Obs+Gynae Flashcards
How is cervical carcinoma staged?
Examination under anaesthetic Vaginal and rectal examination Cystoscopy Proctoscopy Possibly MRI
How is cervical carcinoma diagnosed?
Biopsy
What is occult cervical carcinoma?
Diagnosis made on biopsy or LLETZ
What is clinical cervical carcinoma?
Postcoital bleeding
Intermenstrual bleeding
Offensive discharge
Post menopausal bleeding
Late stages: uraemia, haematuria, rectal bleeding, pain
Smears often missed
What are the stages of cervical carcinoma?
1: restricted to cervix
2: invasion into vagina but not pelvic side wall
3: invasion of lower vagina or pelvic wall -> ureteric obstruction
4: invasion of bladder or rectal mucosa, or beyond true pelvis
What are the risk factors for ectopic pregnancy?
Smoking Prev PID/chlamydia Hx infertility IVF Prev tubal surgery/ectopic IUD/POP
What are the management options for ectopic pregnancy?
Surgical: salpingectomy, salpingotomy
Medical: IM methotrexate with regular HCG follow up
Expectant: wait and see, if HCG decreasing spontaneously at 48 hrs
What are the requirements for methotrexate treatment of ectopic pregnancy?
Normal FBC, U+Es, LFTs
Compliance with follow up
Avoiding conception for 3 months following treatment due to teratogenic effects
SE: abdo pain, nausea, diarrhoea, rarely conjunctivitis/ stomatitis
What are risk factors for SUFE: slipped upper femoral epiphysis?
Obesity
Male
How might a SUFE present?
Limp
Groin + thigh pain (referred knee pain, hip pain)
Leg flexed and externally rotated on lying
No Hx trauma
Restriction of int rotation, abduction and flexion
What investigation is required to confirm diagnosis of SUFE?
Radiographs of the hip joint
AP view
Lateral (frog leg view) to avoid missing minor slips
How would you manage a child with SUFE?
Admit, no weight bearing
Urgent orthopaedic referral
Acute or chronic slip can lead to avascular necrosis
Pin femoral head to femoral neck
