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Phase 3A > Women's Health > Flashcards

Women's Health Flashcards

1
Q

what is endometriosis

A

presence of endometrial tissue outside the uterus

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2
Q

what are common sites affected by endometriosis

A 
ovaries
pelvic cavity 
distal ureters
rectosigmoidal colon
bladder
pouch of douglas
uterosacral ligaments
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3
Q

risk factors for endometriosis

A 
first degree relative with severe endometriosis 
early menarche, late menopause
delayed childbearing 
short menstrual cycle 
long menstrual flow
obstruction to vaginal outflow
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4
Q

common presentation of endometriosis

A

dyspareunia
dysmenorrhea
cyclical or chronic pelvic pain
infertility

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5
Q

differential diagnosis of endometriosis

A

adenomyosis
chronic PID
IBS

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6
Q

investigations for endometriosis

A

laparoscopy
MRI: adenomyosis + bladder, bowel and ureteric involvement
TVS: endometrioma

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7
Q

signs of endometriosis on laparoscopy

A

active stage: red vesicles + punctate marks on peritoneum
less active: powder burn spots or white scars surrounded by abnormal blood vessels
severe disease: adhesions and chocolate cysts in ovaries

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8
Q

management of endometriosis

A

pain management: NSAIDs
ovarian suppression: COCP, IUS, GnRH analogues
surgical: laparoscopic excision or ablation; ovarian cystectomy; hysterectomy + salpingo-oopherectomy

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9
Q

what is gestational trophoblastic disease

A

group of disorders ranging from molar pregnancy (complete or incomplete hydatidifore mole) to malignant conditions like choriocarcinoma

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10
Q

STI symptoms in women

A 
vaginal discharge 
vulval discomfort, itching or pain
pelvic pain or dyspareunia
vulval lumps or ulcers
postcoital or intermenstrual bleeding
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11
Q

STI symptoms in men

A

urethral discharge, pain or discomfort
dysuria
testicular pain or swelling
genital ulcers, sores, blisters lumps or rash

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12
Q

what is the triple swab

A

endocervical chlamydia swab
endocervical charcoal media swab
high vagina swab

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13
Q

discharge in bacterial vaginosis

A 
thin 
profuse
fishy smelling
not usually associated with itching 
vaginal pH>4.5
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14
Q

discharge in candidiasis

A 
thick 
white
cottage cheese
non-offensive
associated with itching, soreness, dysuria and superficial dyspareunia
normal pH
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15
Q

First line management of BV

A

oral metronidazole

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16
Q

management of candidiasis

A

clotrimazole: topical or pessary

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17
Q

causative agent and treatment of chlamydia

A

Chlamydia trachomatis

single dose oral azythromycin

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18
Q

causative agent and treatment of gonorrhoea

A

neisseria gonorrhoeae

oral azithromycin + IM ceftriaxone

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19
Q

causative agent and treatment syphilis

A

treponema pallidum

oral prednisolone followed by benzathine benzylpenicillin

20
Q

causative agent and treatment of HSV

A

HSV 1 + 2

acyclovir

21
Q

causative agent and treatment of genital warts

A

HPV 6 and 11

podophyllotoxin

22
Q

causative agent and treatment of HIV

A

HIV

Antiretroviral therapy

23
Q

causative agent and treatment of trichomoniasis

A

trichomonas vaginalis

oral metronidazole

24
Q

Endometrial polyps: presentation, investigation and management

A

menorrhagia, intermenstrual bleeding
I: US, hysteroscopy
management: cutting diatherimy

25
Q

management of ovarian torsion

A

laparoscopic surgery to uncoil affected ovary; salpingo-oopherectomy if severe vascular compromise

26
Q

ovarian cysts presentation

A 
asymptomatic 
dull ache in abdomen
dyspareunia 
swollen abdomen + palpable mass
pressure effects: urinary frequency, varicose veins
27
Q

risk factors for ovarian cyst

A

obesity, tamoxifen therapy, early menarche, infertility family history (dermoid cyst)

28
Q

types of fibroids

A

most: intramural
submucosal
subserosal

29
Q

presentation of fibroids

A

asymptomatic
menorrhagia
intermenstrual bleeding (pedunculated submucosal fibroids)
enlarged uterus: urinary frequency, lower abdominal discomfort/pain
recurrent miscarriage or infertility

30
Q

investigations for suspected fibroids

A

pregnancy test
TV ultrasound
FBC + iron studies

31
Q

management of fibroids

A

menorrhagia: antifibrinolytic agent e.g. tranexamic acis
levonorgestrel IUS
surgery: myomectomy or hysterectomy

32
Q

what foods should women avoid when pregnant

A 
uncooked meat, fish or eggs
unpasteurised milk 
soft mould ripened cheese
unwashed fruit/veg
raw shellfish 
fish high in mercury
vitamin A and liver
33
Q

how much folic acid is needed

A

400mcg up to 12 weeks

5mg if family Hx of NTD or diabetes

34
Q

what other medication is recommended during pregnancy and at what dose

A

Vitamin D
400 units

1000 units if at high risk

  • darker skin
  • housebound
  • pre-pregnancy BMI >30

pre-eclampsia risk: 800 units + calcium

35
Q

define anaemia in pregnancy

A

<110 in first trimester
<105 in second and 2rd trimester
<100 post partum

36
Q

effects of smoking on pregnancy

A

IUGR and low birth weight
miscarriage and still birth
premature delivery
placental problems

37
Q

what investigations should occur in antenatal appointments

A

BP

urine: proteinuria

38
Q

risk factors for pre-eclampsia

A 
previous history
nulliparous 
multiple pregnancy 
aged > 40
close family history 
BMI > 35
pre-existing vascular, renal or diabetic disease
39
Q

what is the booking appointment

A

1st appointment; before week 12 ideally by week 10

40
Q

what happens during the booking appointment

A

lifestyle advice
measure weight, BMI and BP

screening (anaemia, red cell antibodies, hepatitis B, HIV, rubella, syphilis, chlamydia, sickle cell and thalassaemia, risk of gestational diabetes)

offer screening for foetal chromosomal abnormalities

41
Q

what screening is available for chromosomal abnormalities

A

combined screening test

quadruple serum screening test

42
Q

what are risk factors for gestational diabetes

A 
BMI>30
previous gestational diabetes
previous baby >4.5kg
1st degree relative with diabetes 
afro-caribbean, south asian or middle eastern origin
43
Q

what other appointments are there in antenatal care

A

16 weeks: review test results

18-20 weeks: structural abnormalities + placenta position

25 weeks: nulliparous, (plotting of symphysis fundal height from this appointment onwards)

28 weeks: proteinuria, BP, anaemia, anti-D prophylaxis, pertussis vaccination

31 weeks: nulliparous women

34 weeks: preparation for labour/birth information; second dose anti-D prophylaxis

36 weeks: external cephalic version

38 weeks

40 weeks: nulliparous women

41 weeks: membrane sweep/ induction of labour

44
Q

management of shoulder dystocia

A 
Help 
Episiotomy 
Legs in McRoberts position
Pressure on suprapubic 
Enter the pelvis
Remove posterior shoulder
45
Q

the combined test

when is it done
what does it screen for
what is composed of

A

10 - 13+6 weeks

Nuchal translucency increased
PAPP-A (pregnancy associated plasma protein) reduced
B-HCG increased

chromosomal abnormalities

46
Q

the quadruple test

A 
free beta-hCG (raised)
alpha fetoprotein (AFP) (decreased)
inhibin-A and (raised)
unconjugated estriol (decreased)

Phase 3A (9 decks)

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