My Clinical Notes

Home Birth Arguments

admin — Fri, 22 Apr 2011 12:30:14 +0000

Arguments for and against home birth Arguments against home birth

1) What if things don’t go right? Consequences are disasterous

2) What if you cant get to hospital?

3) What if my midwife changes? Always hearing about problems with midwives, what if I fall through the net?

4) Doctors are often against home deliveries [...]

Smear Tests

admin — Thu, 21 Apr 2011 12:23:52 +0000

Smears

Liquid-based cytology >25years every 3 years >49 years every 5 years >65 years only if previous evidence of dyskaryosis/cervical cancer

When to refer to the colposcopy clinic:

after 3 inadequate samples and after mild, moderate or severe dyskaryosis, invasive smears & those with glandular changes. Mild dyskaryosis/Borderline smear tests send to colposcopy [...]

Vulva

admin — Wed, 20 Apr 2011 11:34:38 +0000

Lichen sclerosis Occurs at all age groups but is more common after the menopause Possible autoimmune Leads to atrophy, fibrosis and scarring Skin becomes pale grey and parchment like The labia become atrophied Introitus becomes narrowed It is not recognised as being precancerous but a greater risk of subsequent carcinoma may occur in [...]

Clinical immunology

admin — Tue, 19 Apr 2011 20:08:00 +0000

Immunopathology of autoimmune diseases Sjogrens syndrome Autoimmune destruction of the exocrine glands, most prominently the lacrimal and salivary glands Other glands in the respiratory mucosa and vagina may also be affected May be associated with other CT diseases such as SLE, scleroderma and RA Primary Sjogrens syndrome is associated with anti Ro and La antibodies [...]

Acquired Immune Deficiency Syndrome

admin — Tue, 19 Apr 2011 20:03:49 +0000

Caused by the retrovirus HIV In the USA in 2002 it was the 2nd leading cause of death of men aged 25-44 and the 3rd leading cause in women 42 million people with HIV/AIDS – 70% in Africa and 15% in Asia Epidemiology of Acquired Immune Deficiency Syndrome 5 groups at risk [...]

Blood Transfusions

admin — Tue, 19 Apr 2011 19:21:27 +0000

Donated blood is screened for; Hep B and C HIV I and II HTLV I and II Syphilis Malaria – T cruzi if donors are travellers CMV for immunosuppressed patients Red cells comprise a unit from a single donor in which the plasma has been removed For storage they are issued in an additive solution [...]

Gestational Diabetes

admin — Tue, 19 Apr 2011 19:16:08 +0000

Pregnancy associated with insulin resistance particularly by the second half of pregnancy

Generally reverts to normal after delivery

Definition of Gestational Diabetes

Defined as diabetes with first onset or recognition during pregnancy

Diabetes confirmed with fasting venous glucose >5.5 mmol/L or >9.0 mmol/L 2 hours after a glucose load.

Investigation is generally via an oral [...]

Gynaecological Examination

admin — Tue, 19 Apr 2011 19:12:01 +0000

What to expect during a gynaecological examination.

Gynaecological examinations are done for several reasons. Most commonly (if you are between 25 and 65) they are done routinely as part of the smear test for cervical cancer. They may also be carried out if you present to your doctor with other problems such as abnormal vaginal [...]

Cervical Cancer

admin — Tue, 19 Apr 2011 11:24:35 +0000

Cervical Transformation Zone Cervix is divided into ectocervix and endocervix The ectocervix is covered with stratified non keratinising epithelium which is continuous with the vagina and converges centrally at the external os The endocervix is above the os and lined with columnar mucus secreting epithelium The point with the squamous and columnar epithelium meet is [...]

Pelvic inflammatory disease

admin — Mon, 18 Apr 2011 11:14:36 +0000

Pelvic Inflammatory Disease is characterised by Pelvic pain Adnexal tendernes Fever Vaginal discharge

Pelvic Inflammatory Disease results from infection by either Gonococcus Chlamydiae Enteric bacteria

In the case if spontaneous/induced abortions and delivery can also be caused by;

Staphylococci Streptococci Coliform bacteria Clostridium perfrigens

These tend to spread up the genital tract by the [...]