug use ▪️️congenital infection e.g. CMV ▪chromosnal abnormalities
Antepartum haemorrhage
Undetermined origin Placental abruption Placenta praevia Incidental genital tract pathology Uterine rupture Vasa praevia
Abdominal pain in pregnancy
Obstetric cause ▪️labour pain - premature or at term ▪️️pre- eclampsia/ HELP syndrome - RUQ ▪️placental abruption ▪️uterine rupture ▪️chorioamniotis ▪️acute fatty liver of pregancy ▪️️acute polyhydraminios ▪️severe uterine torsion acute appendicitis cholecystitis and gallstones Urinary tract obstruction Pyelonephritis Comstipation DKA Gastroenteritis IBS Musculoskeletal cause ▪️round ligament pain ▪️rectus muscle heamatoma ▪️symphysis pubis dihisence
Post partum bleeding
Atonic uterus Thrombophllias Retained products of conception Trauma ️Chorioamniotis
Pyrexia in pregnancy
Urinary tract infection ️gential tract infections Mastitis Sepsis DVT
