21/06 Flashcards
which cancers does COCP protect against
endometrial
ovarian
colorectal
which cancers does COCP increase risk of
breast
cervical
positive antiphospholipid antibodies (e.g. in SLE)
UKMEC 4 for cocp
when does cocp need to be taken for no extra precautions
first 5 days of cycle (otherwise 7 days condoms)
POP MOA
thickens cervical mucous
IUS MOA
prevents endometrial proliferation
restrating hormonal contraception after emergency contraception
levenorgestrel - straight away
ullipristal - 5 days
inter-pregnancy interval of less than 12 months
increased risk of preterm birth, low birth weight and small for gestational age babies
enlarged, boggy uterus
adenomyosis
adnomyosis invx
transvaginal USS
when is cervical screening delayed until if pregnant
3 months post partum
cervical intraepithelial neoplasia
Large loop excision of transformation zone (LLETZ)
primary dysmenorrhea tx
NSAIDs eg mefanemic acid and ibuprofen
COCP
2ndary dysmenorrhea
refer to gynae
medical mx of ectopic
methotrexate
most dangerous ectopic site
isthmus
cervical cancer tx
surgery
radiotherapy
endometrial cancer tx
surgery
post op radiotherapy if high risk
endometrial cancer if frail elderly women not suitable for surgery
progestogen
tx of simple endometrial hyperplasia without atypia
high dose progestogens with repeat sampling in 3-4 months. The levonorgestrel intra-uterine system may be used
tx of endometrial hyperplasia with atypia
hysterectomy
low-grade fever, pain and vomiting during pregnancy
?fibroid degeneration
menorrhagia tx does not require contraception
mefanemic acid or tranexamic acid
menorrhagia tx does require contraception
IUS first-line
combined oral contraceptive pill
long-acting progestogens