PACES - O and G Flashcards
What are the differentials for pelvic pain?
PID
Ectopic pregnancy
Endometriosis
Ovarian cyst torsion/rupture/haemorrhage
What are the features of PID?
BIlateral pelvic pain Vaginal discharge Dyspaeruniae and dysmenorrhoea Fever Post-coital or intermenstrual bleeding
What are the features of ectopic prenancy?
Recent period of amenorrhoea
Unprotected sex - 4-12 weeks gestation
Vaginal spotting
Shoulder tip pain
What are the features of Ovarian cyst torsion/rupture/haemorrhage?
Sudden unilateral pain
Fever / vomiting may occur
What are the features of endometriosis?
Cyclical pelvic pain
Dysmenorrhoea
Deep dyspaerunia
Menstrual disturbance
What are the differentials for Heavy menstrual bleeding?
Dysfunctional uterine bleeding Fibroids Endometriosis PID IUD Endometrial/cervical polyps
What are the DDx for intermenstrual bleeding?
Mid-cycle oestrogen production (around ovulation)
Endometrial/cervical polyps
Ectropion
Endometrial carcinoma (if >45yo)
What are the DDx for post-coital bleeding?
Ectropion
Cervical trauma
Cervical polyps
Cervical carcinoma
What are the DDx of post-menopausal bleeding?
Endometrial carcinoma
Atrophic vaginitis
cervical/endometrial polyps
What are the gynaecological causes of secondary ammenorrhoea?
Pregnancy
PCOS
Menopause/Premature ovarian failure
What are the differentials for subfertility?
PCOS
Fallopian tube damage
Endometriosis
What are the features of PCOS?
Acne
Hirsuitism
Obesity
Oligo/amenorrhoea
What are the features of menopause?
Hot flushes
Mood swings
Lack of Concentration
Memory problems
What are the obstetric causes of abdominal pain?
Ectopic
Miscarriage
Braxton Hicks contractions
Labour
What are the gynaecological causes of abdominal pain?
Fibroids (red degeneration) PID Ovarian cyst torsion/rupture/haemorrhage Placental abruption Pre-eclampsia Uterine rupture Chorioamnitis Fatty liver of pregnancy Symphysis pubis dysfunction
What are the DDx for early bleeding in pregnancy?
Implantation
Ectopic
Miscarriage
What are the DDx for late bleeding in pregnancy?
Labour
Placental abruption
Placenta praevia
Vasa praevia
What are the features of miscarriage?
<24 gestation
Associated with PV bleeding
May pass clots or products of conception
What are the features of Labour?
> 24 weeks gestation
Painful regular rhythmic contractions
What are the features of placental abruption?
Antepartum Haemorrhage
Continuous abdominal pain
Uterine contractions
What are the features of placenta praevia?
Painless bleeding >28 weeks
Sudden profuse intermittent PV bleeding
What are the features of vasa praevia?
Painless bleeding after rupture of membranes
Fetal bradycardia/death
