Saturday, August 15, 2015

Obstetrics & Gynecology Mnemonics


Obstetrics & Gynecology Mnemonics


Post-partum examination simplified checklist BUBBLES:
Breast
Uterus
Bowel
Bladder
Lochia
Episotomy
Surgical site (for Cesarean section)


Cardiotocogram (CTG) interpretation Dr. C. BraVADO
Define Risk
Contractions (in 10 mins)
Baseline Rate (should be 110-160)
Variability (should be greater than 5)
Accelerations
Decelerations
Overall (normal or not)


Postpartum collapse: causes HEPARINS:
Hemorrhage
Eclampsia
Pulmonary embolism
Amniotic fluid embolism
Regional anaethetic complications
Infarction (MI)
Neurogenic shock
Septic shock
Multiple pregnancy complications HI, PAPA:
Hydramnios (Poly)
IUGR
Preterm labour
Antepartum haemorrhage
Pre-eclampsia
Abortion


Omental caking: likeliest cause Omental CAking
Ovarian CA
· "Omental caking" is term for ascities, plus a fixed upper abdominal and pelvic
mass. Almost always signifies ovarian cancer.


IUD: side effects PAINS:
Period that is late
Abdominal cramps
Increase in body temperature
Noticeable vaginal discharge
Spotting


Labour: preterm labor causes DISEASE:
Dehydration
Infection
Sex
Exercise (strenuous)
Activities
Stress
Environmental factor (job, etc)


Polycystic Ovarian Syndrome (PCOS): first line treatment
Treat PCOS with OCP's(oral contraceptive pills).


Antepartum hemorrhage (APH): major differential APH:
Abruptio placentae
Placenta previa
Hemorrhage from the GU tract


Miscarriage: recurrent miscarriage causes RIBCAGE:
Radiation
Immune reaction
Bugs (infection)
Cervical incompetence
Anatomical anomaly (uterine septum etc.)
Genetic (aneuploidy, balanced translocation etc.)
Endocrine


Shoulder dystocia: management HELPER:
Call for Help
Episiotomy
Legs up [McRoberts position]
Pressure subrapubically [not on fundus]
Enter vagina for shoulder rotation
Reach for posterior shoulder and deliver posterior shoulder/ Return
head into vagina [Zavanelli maneuver] for C-section/ Rupture clavicle or
pubic symphisis


Labour: factors which determine rate and outcome of labour 3
P's:
Power: stength of uterine contractions
Passage: size of the pelvic inlet and outlet
Passenger: the fetus--is it big, small, have anomalies, alive or dead


Alpha-fetoprotein: some major causes for increased maternal serum AFP
during pregnancy
 TOLD:
Testicular tumours
Obituary (fetal death)
Liver: hepatomas
Defects (neural tube defects)


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: causes IUGR:
Inherited: chromosomal and genetic disorders
Uterus: placental insufficency
General: maternal malnutrition, smoking
Rubella and other congenital infecton


Early cord clamping: indications RAPID CS:
Rh incompatibility
Asphyxia
Premature delivery
Infections
Diabetic mother
CS(caesarian section) previously, so the funda is RAPID CS


Oral contraceptives: side effects CONTRACEPTIVES:
Cholestatic jaundice
Oedema (corneal)
Nasal congestion
Thyroid dysfunction
Raised BP
Acne/ Alopecia/ Anaemia
Cerebrovascular disease
Elevated blood sugar
Porphyria/ Pigmentation/ Pancreatitis
Thromboembolism
Intracranial hypertension
Vomiting (progesterone only)
Erythema nodosum/ Extrapyramidal effects
Sensitivity to light


Pelvic Inflammatory Disease (PID): causes, effects "PID 
CAN
 be EPIC":
· Causes:
Chlamydia trachomatis
Actinomycetes
Neisseria gonorrhoeae
· Effects:
Ectopic
Pregnancy
Infertility
Chronic pain


RLQ pain: brief female differential AEIOU:
Appendicitis/ Abscess
Ectopic pregnancy/ Endometriosis
Inflammatory disease (pelvic)/ IBD
Ovarian cyst (rupture, torsion)
Uteric colic/ Urinary stones


Forceps: indications for delivery FORCEPS:
Foetus alive
Os dilated
Ruptured membrane
Cervix taken up
Engagement of head
Presentation suitable
Sagittal suture in AP diameter of inlet


Delivery: instrumental delivery prerequisites AABBCCDDEE:
Analgesia
Antisepsis
Bowel empty
Bladder empty
Cephalic presentation
Consent
Dilated cervix
Disproportion (no CPD)
Engaged
Episiotomy


APGAR score components SHIRT:
Skin color: blue or pink
Heart rate: below 100 or over 100
Irritability (response to stimulation): none, grimace or cry
Respirations: irregular or good
Tone (muscle): some flexion or active


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


Female pelvis: shapes GAP:
· In order from most to least common:
Gynecoid
Android /Anthropoid
Platypelloid


Pelvic Inflammatory Disease (PID): complications I FACE
PID
:
Infertility
Fitz-Hugh-Curitis syndrome
Abscesses
Chronic pelvic pain
Ectopic pregnancy
Peritonitis
Intestinal obstruction
Disseminated: sepsis, endocarditis, arthritis, meninigitis


B-agonist tocolytic (C/I or warning) ABCDE:
Angina (Heart disease)
BP high
Chorioamnionitis
Diabetes
Excessive bleeding


Secondary amenorrhea: causes SOAP:
Stress
OCP
Anorexia
Pregnancy


Post-partum haemmorrage (PPH): risk factors PARTUM:
Polyhydroamnios/ Prolonged labour/ Previous cesarian
APH/ ANTH
Recent bleeding history
Twins
Uterine fibroids
Multiparity


Fetus: cardinal movements of fetus "Don't Forget
I Enjoy Really Expensive Equipment":
Descent
Flexion
Interal rotation
Extension
Restitution
External rotation
Expulsion


Sexual response cycle EXPLORE:
EXcitement
PLateau
Orgasmic
REsolution


Parity abbreviations (ie: G 3, P 2012) "TPeace
And Love":
T: of Term pregnancies
P: of Premature births
A: of Abortions (spontaneous or elective)
L: of Live births
· Describes the outcomes of the total number of pregnancies (Gravida).


Preeclampsia: classic triad PREeclampsia:
Proteinuria
Rising blood pressure
Edema


Oral contraceptive complications: warning signs ACHES:
Abdominal pain
Chest pain
Headache (severe)
Eye (blurred vision)
Sharp leg pain


Abdominal pain: causes during pregnancy LARA CROFT:
Labour
Abruption of placenta
Rupture (eg. ectopic/ uterus)
Abortion
Cholestasis
Rectus sheath haematoma
Ovarian tumour
Fibroids
Torsion 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 cancer
Family history
Infertility
Low parity
Mumps


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


Asherman syndrome features ASHERMAN:
Acquired Anomaly
Secondary to Surgery
Hysterosalpingography confirms diagnosis
Endometrial damage/ Eugonadotropic
Repeated uterine trauma
Missed Menses
Adhesions
Normal estrogen and progesterone


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


Gestation period, oocytes, vaginal pH, menstrual cycle: normal
numbers
 4 is 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.
28 days in a normal menstrual cycle.
280 days (from last normal menstrual period) in a normal gestation
period.


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


Alpha-fetoprotein: causes for increased maternal serum AFP during
pregnancy
 "Increased Maternal Serum Alpha
Feto Protein":
Intestinal obstruction
Multiple gestation/ Miscalculation of gestational age/ Myeloschisis
Spina bifida cystica
Anencephaly/ Abdominal wall defect
Fetal death
Placental abruption

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