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obs and gynae > obs & gynae PT > Flashcards

obs & gynae PT Flashcards

1
Q

where are LH and FSH released from?

A

ant pit

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2
Q

what are the symptoms of menopause (two categroeis..)

A

loss of oestrogen

loss of progesterone

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3
Q

how long do post menopausal women need to use contraception for?

A

12 months after the last period in women > 50 years

24 months after the last period in women < 50 years

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4
Q

how do you confirm

A

FSH - 2 measurements - 2 weeks apart - if elevated in both measurements - going through the menopause

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5
Q

treating menopause with HRT

A

without a womb - oestrogen replacement

with a womb - oestrogen + progesterone

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6
Q

what are the differentials of PMB?

A

ENDOMETRIAL CA
uterine polyps
fibroids (as always)

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7
Q

define premature menopause and early perimenopause

A

Premature menopause, also called ‘premature ovarian insufficiency’ or ‘premature ovarian failure’, is usually defined as menopause occurring before the age of 40 years.

early perimenopause (menopause between the ages of 40 and 45 years)

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8
Q

what is the management of FIGO stage 1+2 endometrial Ca (and what are the definitions of them…)

A

radial hysterectomy with bilateral salpingo-oophrectomy.

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9
Q

what are the two classifications of endometrial Ca?

A

oestrogen dependent

non-oest dependent

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10
Q

what are the causes of a discrepancy between SFH and gest age

A 
incorrect dating
incorrect measurinf
mult preg 
polyhydramnios 
gestational diabetes
masternal obesity
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11
Q

what is polyhydramnious and what are the RFs?

A

xs vol of amniotic fluid
usually increased foetal urination / decreased foetal swallowing
RFs: mult gestation / mat DM / oesoph atresia / T18 edwards/ T21 / foetal anaemia
50% idiopathic

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12
Q

how would you manage polyhydramnios

A

ID cause - OGGT / TORRCH screen / amniocentesis if considering genetic abnormalities

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13
Q

how would you manage polyhydramnios

A

ID cause - OGGT / TORRCH screen / amniocentesis if considering genetic abnormalities
**look at more

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14
Q

how is GDM defined?

A

FPG>5.6
RPG>7.8
urinary proteins??

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15
Q

what is the managment of GDM?

A
  1. FPG5.6-7 = start on lifestyle, add insulin if inadequate after 1/2wks
  2. FPG5.6-7 + Polyhydramnios etc OR FPG>7.0 - Insulin + lifestyle (add metformin if required)
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16
Q

what is the management (acronym) of active labour

A

PROGRESS

17
Q

what is the management of shoulder dystocia?

A
  1. HELP - call senior obstetrician + senior midwife
  2. stop mat pushing
  3. avoid downward traction of the foetal head
  4. mcroberts manouverue
    5 more advanced manouvers
  5. emergency category 1 C section
18
Q

what are the complications of shoulder dystocia?

  1. mat
  2. foetal
A
  1. PPH /

2. death / erb’s palsy

19
Q

which investigation NEEDS to be done in placenta praevia

A

TV-Ultrasound scan..

20
Q

what are the 6 things in a placenta praevia / accreta bundle

A 
1. consultant obstetrician planned 
2.
3.
4.
5.
6.
21
Q

what are red flag symptoms for suspected pre-eclampsi

A 
blurred vision
abdo pain
clonus
headache - severe, usually frontal
vomiting
epigastric pain / liver tenderness - HELPP syndrome
22
Q

what is the crieria for preeclampsia

A

pregannt woman with
bp>140/90
urine dip 1 or more plus of protein

23
Q

how do you manage (moderate) gestational HTN

A

criteria - 150-1
labetalol
weekly bp and urine dip
others - check

24
Q

when does the foetus have to be delivered in a pre-eclampsia pregnancy?

A

34-36 weeks

25
Q

management of eclampsia:

A 
ABCDE approach to stabilise the mother
lie mother in lt lateral posn
MgSO4 loading dose 4gIV - then contnue for 1g/hr until 24hrs after last seizure
IV labetalol
OTHERS - look for....
?deliver ASAP?
26
Q

are women with pre-eclampsia / at risk of seizures post partum?

A

yes - for 6 weeks

27
Q

causes of dysmenorrhea

A 
primary dysmenorrhea
endometrosis
pid
pelvic adhesions
Fibroids
Copper IUD
28
Q

causes of dysmenorrhea

A 
primary dysmenorrhea
endometrosis
pid
pelvic adhesions
Fibroids
Copper IUD
29
Q

having a longer period than normal is a risk factor for what common condition?

A

Endometriosis

30
Q

what is a chocolate cyst?

A

an ovarian endometrioma

31
Q

what is the management of endometriosis?

A
  1. conservative management
  2. medical
    - dysmenorrhea - low dose OCs / mirena / depo-provera
    - nsaids pain releif
    - 2nd line - GnRH agonists / danazol (dampen down sex hormones)
  3. surgical -
32
Q

screening for Post-natal depression

A

Edinburgh Postnatal Depression Scale (EPDS)

33
Q

screening for Post-natal depression

A

Edinburgh Postnatal Depression Scale (EPDS)

34
Q

name a ‘good’’ ssri for a breastfeeding mother

A

sertraline / paroxetine

35
Q

what drugs should be avoided in breastfeeding women?

A

lithium / valproate / carbemazepine / clozapine

obs and gynae (4 decks)

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