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Obs and Gynae > Obs and Gynae > Flashcards

Obs and Gynae Flashcards

1
Q

What is the definition of antepartum haemorrhage?

A

Bleeding from anywhere in the genital tract after 24th week of pregnancy (>50ml)

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2
Q

What should you be worried about if bleeding is before 24 weeks?

A

Miscarriage

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3
Q

What are the three main causes of antepartum haemorrhage?

A
  • placenta praevia
  • placenta abruption
  • vasa praevia
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4
Q

What is the presentation of placenta praevia?

A
  • Intermittent painless bleeding

* Increasing in frequency and intensity

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5
Q

What are the risk factors for placenta praevia?

A
  • Previous placenta praevia
  • Previous c-section
  • Multiple pregnancies
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6
Q

What is placenta praevia?

A

Placenta praevia is where the placenta is attached in the lower portion of the uterus, lower than the presenting part of the fetus.

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7
Q

What are the investigations for placenta praevia?

A

•Monitoring using TVUS

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8
Q

What is the management for placenta praevia?

A
  • Elective c-section 36-37 weeks if asymptomatic + antenatal steroids
  • If bleeding:
  • > 37 weeks C-section
  • <37 weeks – if haemodynamically unstable deliver. If stable bed rest, antenatal steroids, plan for ELCS
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9
Q

What is placenta abruption?

A

Placental abruption refers to when the placenta separates from the wall of the uterus during pregnancy. The site of attachment can bleed extensively after the placenta separates.

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10
Q

What are the risk factors for placenta abruption?

A
  • IUGR
  • Pre-eclampsia
  • AI disease
  • Smoking and cocaine use
  • History of placental abruption
  • Multiple pregnancy
  • Multiparity
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11
Q

What is the presentation of placenta abruption?

A
  • Painful antepartum or peripartum bleeding
  • “Woody” (tense all of the time) uterus
  • Fetal death common
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12
Q

What is the management of placenta abruption?

A
  • Fetal distress – category 1 (emergency) section
  • <36 weeks and no fetal distress: observe, steroids, plan delivery
  • > 36 weeks and no fetal distress: delivery vaginally
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13
Q

What is vasa praevia?

A

Vasa praevia is a condition where the fetal vessels are within the fetal membranes (chorioamniotic membranes) and travel across the internal cervical os.

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14
Q

What is the presentation of vasa praevia?

A
  • Painless bleeding from when membranes rupture
  • Fetal distress on CTG
  • High risk of fetal haemorrhage
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15
Q

What is the management of vasa praevia?

A

Emergency C-section

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16
Q

What is primary amenorrhea?

A

Not menstruated by age of 16 with normal growth and secondary sex characteristics or by the age of 14 with abnormal growth and lack of secondary sex characteristics

17
Q

What is the level of FSH/LH in hypogonadotropic hypogonadism?

A

Low

18
Q

Name 5 causes of hypogonadotropic hypogonadism.

A
  • Pituitary gland damage
  • Hypothalamic issues
  • Kallmann’s syndrome (condition characterized by delayed or absent puberty and an impaired sense of smell)
  • Hyperprolactinaemia
  • Hypo/hyperthyroidism
19
Q

What is the level of FSH/LH in hypergonadotropic hypogonadism?

A

High

20
Q

Name 3 causes of hypergonadotropic hypogonadism.

A
  • Swyer syndrome (46XY)
  • Turner’s syndrome (46XO)
  • Premature ovarian failure (46XX)
21
Q

What is the classic presentation of outflow tract obstruction?

A

A patient who has developed secondary sexual characteristics and is experiencing cyclical abdominal pain but no bleeding. Patient may also have bloating due to the build up of menstrual blood in the vagina (haematocolpus)

22
Q

What is androgen insensitivity syndrome?

A

Androgen insensitivity syndrome is a condition where cells are unable to respond to testosterone due to a lack of testosterone receptors.

23
Q

What is the genetic heritability of androgen insensitivity syndrome?

A

X-linked recessive

24
Q

How would androgen insensitivity syndrome present?

A
  • Genetically male (46XY), phenotypically female
  • Breast development due to increased oestrogen
  • Palpable abdominal hernias - undescended testes
  • amenorhhea
25
Q

What is mullerian agenesis (46XX)?

A

Failure of the development of the Mullerian Duct as an embryo causing missing uterus and a variable degree of vaginal hypoplasia

26
Q

What is secondary amenorrhoea?

A

Cessation of menstruation for 3–6months in women with previously normal and regular periods, or for6–12months in women with previously irregular periods

27
Q

Name 10 causes of secondary amenorrhea.

A
  • Pregnancy!!
  • Breastfeeding
  • Contraceptives
  • Hypothalamic (anorexia, athleticism)
  • PCOS
  • Outflow Tract Obstruction
  • Premature Ovarian Failure
  • Prolactinoma
  • Cushing’s Syndrome
  • Thyroid Disease
28
Q

What is the presentation of polycystic ovary syndrome?

A
  • Amenorrhoea or irregular menstrual bleeding
  • Acne
  • Excess body/facial hair
  • Infertility

Obs and Gynae (2 decks)

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