Women's Health Flashcards
Booking visit is at ________ weeks gestation. Ideally < ____ gestation.
8-12 weeks
Ideally < 10 weeks
What is checked at booking visit?
General info: lifestyle, folic acid, vitamin d, BMI.
Bloods:
- FBC
- Blood group + rhesus status
- BBV: Hep B, Syphilis, HIV
Urine culture:
- For bacteriuria (e.g. GBS)
Early pregnancy scan to confirm dates is at ______ weeks gestation.
10 - 13+6 weeks
Down’s syndrome from 11 - 13+6 weeks
Anomaly scan is at ______ weeks gestation
18 - 20+6 weeks
When is first dose of anti-D prophylaxis given to rhesus negative women?
25 weeks
28 weeks
30 weeks
34 weeks
28 weeks
When is second dose of anti-D prophylaxis given to rhesus negative women?
25 weeks
28 weeks
30 weeks
34 weeks
34 weeks
External cephalic version is offered at ____ weeks gestation.
36 weeks
30F. Severe dysmenorrhoea, heavy & irregular bleeding, pain on defecation and dyspareunia. Likely diagnosis?
Endometriosis
20F. 1 week cramping and constant lower abdo pain, intermenstrual bleeding, dyspareunia + dysuria
PID
‘Snowstorm’ appearance on USS.
Hydatidiform mole (molar pregnancy)
- Abnormal growth of cells in uterus. Type of gestational trophoblastic disease.
Mechanism of action of implant?
Inhibits ovulation and thickens cervical mucus
Mechanism of action of depot provera?
Inhibits ovulation and thickens cervical mucus
Mechanism of action of IUS?
Prevents endometrial proliferation
Levonorgestrel is in what contraception?
Mirena coil and Plan B emergency contraception (within 72 hours)
Medroxyprogesterone acetate is in what contraception?
Depot Provera
Etonogestrel is in what contraception?
Implant
Cervical smear shows negative (high-risk) HPV - how should this person be managed?
- Return to normal recall
- Repeat in 3 months
- Cytology
Return to normal recall. No need for cytology examination
How to manage hrHPV positive and cytology normal smear?
Repeat smear in 12 months
Repeat smear at 12 months for HPV positive + normal cytology shows HPV still positive…
Repeat smear in another 12 months
HPV positive with normal cytology at 24 months
Refer to colposcopy
First inadequate sample should be managed by _______.
Two inadequate samples should be managed by _______.
Repeat smear at 3 months
Refer to colposcopy if 2 consecutive inadequate smears.
Contraceptives: time until effective?
Implant
After 7 days
Contraceptives: time until effective?
Combined oral contraceptive pill
After 7 days
Unless taken within first 5 days of cycle - then covered
Contraceptives: time until effective?
Depo Provera
After 7 days
The placenta is attached to myometrium in placenta _______. This can cause PPH.
Accreta
Strongest risk factor for cervical cancer?
- HPV (16 & 18)
- COCP
- Many sexual partners
Mutation of BRCA1 gene is a risk factor for what female cancers?
Ovarian and breast cancer
Mechanism of action of COCP?
Inhibits ovulation
How does HPV 16 cause cervical cancer?
- Produces E6 oncogene
- This inhibits the p53 tumour suppressor gene
How does HPV 18 cause cervical cancer?
- Produces E7 oncogene
- This inhibits RB suppressor gene
COCP counselling - what are the potential risks?
> 99% effective if take correctly
Risks:
- Blood clots
- MI and stroke
- Breast and cervical cancer
Endometrial cancer risk factors?
- Obesity, DM, PCOS
- Early menarche and late menopause
- Nulliparity
- Drugs: unopposed oestrogen (e.g. HRT), tamoxifen
Investigation for endometrial cancer?
- Trans-vaginal ultrasound - to look at endometrial thickness
- Endometrial biopsy
Management of endometrial cancer?
TAH + BSO
+/- post-operative RTX
Mechanism of action of IUD?
Decreases sperm motility and survival
