REPRO 4 Flashcards

1
Q

menopause should happen when
early
late
premature and causes

A

51
45
54
40 genetics, radio/chemo, cancer

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2
Q

some symptoms of menopause

A

hot flushes and night sweats, mood changes, palpitations, insomnia, anxiety, difficulty concentrating, forgetfulness, decreased libido, dry vagina, atrophy of breasts and genitals, incontinance, UTIs, headaches, joint aches

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3
Q

ix for menopause

A

can check LH/FSH level which will be high but not done regularly as can be high in depo, breastfeeding, SSRIs, prior to ovulation, stopping COCP

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4
Q

complications of menopause

A

osteoporosis, increased risk of ischaemic heart disease

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5
Q

contraception till how long after last period if aged over 50 and if under

A

> 50 12mmonths

<50 24 months

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6
Q

PMB - when does it need to be investigation

A

after a year

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7
Q

contraindications for HRT

A

past or current angina, MI, PE etc

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8
Q

non HRT treatment - lifestyle - for menopause

A

diet, decrease weight, exercise, lifestyle, caffeine

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9
Q

mennorhagia

A

MFA, TXR, preg, IUS, endom ablation, hysterectomy

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10
Q

non HRT for vasomotor symptoms 5

A
fluoxetine 20mg OD
citalopram 20mg OD
velefaxine 37.5mg BD
clonidine - lots of SE
vaginal dryness - lubricant/moisturiser
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11
Q

HRT for vasomotor symptoms

A

oral or transdermal combined

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12
Q

HRT for no uterus

A

oral or transfermal oestrogen only

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13
Q

premenopausal

A

steroid and HRT or COC

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14
Q

HRT for mood

A

oraltrandmeral

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15
Q

urogenital atrophy

A

topical oestrogen

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16
Q

vaginal dryness

A

moisturise, lubricant, topical oestrgent

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17
Q

sexual dysf

A

testosterone - off licence

18
Q

benefits of HRT

A

decreased risk of fragility fracture, decreased risk of bowel cancer, muscle strength and mass

19
Q

risks of HRT

A

VTE oral >trandermal
increased risk in breast cancer
CHD and stroke in oestrogen and progesterone combined

20
Q

prolapse risk factors

A

increased age, obesity, increased number of vaginal deliveries, increased abdominal pressure

21
Q

anterior aka

what is it

A

cystocele

bladder drops into anterior vagina

22
Q

middle aka

A

apical/enterocele

herniation of pouch of douglas into vagina

23
Q

posterior aka

A

rectocele

prolapse of rectum into posterior vagina walls

24
Q

uterine prolapse levels

A

in vagina
at interoitus
outside vagina
procidenta

25
Q

ix for prolapse

A

abd exam

biman exam - cough, speculum

26
Q

POPQ

A
0 no prolapse
1 >1cm above hymen -ve
2 within 1cm -ve
3 1-2cm below +ve
4 exercion
27
Q

treatment of prolapse conservative and non

A
avoid heavy lifting 
lose weight 
vaginal oestrogen - if atrophy
pessary 
-surgery
28
Q

risks of pessary

A

can fall out
bleeding
erosion -> fistula

29
Q

conception - what is started

A

FA 0.4mg daily for up to 3months into pregnancy

if BMI>30 5mg

30
Q

booking is when

what is checked

A

8-12 weeks
scan
blood group, FBC, syphilis, Hep B/C, HIV, VDRLA, haemoglobinopathies, rubella, random BG, urinalysis, BP

31
Q

anomaly scan

A

18-21w

32
Q

visits

A

monthly visits till 28 weeks
fortnightly visits till 36w
weekly visits from 36>

33
Q

growth scan when

what is checked and why

A

28 weeks
abd circumferance IUGR
femur length weight
head circumference IUGR

34
Q

anti D

A

28 and 34 weeks or all at 28w

35
Q

vaccines offered to pregnant woman

A

pertussis from 16-32w

flu every year from oct-march

36
Q

assessment of fatal growth

A

fatal growth chart

37
Q

normal metal heart baseline
variability
acceleration? decelerations?

A

120-160
>5bpm
accelerations present. no decel

38
Q

early decel happen when
part of what
why are they happening

A

same time as contraction
normal labour
head and orbital compressed during second stage

39
Q

variable decel - why variable
why
when are they pathological

A

variable in depth and timing to contraction
umbilical cord compression
pathological if deep and prolonged and other CTG features present

40
Q

late decel when
why
action

A

after contractions
fetal hypoxia, fetal distress
fetal blood sample. deliver

41
Q

biophysical USS - what is assessed and numbers

A

movement, tone, breathing , liquor vol

8-10 satisfactory, 4-6 repeat, 0-2 deliver

42
Q

umbilical artery doppler

A

20-24 weeks

screening for PET