Obs and Gynae 2

Question 1

What are majority cases you treat in the EPAU?

Answer 1

Miscarriage, ectopic pregnancy, hyperemesis

Question 2

What are the most common presentations in EPAU?

Answer 2

Pain

Bleedign

Both

Nausea and vomitting

Others (infection, abnormal discharge, etc)

Question 3

When doing a clinical history what are the main things you need to cover in EPAU

Answer 3

1. Make a good impression
2. Presennt compliant
   - pain: SOCRATES
   - bleeding: amount, colour, clots, products
3. LMP/Pregnancy test
4. Previous Obstertic Hx (parity/miscarriage/Csection)
5. Previous Gynae Hx (lenght of cycle/periods/STI/Smears)
6. PMHX/SUrgical
7. ALlergies
8. SMoking/drinking
9. Expectations

Question 4

CLincial examination that should be done in EPAU?

Answer 4

Basics

Obs

pregnancy test

Hemocue

Abdo exam

explore 4 quadrants

is there guarding, pain on palpation. tenderness/ masses

Speculum

Bimanual

Question 5

Management fo rectopic pregnancy?

Answer 5

Medical

Methrotrexate provifed the patient is stable, small, no free fluid on US, Bhsc

Surgical

Salpongectomy

Question 6

Management for miscarriage?

Answer 6

Missed miscarriage: Conservative/Medical (misoprostol)/Surgical approach

Incomplete Miscarriage: As per above

Inevitable Miscarriage: aim to maintain patirnt stbale/monitor the bleedinf. If active bleedign or bleeding do not settle, she would need surgical management

Question 7

What are the common presentations fo gynae emergency department (GED)

Answer 7

Early pregancny

bleeding

oain

vomitting

Non-pregnant

Pelvic pain

acute bleeding

vulval paim

symptomatic oncolcgy patietns

post-op complication

vaginal foreign body

etc