7/4/22 Flashcards
What do you ask in a sexual history taking under BBV risk?
BBV = BBC = MOTD = MMOTDD
MSM or you had sex with man?
Money - paid or been paid for sex?
Overseas - had sex with someone not born in UK?
Tattoo - dodgy tattoo?
Drugs - PWID you or partner? Use drugs to enhance sex?
Diagnosis - you or partner have ever been told have BBV?
What is a good thing to ask in drug history in sexual history?
Ever used an online pharmacy to manage your symptoms
What do you include under the gynae part of a gynae/sexual history?
- Ever visited a gynae before for any reason?
- Any surgeries or procedures down there?
- When was your last period?
- Any change?
- Any bleeding between periods or after sex?
- Any menopause symptoms?
Smear test
- when was last one?
- ever had any follow up
A woman presenting at her 12 week booking appointment has trace glycosuria on her dipstick. is this normal?
Yes
What two hormones are responsible for lactation and how?
Prolactin = production of milk
Oxytocin - let down hormone and causes muscle contraction = ejection of milk
What is chloramphenicol used for?
Bacterial eye infections
What is sodium cromoglycate used for?
Anti-inflammatory/anti-allergy eye conditions
What is the treatment of impetigo?
Topical hydrogen peroxide
If spread:
- fluoxacillin
What is the first line management of tonsillitis?
Penicllin V
What is a quinsy?
Peritonsollar abscess
How do you manage PID as outpatient?
Ofloxacin + metronidazole
What is meant by salpingo-oophorectomy?
Remove ovaries and fallopian tubes
What causes a “whirlpool sign” on TVUSS?
What is the main pathology?
How would a patient present?
How is it managed?
Ovarian torsion
Partial or complete torsion of the ovary (if involves fallopian tube as well = adnexal torsion)
Caused by either hypermobility of ovary or >5cm ovarian mass -most commonly dermoid cyst (one with hair and skin in it)
Sudden onset of unilateral abdo pain w N+V
Laproscopy => salpingo-oophorectomy
We have many types of ovarian cysts/masses and there are very nice ways to remember them all.
- Yolk sac
- Dysgerminoma
- Teratoma
- Fibroma
- Sertoli-Leydig
- Granulosa Theca Cell
Yolk sac = think SAC
- schiller-duval bodies
- AFP raised
- Children (girls and boys)
Dysgerminoma = think dysGERMANoma (Nazis -> bad nazis -> bad = malignant)
- High LDH
- High hCG
Teratoma = think TERROR-toma
- looks terrifying made up of multiple different tissues
- teeth
- thyroid hormone
- hair
Fibroma (FAP) (think fi-BRO-ma = ‘hey BRO pass me a beer = distended tummy from drinking beer)
Sertoli-leydig tumour (think ley-DIG)
- DIG for crystals = Reinke crystals
- virilization (females develop seocondary sex characterisitcs similar to males) in response to increase androgens
- fibroma
- ascietees
- pleural effusion
Granulosa Theca cell tumour ("call GRANny Exner)
- Gran = granulosa
- call-exner bodies
- excess oestrogen production
= kids = early puberty
= adults = endometrial hyperplasia
What is the most common type of cervical cancer?
Squamous cell carcinoma
What produces CSF in the brain and where is it found?
Choroid plexus - in the ventricles
Describe the pathway of CSF from production.
Produced in all ventricles but this is taking from route of lateral ventricles
Lateral ventricles Interventricular foramen 3rd ventricle Cerebral aqueduct 4th ventricle Medial and lateral apetures Subarachonid space
Through what layer of the meninges do blood vessels travel?
Sub-arachnoid space
What makes up the walls of the superior sagittal sinus?
What is found in it?
Splitting of the two layers of the dura mater
Drains venous blood and also contains CSF which has drained in from the subarachnoid space via. arachnoid granulations
What level is lumbar puncture at?
What layers do you have to go through to get to the CSF?
What is different about epidural
L3-4
Supraspinous ligament Interspinous ligament Ligamentum flavum Epidural space Dura mater Arachnoid mater SUBARACHNOID SPACE
Epidural L1-2
Stop at epidural space
What is the complication that can arise from spinal anasthetic and why?
Blockade of sympathetic tone to all arterioles = vasodilation = hypotension
MUST closely monitor
What pathway are you putting any woman aged >55 w/postmenopausal bleeding on?
Endometrial cancer pathway immediately
