Women's health Flashcards
What is the classical triad for premature ovarian failure?
- Amenorrhoea
- Hypergonadotropism (raised LH and FSH)
- Hypoestrogenism (low oestradial)
What happens to protein/creatinine ratio in preeclampsia?
It’s raised
What is the chance of vaginal delivery following previous Caesarian section?
72-75%
What are 2 side effects of tamoxifen?
Endometrial hyperplasia and carcinoma
What uterine position is associated with endometriosis?
Retroverted uterus
Which investigation could be used to identify if a woman with infertility is ovulating?
Mid luteal phase serum progesterone
Folate is recommended in pregnancy and used to fortify foods to stop what congenital abnormality?
Neural tube defects
What is CTG?
- Used during pregnancy to monitor foetal heart rate and uterine contractions
- Most commonly used in third trimester to monitor foetal wellbeing and detect early signs of foetal distress
- (remember formative RTA question: A 36 week woman is involved in an RTA and has trauma to her abdomen. She has perceived less foetal movement since the accident. Her abdomen is tender and you can hear the foetal heart clearly. She has had no vaginal bleeding. What would be the most appropriate first line management? CTG to assess foetal wellbeing)
What examination should you not perform in a bleeding placenta praevia?
Speculum
What is pre-eclampsia a risk factor for?
- Placental abruption
- Eclampsia
What are some signs of placental abruption?
- Sudden onset abdo pain
- Continuous contractions that don’t seem to stop
- Pain in abdo and back
- PV bleeding
- Enlarged uterus (disproportionate to the gestational age of the foetus)
- Decreased foetal movement and heart rate
What is the safest form of contraception in women with history/family history of breast cancer/BRCA mutation?
Copper coil
What are the wait times for effectiveness of contraception?
- Instant: IUD
- 2 days: POP
- 7 days: COC, injection, implant, IUS
First line treatment for gestational diabetes?
- Insulin
- +/- metformin
What test is used to confirm menopause?
FSH level (increased)
When is cervical screening delayed until in pregnancy?
3 months post partum
What Bishop score suggests favourable cervix for delivery?
> =8
What is first line treatment for menorrhagia?
- IUS (Mirena coil) if don’t want children
- Mefenamic acid (particularly if there is dysmenorrhoea as well) or tranexamic acid if do want children
What is a protective factor against hyperemesis gravidarum?
Smoking
What are some risk factors for hypremesis gravidarum?
- Obesity
- Trophoblastic disease
- Nulliparity
- Carrying twins
What is the most important investigation for 1st trimester bleeding?
Transvaginal USS
Management/prophylaxis of new born sepsis?
- Maternal IV antibiotics during labour if at risk
- Only give newborn IV antibiotics if they show signs of sepsis
What is the management of ovarian cancer?
Stage 1) LETZZ or cone biopsy
Stage 2-4) Surgery and platinum-based chemotherapy
What is the investigation for SFGA?
USS
What medications can be used to shrink fibroids (e.g. before surgery)?
- GnRH agonist
- E.g. leuprolide
What is the antibiotic of choice for group B strep (e.g. in prophylaxis of neonatal sepsis)?
Benzylpenicillin
What is the investigation of choice for placenta praaevia, and what investigation shouldn’t you do?
- Transvaginal ultrasound is choice
- DO NOT do digital vaginal exam
What is the COCP link to cancers?
- Increased risk of breast and cervical cancer
- Protective against ovarian and endometrial cancer
How long should women wait to start hormonal contraception after taking the emergency pill?
5 days
What is the most common types of ovarian cancer?
Serous carcinoma
What is the most common type of ovarian cyst?
Follicular cyst
How long do women have to weight before starting the COCP after pregnancy?
21 days due to risk of VTE
Which antibiotics are safe to use in breastfeeding?
Cephalosporins
What are normal find gins on cardiac exam in pregnancy?
- Third heart sound
- Ejection systolic murmur
- Forceful apex beat
- Peripheral oedema
What is the most likely side effect of induction of labour?
Uterine hyperstimulation