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3rd year > Repro - other + breast pathology > Flashcards

Repro - other + breast pathology Flashcards

1
Q

what is the definition of rape

A

Penetration of the vagina, anus or mouth by the penis without consent

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2
Q

when is consent invalid

A

incarcerated
incapacitated by alcohol/drugs
under violence/threat of violence

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3
Q

what is the management of rape

A 
consider forensic exam
consider PEPSE
STI/pregnancy screening 
PSTD treatment 
practical and psychosocial support
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4
Q

how much folic acid should be taken if you have epilepsy

A

5mg daily

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5
Q

what is the main foetal side effect of epileptic drugs

A

congenital malformations: cranial tube defects

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6
Q

what medication is safe for diabetes in pregnancy? what is not?

A

insulin = safe

sulfonylureas = not safe

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7
Q

what is the 1st line treatment for hypertension in pregnancy

what is the 2nd line

A

1st line = labetalol

2nd line = methyldopa

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8
Q

what medication should be avoided in hypertension during pregnancy? why?

A

ACEI/ARBs = renal issues

Beta blockers = restrict growth

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9
Q

can antidepressants be used in 1st trimester

A

yes; generally no major side effects

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10
Q

what antidepressants should you avoid in 1st trimester

A

parotextinte = heart defects

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11
Q

can antidepressants be used in 3r trimester

A

yes but risk of neonatal withdrawal

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12
Q

what antidepressants should you recommend in 3rd trimester

A

non- SSRI = imipramine

if SSRI = sertraline, fluoxetine

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13
Q

can antidepressants be used while breastfeeding

A

yes, all in breast milk but cause no side effects

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14
Q

what antidepressants should you avoid while breastfeeding

A

citalopram

doxepin

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15
Q

what antidepressants should you recommend while breastfeeding

A

sertraline
fluoxetine
imipramine

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16
Q

can benzodiazepines be used while pregnant? why?

A

NO: risk of foetal malformation, risk of floppy baby syndrome

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17
Q

can benzodiazepines be used while breast feeding? why?

A

avoid regular use; risks of lethargy, weight loss, accumulation of drug

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18
Q

can lithium be used while breastfeeding

A

NO; high concentration in milk

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19
Q

can lithium be used during 1st trimester

A

NO; risk of foetal abnormality

only continue if risk out weighs benefit

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20
Q

can lithium be used during 3rd trimester

A

can be reintroduced with serum levels monitored

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21
Q

can sodium valproate be used during pregnancy? why?

A

NO; neural tube defect

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22
Q

can sodium valproate be used while breastfeeding

A

low risk

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23
Q

can clozapine be used during pregnancy? why?

A

NO; risk of agranulocytosis

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24
Q

can clozapine be used while breastfeeding? why?

A

NO; risk of agranulocytosis

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25
Q

what is the side effect of tetracycline during pregnancy

A

stains bones and teeth

don’t prescribe to under 12s

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26
Q

what is the side effect of phenytoin during pregnancy

A

clef lip and palate

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27
Q

what is the side effect of diesthylstibestrol during pregnancy

A

vaginal adenocarcinoma or urological malignancy in boys

28
Q

what is the side effect of alcohol during pregnancy

A

alcohol foetal syndrome

29
Q

what is done at a woman first antenatal appointment

A 
BP
BMI
mental health 
bloods glucose 
bloods - HIV, Hep, syphilis
anaemia - iron/folate/B12
antibodies - chicken box
blood group + Rh status
30
Q

what is determined at the 12 week scan

A

number of babies
estimated delivery date
viability - ectopic/molar/structural abnormalities etc

31
Q

what is determined at the 20 week scan

A

gender
genetic testing
foetal anomaly

32
Q

when is amniocentesis performed

A

between 15-20 weeks

33
Q

when is chorionic villus sampling performed

A

between 11-14 weeks

34
Q

what is the screening tests for downs syndrome? when can they be done?

A 
nuchal thickness = 11-13 wks
blood sample = 15-20 wks
HCG = 2nd trimester
AFP = 2nd trimester 
biochemical markers = any stage
amniocentesis 
chorionic villus sampling
35
Q

what are the biochemical markers for downs syndrome

A

Alpha-fetoprotein (AFP)
human Chorionic Gonadotrophin (hCG)
unconjugated oestradiol (UE3)
inhibin A

36
Q

what is clause C in the abortion act? what is the limit?

A

continuing the pregnancy would risk physical or mental health to women more than the risk of continuing the pregnancy would

limit = 24 wks

37
Q

what is clause E in the abortion act? what is the limit?

A

risk that child would be born seriously handicapped

no limit

38
Q

what are the two emergency clauses in the abortion act? how do they differ from the rest

A

F&G

only required one dr to sign

39
Q

when does conscientious objection not apply to abortion

A

emergency/life-threatening situation
can’t delay/prevent access to care
doesn’t apply to ‘indirect’ tasks e.g. administrative etc

40
Q

what are the 2 types of abortion

A

medical

surgical

41
Q

what happens in a medical abortion

A

Mifepristone is given then  Misoprostol 24-48hrs later

<10 weeks = self-administer
>10weeks = inpatient

42
Q

are the types of surgical abortion? when can they take place?

A

manual vacuum = up to 10 wks
electric vacuum <14 wks
dilatation and evacuation >14wks

43
Q

what must happen prior to a surgical abortion

A

cervical priming via misoprostle or osmotic dilators

44
Q

what is required after a surgical abortion

A

VTE high risk = LMWH
antibiotic if risk of STI
anti-D Ig

45
Q

what prophylaxis antibiotics are given after abortion

A

7 days doxycycline or azithromycin

46
Q

how often should women have cervical screening

A 
25-49 = every 3 years 
50-64 = every 5 years
47
Q

what is gynaecomastia

A

breast development in men

it is ductal growth with our lobular development

48
Q

what causes gynaecomastia

A

hormones
cannabis
prescription drugs
liver disease

49
Q

what are the symptoms of fibrocystic change

A

smooth discrete lumps
sudden/cyclical pain
menstrual abnormalities

50
Q

what is the pathology of fibrocystic change

A

cysts with intervening fibrosis

51
Q

what is a hamartoma

A

Circumscribed lesion composed of cell types normal to the breast but present in an abnormal proportion or distribution

52
Q

what are the symptoms of fibroadenoma

A

painless, firm, discrete mobile mass

solid on ultrasound

53
Q

what is a fibroadenoma made of

A

epithelium + stroma

54
Q

what are sclerosing lesions

A

benign, disorderly proliferation of acini and stroma

55
Q

what is a radial scar

A

type of sclerosing lesion

56
Q

what can be seen on mammogram of a radial scar

A

stellate architecture
central puckering
radiating fibrosis

57
Q

what is the treatment of radial scar

A

excise as it may become invasive

58
Q

what is the cause of fat necrosis

A

local trauma

warfarin therapy

59
Q

what is duct ectasia

A

milk duct widens and fills with milk

60
Q

what is duct ectasia associated with

A

smoking

61
Q

what are the symptoms of duct ectasia

A 
pain 
acute episodic inflammatory changes 
bloody/purulent discharge
fistulation 
nipple distortion
62
Q

what is the treatment of duct ectasia

A

treat acute infections
stop smoking
excise ducts

63
Q

what is the cause of duct ectasia

A

mixed organisms, anaerobes

64
Q

what is the cause of acute mastitis/abscess

A

if lactating usually staph aureus or step pyogenes

65
Q

what is the treatment of mastitis/abscess

A

antibiotics

drainage = surgical or percutaneous

3rd year (12 decks)

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