Obstetrics and gynaecology Flashcards
suspicious or confirmed preeclampsia bloods
FBC, U+E, LFT and coag screen for baseline in case HELLP
stress incont
duloxetine
urge incont
oxybutynin
routine smear recall
3 years for 25-49 years old and 5 years for 50-64 years old
uti when preg
Nitro for 7 days even if no symptoms
other cause of high ca125
endometriosis
PPH
syntocinon then ergometrine
blood stained nipple discharge young
intraductal papilloma
green nipple discharge and lump and nipple retraction
duct ectasia
drug post or pre meno ER pos
Tamoxifen for ER+ pre or peri menopause and anastrazole if post menopause
pregnancy drug that can’t be given
statin
PE in pregnancy
LMWH
stages of labour
1st: 4-10cm usually (1-3cm per h)
2nd: 10cm-delivery (up to 2h in prim)
4rd: placental
physiological changes in labour
-increase oestrogen
-decreased diastolic BP
-increased CO
-RAAS so total blood volume increase
-tidal volume and minute ventilation increases
-resp alkalosis
-thromboembolic risk increases
-dilutional anaemia
rod concetraception cover
days 1-5 fine
otherwise 7 day condoms
contraindications to COCP
BP over 140/90
smoke >15 day
migraine aura
breast cancer
levonelle
within 3 days
can start pill asap
ella one
within 5 days
can’t be given if contraception taken within 7 days
emergency IUD
up to 5 days after sex or 5 days within date of ovulation
TOP law
up to 24w for any reason then after 24w for risk to mothers life or foetal abnormalities
medical TOP
(((oral mifepristone))) then PV misoprostol
HBsAg
active or chronic infection
HBeAg
high infectivity
HBcAb
past or current infection, IgM 2-6m IgG is chronic
HBsAb
vaccination or past infection
HBV DNA
viral load count
cervical screening
25-64 years HPV every 5 or every 1 if pos but cytology good
Klienfelter’s syndrome
high FSH and LH but low testosterone = hypergonadotrophic hypogonadism
over 30 new lump could be fibroadenoma
urgent because over 30
contraception causing weight gain
depo
wheelchair user wants contraception
no COCP due to risk of clots
Bishop score < or equal to 6
labour is unlikely to start without induction so give vaginal prostaglandin/oral misoprostol
Bishop score > 6 but less than 8
amniotomy and IV oxytocin
how to confirm ovulation
take serum progesterone level 7 days before next expected period (day 21 if typical cycle)
LGV stages
primary: painless ulcer
secondary: lymphadenitis
tertiary: proctitis and proctocolitis
test for deafness in baby with mother who is deaf
routine neonatal screening plus brainstem evoked response test
management of PPH
1- rub uterus and catheterise
2- oxytocin, ergometrine, carboprost, miso then TXA
3- intrauterine balloon tamponade, artery ligation etc
first line for induction of labour
vaginal prostaglandins
second line oxytocin infusion
breast screening
50-70 every 3y mammogram
imaging breast different ages
mammogram over 35y, US younger
vaccinations in pregnancy
pertussis and influenza
placenta praevia investigation
TVUS
regular test Down’s syndrome
-11-13+6 weeks
-nuchal translucency and serum bhcg and pregnancy-associated plasma protein A
-high HCG, low PAPP-A and thickened nuchal translucency
woman books later Down’s syndrome test
-quadruple test between 15 and 20 weeks
-AFP, unconjugated oestriol, HCG and inhibin A
-low AFP, low oestriol, high BHCG and high inhibin A
if higher chance from Down’s screening what next
NIPT or CVS/amniocentesis
PROM reducing RDS
dexamethasone
IUS effective for how long
5 years
gestational diabetes fasting glucose >=7
insulin immediately
(under 7 do lifestyle measures and then metformin if not better in 1-2 weeks)
emergency contraception
-levonelle 72 hours (stop ovulation and inhibit implant)
-ellaone 120 hours (inhibits ovulation)
-copper IUD 5 days
pill cancer risks
increases risk of breast and cervical
protective against ovarian and endometrial
women at risk of preeclampsia management
aspirin from 12 weeks until birth
