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18:11, 26 July 2023 Nikolas talk contribs created page File:Intrapartum CTG classification.jpg
18:11, 26 July 2023 Nikolas talk contribs uploaded File:Intrapartum CTG classification.jpg
18:10, 26 July 2023 Nikolas talk contribs created page B8. Prenatal diagnostics II. (non-invasive methods) (Created page with "Non-invasive prenatal diagnostics are the first-line investigations for screening for foetal genetic disorders. Multiple non-invasive methods exist: * Ultrasound * Cell-free DNA * Combined tests * Biophysical profile In general, it’s recommended that all women should be offered prenatal diagnostics should they wish. However, the conditions for which the diagnostics are paid for by the state differ from country to country. In general, women with a higher risk for foet...") Tag: Visual edit
18:09, 26 July 2023 Nikolas talk contribs created page B7. Prenatal diagnostics I. (invasive methods) (Created page with "Prenatal diagnostics are techniques which can be used to detect genetic disorders or birth defects in the foetus. There are three purposes of these: * To prepare necessary medical or surgical treatments soon after birth, or even intrapartum * To give the parents the chance to abort a foetus with the diagnosed condition * To give the parents the chance to prepare for a baby with a certain condition We distinguish invasive and non-invasive methods. The invasive methods a...") Tag: Visual edit
18:07, 26 July 2023 Nikolas talk contribs created page B6. Infectious diseases during pregnancy (hepatitis, HIV, toxoplasmosis, syphilis, Group B Streptococcus) (Created page with "''There was never a lecture on this and so much of this topic is based on Norwegian sources and UpToDate.'' == Group B streptococcus == Group B streptococci (GBS), technically ''streptococcus agalactiae'', is a bacteria found in normal flora (<abbr>GI</abbr> tract, vagina) but is the most common cause of neonatal infection. 10 – 35% of pregnant women are colonised with GBS, and colonised women can transmit the bacterium to offspring. GBS bacteriuria is a sign of signi...") Tag: Visual edit
18:05, 26 July 2023 Nikolas talk contribs created page B5. Non-stress test and stress test (+ CTG basics) (Created page with "The non-stress test (NST) and contraction stress test (CST) are two tests which use cardiotocography (CTG) to measure how the foetal heart rate (FHR) changes in response to foetal movements and oxytocin-induced uterine contractions, respectively. The cardiotocograph is a diagnostic tool which records both the foetal heart rate and the uterine contractions with the help of two electrodes placed on the mother’s abdomen. It gives information of the foetal wellbeing. One...") Tag: Visual edit
18:04, 26 July 2023 Nikolas talk contribs created page File:CTG without FHR variability.jpg
18:04, 26 July 2023 Nikolas talk contribs uploaded File:CTG without FHR variability.jpg
18:03, 26 July 2023 Nikolas talk contribs created page File:Variations in CTG.png
18:03, 26 July 2023 Nikolas talk contribs uploaded File:Variations in CTG.png
18:02, 26 July 2023 Nikolas talk contribs created page File:Normal CTG.png
18:02, 26 July 2023 Nikolas talk contribs uploaded File:Normal CTG.png
18:01, 26 July 2023 Nikolas talk contribs created page B4. Fetal lie. Assessing fetal lie (Created page with "Foetal lie refers to how the foetus lies in the uterine cavity, specifically how the foetus’ long axis is compared to the mother’s long axis. Foetal lie may be: * Longitudinal – foetus’ long axis is parallel with the mother’s ** Can be either cephalic (physiological) or breech presentation * Transversal – foetus’ long axis is perpendicular to the mother’s * Oblique – foetus’ long axis is oblique compared to the mother’s Transverse lie and breech p...") Tag: Visual edit
18:00, 26 July 2023 Nikolas talk contribs created page B3. Placenta accreta, increta and percreta (Created page with "The placenta accreta spectrum (PAS) disorders, also called abnormally invasive placenta (AIP) or placentation abnormalities, are a group of disorders where the placenta invades deeper into the uterine wall than normal. The three disorders are: * Placenta accreta – (80%) – the placenta extends to the myometrium and attaches to it * Placenta increta – (15%) – the placenta invades through the entire thickness of the myometrium * Placenta percreta – (5%) – the p...") Tag: Visual edit
17:59, 26 July 2023 Nikolas talk contribs created page B2. Conception, implantation (Created page with "Fertilisation (conception) is the process during which a sperm cell fuses with the oocyte. This occurs within 1 day of ovulation, usually in the ampullary region of the fallopian tube. Before sperm cells can fuse with the oocyte, they must undergo two processes, capacitation and the acrosome reaction. After these reactions, the sperm cell has fused with the oocyte, forming a zygote, a diploid cell with 46 chromosomes. At this point, the oocyte completes meiosis II. The...") Tag: Visual edit
17:59, 26 July 2023 Nikolas talk contribs created page B1. Diagnosing pregnancy (Created page with "== Signs suspicious for pregnancy (presumptive signs) == These signs are not proof of pregnancy but may make a woman suspicious that she is pregnant. * Nausea, morning vomiting * Affection to unusual things (like food, ice, etc, or reverse feeling for things she liked earlier) * Breast enlargement and tenderness == Probable (“warning”) signs of pregnancy == These signs are also not proof of pregnancy but are more specific to it than the presumptive signs. * Change...") Tag: Visual edit
17:57, 26 July 2023 Nikolas talk contribs created page A15. Puerperal fever and sepsis (Created page with "Puerperal fever (postpartum fever or childbed fever) refers to fever which occurs within the first 10 days postpartum. In most cases, fever is due to endometritis, but it can also be due to other causes. It’s most commonly seen after C-section but may occur following vaginal birth as well. Most cases are mild and resolve quickly with antibiotics. Fever in the first day is especially common and often resolves spontaneously. However, some cases are severe and may cause...") Tag: Visual edit
17:56, 26 July 2023 Nikolas talk contribs created page A14. DIC, HELLP, amniotic fluid embolism (Created page with "== Amniotic fluid embolism == Amniotic fluid embolism (AFE) refers to the entry of amniotic fluid (which contains foetal cells or hair) into the maternal circulation, which then embolise. It causes a systemic inflammatory response syndrome (SIRS)-like syndrome and is an obstetrical emergency which is often lethal. It occurs during labour or within 30 minutes postpartum. Thankfully, it is rare (1 – 10 per 100 000 deliveries). === Etiology === Risk factors for AFE are n...") Tag: Visual edit
17:55, 26 July 2023 Nikolas talk contribs created page A13. Uterine rupture (Created page with "Rupture of the uterus is a life-threatening complication for both the mother and the foetus. It mostly occurs during labour, and mostly in people who’ve had a previous C-section (vaginal birth after C-section, VBAC). However, it can also occur antepartum and in women without previous surgery. It’s an obstetric emergency which requires emergency surgery. In a uterine rupture the uterus opens into the abdominal cavity. In case of uterine dehiscence, a related conditio...") Tag: Visual edit
17:54, 26 July 2023 Nikolas talk contribs created page A12. Uterine atony (Created page with "In normal conditions, the uterus contracts after delivery. A high uterine muscle tone is essential for compressing vessels postpartum, preventing haemorrhage. Uterine atony refers to when the uterine muscle tone is absent. It’s the most common cause of postpartum haemorrhage. If uncontrolled, it can lead to haemorrhagic shock. == Etiology == * Overdistension (macrosomia, polyhydramnios, multiple pregnancy) * Exhausted myometrium (long labour, excessive use of uterot...") Tag: Visual edit
17:53, 26 July 2023 Nikolas talk contribs created page A11. Maternal obstetrical injuries (Created page with "Multiple injuries may befall the mother during labour. The most common maternal obstetrical injuries include perineal ruptures, labial and vaginal lacerations, cervical injury, genital haematoma, nerve injuries, and uterine rupture (covered in topic A13). == Perineal rupture == === Definition === During vaginal birth, the perineum may rupture, which constitutes the most common form of maternal obstetric injury. Most nulliparous women sustain a perineal injury during va...") Tag: Visual edit
17:52, 26 July 2023 Nikolas talk contribs created page A10. Placenta praevia (Created page with "Placenta praevia refers to the situation when the placenta partially or completely covers the internal os of the cervix. This makes vaginal birth impossible and increases the risk for preterm delivery and severe postpartum haemorrhage. Also related are the marginal and low-lying placentas. Placenta praevia is associated with the placenta accreta spectrum disorders (accreta, increta, percreta). == Etiology == The cause of placenta praevia is unknown. Some risk factors i...") Tag: Visual edit
17:51, 26 July 2023 Nikolas talk contribs created page A9. Placental abruption. Pathomechanism, diagnosis, differential-diagnosis (Created page with "Placental abruption refers to when the placenta separates from the uterus prematurely, sometime before the second stage of labour, but typically sometime in the second half of pregnancy. This leads to a retroplacental bleeding which may range from small and asymptomatic to severe and life-threatening. It is one of the life-threatening causes of vaginal bleeding in this half of the pregnancy, and so recognising it early is important. Abruption may be partial or complete....") Tag: Visual edit
17:50, 26 July 2023 Nikolas talk contribs created page A8. Signs and differential diagnosis of pending uterine rupture and placental abruption (Created page with "''You should read topics A9 and A13 before this.'' == Vaginal bleeding in the second half of pregnancy == === Definition === There are many possible causes of vaginal bleeding in the second half of the pregnancy. Some are life-threatening and some aren’t. In either case, it’s important to identify the cause of bleeding and treat it if possible. As the topic name suggests, we’ll focus on signs and differential diagnosis of pending uterine rupture and placental ab...") Tag: Visual edit
17:49, 26 July 2023 Nikolas talk contribs created page A7. Prolapse of umbilical cord and fetal limb (Created page with "== Umbilical cord prolapse == === Definition and epidemiology === Umbilical cord prolapse refers to when the umbilical cord prolapses before or alongside the foetus during labour, causing both to be present simultaneously in the pelvis. This is problematic because the cord will be compressed during delivery, which deprives the foetus of oxygen and nutrients, causing asphyxia. Luckily, it’s rare. === Etiology === Umbilical cord prolapse is often seen in presentation a...") Tag: Visual edit
17:49, 26 July 2023 Nikolas talk contribs created page A6. Premature rupture of membranes (Created page with "Prelabour rupture of membrane (PROM) refers to rupture of the membranes before labour begins, but after 37 weeks of gestation. If it occurs before 37 weeks of gestation, it’s called preterm prelabour rupture of membranes (PPROM). As the membranes protect against infection, early membrane rupture predisposes to intrauterine infection. They main issue with PROM is whether to wait for spontaneous labour to begin or to induce labour. Almost all patients with PROM will go...") Tag: Visual edit
17:47, 26 July 2023 Nikolas talk contribs created page A5. Operative vaginal delivery. forceps and vacuum-extraction (Created page with "Operative delivery (or assisted vaginal delivery) refers to using special tools to assist vaginal birth, either forceps or vacuum extraction. It’s only performed during the second stage of labour. These tools allow the operator to apply both pulling forces and, in case of forceps extraction, rotation forces as well. Like C-section, operative delivery carries some risk to the mother and foetus and so is only used when the risk of not performing it outweighs the risk of...") Tag: Visual edit
17:47, 26 July 2023 Nikolas talk contribs created page A4. Forms of cesarean delivery, indications (Created page with "Caesarean section (from Latin, ''caesura'' = to cut) is a surgical procedure where the foetus is delivered by open surgery, through an incision in the abdominal wall and uterus. Often called simply C-section, this procedure has no absolute contraindications and can therefore in theory be performed on anyone. This makes C-section the ideal “plan B” in case vaginal labour is too risky, not progressing properly, or frankly impossible. However, C-section is generally onl...") Tag: Visual edit
17:46, 26 July 2023 Nikolas talk contribs created page A3. Classification of abortions, etiology, therapy options (Created page with "An abortion is the termination of a pregnancy before a life birth is possible (< 24th week of gestation). We distinguish spontaneous (uninduced) and induced abortions. Some use the term “abortion” to refer to induced abortions only, while leaving the term “miscarriage” for spontaneous abortion. Transvaginal ultrasound is essential in evaluating these conditions, as the foetus is too small to be visualised with transabdominal ultrasound. == Spontaneous abortion...") Tag: Visual edit
17:45, 26 July 2023 Nikolas talk contribs created page A2. Lactation, mastitis (Created page with "== Lactation == === Introduction === Lactation is the process of secreting milk from the breast to feed the infant. The synthesis of breast milk is induced by prolactin and ejecting of milk is induced by oxytocin. Ideally, the infant should be exclusively breastfed in the first 6 months, followed by partial breastfeeding and partial vegetables and fruits from month 6 onwards. Breast milk contains enough energy and nutrients for the infant for the first 6 months, but af...") Tag: Visual edit
17:44, 26 July 2023 Nikolas talk contribs created page A1. Stages of labour (Created page with "Labour (childbirth) is the last phase of pregnancy, which ends with the foetus, placenta, and foetal membranes being expulsed through the vaginal canal or by Caesarean section. In most cases they begin spontaneously, but in some cases, labour must be induced (topic B23). Although it’s sometimes called childbirth, labour doesn’t end when the foetus is out of the birth canal; there are two more stages after this. ''Normal labour'' (partus normalis) refers to childbirt...") Tag: Visual edit
17:43, 26 July 2023 Nikolas talk contribs created page A0. Good-to-know gynaecology stuff which isn’t covered in other topics (Created page with "''This topic includes some stuff which I think is important to know, but which don’t fit under any specific topic. I will add to this topic as I go about writing the other topics.'' == Obstetric notation == During obstetric history taking, it’s important to ask the number of pregnancies and deliveries thus far, as well as the mode of delivery. Not all pregnancies end in a delivery, and so the two numbers are often different and summarised in a short-hand notation. T...") Tag: Visual edit
17:41, 26 July 2023 Nikolas talk contribs created page Category:Obstetrics and gynaecology 1 (Created page with "Category:5th year") Tag: Visual edit
17:40, 26 July 2023 Nikolas talk contribs created page Category:5th year (Created page with "Category:Pages by POTE course") Tag: Visual edit
13:30, 25 July 2023 Nikolas talk contribs created page Future perspectives of pharmacology (no longer a topic) (Created page with "According to prof. Erika Pintér this is not part of the curriculum for pharma 3 exam this semester (2019 fall semester). She was surprised that it is on the topic list, and she said that it shouldn’t be on it. If you are interested, here are some of the things she talked about in the lecture: ==== Advanced therapy medicinal products ==== * Gene therapy ** SiRNA *** Patisiran – silences amyloid gene, treatment of a rare type of amyloidosis ** MiRNA * Cell therapy...") Tag: Visual edit
13:29, 25 July 2023 Nikolas talk contribs created page 86. Drug intoxications. Mechanisms, symptoms, treatment (Created page with "''According to the lecturer the most important drugs to know here are sedative hypnotics, opioids, digitalis, sympathomimetics, anticholinergics, iron and paracetamol.'' == Types of intoxications according to mechanism of death == * Intoxication with decreased level of consciousness ** Sedative hypnotics ** Tricyclic antidepressants ** Antipsychotics ** Opioids * Intoxication with excitatory drugs ** Sympathomimetics ** Ketamine and PCP ** Anticholinergics ** Theophyll...") Tag: Visual edit
13:25, 25 July 2023 Nikolas talk contribs created page 85. The treatment of the intoxicated patient: decontamination, facilitation of toxicant elimination, antidote administration, supportive treatment (Created page with "''According to the lecturer the most important parts of this topic are the fascilitation of elimination and the antidotes''. The most important mechanisms intoxications can cause morbidity and death are: * Respiratory failure * Circulatory failure * Systemic hypoxia * Seizures * Other organ damage ** Liver ** Lung === Poisoning-related respiratory failure === This is usually due to overdose by CNS depressant drugs, like opioids, sedative hypnotics, ethanol, tricyclic...") Tag: Visual edit
13:19, 25 July 2023 Nikolas talk contribs created page 84. Drug interactions (Created page with "We can categorize drug interactions based on the magnitude of the combined effect. When two drugs interact, the result can be: * Additive – the combined effect is higher that either of the individual effects but not higher than the sum of the two individual effects * Potentiated/synergic – the combined effect is higher than the sum of the two individual effects * Antagonized – the combined effect is smaller than that of one of the individual effects We can also c...") Tag: Visual edit
13:14, 25 July 2023 Nikolas talk contribs created page 83. Harmful effects of drugs (Created page with "Drugs rarely have their intended therapeutic effect without causing some harmful effects too, most often mild effects but sometimes severe. What are the “side effects” of a drug? Can what qualifies as side effects of a drug change? The truth is that we decide which effects a drug has are its “main” effects and which are its “side” effects. When minoxidil was used as an antihypertensive the increased hair growth was called a side effect. Nowadays minoxidil is...") Tag: Visual edit
11:58, 30 April 2023 Nikolas talk contribs created page 82. Pharmacogenetics, pharmacogenomics. Effects of age, diet and disease on drug action (Created page with "== Personalized medicine == When studying the effect of a drug, we do it on populations with many hundred or thousand people. These clinical trials measure the average effect of the drug on many people. These trials don’t take into account the individual response of the drug. This is a problem, because while we study drug effects on large populations, physicians use the drugs to treat individual patients. The same drug given in the same dose doesn’t necessarily prod...") Tag: Visual edit
11:51, 30 April 2023 Nikolas talk contribs created page File:SSRI panel.jpg
11:51, 30 April 2023 Nikolas talk contribs uploaded File:SSRI panel.jpg
11:48, 30 April 2023 Nikolas talk contribs created page 81. Antiseptics and disinfectants (Created page with "A disinfectant is a compound which destroys or inhibits the growth of microorganisms on ''non-living objects'', like tables, walls, beds, etc. An antiseptic is a compound which destroys or inhibits the growth of microorganisms on ''living tissue'', like on the skin or on mucous membranes. They are not meant for systemic use, which separates them from antibiotics. An ideal antiseptic (or disinfectant) must have the following properties. It must: * destroy or remove all...") Tag: Visual edit
11:44, 30 April 2023 Nikolas talk contribs created page 80. Anthelminthic drugs (Created page with "== Helminths == Helminths are parasitic worms. They’re categorized like this: * Helminths (worms) ** Plathelminths (flatworms) *** Cestodes (tapeworms) *** Trematodes (flukes) ** Nemathelminths (roundworms) *** Nematodes (threadworms) **** Intestinal nematodes **** Filariae == Antihelminthic drugs == Classified according to mechanism of action: * Drugs against flatworms ** Drugs which bind tubulin *** Benzimidazoles ** Drugs which interfere with energy production **...") Tag: Visual edit
13:50, 26 April 2023 Nikolas talk contribs created page 79. Antiprotozoal drugs (Created page with "== Antimalarial drugs == Malaria is the most common disease in the world. It’s caused by the ''plasmodia'' species of parasites, which are spread by the ''Anopheles'' mosquito. Plasmodium vivax causes benign tertian malaria. Plasmodium falciparum causes malignant tertian malaria, which affects the CNS. === Compounds === * Chloroquine * Primaquine * Artesunate * Quinine * Atovaquone * Proguanil * Pyrimethamine * Doxycycline * Clindamycin Of all of the antimalarials t...") Tag: Visual edit
13:48, 26 April 2023 Nikolas talk contribs created page 78. Antiviral drugs against HIV and influenza viruses (Created page with "== Antivirals against HIV == * Nucleotide reverse transcriptase inhibitors (NRTIs) ** Zidovudine ** Lamivudine ** Abacavir * Non-nucleotide reverse transcriptase inhibitors (NNRTIs) ** Nevirapine ** Efavirenz * Protease inhibitors (PIs) ** Darunavir ** Lopinavir ** Ritonavir * Integrase strand transfer inhibitors (INSTIs) ** Raltegravir ** Dolutegravir * Entry inhibitors ** Enfuvirtide * CCR5-antagonists ** Maraviroc === Indications === The standard regimen for ''antir...") Tag: Visual edit
13:39, 26 April 2023 Nikolas talk contribs created page 77. Antiviral drugs against herpes and hepatitis viruses (Created page with "== Antivirals against HSV, VZV and CMV == We can classify the antivirals against herpes viruses according to the mechanism of action: * Guanosine analogues activated by thymidine kinase ** Acyclovir ** Valacyclovir – prodrug of acyclovir ** Penciclovir ** Famciclovir – prodrug of penciclovir * Guanosine analogues activated by UL97 kinase ** Ganciclovir ** Valganciclovir – prodrug of ganciclovir * Direct viral DNA/RNA polymerase inhibitor ** Foscarnet * Cytidine an...") Tag: Visual edit
13:37, 26 April 2023 Nikolas talk contribs created page 76. Antifungal drugs (Created page with "== Polyenes == === Compounds === * Amphotericin B * Nystatin * Natamycin === Indications === Amphotericin is the first choice for severe systemic fungal infections. Nystatin and natamycin are too toxic for systemic use and instead used topically for oral and vaginal candidiasis. === Mechanism of action === Polyenes disrubt fungal cell wall synthesis by binding to ergosterol in the fungal cell membrane, which leads to formation of pores in the membrane, causing leaka...") Tag: Visual edit
13:36, 26 April 2023 Nikolas talk contribs created page 75. Antituberculotic drugs. Anti-leprosy drugs (Created page with "== Antituberculotic drugs == Treating mycobacteria is a challenge for the following reasons: * The mycobacterial cell wall is thick and less permeable for antibiotics, and it expresses several efflux transporters * Mycobacteria multiply slowly * Many mycobacteria are genetically resistant to many antibiotics For these reasons there are many drugs which are available for treating TB, so that we have multiple options in case of resistance. The first-line agents in treat...") Tag: Visual edit
13:32, 26 April 2023 Nikolas talk contribs created page 74. Macrolide antibiotics, clindamycin, chloramphenicol, oxazolidinones, streptogramins (Created page with "== Macrolides == === Compounds === * Erythromycin * Clarithromycin * Azithromycin === Mechanism of action === Macrolides bind to the 50S subunit of bacterial ribosomes, inhibiting translocation. This effect is bacteriostatic. === Mechanism of resistance === Resistance is often encoded by a plasmid. It can be mediated by drug efflux, enzymatic inactivation or changing the binding-site of macrolides on the ribosomes. === Pharmacokinetics === Macrolides are orally abso...") Tag: Visual edit