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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
What are the symptoms of ovarian torsion (2)?
* Severe abdo pain * N+V
26
How is ovarian torsion treated?
Laparoscopic surgery (may require oophorectomy)
27
What is PID?
Infection of the uterus, fallopian tube or ovaries
28
Symptoms of PID?
* Pelvic pain * Dysuria * Dyspareunia
29
What usually causes PID?
STI
30
What are some risk factors for PID?
* Multiple sexual partners * IUS/IUD
31
How is PID treated?
* IM Ceftriaxone * Metronidazole PO * Doxycycline PO *Partner treated as well*
32
What are some complications of ovarian cysts?
* Large or twist and block blood supply * Ruptures (conservatively managed)
33
What are obstetric emergencies?
34
What is antepartum haemorrhage?
Bleeding from genital tract after 24 weeks of pregnancy
35
What are some causes of antepartum haemorrhage?
* Low lying placenta * Vasa praevia * Minor/ major abruption * Infection
36
What is a low lying placenta?
Placenta that has implanted in lower portion of uterus
37
What is a major vs minor low lying placenta?
* Major = covering/ reaching os * Minor = in lower segment
38
Low lying placenta management?
* Advise no sex * Advise to present if bleeding * Elective LSCS around 37/40
39
How is a bleeding placenta praaevia treated?
* ABCDE treatment * Monitoring * Emergency c-section if necessary
40
What is vasa praevia?
Foetal vessels running over internal os can lead to rupture --> foetal haemorrhage
41
What is foetal mortality for vasa praevia?
60%
42
What is morbidly abhorrent placenta?
Placenta penetrates through the decidua basalis and through the myometrium
43
How is an abnormally invasive placenta managed?
* Elective CS at 37 weeks * ITU bed for mother * MRI scan
44
What is a placental abruption?
Separation of the placenta from uterus wall
45
What are the symptoms of placental abruption?
* Hard uterus * Antepartum haemorrhage * Maternal shock
46
What is pre-eclampsia?
Hypertension in pregnancy
47
What is severe pre-eclampsia?
* Hypertension + proteinuria * + one other symptom (e.g. severe headache, abnormal LFTs, clonus)
48
How is pre-eclampsia treated?
* Labetolol = 1st line * Nifedipine * Methyldopa
49
What is eclampsia?
Seizures in a woman with hypertension/ pre-eclampsia
50
How is eclampsia treated?
* MgSO4 (stabilise mother first) * Deliver baby
51
What is the leading direct cause of maternal death in the uk?
Sepsis
52
When might you suspect fetal compromise?
Prolonged bradycardia on CTG
53
What is cord prolapse?
When umbilical cord is coming out before baby
54
What are some risk factors for cord prolapse?
* Premature rupture membranes * Polyhydramnios (large amniotic fluid volume) * Long umbilical cord * Foetal malpresentation * Multiparity * Multiple pregnancy
55
What is shoulder dystocia?
Head delivered, shoulder stuck on symphysis pubis
56
What manoeuvre is usually effective at delivering a baby with shoulder dystocia?
McRoberts (knees up to shoulders)
57
What are the two types of post partum haemorrhage?
* Primary < 24 hours * Secondary 24 hours to 12 weeks
58
What are the causes of PPH?
* **T**issue (ensure placenta delivered) * **T**one (ensure uterus contracted) * **T**rauma (look for tears) * **T**hrombin (check clotting)
59
When is term?
37 to 42 weeks
60

Phase 3A flashcards (5 decks)

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