Reproductive/Gynaecological Emergencies Flashcards
What is Epididiymitis?
Inflmmation of the epididymis, most commonly caused by bacteria
Reconition of epididymis
Pain and swelling of one teste,
fever
Affected teste will hang over
Occurs over several days
What is Orchitis?
Inflammation of one or both of the testes caused by bacterial infection
Orchitis recongonition?
Sevre pain, Visable swelling of groin lymph nodes on affected site Fever Blood in sperm (hamatospermia) Blood in urine (hematuria)
What is Testicular Torsion?
Occurs when spermatic cord is twisted, cutting off the testical’s blood supply can result in loss of teste
testicular torsion recognition
Sevre testicular pain, nausea/vommitting, mild fever and redness of area
What is varicoele
Abnormal enlargement of connective tissue of the scrotum can result in infertility
What is Haematocele?
collection of blood in the tunica vaginalis (the lining of the scrotum)
recognition of haematocele and variocele
soft lumps around testes, redness, pain and tenderness
What is hydrocele?
Accumlation of serous fluid around a teste caused by a issue with production or drainage of fluid
causes swelling
what is spermatocele
A abnormal cyst that devops in the epididymis
What is Priaprism
An errection in the absecnce of stimulation or after stimulation has ended
very painful
requires urgent treatment
Common infection sites of in the female reproductive system include
uterus, ovaries and fallopian tubes, but because of the open-ended structure of female reproductive sustem the infection can easily spread to surrounding organs
What is a ruptured ovarian cyst?
Fluid filled sac on the surface of an ovary, their sizes alter at diffrent stages of the menstrual cycle. Intact cysts are asymtomatic, when ruptured it can result in massive haemorrhage and significant abdo pain
Recognition of Ruptured Ovarian Cyst
Abdo pain can be a sign of cyst expansion, torsion (twisting) can lead to ischemia and acute rupture
Unilateral lower abdo pain
Inflammation that can lead to sepsis
Intraperitoneal haemorrhage
What is an ectopic Pregnancy
Pregnancy that develops outside the uterus (mostly in fallopian tubes). Clinical signs appear 6-8 weeks after last normal menstural period. If it continues to grow growing egg is placing pressure and strecthing the fallopian tubes and surrounding organs. Will result in rupture of tubes
Risk factors for ectopic pregnancy include:
Hx of STDs and Pelvic Inflammatory DIsease
IUCD (intra-uterine contraceptive device)
Maternal age over 40
IVF
Recognition of Ectopic Pregnancy
First Trimester bleeding, abdo pain and amenorrhoea (absence or missed menstural period)
Lower abdo pain and cramping that can spread to lower back, pelvis and shoulder tip
vaginal spotting
Dizziness/fainting
Diarrohea and pain on defaction
If an ectopic pregancy ruptures what will it lead to
Internal haemorrhage, hypovolemic shock, sepsis, death
As well as infertility
What is cystits
UTI or bladder infection
Difference between simple cystis and kidney infection
Simple cystis - Lower urinary tract
Kidney Infection - upper urinary tract
Recogniton of Cystits
Painful urination (stinging/burning), frequent urge to urinate, fever, flank pain, lower abdo pain, Purulent urine, cloudy urine and haematuria
What is Pelvic Inflammatory Diease
Infection of the upper female genital tract (uterus, fallopian tubes, ovaries and surrounding structures), commonly caused by STI bacteria or bacterial infections
How does Pelvic Inflammatory infection begin?
Generally begins as an infection that travels from the geneital tract to the cervix which leads to inflammation
Symtoms of Pelivic Inflammatory Disease
mucoprulent cervical discharge (mucous/puss)
Intermenstrual or post-intercourse bleeding
Pain in intercourse (dyspareunia)
Low grade fever, abdo pain, vaginal discharge, pain on walking (PID shuffle), generalised signs of sepsis.
Consequences of PID
Scarring/rigidity of the reproductive tract (greater risks of complications of infertiliaty and pregnancy) Pelvic Adhesions/scar tissue Chronic Pain Ovarain Abscess Infertility Ectopic Pregnancy
What is Endometritis
Uterus lining inflammed from infection can be acute or chronic
Acute vs Chronic Endometritis
Acute Endometritis is characterised by infection, high fever and purulent discharge symtoms reslove after 2 weeks
Chronic Endometritis is characterised by plasma cells in Stroma (connective tissue) well perfused by blood - ideal for bacteria growth
Common bacteria includes STI’s
What is Endometriosis?
The growth of endometrial tissue on outside of uterus occurs as small fragments of tissue are “regurgitated” during menstration through the fallopian tubes into the peritoneal cavity. These endomertial tissue implant on surfaces and grow small cystic structures
Where does endometriosis usually devlop?
The outside of the ovaries, utero-sacral ligaments (outside ovaries) fallopian tubes and peritonieal surfaces
Endometriosis symtoms
chronic pelvic pain
Dyspareunia (pain w/ sex)
Dsymaenorrhoea (pain during menstration)
Endometriosis Complications
adhesions/scar tissue form which dont stretch and can cause pain
Compression and infiltration of pelvic nerves
Endometriosis treatment
analgesia, NSAIDS, hormonal therapy oral contraceptives, progesterone or gonadotropine-releasing-hormone (GRH)
Miscarriage Defination:
An interuption of pregnancy before the 24th week either spontaneous or induced. Most commonly caused in the first 12 weeks following contraception
Contributing factors towards Miscarriages
Genatic abnormalaties Hormonal abnormalaties Maternal Factors Uterine abnormalaties Incompetence of the cervix (Cervix fails to protect the fetus)
Classification of Miscarriages
There are 6 but only two are relevant to the pre-hospital setting
Threatend Miscarriage -> where the body is showing signs of miscarriage such as vaginal bleeding, lower abdo pain, may continue or reslove
Incomplete Miscarriage: This is where the threatned miscarriage continues further and results in a loss of the fetus. Signs inlcude increased bleeding and pain.
Incomplete Miscarriage complications
The cervix dilates and products of contraception or parts of the placenta may be passed or retained by the cervix. Retained products/placenta must be removed surgically as they are a major source of infection
Miscarriage Treatment includes
Supporitive measures, pain nausea and hypovolemic managements
try and estimate blood loss and collect expelled tissue
Stilbirth Defination
Death of the fetus in-utero or at least 20 weeks of completed gestation that shows no-signs of life after birth
Risk factors of still birth
Smoking Diabetes High BP Obese Previous Still Birth Over 35 years being over 41 weeks pregant hx of reproductive issues Reduced baby movements
