Obs & Gynae Flashcards
What infections commonly cause congenital abnormalities?
TORCHH Toxoplasmosis Other - syphilis, varicella zoster, parvovirus Rubella CMV Herpes simplex virus HIV
Clinical manifestations of neonatal infection?
SHMOC Seizures Hydrops fetalis Microcephaly Organomegaly Cataracts
Congenital toxoplasmosis manifestations?
Triad:
- Intracranial calcification
- Hydrocephalus
- Chorioretinitis
Neonatal complications of maternal gestational diabetes?
"Fat SweetHeart with Cancer" Macrosomy Neonatal hypoglycaemia Hypertrophic obstructive cardiomyopathy Polycythaemia
What is haemolytic disease of the foetus or newborn?
HDFN - Placental transmission of IgG from mother starts destroying RBCs in foetus/newborn, neonates can present with jaundice, and other complications
Test for HDFN?
Indirect and direct Coombs test
Biochemistry for jaundice
Greatest risk for teratogenic effects to foetus/embryo?
Weeks 2-8 (first trimester)
Drug treatment options for heavy menstrual bleeding?
Tranexamic acid (antifibrinolytic) Mefenamic acid (NSAID) COCP Oral Progesterones (NO use in regular menorrhagia)
Definitive treatment for HMB?
Levonorgestrel IUS
Mirena
Medical management for termination of pregnancy?
Mifepristine
Misopristol
High pulse rate for 0-2yrs?
> 200bpm
High RR for children?
Infant >60
Toddler >40
School age >30
Hypotension in children?
SYSTOLIC:
Neonates < 60 (0-28days)
Infants < 70
Upto 10yrs < 70 + (age yrs x 2)
Lab tests dos and don’ts for HMB?
DO: FBC Coag screen (if HMB since menarche, or FHx of coag disorder) DON'T: Ferritin levels Hormone levels
Indications of HMB for physical examination and USS?
Intermenstrual bleeding
Post-coital bleeding
Pelvic pain
Pressure pain
Indication in HMB of pharmaceutical treatment?
- HMB with no structural/histological abnormalities
2. Fibroids < 3cm diameter
Treatment for fibroids?
- Ulipristal acetate
2. Gonadotrophin-releasing hormone analogue
prior to surgery for fibroids, or if surgery is contraind.
Diagnosis of premature ovarian failure?
< 40 yrs
Menopausal symptoms (oligo/amenorrhoea)
Elevated FSH levels twice (4-6 weeks apart)
Perimenopause?
> 45 yrs
Vasomotor symptoms (hot flushes, sweats)
Irregular periods
Menopause?
> 45 yrs
12 month amenorrhoea
FSH not needed unless atypical presentation
When should FSH NOT be used?
Pt taking COCP, or progesterone
Pt perimenopausal as FSH levels vary
HRT complications?
VTE
Osteoporosis
(Increased muscle bulk/mass)
