Formule Mem Ginecologie

8/13/2019 Formule Mem Ginecologie

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Oral contraceptive complications: warning signs

ACHES:Abdominal painChest painHeadache (severe)Eye (blurred vision)

Sharp leg pain

Abdominal pain: causes during pregnancy

LARA CROFT:LabourAbruption of placentaRupture (eg. ectopic/ uterus)AbortionCholestasisRectus sheath haematomaOvarian tumourFibroidsTorsion of uterus

Post-partum haemorrhage (PPH): causes

4 'T's:Tissue (retained placenta)Tone (uterine atony)Trauma (traumatic delivery, episiotomy)Thrombin (coagulation disorders, DIC)

Ovarian cancer: risk factors

"Blue FILM":Breast cancerFamily historyInfertilityLow parityMumps

Prenatal care questions

ABCDE:Amniotic fluid leakage?Bleeding vaginally?Contractions?Dysuria?Edema?Fetal movement?

Asherman syndrome features

ASHERMAN:Acquired Anomaly

Secondary to SurgeryHysterosalpingography confirms diagnosisEndometrial damage/ EugonadotropicRepeated uterine traumaMissed MensesAdhesionsNormal estrogen and progesterone


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Vaginal pH

Vagina has 4labia and normal pH of vagina is about 4.

Gestation period, oocytes, vaginal pH, menstrual cycle: normal numbers

4is the normal pH of the vagina.40 weeks is the normal gestation period.

400 oocytes released between menarche and menopause.400,000 oocytes present at puberty.28days in a normal menstrual cycle.280 days (from last normal menstrual period) in a normal gestation period.

CVS and amniocentesis: when performed

"Chorionic" has 9letters and Chorionic villus sampling performed at 9weeks gestation."AlphaFetoProtein" has 16letters and it's measured at 16weeks gestation.

Alpha-fetoprotein: causes for increased maternal serum AFP during pregnancy

"Increased Maternal Serum Alpha Feto Protein":Intestinal obstructionMultiple gestation/ Miscalculation of gestational age/ MyeloschisisSpina bifida cysticaAnencephaly/ Abdominal wall defectFetal deathPlacental abruption

Spontaneous abortion: definition

"Spontaneous abortion" has less than 20letters [it's exactly 19 letters].Spontaneous abortion is defined as delivery or loss of products of conception at less than 20weeksgestation.

Female pelvis: shapes

GAP: In order from most to least common:

GynecoidAndroid /AnthropoidPlatypelloidPelvic Inflammatory Disease (PID): complications

I FACE PID:InfertilityFitz-Hugh-Curitis syndrome

AbscessesChronic pelvic painEctopic pregnancyPeritonitisIntestinal obstructionDisseminated: sepsis, endocarditis, arthritis, meninigitis

B-agonist tocolytic (C/I or warning)

ABCDE:Angina (Heart disease)

BP highChorioamnionitisDiabetesExcessive bleeding


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Secondary amenorrhea: causes

SOAP:StressOCPAnorexiaPregnancyPost-partum haemmorrage (PPH): risk factors

PARTUM:Polyhydroamnios/ Prolonged labour/ Previous cesarianAPH/ ANTHRecent bleeding historyTwinsUterine fibroidsMultiparityFetus: cardinal movements of fetus

"Don't Forget IEnjoy Really Expensive Equipment":Descent

FlexionInteral rotationExtensionRestitutionExternal rotationExpulsionSexual response cycle

EXPLORE:EXcitementPLateauOrgasmicREsolutionParity abbreviations (ie: G 3, P 2012)

"To Peace And Love":T: of Term pregnanciesP: of Premature birthsA: of Abortions (spontaneous or elective)L: of Live births Describes the outcomes of the total number of pregnancies (Gravida).

Preeclampsia: classic triad

PREeclampsia:ProteinuriaRising blood pressure

Edema

Alpha-fetoprotein: some major causes for increased maternal serum AFP duringpregnancy

TOLD:Testicular tumoursObituary (fetal death)Liver: hepatomasDefects (neural tube defects)


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Dysfunctional uterine bleeding (DUB): 3 major causes

DUB:Don't ovulate (anovulation: 90% of cases)Unusual corpus leuteum activity (prolonged or insufficient)Birth control pills (since increases progesterone-estrogen ratio)

IUGR: causesIUGR:Inherited: chromosomal and genetic disordersUterus: placental insufficencyGeneral: maternal malnutrition, smokingRubella and other congenital infecton

Early cord clamping: indications

RAPID CS:Rh incompatibilityAsphyxiaPremature delivery

Infections

Diabetic motherCS (caesarian section) previously, so the funda is RAPID CS

Oral contraceptives: side effects

CONTRACEPTIVES:Cholestatic jaundiceOedema (corneal)Nasal congestionThyroid dysfunctionRaised BPAcne/ Alopecia/ AnaemiaCerebrovascular diseaseElevated blood sugar

Porphyria/ Pigmentation/ PancreatitisThromboembolismIntracranial hypertensionVomiting (progesterone only)Erythema nodosum/ Extrapyramidal effects

Sensitivity to light

Pelvic Inflammatory Disease (PID): causes, effects

"PID CAN be EPIC": Causes:Chlamydia trachomatisActinomycetesNeisseria gonorrhoeae Effects:EctopicPregnancyInfertilityChronic pain


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RLQ pain: brief female differential

AEIOU:Appendicitis/ AbscessEctopic pregnancy/ EndometriosisInflammatory disease (pelvic)/ IBDOvarian cyst (rupture, torsion)

Uteric colic/ Urinary stones

Forceps: indications for delivery

FORCEPS:Foetus aliveOs dilated

Ruptured membraneCervix taken upEngagement of headPresentation suitableSagittal suture in AP diameter of inlet

Delivery: instrumental delivery prerequisites

AABBCCDDEE:AnalgesiaAntisepsisBowel emptyBladder emptyCephalic presentationConsentDilated cervixDisproportion (no CPD)EngagedEpisiotomy

APGAR score components

SHIRT:Skin color: blue or pinkHeart rate: below 100 or over 100Irritability (response to stimulation): none, grimace or cryRespirations: irregular or good

Tone (muscle): some flexion or active

Postpartum collapse: causes

HEPARINS:HemorrhageEclampsiaPulmonary embolismAmniotic fluid embolismRegional anaethetic complications

Infarction (MI)Neurogenic shockSeptic shock


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Multiple pregnancy complications

HI, PAPA:Hydramnios (Poly)IUGRPreterm labourAntepartum haemorrhage

Pre-eclampsiaAbortion

Omental caking: likeliest cause

Omental CAking = Ovarian CA "Omental caking" is term for ascities, plus a fixed upper abdominal and pelvic mass. Almost always signifiesovarian cancer.

IUD: side effects

PAINS:Period that is lateAbdominal crampsIncrease in body temperature

Noticeable vaginal dischargeSpotting

Labour: preterm labor causes

DISEASE:DehydrationInfection

SexExercise (strenuous)ActivitiesStressEnvironmental factor (job, etc)

Polycystic Ovarian Syndrome (PCOS): first line treatmentTreat PCOSwith OCP's(oral contraceptive pills).Antepartum hemorrhage (APH): major differential

APH:Abruptio placentaePlacenta previaHemorrhage from the GU tract

Miscarriage: recurrent miscarriage causes

RIBCAGE:RadiationImmune reaction

Bugs (infection)Cervical incompetenceAnatomical anomaly (uterine septum etc.)Genetic (aneuploidy, balanced translocation etc.)Endocrine


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Shoulder dystocia: management

HELPER:Call for HelpEpisiotomyLegs up [McRoberts position]Pressure subrapubically [not on fundus]

Enter vagina for shoulder rotationReach for posterior shoulder and deliver posterior shoulder/ Return head into vagina [Zavanelli maneuver] forC-section/ Rupture clavicle or pubic symphisis

Labour: factors which determine rate and outcome of labour

3 P's:Power: stength of uterine contractionsPassage: size of the pelvic inlet and outletPassenger: the fetus--is it big, small, have anomalies, alive or dead

Post-partum examination simplified checklist

BUBBLES:Breast

UterusBowelBladderLochiaEpisotomySurgical site (for Cesarean section)

Cardiotocogram (CTG) interpretation

Dr. C. BraVADODefine RiskContractions (in 10 mins)Baseline Rate (should be 110-160)Variability (should be greater than 5)

AccelerationsDecelerationsOverall (normal or not)

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