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JL Reproduction and Sexual Health > Week 4 part 3 > Flashcards

Week 4 part 3 Flashcards

1
Q

When does bleeding in early pregnancy occur?

A

less than 24 weeks

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2
Q

Bleeding from the genital tract after 24 weeks gestation?

A

Antepartum haemorrhage

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3
Q

Are preeclampsia and hypertension risk factors for placental abruption?

A

Yes

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4
Q

Name a cause of couvelaire uterus?

A

Placental abruption

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5
Q

Uterine tenderness/wooden hard?

A

Placental abruption

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6
Q

Sudden-onset abdominal pain, vaginal bleeding, and uterine tenderness. Also abnormally freuqent contractions and uterine hypertonus?

A

Abruption

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7
Q

Placenta is partially or totally implanted in lower uterine segment?

A

Placenta previa

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8
Q

Painless, ‘causeless’ recurrent 3rd trimester bleeding? Uterus is soft and non tender

A

Placenta previa

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9
Q

How do you diagnose placenta oprevuia?

A

Ultrasound (20 week scan) - do not perform vaginal exam until you exclude it

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10
Q

Placenta invades myometrium?

A

Placenta accreta - percreta (placenta has reached serosa). Associated with sever ebleeding, PPH and may end up with hysterectomy

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11
Q

With placenta praevia - if ther has been prior bleeding in pregnancy or suspected/confirmed placenta accreta how is baby delivered?

A

Caesarea section at 37 weeks

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12
Q

With placenta preavia are steroids given?

A

Yes - promote fetal lung surfactant production (e.g. betamethasone)

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13
Q

Greater than 500ml blood loss post partum?

A

PPH

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14
Q

4 t’S OF pph?

A

Tone - 70%
Trauma - 20%
Tissue -10%
Thrombin - <1%

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15
Q

What is the initial management of PPH?

A
  1. Uterine massage
  2. 5 units IV syntocinon stat
  3. 40 units syntocinon in 500ml Hartmanns
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16
Q

Management of persistent PPH

A

Catheter

500microg ergometrine IV

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17
Q

Deepest layer of pelvic floor?

A

Pelvic diaphragm

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18
Q

What two muscle groups make up pelvic diapgrahm?

A

Levator ani
+
Coccygeus

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19
Q

Forms most of pelvic diaphragm?

A

Levator ani

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20
Q

What are three muscles making up levator ani/

A
  1. Iliococcygeus
  2. Pubococcygeus
  3. Puborectalis
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21
Q

Name 4 pelvic ligaments?

A
  1. Uterosacral
  2. Transverse cervical
  3. Lateral ligament of bladder
  4. Lateral rectal ligaments
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22
Q

What lies below fascia covering inferior aspect of pelvic diaphragm, and lies above perineal membrane?

A

Deep perineal pouch - conatains part of urethra, bulbourethral glands, NVB for penis/clitoris, extensions of ischioanal fat pads and muscles

23
Q

What in males, contains bulb - corpus spongiosim, crura - corpus cavernosum. associated muscles - bulbospongiosus and ischiocavernosus?

A

Superficial perineal pouch - male

24
Q

What in females, contains female erectile tissue and associated muscles: clitoris and crura - corpus cavernosum, bulbs of vestibule - paired, associated muscles - bulbospongiosus and ischiocavernosus

A

superficial perineal pouch - female

25
Q

Lump in vaginal wall?

A

Prolapse - vaginal

26
Q

Dragging sensation, feeling of lump, urinary incontinence?

A

Uterine prolapse

27
Q

Predominant locations and role of muscarinic receptor subtypes: M1

A

Brain (cortex, hippocampus); salivary glands

Cognitive functioning and memory; saliva secretion

28
Q

Predominant locations and role of muscarinic receptor subtypes: M2

A

Heart, brain, smooth muscle

Regulation of heart rate and heart rate flexibility; behavioural flexibility

29
Q

Predominant locations and role of muscarinic receptor subtypes: M3

A

Smooth muscle, glands, eye

Smooth muscle contraction; gland secretion; iris contraction

30
Q

Predominant locations and role of muscarinic receptor subtypes: M4

A

Brain (forebrain, striatum)

Modulation of several important dopamine-dependent behaviours

31
Q

Predominant locations and role of muscarinic receptor subtypes: M5

A

Brain (substantia nigra); eye

Regulation of striatal dopamine release

32
Q

Stress urinary incontinence?

A

leakage of urine during raised intra-abdominal pressure

33
Q

leakage associated with urgency, usually with detrusor activity

A

Overactive bladder

34
Q

What test is useful to differentiate between stress urinary incontinence and overactive bladder in patients whom surgery considered?

A

Urodynamics

35
Q

a method by which the pressure/volume relationship of the bladder is measured during filling, provocation and during voiding

A

Cystometry

36
Q

Drug for stress urinary incontinence

A

Duloxetine

37
Q

Drug for overactive bladder?

A

Oxybutynin

38
Q

1st degree uterine descent?

A

In vagina

39
Q

2ND degree uterine descent?

A

In interiotus

40
Q

3rd degree uterine descent?

A

Procidentia (entiryl outside vagina)

41
Q

What has prolapsed if it is an enterocele prolapse?

A

Pouvh of douglas cobtaining small bowel

42
Q

What type of prlapse: stress urinary incontinence, urinary retention, recurrent UTI?

A

Cystourethrocele

43
Q

What typeof prolapse? Backache, ulceration if procidentia/everted?

A

Uterine/vault prolapse

44
Q

What type of prolapse - constipation, dyschezia?

A

Rectal

45
Q

When is the nadir reached in pregnancy for BP/

A

22-24 weeks

46
Q

What are the two stages in pathogenesis of preeclampsia?

A
  1. aBNORMAL placental perfusion

2. Maternal syndrome

47
Q

What can be used to predict pre-eclampsia?

A

Maternal Uterine Artery Doppler 20-24 weeks

48
Q

Treatment of hypertension in pregnancy: METHYLdopa contraindication?

A

Depression

49
Q

Treatment of hypertension in pregnancy: labetalol contraindication?

A

Asthma

50
Q

Tonic-clonic (grand mal) seizure occuring with features of pre-eclampsia

A

Eclampsia - most common post partum 44%, more common in teenagers

51
Q

What hypertensives are given for eclampsia?

A

IV Labetalol

IV hydralazine

52
Q

How are seizures treated in eclampsia?

A

Magnesium sulphate

53
Q

What is main cause of death in eclampsia?

A

Pulmomary oedema

54
Q

whats is given in low dose to high risk woemn for preeclampsia?

A

Aspirin- commence before12 weeks

JL Reproduction and Sexual Health (18 decks)

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