Repro - other + breast pathology Flashcards by Eilidh Edmiston

what is the definition of rape

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

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when is consent invalid

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

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what is the management of rape

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

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how much folic acid should be taken if you have epilepsy

5mg daily

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what is the main foetal side effect of epileptic drugs

congenital malformations: cranial tube defects

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

insulin = safe

sulfonylureas = not safe

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what is the 1st line treatment for hypertension in pregnancy

what is the 2nd line

1st line = labetalol

2nd line = methyldopa

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

ACEI/ARBs = renal issues

Beta blockers = restrict growth

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can antidepressants be used in 1st trimester

yes; generally no major side effects

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what antidepressants should you avoid in 1st trimester

parotextinte = heart defects

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can antidepressants be used in 3r trimester

yes but risk of neonatal withdrawal

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what antidepressants should you recommend in 3rd trimester

non- SSRI = imipramine

if SSRI = sertraline, fluoxetine

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can antidepressants be used while breastfeeding

yes, all in breast milk but cause no side effects

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what antidepressants should you avoid while breastfeeding

citalopram

doxepin

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what antidepressants should you recommend while breastfeeding

sertraline
fluoxetine
imipramine

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can benzodiazepines be used while pregnant? why?

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

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can benzodiazepines be used while breast feeding? why?

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

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can lithium be used while breastfeeding

NO; high concentration in milk

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can lithium be used during 1st trimester

NO; risk of foetal abnormality

only continue if risk out weighs benefit

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can lithium be used during 3rd trimester

can be reintroduced with serum levels monitored

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can sodium valproate be used during pregnancy? why?

NO; neural tube defect

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can sodium valproate be used while breastfeeding

low risk

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can clozapine be used during pregnancy? why?

NO; risk of agranulocytosis

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can clozapine be used while breastfeeding? why?

NO; risk of agranulocytosis

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what is the side effect of tetracycline during pregnancy

stains bones and teeth don't prescribe to under 12s

what is the side effect of phenytoin during pregnancy

clef lip and palate

what is the side effect of diesthylstibestrol during pregnancy

vaginal adenocarcinoma or urological malignancy in boys

what is the side effect of alcohol during pregnancy

alcohol foetal syndrome

what is done at a woman first antenatal appointment

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

what is determined at the 12 week scan

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

what is determined at the 20 week scan

gender genetic testing foetal anomaly

when is amniocentesis performed

between 15-20 weeks

when is chorionic villus sampling performed

between 11-14 weeks

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

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

what are the biochemical markers for downs syndrome

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

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

continuing the pregnancy would risk physical or mental health to women more than the risk of continuing the pregnancy would limit = 24 wks

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

risk that child would be born seriously handicapped no limit

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

F&G only required one dr to sign

when does conscientious objection not apply to abortion

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

what are the 2 types of abortion

medical | surgical

what happens in a medical abortion

Mifepristone is given then  Misoprostol 24-48hrs later <10 weeks = self-administer >10weeks = inpatient

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

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

what must happen prior to a surgical abortion

cervical priming via misoprostle or osmotic dilators

what is required after a surgical abortion

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

what prophylaxis antibiotics are given after abortion

7 days doxycycline or azithromycin

how often should women have cervical screening

``` 25-49 = every 3 years 50-64 = every 5 years ```

what is gynaecomastia

breast development in men it is ductal growth with our lobular development

what causes gynaecomastia

hormones cannabis prescription drugs liver disease

what are the symptoms of fibrocystic change

smooth discrete lumps sudden/cyclical pain menstrual abnormalities

what is the pathology of fibrocystic change

cysts with intervening fibrosis

what is a hamartoma

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

what are the symptoms of fibroadenoma

painless, firm, discrete mobile mass | solid on ultrasound

what is a fibroadenoma made of

epithelium + stroma

what are sclerosing lesions

benign, disorderly proliferation of acini and stroma

what is a radial scar

type of sclerosing lesion

what can be seen on mammogram of a radial scar

stellate architecture central puckering radiating fibrosis

what is the treatment of radial scar

excise as it may become invasive

what is the cause of fat necrosis

local trauma | warfarin therapy

what is duct ectasia

milk duct widens and fills with milk

what is duct ectasia associated with

smoking

what are the symptoms of duct ectasia

``` pain acute episodic inflammatory changes bloody/purulent discharge fistulation nipple distortion ```

what is the treatment of duct ectasia

treat acute infections stop smoking excise ducts

what is the cause of duct ectasia

mixed organisms, anaerobes

what is the cause of acute mastitis/abscess

if lactating usually staph aureus or step pyogenes

what is the treatment of mastitis/abscess

antibiotics | drainage = surgical or percutaneous