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Phase 3A > Women's health > Flashcards

Women's health Flashcards

(96 cards)

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1
Q

At which fat percentage does ovulation cease?

A

below 22%

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2
Q

How does fluid balance change in the body of a pregnant woman?

A

30-50% increase in plasma volume
Decrease in plasma oncotic pressure
Decreased threshold for thirst
Increased natriuretic factors

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3
Q

What happens to the kidneys during pregnancy?

A

Dilation of renal pelvis and calyxes
Reduced renal peristalsis - causes hydronephrosis
Increased renal blood flow
Increased GFR by 50%

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4
Q

What changes occur in the cardiovascular system during pregnancy?

A

Increased HR, stroke volume and cardiac output

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5
Q

What changes occur in the blood during pregnancy?

A

Increase in plasma fibrinogen
Increase in clotting factors 7, 8, 10
Increased plasminogen inhibitor
Increased WBCs and fluid

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6
Q

What physical changes occur in the thoracic cavity during pregnancy?

A

Diaphragm elevated by up to 4cm
Heart displaced up and left
Increased pulmonary blood flow and subcostal angle

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7
Q

What changes occur in the lungs during pregnancy?

A

Increased O2 consumption
Tidal volume increases
PCO2 decreases to allow a fetal:maternal gradient
Bronchial smooth muscle relaxation

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8
Q

What changes occur in the gastrointestinal system during pregnancy?

A 
Delayed gastric emptying
Sphincter relaxation
Increased nutrient and water absorption
decreased bowel motility
reduced CCK secretion
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9
Q

What is ptyalism/ sialorrhea gravidarum?

A

Sensation of excess salivation

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10
Q

What is pica?

A

Consumption of not-nutritive substances; eg. paper/mud

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11
Q

What changes in plasma glucose occur during preganacy?

A

Raised glucose levels

Increase in maternal insulin response but decreased maternal sensitivity

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12
Q

What is foetal HPL?

A

Human placental lactogen - diabetogenic agent, mobilises glucose from fat reserves and converts mammary glands into milk-secreting tissue

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13
Q

What changes occur in the reproductive system during pregnancy?

A

Uterine mass increases 46g to 1kg
Endovascular invasion
Cervix softens and increases in vascularity
Early on tissues become purple/blue - chadwick’s sign

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14
Q

What is IMB?

A

Intermenstrual bleeding

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15
Q

What is PCB?

A

Post-coital bleeding

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16
Q

What is PMB?

A

Post menopausal bleeding

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17
Q

What is menarche?

A

Time when first period occurred

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18
Q

What is menopause?

A

Age of last spontaneous period

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19
Q

What is Climacteric?

A

Years before menopause, symptomatic but still menstruating

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20
Q

What is postmenopausal?

A

No periods for 1 year if over 50, or no periods for two years if under 50

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21
Q

What is gravidity?

A

Total number of pregnancies

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22
Q

What is parity?

A

Total number of deliveries after 20 weeks

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23
Q

What is a miscarriage?

A

A loss of a pregnancy before 24 weeks

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24
Q

What is an IUFD?

A

Intrauterine foetal demise

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25
What is a still birth?
A baby born dead after 24 weeks
26
What is a neonatal death?
Death of a baby within the first 28 days of life
27
How long is normal gestation?
37-42 weeks
28
What is macrosomia?
A large baby
29
What could cause positive haematuria on a urine dip?
cancer, nephropathy, infection
30
What could cause positive proteinuria on a urine dip?
renal/cardiac disease
31
What percentage of adult women have urinary incontinence?
20%
32
What are the treatments for urinary incontinence?
catheters, pads, pessaries, barrier creams, HRT: vaginal oestrogen
33
What are the treatments for an overactive bladder?
Bladder drill, anticholinergics, antimuscarinics, adrenergic agonists, botox - blocks Ach release
34
What is colposuspension?
Supporting the bladder neck pulling the vagina up
35
How do you treat a utero-vaginal prolapse?
Pessary: shelf, ring, gelhorn, sacrospinal fixation, sacropopexy
36
What are the symptoms of a utero-vaginal prolapse?
SCD lump, discomfort, pelvic floor and sexual dysfunction
37
What is a sacrospinous fixation?
Attaching the vagina to the sacrospinous ligaments to hold it up - preventing prolapse
38
What is sacropopexy?
Mesh to hold the vagina up
39
Name some non sexually transmitted infections of the genitals
Candidiasis, bacterial vaginosis, genital dermatoses, vulval conditions
40
What do you need to ask when taking a sexual history?
Last time, how many partners in last 3 months, protection used, gender of partners, type of sex
41
What tests do you do for asymptomatic STI screening in women?
Self vaginal swab, NAAT: chlamydia and gonorrhoea | Bloods for syphilis and HIV
42
What tests do you do for asymptomatic STI men who have sex with men?
First void - NAAT for chlamydia and gonorrhoea Pharyngeal and rectal swab Bloods for syphilis, HIV and Hep B
43
What tests do you do for symptomatic STI screening in women?
Vaginal swab for NAAT, and high vaginal swab: bacterial vaginosis, trichomonas vaginalis and candida Cervical swab on slide Dipstick urinalysis
44
What tests do you do for symptomatic STI screening in men who have sex with men?
First void - NAAT for chlamydia and gonorrhoea Pharyngeal and rectal swab Bloods for syphilis, HIV and Hep B Cultures and slides from all areas involved
45
In which groups would you do hep B screening?
MSM, commercial sex workers and users, IVDU, african, asian and eastern european people
46
Which types of diseases usually get better during pregnancy?
Autoimmune disease, as pregnancy causes some immune suppression
47
Why is anaemia more common in pregnancy?
Increased iron and folate requirements
48
What are the consequences of anaemia during pregnancy?
Low birth weight and pre-term delivery
49
What are the risk factors for venous thromboembolism during pregnancy?
Being pregnant, increased maternal age, increased BMI, operative delivery
50
How does pregnancy affect asthma?
Physiological changes can make asthma slightly worse, most medications are fine to use during pregnancy
51
Which cardiac conditions mean that the pregnancy is high risk?
aortic stenosis, prosthetic valves, cyanosed patients
52
What is obstetric cholestasis?
Reduction in the flow of bile from the gallbladder during pregnancy
53
What are the symptoms of obstetric cholestasis?
Itching without rash, jaundice, dark urine pale stools
54
How do you treat obstetric cholestasis?
Ursodeoxycholic acid improves liver function but not foetal complications, resolved by delivery
55
What are the complications of obstetric cholestasis?
Stillbirth, premature birth
56
What are the complications of hyperthyroidism during pregnancy?
Maternal: thyroid crisis with cardiac failure Foetal: thyrotoxicosis due to TSantibodies
57
How do you treat hyperthyroidism during pregnancy?
Propylthiouracil
58
What are the complications of hypothyroidism during pregnancy?
early foetal loss, impaired neurodevelopment
59
How do you treat hypothyroidism during pregnancy?
thyroxine
60
How do you treat gestational diabetes?
Stop ACEI and statins, higher folic acid dose, insulin and metformin
61
What is gestational diabetes?
Diabetes that is first recognised during pregnancy
62
What are the complications of gestational diabetes?
Miscarriage, still birth, genetic abnormalities, premature, macrosomia, shoulder dystocia, neonatal polycythaemia, hypoglycaemia, respiratory distress
63
What are the maternal complications of Chronic renal disease?
Increased risk of pre-eclampsia
64
What are the foetal complications of chronic renal disease?
malformations due to drugs, growth restriction, stillbirth, premature
65
What are the maternal complications of epilepsy?
Increased seizure frequency usually because they take less medications as they are teratogenic, increased risk of SUDEP
66
What are the foetal complications of epilepsy?
abnormalities, inheritance of epilepsy, foetal hypoxia with maternal seizures
67
Which epilepsy medication is the worst during pregnancy?
Sodium valproate
68
What are the complications of taking sodium valproate during pregnancy?
neural tube defects, ASD, cleft palate, polydactyly, craniosynostosis, learning difficulties
69
What is heavy menstrual bleeding?
<80ml per cycle, or affecting daily life - 1/20 women
70
What investigations could you do for heavy menstrual bleeding?
vaginal examination, FBC, Transvaginal ultrasound, hysteroscopy
71
What are the main causes of heavy menstrual bleeding?
polyps, adenomas, leiomyomas, malignancy, coagulopathy, endometriosis, iatrogenic
72
Name some medical treatments for heavy menstrual bleeding
mirena coil, tranexamic acid, NSAIDS, COCP, POP, implant
73
Name some surgical treatments for heavy menstrual bleeding
Endometrial ablation, Uterine artery embolization, myomectomy, hysterectomy
74
How does the (levonogestrel-releasing intrauterine system) mirena coil reduce menstrual bleeding?
releases progesterone which thins the lining of the womb, contraceptive and lasts up to 5 years
75
Pros and cons of tranexamic acid for managing heavy menstrual bleeding
2 tablets, 3x a day for 1st 4 days of period, not contraceptive or hormonal, doesn't reduce length or pain of periods
76
Pros and cons of NSAIDs for heavy menstrual bleeding
3x a day for 1st 5 days of period, helps with period pain as well, non contraceptive and worsens asthma
77
Pros and cons of Combined Oral Contraceptive pill for heavy menstrual bleeding
Take every day for 3 weeks then 1 week off, helps with pain, contraceptive, increases risk of clots
78
Pros and cons of progesterone for heavy menstrual bleeding
Weight gain, bloating, acne, contraceptive, doesn't increase risk of clots
79
What is endometrial ablation?
Surgery to destroy the lining of the womb by norvasure or thermal balloon
80
Pros and cons of endometrial ablation for heavy menstrual bleeding
Minimally invasive, can be done under local anaesthetic, cannot get pregnant after
81
How does uterine artery embolization work?
Blocks blood supply to the endometrium and fibroids so they shrink, allows for pregnancy in the future
82
Pros and cons of myomectomy
Major surgery, allows for pregnancy in the future
83
Pros and cons of Hysterectomy
Periods stop permanently, cannot get pregnant, major surgery, can effect bladder
84
What are the signs of pre-eclampsia?
proteinuria >0.3g protein/24hrs and hypertension > 140/90
85
What is pre-eclampsia?
Systemic syndrome, abnormal development of placenta, less vasodilatation of the spiral arteries
86
What are the maternal complications of pre-eclampsia?
Can become eclampsia - seizures, and can develop renal failure, liver failure and pulmonary oedema
87
What are the foetal complications of pre-eclampsia?
Foetal growth retardment, DIC, pre term birth, hypoxia
88
What are the symptoms of pre-eclampsia?
Visual disturbances, migraine, epigastric pain, oedema, rapid weight gain, brisk reflexes and ankle clonus
89
How do you treat pre-eclampsia?
Delivery is the only treatment, magnesium sulphate is used to prevent eclampsia, hydralazine and labetalol for hypertension
90
What is a premature birth?
A baby born earlier than 37 weeks
91
What is low birth weight?
<2.5kg at birth
92
What are some consequences of premature birth?
Cerebral palsy, learning difficulties, death
93
What can you give to promote foetal development?
Antenatal steroids
94
Name some causes of spontaneous preterm labour
Premature rupture of membranes, cervical weakness, amnionitis
95
Why does maternal infection cause pre term birth?
Prostaglandins are released which trigger contractions causing labour
96
What is a tocolytic?
Oxytocin receptor antagonist

Phase 3A (14 decks)

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