超音波
黃醫師 TMU教學長
Uterus往膀胱: 前傾
TAS 喝 1000cc & wait 2 hour.(~500cc in
bladder)
TVS
不會看到膀胱,在右下角
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Uterus 7cm
Postmenopausal
3-5cm
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Fetal head
size uterus
Enlargement
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18mm follicle
near ovulation
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Uterine myoma
Progesterone
antagonist: Mifepristone
自費，一天兩百元
可縮小一半
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單極電刀用蒸餾水
雙極D5 water
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Uterine
Sarcoma 3-6‰
Ddx
- Lung metastasis
- Urachal cancer
- Colon cancer
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Adenomyosis
Abdominal
mass
Dysmenorrhea
Peak age 40
Menometrorrhagia.
Duration 10 days, irregular, 非月經期也流血
Treatment
Danazol.
長鬍子，雄性化，聲音變低不可逆
停經針
黃體素避孕器Mirena，副作用點狀出血
Subtotal
resection, 不要wedge, 三年復發， 懷孕破裂
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備血 最快半小時
Colloid
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驗孕
沒尿就驗血
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止血可用Oxytocin
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Endometrial
cancer
Spotting
bleeding
Menometrorrhagia
Risk
PCOS
Lymph node
Meta
Stage 3c1, 2,
3
IA Tumor confined to the uterus, no or < ½ myometrial invasion
IB Tumor confined to the uterus, > ½ myometrial invasion
II Cervical stromal invasion, but not beyond uterus
IIIA Tumor invades serosa or adnexa
IIIB Vaginal and/or parametrial involvement
IIIC1 Pelvic node involvement
IIIC2 Para-aortic involvement
IVA Tumor invasion bladder and/or bowel mucosa
IVB Distant metastases including abdominal metastases and/or inguinal lymph nodes
想懷孕用high dose progesterone三個月
只有stage
1A 做IVF
一定要拿掉卵巢
停經後出血10% cancer
衛生紙擦到棕色
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Substitute
Pregnancy
US$200,000
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Abortion
in TW要先生同意書
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避孕器在腹腔:要拿掉, 怕腸子破掉
Common
infection
Actinomycosis
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Polyp亮亮的
月經後出血
Risk
Tamoxifen
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Low segment
CS scar
超音波像小火龍
小心之後Ectopic Pregnancy
Acreta
Ercreta
不建議VBAC;
vaginal birth after Cesarean
Myomectomy過的一定要CS
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OHSS
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PID
CBC
TOA
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月經中來診
- Luteal cyst rupture 性行為，被撞到
- Ectopic Pregnancy
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Sand-like
Chocolate cyst
- 不會torsion
- 經痛
Surgery
indication
- Infertility
- Too big would rupture
- Symptom
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Huge pelvis
cyst
Bladder
retention
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Thin septum
<0.3 cm
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Sausage-like
Fallopian
Hydrosalpinx
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Tubal
plasty 成功率很低
直接做IVF
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五週超音波才看得到
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Grand
round次專科討論會
RPL;
recurrent Pregnancy loss
50% unknown
50%
aneuploidy
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PGS降低流產率
36%>13%
miscarriage
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Idiopathic miscarriage
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Day 5
> day3 準確
Array
CGH >FISH 準確
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PGS
US$45300
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>37
yo 做PGS比較cost effective
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周醫師
Abdominal
girth 腹圍增加
Palpable mass >10cm
Pregnancy 20
weeks-> umbilicus
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超音波 脂肪 黑色
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Mucinous
cystadenoma
Multicystic,
septum<4 mm
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少一顆卵巢，提早2-5年更年期
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手術注意
- Bilateral
- Check metastasis
- Colon
- Appendix
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Pseudoperitoneum,
PP
Malnutrition
Die
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家族史: 提早十年開始篩檢乳癌
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吳醫師 禾馨副院長
Colposcopy
1924
Hinselmann
biopsy交界
Advanced
study: 醋酸 蛋白變性 Pathology
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Pap smear 70%
檢測率
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Syphilis
Primary one
dose
Secondary 3
weeks
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Genital warts
Wartec 8
weeks
Aldara 12
weeks
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Trichomoniasis
Metronidazole 一次八顆 0.25 g
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Phthirus
pubis 陰蝨
除毛
曬太陽
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Monilia
Candidiasis
Fluconazole
one dose
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Chronic
vulvar inflammation
Lichen
sclerosis
…
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PID 診斷要件
Sex
within 6 month
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