Adolescent Gynae BW 3 Flashcards
Menarche and initial cycles:
What role does nutrition have in menarche?
What is HMB? Heavy menstrual bleeding?
What impact does HMB have on individuals?
What is AUB? Abnormal uterine bleeding
PALM
COIEN
What are non structual causes of AUB? PALM COIEN:
Periods (menstrual symptoms+ Signs)
Caused by increased PG
What is retrograde menstruation?
What would you find (signs and symptoms)? What time of pain does this cause?
Fixing periods problems:
- NSAIS
- TXA
- Cyclic progestagens
- OCP- Pill - easy once per day
- Mirena IUS
Contious OCP, Continous progestogens (not bleeding) - Different methods:
RCH guidelines on skipping periods and good for patients:
What are other benefits of OCP?
List 4 - 2 marks
Preparing for periods in girls with disabilities:
What should be done and discussed?
Explaining what the period is
Chnages that occur
Age approriate manner
Show how to change and dispose
Being comfortable with the idea of bleeding- Not bad
Period products suitable for patient
CAse 1: Read
- Education for child and parent
- teaching how to use pads correctly
- pain management? Heavy?
- Behaviourally difficult because shes in pain? (non verbal)
- Consider NSAIDs for symptoms
- Heat packs, rest
- COCP
- Depo-provera
- Period underwear
- LARC - mirena
Practise points:
read: For previous case
What is amenorrhoea?
Primary vs secondary?
Causes of amenorrhoea: From head to toe:
ALWAYS do HCG first!
What investigations?
What are common causes of secondary amenorrhoea?
1) FBC, Prolactin levels, TFTs
2) PCOS, excsise (common secondary causes)
History and examination for amenorrhoea: Outline assessment? What are you going to ask?
Physical examination: General appearance? height and weight? BP? Secondary characteritics? Thryroid/hirituism
Tanner stage?
Secondary characteritics?
First line investigations for Amenorrhoea?
- FSH, LH
- Oestradiol
- TSH -
- Prolactin
- Pelvic USS- check for no obstruction +uterus present
Case 2:
Hx? Exam? Management?
Common vulval conditions: Anatomy: Is described in clocklike fashion:
What is the hymen? What is an imperforate hymen?
Different hymen anomalies:
What is an imperforate hymen?
What is vulvavaginitis?
What ages? What causes it?
Why does it occur?
Hypoesotrogenic state- allows inflammation to occur in vagina
Often posttoliet training, inadequate wiping, irratants
What do you explain to parents about vulvavaginitis?
Treatment options? Explain to parent
What if it continues? What should you do?
What other things need to be considered? think derm conditions
What is labial fusion? When does it occur?
Why? Can be distressing to parents - What do you need to explain to parents? that it will go away through puberty
Lichen scleorsus:
What is it?
What are signs and symptoms?
Treatment?
What are different types of ovarian cysts?
What is a functional ovarian cyst? (
Management?
What is a dermoid cysts?
What years of life do they occur in?
Treatment options? - (they are quite heavy- can cause twisting and tort on themselves) - they dont go away on their own
Ovarian cancer in adolescents:
Often germ cells:
Need to add on what tumour markers? to look?
Ovarian torsion:
outline symptoms: Key features?
