Repro Presentations Flashcards
Androgen insensitivity syndrome clinical presentation and reproductive organ abnormalities
Present at puberty with primary amenorrhoea and lack of pubic hair
Testis develop but don’t descend
Female external genitalia
Absence of uterus and ovaries and short vagina
Features of obstructive male infertility
Normal testicular volume
Normal secondary sexual characteristics
Vas deferens may be absent
Normal LH, FSH and testosterone
Features of non-obstructive male infertility
Low testicular volume
Reduced secondary sexual characteristics
Vas deferens present
High LH, FSH and maybe low testosterone
Pelvic inflammatory disease presentation
Post-coital or intermenstrual bleeding
Lower abdominal pain
Dyspareunia
Mucopurulent cervicitis
Presentation of mycoplasma genitalium infection
Non-gonococcal urethritis
PID
Presentation of gonorrhoea in females
Asymptomatic (up to 50%) Increased/altered discharge Dysuria Pelvic pain (<5%) Pharyngeal and rectal usually asymptomatic
Presentation of primary HIV and how long after infection symptoms occur?
Fever Rash (maculopapular) Myalgia Pharyngitis Headache/aseptic meningitis
2-4 weeks after infection
What causes cervical shock and what are the presenting symptoms?
Vaso-vagal effect of POC passing through cervix causes reflex bradycardia Symptoms: Cramps N&V Sweating Fainting
Ectopic pregnancy presentation.
Pain more than bleeding Dizziness Collapse SOB Shoulder tip pain Pallor Haemodynamic instability Peritonism
Molar pregnancy presentation
Hyperemesis
Bleeding and passage of grape like tissue
Fundus is larger than dates
Ocassionally shortness of breath (molar tissue can embolise)
Implantation bleeding presentation
Around 10 days post-ovulation Bleeding is light/brownish and limited Soon signs of pregnancy emerge Occ mistaken for period Usually settles and pregnancy continues
Presentation of chorionic haematoma
Bleeding
Cramping
Threatened miscarriage
Usually self limiting and resolves
Large for dates definition
Symphyseal-fundal height >2cm for gestational age
Clinical features of polyhydramnios
Abdo discomfort Pre-labour rupture of membranes Preterm labour Cord prolapse Large for dates Malpresentation Tense shiny abdomen Inability to feel foetal parts
Symptoms and signs of multiple pregnancy
Exaggerated pregnancy symptoms (excessive sickness, hyperemesis gravidarum)
High AFP
Large for dates uterus
Multiple foetal poles
Presentation of poor foetal growth
Predisposing factors
Fundal height less than expected
Reduced liquor
Reduced foetal movements
Clinical features of anti-phospholipid syndrome in pregnancy
Arterial/venous thrombosis Recurrent early pregnancy loss Late pregnancy loss Placental abruption Severe early onset pre-eclampsia (PET) Severe early onset foetal growth restriction (FGR)
Presentation of HELLP syndrome (assoc with pre-eclampsia)
Haemolysis
Elevated Liver enzymes
Low Platelet count
Symptoms of pre-eclampsia
Headache Visual disturbance Epigastric/RUQ pain N&V Rapidly progressing oedema
Signs of pre-eclampsia
Hypertension Proteinuria Oedema Abdo tenderness Disorientation Small for gestational age (SGA) foetus Intra-uterine death Hyper-reflexia/involuntary movements/clonus
Presentation of crises in pre-eclampsia.
Eclampsia (seizures) HELLP syndrome Pulmonary oedema Placental abruption Cerebral haemorrhage Cortical blindness DIC Acute renal failure Hepatic rupture
Baby blues presentation and disease course
Tearful Irritable Anxiety Poor sleep Confusion
Days 3-10 and is self-limiting
Puerperal psychosis risk factors
Bipolar
Previous puerperal psychosis
1st degree relative with history
Puerperal psychosis typical time of onset
Within 2 weeks of delivery
Puerperal psychosis early symptoms
Sleep disturbance
Confusion
Irrational ideas
Puerperal psychosis later symptoms
Mania
Delusions
Hallucinations
Confusion
Postnatal depression time of onset and how long does it last?
2-6 weeks post natally
Lasts weeks to months
What is an antepartum haemorrhage?
Bleeding from the genital tract from 24+0 weeks gestation
Placental abruption symptoms
Severe continous abdo pain
Bleeding (may be concealed)
Preterm labour
Maybe maternal collapse
Placental abruption signs
Signs inconsistent with revealed blood Uterine tenderness Woody hard uterus Foetal parts difficult to identify May be preterm labour Foetal bradycardia/intrauteruine death CTG shows irritable uterus
Placenta praevia symptoms
Painless bleeding >24 weeks;
Usually unprovoked but coitus can trigger bleeding
Bleeding can be minor eg spotting/ severe
Fetal movements usually present
Placenta praevia signs
Condition proportional to amount of bleeding Uterus soft and non-tender Presenting part high Malpresentation CTG usually normal
Uterine rupture symptoms
Severe abdominal pain
Shoulder-tip pain
Maternal collapse
PV bleeding
Uterine rupture signs
Intra-partum - loss of contractions Acute abdomen PP rises Loss of uterine contractions Peritonism Fetal distress / IUD
When will vasa praevia present and what will be the signs?
Presents at amniotomy (artificial rupture of membranes)
Sudden dark red bleeding
Foetal bradycardia and death
Amniotic fluid embolus presentation
Profound foetal distress
Sudden respiratory distress
Seizure
DIC
Cystocele presentation.
Dragging sensation Discomfort Feeling of a lump coming down Dyspareunia Backache Urinary urgency and frequency Incomplete bladder emptying Urinary retention if urethra is kinked
Rectocele presentation
Dragging sensation Discomfort Feeling of a lump coming down Dyspareunia Backache Constipation Difficulty with defaecation
Menopause presentation
Menstrual irregularities (irregularity then stopping)
Vasomotor disturbances (sweats, palpitations, flushes)
Vaginal and breast atrophy (can cause vaginal and urinary infection, dyspareunia, traumatic bleeding, stress incontinence, prolapse)
Osteoporosis
Insomnia
Joint aches
Headaches
Endometriosis presentation
Severe dysmenorrhoea and premenstrual pain
Dyspareunia
Subfertility
Ovarian cancer presentation
May be mass, swelling, Malignant ascites with protein exudate Heartburn/indigestion Early satiety Weight loss/anorexia Bloating Pressure symptoms esp bladder Change of bowel habit SOB/pleural effusion Leg oedema/DVT
Fibrocystic change presentation
Smooth discrete lumps Sudden pain Cyclical pain Lumpiness Incidental finding
Fibroadenoma presentation
3rd decade peak incidence
Painless, firm, discrete mobile mass
Solid on ultrasound
Duct ectasia presentation
Pain Acute episodic inflammatory changes Bloody or purulent discharge Fistulation Nipple retraction and distortion
Phyllodes tumour presentation
40-50 years old
Slow growing unilateral breast mass
Breast cancer symptoms
Dimpled/depressed skin Visible lump Nipple change e.g. inversion Bloody discharge Texture change Colour change
