Random Flashcards
How to manage lost coil
Pregnancy Test
Coil retriever
pelvic USS
If not visible abdo XR
Abortion act clause A
Continuation of pregnancy involve greater risk of life to the pregnant person versus termination
Abortion act clause B
Termination necessary to prevent permanent injury to physical/mental health of women the pregnant woman
Abortion act clause C
< 24 weeks continuing pregnancy greater risk to pregnant woman than continuing to physical/mental health
Abotion act clause D
< 24 weeks and continuing pregnancy greater risk than termination to physical mental well-being of other existing children
Abortion clause E
substantial risk if child born would suffer physical or mental abnormality that would be significantly handicapped
Abortion clause F
Emergency to save women life
Abolition clause G
Emergency to prevent grave and permenent injury physical or mental to pregnant woman
Swab for chlamydia
Vulvo-vaginal and NAAT
What proportion of women will clear chalymdia without treatment in 12 months?
50%
Rates of chlamydia in sexual partner
75%
Treatment for chlamydia non pregnancy
1st: Doxycycline 100mg BD 7 days (contraindicated in pregnancy)
2nd Azithromycin 1 g, 500mg PO OD for 2 dats
3rd Erythromycin 500mg BD 10-14D, Ofloxacin 200mg BD 7D/400mg OD 7D
Ofloxacin (CI pregnancy, children, growing adolescent)
Chlamydia in pregnancy
Azithromycin 1g, then 500mg PO OD 2D
Erythromycin 500mg QDS 7D, 500mg BD 14D
Amoxcillin 500mg TDS 7D
Best swab to detect gonorrhoea
Vulvo-vaginal swab + NAAT
> 95% sensitive
Treatment for gonorrhoea
IV 1g ceftriazone - single dose
(high levels ciprofloxacin resistance)
Best swab for BV?
High vaginal swab and microscopy
Summary findings for BV
Thin discharge. Offensive or fishy odour
No itch
Discharge coating vagina and vestibule
No vulval inflammation,
Vaginal pH ≥4.5
High vaginal swab (from lateral vaginal walls – diagnosis made using Amsel’s criteria (3/4 present): White discharge, pH>4.5, Fishy odour (with addition of 10% KOH to discharge), Clue cells (vaginal epithelial cells surrounded by bacteria)
Treatment for BV
Metronidazole 400mg BD 5-7 days
Metronidazole 2g single dose
Intravaginal metrionidazole gel 0.75% OD for 5 days
Intravaginal clindamycin cream 2% OD for 7 days
Treatment for BV in pregnancy
Same as non pregnant except cannot give high 2g PO regieme
Offer resetting after 1 month if still symptomatic
Best swab for trichomoniasis?
High vaginal swab + NAAT
Summary findings trichomoniasis
Anaerobic, flagellated protozoan parasite, causes trichomoniasis
Commonest pathogenic protozoan infection of humans in industrialized countries
Infection rates similar in men and women but women more symptomatic
Transmission typically through vaginal intercourse
Causes frothy, greenish vaginal discharge with a musty malodorous smell
Only 2% of infected women have a “strawberry” cervix (an erythematous cervix with pinpoint areas of exudation) or vagina on examination
May cause urethritis and prostatitis in males
Diagnosis made on cervical smear, infected women have a transparent “halo” around their superficial cell nucleus however this has low sensitivity
T. vaginalis was traditionally diagnosed via a wet mount, in which “corkscrew” motility was observed
Currently, the most common method of diagnosis is via overnight culture
Treated with metronidazole or tinidazole with contact tracing
Treatment trichomoniasis
Metronidazole 400-500mg 5-7 days (can give in pregnancy)
Metronidazole 2g single dose or tinidazile 2g PO single dose (do not give in pregnancy)
Treat current partner(s) simultaneously or any partner from 4 weeks previous
Sexual abstinence for 1 week after treatment
Best swab for candiaida?
High vaginal swab + culture
Summary for findings candida
Thick white discharge
Non-offensive
Vulval itch or soreness
Superficial dyspareunia
External dysuria
Normal findings or Vulval erythema, oedema, fissuring, satellite lesions
Vaginal pH <4.5
Best swab for genital herpes?
Vulvo-vaginal swab and NAAT
Which bacteria causes donovanosis? How does it present?
Klebsiella granulomatsis - a firm papule that later ulcerates, 90% genital
‘Donovan bodies’ Gram -ve
When to stop contraception with Lap Sterilisation?
POP implant/injection - stop at time
CHC, POP, non hormona, coils - stop after 7 days
If CHC, HFI or Day 1, omit HFI and take further 7D
If coil in pregnancy and threads visible
Remove coil asap
When does the HFI start for COCP/patch/ring
COCP - 24 hours after last tablet
Patch/ring - as soon as removed
Shortest time between fertilisation and implantation?
6 days
Max time
1) Referral to aborition provider
2) Abortion service must offer review within
3) Abortion must offer service within how long from decision
4) Max time seeing abortion provider and procedure
1) 2 days
2) 5 days
3) 5 days
4) 10 days
