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Year 3/4 H&S > Womens Health > Flashcards

Womens Health Flashcards

1
Q

Difference between sex and gender?

A

Sex is the biological classification of male or female through external genitalia and chromosomal makeup

Gender is social and/or cultural conformities and individual ideology

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2
Q

main types of gynaecological malignancies?? (4)

A

Vulval
Cervical
Endometrial
Ovarian

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3
Q

Risk factors for vulval cancer

A
  1. VIN
  2. Melanoma or lichen sclerosis
  3. Recurrent HPV infections
  4. Paget’s disease
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4
Q

Cervical cancer RFs?

A

Smoking
CIN
Recurrent HPV
Immunocompromised (immunosuppressants, HIV, transplants)
COCP - due to no use of condom

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5
Q

Endometrial cancer RFs?

A

Obesity, T2DM, HTN
Smoking, alcohol, bad diet
Family history
Previous history with other gynaecological cancers or breast cancers
Early menarche - late menopause
Ostrogen only HRT
Nulliparous

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6
Q

Ovarian cancer RFs

A

Smoking obesity
Family history
Breast cancer or tamoxifen use
Nulliparous
Early menarche-late menopause
Age
Talcum powder pre 1975 and asbestos exposure

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7
Q

Cervical Screening explained

A

Introduced 1988
Women aged 25-64
25-49 = every 3 years
50-64 = every 5 years
HIV/CIN +ve = annually

Rescheduled if:
- PID
- Bleeding
- Less than 12 weeks postpartum

Don’t need if:
- cancer referral required
- virgin

Process:
1. Speculum and HSV brush
2. Swab placed in liquid
3. Microbiologist take look if +ve —> cytology
4. If dyskaryosis seen on cytology then colposcopy and biopsy

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8
Q

figures around the effects of cervical examinations?

A

4,500 lives saved per year, 5% abnormalities found, stats dropped between 1988-1999

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9
Q

Who’s included in a gynaecological MDT

A

MDT coordinator
- GP
- Gynaecologist/consultant
- radiologist
- histopathologist
- specialist nurse

Extended:
- OT
- dietician
- palliative care if needed
- chaplain if needed
- social worker if needed

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10
Q

What is the 5 main purposes of an MDT

A
  1. Discuss new cases/diagnoses
  2. Make management plan for patient and communicate
  3. Options for support in terms of dedicating specialist nurses to patients
  4. Review guidelines and audit
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11
Q

how many antenatal visits should be done?

A

10 or 7 if previous babies have been had

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12
Q

Describe the calendar of antenatal screens/checks in an “average” woman

A

8-10 weeks = booking visit (mental health, PMHx, SHx, gynae and obstetric and surgical Hx THEN drug history - following vitamin D and folic acid, blood test for Hep B, HIV, blood group, rhesus factor, anaemia)

BP, WEIGHT AND URINAnalysis is done pretty much all the time to screen for bacturia

12 weeks = USS
11-13+6 = combined test
16 weeks = USS to discuss test and FBC for anaemia for oral iron tablets
18+ anomaly scans (14-20 = triple or quadruple tests)

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13
Q

What is in a combined test

A

Nuchal translucency (USS)
PAPPA & free floating b-hCG (bloods)

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14
Q

What is in a triple test?

A

Free floating b-hCG
Serum oestriol
Alpha-feta protein

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15
Q

What is in a quadruple test?

A

Alpha-feta protein
Free floating b-hCG
Inhibin A
Serum oestriol

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16
Q

Benefits of antenatal screen?

A
  1. Allows patients to educate themselves and feel fully informed moving forward
  2. Allows advanced preparation if keeping baby (household changes etc)
  3. Allows support group connections
  4. Reassurance for those at risk or low risk
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17
Q

Negatives of antenatal screening

A

Just a screening test = could be false positive
Miscarriages

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18
Q

Results for downs on antenatal tests?

A

HIGH = beta h-CG & inhibin
LOW = PAPPa& alpha-fetoprotein & serum oestriol
>6mm NT

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19
Q

Supplements for pregnant women?

A

400mcg of folic acid 3 months prior-12 weeks gestation
5mg of folica acid 3 months prior - 12 weeks gestation

10mcg vitamin D daily through pregnancy and post

Iron tablets if Hg <11

Vitamin A = teratogenic caution

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20
Q

What is FGM

A

Female genital mutilation act 2003

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21
Q

What is the FGM act?

A

Illegal in uK
Illegal to aid and abet in uK
Illegal to send over for FGM
Labioplasty only if preserves mental and phsyical health of a child/woman

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22
Q

4 types of FGM

A

1 - clitoral removal
2 - clitoral and labial removal
3 - closure
4 - burning stitching or piercing of clitoris

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23
Q

IVF on the NHS?

A

Offered for 3 cycles if meet specific criteria:
- <40 if 40-42 or 40 mid treatment only 1 cycle done
- 2 years of trying without contraception
- 12 cycles of alternative fertility treatment clomifene done

Some CCGs look at weight smoking and drinking status too

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24
Q

Still birth?

A

Rates 4.6 - death of a baby antenatally or within 24 hours of life

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25
Q

Perinatal

A

Life of baby antenatally - 7 days post

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26
Q

Neonatal death?

A

2.6 UK death of newborn within first year

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27
Q

Low birth weight?

A

<2.5kg/2500g

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28
Q

How are quality of womens health services assessed?

A

Donabedians:
1. Structure (patient;staff ratio, working contracts/hours)
2. Process (long patient waiting lists, hand hygiene, recording of incidents)
3. Outcome (acquired hospital infections, emergency’s, near miss/major incidents, longer hospitalisations, patient experiences)

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29
Q

What is the human fertilisation and embryology act 1990

A

Women shouldn’t be supported in fertility treatment if the welfare of the child wasnt in their best interest and if not supported by a father (now supported pretending 2008)

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30
Q

What is the human fertilisation and embryology authority?

A

Board of academics that are in control of standardising and checking in on iVF artificial fertilisation clinics in the UK looking at the correct storage of eggs sperm and embryos.

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31
Q

Issues with the human fertilisation and embryology act?

A
  1. Welfare isn’t defined
  2. Welfare isn’t predictable
  3. Fertile couples don’t undergo this scrutiny
  4. Why is a father needed?
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32
Q

abortion act 1967 (1990)

A

It is not illegal to have an abortion if 2 medical practioners have certified is as best interest for mother or baby

If <24 weeks = medical abortion and needs to be in interest of mothers mental and physical wellbeing and if baby may struggle if born due to handicap
If >24 weeks = surgical and pregnancy needs to pose significant risk to mother or baby mental or physical health

If <16 abortion can go ahead with practitioner consent

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33
Q

What are the pro life arguments

A

Justice - for the foetus, seen as human status = human rights to live
Justice - for the mothers who would like to adopt, robbing them of an opportunity
Non-maleficence - harming the foetus
Non-maleficence - medical and mental health future complications

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34
Q

What are the pro abortion arguments?

A

Justice = will allow teenagers to live long fulfilled life
non-maleficence = harm to baby maybe but what about harm to mother?
Non-maleficence = women shouldn’t be placed with emotional burden of rape
Beneficence = contraceptive failure/mistake and their life shouldn’t be impacted by this people make mistakes
Autonomy = own body own choice

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35
Q

HPV epidemiology etc..

A

High risk HPV can be caused by strains 16 and 18
90% of warts are strains 6 and 11

Warts are subcutaneous manifestations of the HPV strain that look brown/red in colour can itch and burn and bleed

Topical lotions or ablations are used for treatment

36
Q

Pubic Lice epidemiology…

A

1-3mm in size tan/grey in colour and can live in coarse hair such as eyebrows eyelashes abdomen hair back hair armpit hair and pubic hair

Leave red lesions and blue lesions in some cases

Treatment is insecticides, good personal hygiene and familial treatment

Can be transmitted through sexual activities or close contact

37
Q

Herpes epidemiology…

A

HSV1 = cold sores
HSV 2 = genital

Starts with febrile prodromal phase, neuralgia, lower abdomen pain and ulcers
Can be active or latent

Treatment is not often acyclovir unless severe

38
Q

Valid argument?

A

Conclusion is logical to the premise

39
Q

Sound argument?

A

True premise that is factual and correct

40
Q

What can be 2 issues of an argument?

A

The premise is incorrect
Anything regarding morality as it cant be justified

41
Q

Can an argument be valid but not sound?

A

Yes

If it has an incorrect premise or moral content

42
Q

What is a straw man fallacy

A

Misrepresentation of person A’s initial argument portrayed as a weaker more frivolous argument that is more likely to be viewed negatively or rejected

43
Q

What is ad hominem fallacy

A

Discredited an argument based of the person who made it (youre a kid you know nothing)

44
Q

What is begging the question fallacy

A

Circular reasoning, where conclusion matches the premises without any evidential backing

45
Q

What is appealing to emotion

A

Using feelings within the argument

46
Q

What is argument from fallacy

A

Discredited and debunking an argument because its initial premise is false/incorrectt

47
Q

What is euthanasia?

A

Euthanasia is the deliberate ending of someone’s life usually due to stop suffering

48
Q

What is assisted suicide

A

Deliberately assisting or encouraging one to commit suicide

49
Q

Active euthanasia?

A

Directly delivering the treatment to end someone’s life

50
Q

Passive euthanasia?

A

With-holding life-prolonging treatment which patients can consent to to eventually kill them

51
Q

Voluntary euthanasia?

A

Patient consents

52
Q

Non-voluntary euthanasia

A

When a person is dying cant consent but usually is through statement of wishes

53
Q

what is involuntary euthanasias

A

Patient does NOT consent = murder

54
Q

Arguments for euthanasia? (3)

A
  1. Autonomy, patients should be able to decide when they die and how they die
  2. DNACPR exists and palliative care with high level sedation for suffering exists why cant others have that treatment
  3. If a patietn is in pain doctors are not being BENEFICENT and acting in their best interest if they want to end life
55
Q

Arguments against euthanasia?

A
  1. Only god can end life
  2. Questions the attitudes towards human life - squanders research
  3. Violates non-maleficence = lack of respect for terminally ill
  4. Detracts from improving end of life care
56
Q

What is the doctrine of double effect

A

Is where an action is put in place to achieve a morally good outcome even if a potentially morally bad side effect may be produced (this can be foreseen or not)

57
Q

what is an example of the doctrine double effect principle?

A

Giving a drug to a terminally ill patient to relieve symptoms but knowing that this could shorten their lives

58
Q

What are 4 terms of doctrine double effect?

A
  1. No other option than giving or doing the action youre doing
  2. The action needs to have a good intention, can’t just be a bad intention (drug to kill)
  3. The action needs to be proportional for helping (cant be too large of a dose to kill just to relieve)
  4. Action must be relevant (correct drug to relieve symptoms)
59
Q

Problems with doctrine double?

A
  1. Unforeseen side effects may occur (quicker death)
  2. Death isn’t alwasy a problem for some
  3. Must take responsibility for both as intention isn’t alwasy enough
60
Q

What is the teenage pregnancy prevention framework 2018?

A

Idea to implement:
- promotion of good quality relationships
- education
- friendly contraceptive providers

61
Q

Issues with teenage pregnancies

A
  1. Lower birth weight increased mortality for baby
  2. Lower socioeconomic status, less education and work = worse outcome for mother and baby
62
Q

What are 2 reasons for teenage pregnancy

A

Low socioeconomic groups = less education
Failing of contraception

Western countries

63
Q

What does MBRRACE-UK stand for?

A

Mothers and babies reducing risk through audits and confidential enquiries across the UK

64
Q

What is reported to MBRRACE-UK

A

Perinatal and maternal mortality (death)

65
Q

What is maternal mortality

A

Death of the mother either up to 42 days or LATE (post 42 days-year)

66
Q

What can cause maternal mortality?

A
  1. Indirect (pre existing condition thats worsened, condition that developed during pregnancy)
  2. Direct (allergy to medication, infection/sepsis, haemorrhage, VTE, eclampsia)
  3. Late can include either of these
67
Q

What are influencing factors to maternal mortality ?

A

Pre-existing conditions - obesity/diabetes etc
Low Socio-economic class - poor education (not attending appts.), no access to healthcare (no momey to drive or public transport), lower groups (smoking, alcohol and drugs), poorer living conditions (nutrition and housing)
obstetric problems - (IVF, Twins and age)

68
Q

What is the main cause of indirect maternal mortality

A

Cardiac death

69
Q

What is still birth?

A

Death of a foetus >24 weeks up to 24 hours post delivery (4.1 in UK)

70
Q

What is early neonatal death

A

Death of new born first 7 days

71
Q

What is death of neonatal?

A

Death of newborn up to 28 days

72
Q

What is death of post neonatal?

A

28-365 days

73
Q

What are the main causes of neonatal death?

A
  1. Prematurity
  2. Congenital risk
  3. Obstetric problems
  4. Infections
74
Q

What is perinatal mortality include

A

Still births and early neonatal deaths

75
Q

What is the main cause of infant death

A

Death in first year of life - 61% die in first year
- prematurity and congenital abnormality

76
Q

What are the trends of infant mortality?

A
  1. Higher rates of teenage pregnancy
  2. Higher rates in lower socioeconomic groups
  3. Higher rates in primps
  4. Higher rates in ethnic minorities
77
Q

Risk factors for still birth

A
  1. Smoke
  2. Obesity
  3. Lower socioeconomic background
  4. Foetal IUGR
  5. Multiple pregnancies
  6. Ethnic problems
  7. Geographical location
  8. Congenital abnormalities
78
Q

Epidemiology of STIs

A

More men than women and easier to diagnose in men
Recent rise in syphilis
15-24

79
Q

What is the most common STIs

A

Chlamydia - warts - herpes - gonorrhoea -

80
Q

3 reasons why increasing sTI rates

A
  1. More condom less sex
  2. More testing
  3. More gay sex
81
Q

Who should be targeted for sexual health promotion

A
  1. Gay men
  2. Young adults
  3. Prison inmates
  4. Sex workers
  5. HIV
  6. Ethnic communities
82
Q

What 3 things should be educated about for promoting sexual health awareness

A
  1. Use and correct use of condoms
  2. Sexual education in schools
  3. Clinics and support group s available
  4. Screenign tests
83
Q

Incidence meaning

A

New cases

84
Q

Prevalance meaning

A

Existing cases

85
Q

What are 3 forms of criminal HIV transmission

A
  1. Accidental (unaware)
  2. Intentional (directly infecting them with intent)
  3. Reckless (not intentional but careless)

Year 3/4 H&S (4 decks)

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