Types of Hysterectomy:
Abdominal and Vaginal
1-Abdominal
-Total hysterectomy (body& cervix are removed).
-Subtotal hysterectomy (body is removed and cervix is preserved) as in PPH and severe adhesions around the cervix
- Extended hysterectomy(TAH + removal for upper vagina + medial part cardinal ligament. It is for treatment of microinvasive cervical CA (IA2)
-Pan hvsterectomv (TAH + BSO).
-Radical hysterectomy (Wertheim' s operation), it's removal of
TAH and BSO
The whole parametrium (broad ligament)
Pelvic ligaments & LN .
-Extended radical hysterectomy (removal of periurethral tissue & up to 3/4+ ofthe vagina.
-Ultra radical hysterectomy (exentration → anterior, posterior or total).
In obstetrics:
-Supra-vaginal hysterectomy
-Caesarean hysterectomy
-Hysterectomy en toto:
Cervix infection
Cervical cancer is first trimester.
2-Vaginal hysterectomy:
-In Uterine prolapse or inversion
-Any patient with uterine size less than 12 week pregnancy as DUB, small fibroids, adenomyosis.
#Obs_Gyne
Abdominal and Vaginal
1-Abdominal
-Total hysterectomy (body& cervix are removed).
-Subtotal hysterectomy (body is removed and cervix is preserved) as in PPH and severe adhesions around the cervix
- Extended hysterectomy(TAH + removal for upper vagina + medial part cardinal ligament. It is for treatment of microinvasive cervical CA (IA2)
-Pan hvsterectomv (TAH + BSO).
-Radical hysterectomy (Wertheim' s operation), it's removal of
TAH and BSO
The whole parametrium (broad ligament)
Pelvic ligaments & LN .
-Extended radical hysterectomy (removal of periurethral tissue & up to 3/4+ ofthe vagina.
-Ultra radical hysterectomy (exentration → anterior, posterior or total).
In obstetrics:
-Supra-vaginal hysterectomy
-Caesarean hysterectomy
-Hysterectomy en toto:
Cervix infection
Cervical cancer is first trimester.
2-Vaginal hysterectomy:
-In Uterine prolapse or inversion
-Any patient with uterine size less than 12 week pregnancy as DUB, small fibroids, adenomyosis.
#Obs_Gyne
Weight gain during pregnancy:
Normal during whole pregnancy is 11-15 kg.
During first month: No weight gain
During second month: Decrease about half to one kg due to nausea, vomiting and loss of appetite.
During third month: Weight is like that of pre-pregnancy weight.
Remaining 6 months, weight gain is by rate of 2kg/month or 1/2 kg per week.
Excessive weight gain occurs as in Hydrominos, multiple pregnancy, diabetic mother.
Sudden weight gain occurs is Preeclampsia.
#Obs_Gyne
Normal during whole pregnancy is 11-15 kg.
During first month: No weight gain
During second month: Decrease about half to one kg due to nausea, vomiting and loss of appetite.
During third month: Weight is like that of pre-pregnancy weight.
Remaining 6 months, weight gain is by rate of 2kg/month or 1/2 kg per week.
Excessive weight gain occurs as in Hydrominos, multiple pregnancy, diabetic mother.
Sudden weight gain occurs is Preeclampsia.
#Obs_Gyne
Pap smear is screening test for early detection of Cervical cancer.
Advice for woman before procedure:
1-No intercourse for 24 hours
2-No vaginal douching for 24 hours.
شل spatula ويجي في رأسها cytobrush نشل من خلالها مسحة ونطرحها على slide ونسوي لها fixation بكحول تركيزه 95٪، ونرسل للـ Cytology.
ونشوف النتيجة لو كانت Normal, inflammatory cells or neoplastic cells.
ونشوف الـ Results على حسب Bethesda system أو Hyperplasia grading.
لوكانت النتيجة Type II high grade lesions
or mild to severe neoplasia.
نسوي بعدها Colposcope لأجل نأخذ punch biopsy لكن لو مش موجود نسوي Schiller test.
Advice for woman before procedure:
1-No intercourse for 24 hours
2-No vaginal douching for 24 hours.
شل spatula ويجي في رأسها cytobrush نشل من خلالها مسحة ونطرحها على slide ونسوي لها fixation بكحول تركيزه 95٪، ونرسل للـ Cytology.
ونشوف النتيجة لو كانت Normal, inflammatory cells or neoplastic cells.
ونشوف الـ Results على حسب Bethesda system أو Hyperplasia grading.
لوكانت النتيجة Type II high grade lesions
or mild to severe neoplasia.
نسوي بعدها Colposcope لأجل نأخذ punch biopsy لكن لو مش موجود نسوي Schiller test.
250 Cases in Clinical Medicine-Elsevier (2019).pdf
13.5 MB
250 Cases in Clinical Medicine-Elsevier.
Remember:
-Dyskariosis refers to abnormality from a smear.
-Dysplasia or cervical intraepithelial neoplasia are histological terms from a biopsy sample.
-CIN should be treated to prevent long-term progression to cervical carcinoma.
-LLETZ is the usual treatment for CIN, with yearly follow-up for 10 years.
-USMEL
#Obs_Gyne
-Dyskariosis refers to abnormality from a smear.
-Dysplasia or cervical intraepithelial neoplasia are histological terms from a biopsy sample.
-CIN should be treated to prevent long-term progression to cervical carcinoma.
-LLETZ is the usual treatment for CIN, with yearly follow-up for 10 years.
-USMEL
#Obs_Gyne
Typical presentations of fibroids:
-Menorrhagia
-Abdominal mass
-Pressure effect from pressure on the bladder, stomach or bowel
-Infertility.
#Obs_Gyne
-Menorrhagia
-Abdominal mass
-Pressure effect from pressure on the bladder, stomach or bowel
-Infertility.
#Obs_Gyne
Remember:
-Most prolactinomas respond to medical treatment with bromocriptine or cabergoline.
-Surgery is only indicated rarely.
#Obs_Gyne
-Most prolactinomas respond to medical treatment with bromocriptine or cabergoline.
-Surgery is only indicated rarely.
#Obs_Gyne
Remember:
The earliest symptom of digoxin toxicity is appetite loss, followed by nausea and vomiting.
-MRCP
#Medicine
The earliest symptom of digoxin toxicity is appetite loss, followed by nausea and vomiting.
-MRCP
#Medicine
What are the indications for steroids in chronic asthma?
-Sleep is disturbed by wheeze
-Morning tightness persists until midday
-Symptoms and peak expiratory flows progressively deteriorate each day
-Maximum treatment with bronchodilators not controlling symptoms
-Emergency nebulizers are needed.
-MRCP
#Medicine
-Sleep is disturbed by wheeze
-Morning tightness persists until midday
-Symptoms and peak expiratory flows progressively deteriorate each day
-Maximum treatment with bronchodilators not controlling symptoms
-Emergency nebulizers are needed.
-MRCP
#Medicine
•Main causes of esophageal varices:
1-Severe liver cirrhosis as aresult of:
a-Chronic hepatitis
b-Alcoholic liver disease
c-Fatty liver disease
2-Primary biliary cirrhosis
3-Thrombosis of portal/splenic vein
4-Parasitic infection as schistosomiasis
5-Budd-chiary syndrome
•RISK_FACTORS:
1-High portal pressure
2-Increase size (large)varices
3-Red streaks on the varices ..when seen by endoscope
4-Continous use of alcohol
5-Sever liver cirrhosis or liver failure.
#Medicine
1-Severe liver cirrhosis as aresult of:
a-Chronic hepatitis
b-Alcoholic liver disease
c-Fatty liver disease
2-Primary biliary cirrhosis
3-Thrombosis of portal/splenic vein
4-Parasitic infection as schistosomiasis
5-Budd-chiary syndrome
•RISK_FACTORS:
1-High portal pressure
2-Increase size (large)varices
3-Red streaks on the varices ..when seen by endoscope
4-Continous use of alcohol
5-Sever liver cirrhosis or liver failure.
#Medicine
Remember:
-Ticagrelor antiplatlet agent demonestrates bactericidal activity against MRSA & may be active against multidrug resistant staphylococcus,or enterococci.
-Medscape
#Medicine
-Ticagrelor antiplatlet agent demonestrates bactericidal activity against MRSA & may be active against multidrug resistant staphylococcus,or enterococci.
-Medscape
#Medicine
Remember:
Low TSH + normal FT4+normal T3:
-subclinical hyperthyroidisim
-sick euothyroid syndrome
-drug effect.
-MRCP
#Medicine
Low TSH + normal FT4+normal T3:
-subclinical hyperthyroidisim
-sick euothyroid syndrome
-drug effect.
-MRCP
#Medicine