pastest Flashcards
atrophic vaginitis
oestrogen deficiency causes this
bladder and urethral atrophy = dysuria, urinary frequency, increased susceptibility to urinary infection
Uterus reaches umbilical by?
week 20
PPH
management?
Uterine massage and oxytocin infusion
large bore cannulae
send bloods for urgent tests
IV fluids
1)massage, oxytocin Infusion
2)more oxytocin/ergometrine/carboprost
3)intrauterine balloon / surgical intervention
High BP and uterine atony what can you not do?
ergometrine infusion
- vasoconstricts and increases bp more
contrainidcated in women w htn
vulvodynia?
unexplained pain
chronic
lichen sclerosis
symptoms
itching
burning
associated
PCOS and diabetes
all women screened
impaired glucose tolerance is defined as a fasting <7.00 with a two hour ogtt >7.8 but less than 11.1
impaired glucose tolerance
Fasting <7.00
with a two hour OGTT >7.8 but less than 11.1
Molar pregnancy
HTN
excessive stimulation of ovarian follicles with hCG = simultaneous growth, enlargement and luteinisation of multiple ovarian follicles
Luteoma of pregnancy?
benign solid ovarian tumour
hirsutism and virilisation
prolapse staging
4- maximum descent
3-protrusion of cervix and uterus outside of vagina
2-descent of cervix to level of introitus
1- no prolapse (failure of cervix to reach interoitus
what is meningomyelocele
NTD associated with valproic acid
should nipple shields be used?
no can worsen symptoms and exacerbate incorrect positioning
Patient with 3cm fibroids, dysmenorrhoea and menorrhagia
PMH: UC
how to manage?
medically with mefenamic acid/ tranexamic acid
surgically you can do myomectomy but only if indicated with size, not responsive to medication
uterien artery embolization if they don’t want surgergy
ulipristal can have restricted use
women with no identified pathology, fibroid 2.5cm and menstrual paina nd hevay bleeding what is first line?
LNG_IUS
2) tranexamix acid, mefanamic acid , hormonal treatment
when should specialist care be taken in menorrhagia?
fibroid >3cm
Infertility initial ix?
women
men
mid luteal phase progesterone
serum gonadotrophins
TFTs
prolactin
screen for chlamydia
semen analysis
screen for chlamydia
mx of infertility?
medical - clomifene
surgical - laproscopy for ablation of endometriosis and surgical correction for epidydmal blockage for obstructive azoospermia
assisted reproduction: intrauterine insemination, IVF, intracytoplasmic sperm injection
what is the earliest diagnostic test for Down’s?
CVS
11 weeks
what would TVuss show for endometriosis?
ovarian endometriomas / involvement of structure such as the uterosacral ligament
hydatidiform mole is a tumour of?
how many types?
trophoblastic villi
2 types
partial, complete
partial is worse
can become invasive and then become a choriocarcinoma
what risks are associated with having diabetes and being pregnant
for foetus?
increased miscarriage rate, congenital birth defect, macrosomia, birth injuries, higher perinatal mortality risks
first line meds for UTI in pregnancy?
nitrofurantoin (but avoided near term)
cefalexin
what UTI med is not given in first term pregnancy UTI?
trimethoprim
gestational diabetes risk in second pregnancy?
early OGTT and then again at 24-28 week
Gestational diabetes lab
It is diagnosed with fasting plasma glucose > 5.6 mmol/l or 2-hour plasma glucose > 7.8 mmol/l after OGTT
how to differentiate fungal infection of nipple and thrush and bacterial infection?
Fungal: Bilateral, white patch on baby’s mouth
> oral thrush
topical miconazole 2% cream applied to the affected nipples
infant treated with?
nystatin oral suspension
Gestational diabetes
how is mother followed up after birth?
GP performs fasting plasma glucose at 6-13 weeks
results of fasting glucose
<6mmol/l low probability of diabetes
6.0-6.9- high risk
> 7mmol/l likely to have diabetes
PCOS treatment for hirsutism and androgenic effects
Co-cyprindiol
marketted as dianette
cryoprotenone acetate acts as an anti androgen
how to investigate Prolactinoma in the first instant
exclusion of hypothyroidism
chronic renal failure
and pregnancy
1- TFTs
First stage of labour
cervical dilation arte?
1 cm per hour
1.5-2cm per hour
PCOS mx - hirsutism
oral combined pill
low birth weight infants - feeding WHO recommends?
exclusively breastfed for 6 months
should commence as soon as possible
donor human milk can be used
<1500 then daily vit d, calcium, phosphorus
Rotterdam criteria for PCOS
oligo
menstrual irregulariy
hyperandrogenism
polycystic ovaries on USS
12 follicles in 1 2-9mm
7 in the other
eleavted testosterne and Lh:FSH
miscarriage recurrence risk
1 miscarriage : 85%
2: 75%
3: 60
