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Phase 3A flashcards > Womens health > Flashcards

Womens health Flashcards

1
Q

What is released by the hypothalamus to stimulate the release of FSH and LH?

A

Gonadotrophin releasing hormone (GnRh)

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2
Q

Where are FSH and LH released from?

A

Anterior pituitary

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3
Q

What are the general effects of LH and FSH?

A

Stimulate the development of follicles in the ovaries leading to the release of progestins and Oestrogens

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4
Q

What does FSH bind to?

A

Granulosa cells

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5
Q

What does LH bind to?

A

Theca cells

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6
Q

What are 5 gynaecological emergencies?

A
  • Ectopic pregnancy
  • Miscarriage
  • Ovarian torsion
  • Cyst accident
  • PID
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7
Q

What are some risk factors for ectopic pregnancy (5)?

A
  • Previous ectopic
  • IUD/IUS use
  • Smoker
  • Age
  • Tubal damage
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8
Q

What are 2 main symptoms of ectopic pregnancy?

A
  • PV bleeding
  • Abdo pain
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9
Q

How is ectopic pregnancy diagnosed?

A

USS +/- bHCG
Adnexal mass that moves separately to ovary

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10
Q

Where do ectopic pregnancies most commonly implant?

A

Fallopian tube

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11
Q

What are criteria for conservative management of ectopic pregnancy?

A
  • Clinically stable + Pain free
  • Tubal pregnancy < 35mm (with no heartbeat)
  • Serum hCG < 1000
  • Must return for follow up
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12
Q

How is ectopic pregnancy managed medically?

A

Methotrexate

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13
Q

What is a downfall to medically managed ectopic?

A

Can’t get pregnant for 3 months after taking methotrexate

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14
Q

When is surgical treatment of ectopic offered?

A
  • Significant pain
  • Adnexal mass > 35mm
  • Heartbeat detected
  • bHCG > 5000
  • Signs of rupture
  • Unstable woman
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15
Q

How is ectopic pregnancy surgically treated?

A

Laparoscopically via salpingectomy or salpingotomy

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16
Q

What is the difference between salpingectomy and salpingotomy?

A
  • Salpingectomy = removal of entire Fallopian tube
  • Salpingotomy = embryo itself removed from Fallopian tube
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17
Q

How many pregnancies end in miscarriages?

A

1 in 4

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18
Q

When does an embryo become a foetus?

A

11th week of pregnancy

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19
Q

What are the three types of miscarriage?

A
  • Incomplete
  • Complete
  • Delayed
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20
Q

Why do patients bHCG need to be monitored after an apparent complete miscarriage?

A

To rule out an ectopic pregnancy (unless IUP previously confirmed)

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21
Q

How is a miscarriage diagnosed?

A
  • Complete = empty uterus on USS
  • Incomplete = something seen in uterus on USS
  • Delayed = USS something seen (must be confirmed by second radiographer)
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22
Q

What is the difference between delayed and incomplete miscarriage?

A
  • Incomplete = products of conception partially expelled from uterus
  • Delayed = products of conception not expelled from uterus
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23
Q

How are incomplete and delayed miscarriage managed?

A

Surgically or medically in or out of hospital depending on a number of factors

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24
Q

What gynaecological emergency involves the ovary?

A

Ovarian torsion

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25
Q

What are the symptoms of ovarian torsion (2)?

A
  • Severe abdo pain
  • N+V
26
Q

How is ovarian torsion treated?

A

Laparoscopic surgery (may require oophorectomy)

27
Q

What is PID?

A

Infection of the uterus, fallopian tube or ovaries

28
Q

Symptoms of PID?

A
  • Pelvic pain
  • Dysuria
  • Dyspareunia
29
Q

What usually causes PID?

A

STI

30
Q

What are some risk factors for PID?

A
  • Multiple sexual partners
  • IUS/IUD
31
Q

How is PID treated?

A
  • IM Ceftriaxone
  • Metronidazole PO
  • Doxycycline PO
    Partner treated as well
32
Q

What are some complications of ovarian cysts?

A
  • Large or twist and block blood supply
  • Ruptures (conservatively managed)
33
Q

What are obstetric emergencies?

A
34
Q

What is antepartum haemorrhage?

A

Bleeding from genital tract after 24 weeks of pregnancy

35
Q

What are some causes of antepartum haemorrhage?

A
  • Low lying placenta
  • Vasa praevia
  • Minor/ major abruption
  • Infection
36
Q

What is a low lying placenta?

A

Placenta that has implanted in lower portion of uterus

37
Q

What is a major vs minor low lying placenta?

A
  • Major = covering/ reaching os
  • Minor = in lower segment
38
Q

Low lying placenta management?

A
  • Advise no sex
  • Advise to present if bleeding
  • Elective LSCS around 37/40
39
Q

How is a bleeding placenta praaevia treated?

A
  • ABCDE treatment
  • Monitoring
  • Emergency c-section if necessary
40
Q

What is vasa praevia?

A

Foetal vessels running over internal os can lead to rupture –> foetal haemorrhage

41
Q

What is foetal mortality for vasa praevia?

A

60%

42
Q

What is morbidly abhorrent placenta?

A

Placenta penetrates through the decidua basalis and through the myometrium

43
Q

How is an abnormally invasive placenta managed?

A
  • Elective CS at 37 weeks
  • ITU bed for mother
  • MRI scan
44
Q

What is a placental abruption?

A

Separation of the placenta from uterus wall

45
Q

What are the symptoms of placental abruption?

A
  • Hard uterus
  • Antepartum haemorrhage
  • Maternal shock
46
Q

What is pre-eclampsia?

A

Hypertension in pregnancy

47
Q

What is severe pre-eclampsia?

A
  • Hypertension + proteinuria
    • one other symptom (e.g. severe headache, abnormal LFTs, clonus)
48
Q

How is pre-eclampsia treated?

A
  • Labetolol = 1st line
  • Nifedipine
  • Methyldopa
49
Q

What is eclampsia?

A

Seizures in a woman with hypertension/ pre-eclampsia

50
Q

How is eclampsia treated?

A
  • MgSO4 (stabilise mother first)
  • Deliver baby
51
Q

What is the leading direct cause of maternal death in the uk?

A

Sepsis

52
Q

When might you suspect fetal compromise?

A

Prolonged bradycardia on CTG

53
Q

What is cord prolapse?

A

When umbilical cord is coming out before baby

54
Q

What are some risk factors for cord prolapse?

A
  • Premature rupture membranes
  • Polyhydramnios (large amniotic fluid volume)
  • Long umbilical cord
  • Foetal malpresentation
  • Multiparity
  • Multiple pregnancy
55
Q

What is shoulder dystocia?

A

Head delivered, shoulder stuck on symphysis pubis

56
Q

What manoeuvre is usually effective at delivering a baby with shoulder dystocia?

A

McRoberts (knees up to shoulders)

57
Q

What are the two types of post partum haemorrhage?

A
  • Primary < 24 hours
  • Secondary 24 hours to 12 weeks
58
Q

What are the causes of PPH?

A
  • Tissue (ensure placenta delivered)
  • Tone (ensure uterus contracted)
  • Trauma (look for tears)
  • Thrombin (check clotting)
59
Q

When is term?

A

37 to 42 weeks

60
Q
A

Phase 3A flashcards (5 decks)

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