Obs and Gynae Flashcards
Triple assessment of the breast- what does it involve?
Examination
US
Tissue sampling
- FNA if soft
- core biopsy if hard
What does peas d’orange skin look like?
What is it a sign of?
Skin looks pitted like an orange- dimpling of the skin.
Associated with inflammatory breast cancer
What does Paget’s disease look like?
Eczema like changes round the breast starting in the nipple- can spread to the areola
What might cause nipple inversion?
- mammary duct ectasia
- mastitis
- breast abscess
- breast cancer
What is a FIBROADENOMA
Circumscribed mobile nodule in reproductive age
- non painful
- can be excised but can also be left untreated
What is mammary duct ectasia?
Dilation of the mammary ducts.
Usually presents around menopause.
Tender lump around the areola +/- green nipple discharge.
If it ruptures can lead to inflammation/ mastitis
Which are the most common types of breast cancer?
Invasive Ductal
Then Lobular
What further tests might you consider in someone who has a spread of breast cancer?
Sentinel node biopsy
How long is each large square on a CTG?
1 minute
How many minutes do you want to count contractions over?
10 minutes so 10 large squares
What should Fetal HB be on a CTG
<160 >110
What are accelerations on a CTG?
Increase of more than 15hb for 0.15s in a fetal HB.
Should occur at same time of contractions
What is a deceleration?
A decrease in FHB of more than 15bpm for more than 0.15s. It is the result of the foetus trying to preserve myocardial oxygenation
Types of decelerations
Early: start when the uterine contractions start- normal
Variable: rapid fall in baseline with variable recovery. May or may not be related to uterine contractions
Late: start at the peak of the uterine contraction
Prolonged: last more than 2 minutes.
- 2-3 mins: non-reassuring
-> 3 mins: abnormal
What causes a variable deceleration?
Usually umbilical cord compression.
Can be corrected by adjusting the position of the mother
What causes a late deceleration?
Maternal hypotension
Pre-eclampsia
Uterine hyperstimulation
Risk with COCP
small risk of blood clots
very small risk of heart attacks and strokes
increased risk of breast cancer and cervical cancer
Risks with POP/ implant
Bleeding
Risks with injection
Weight gain
Bleeding
Osteoporosis
Late return to fertility
Mirena
Periods heaviet
Risk of expulsion
Risk of infection
HRT complications
Breast cancer
Endometrial cancer
VTE - not with transdermal
Stroke
What are some of the common LOCAL causes of menorrhagia
Uterine fibroids
Endometriosis
Cervical or endometrial polyps
Adenomyosis
Pelvic inflammatory disease (PID)
Endometritis
Endometrial hyperplasia or carcinoma
What are some of the SYSTEMIC causes of menorrhagia?
Hypothyroidism
Bleeding disorders
IUD
