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Repro AM > Adolescent gynaecology > Flashcards

Adolescent gynaecology Flashcards

1
Q

What is Gillock competence?

A

Child <16 years can give/withhold consent if the doctor feels they understand what is involved
In certain situations, parents can overrule this

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2
Q

What is Fraser competence?

A

Contraceptive advice can be given o <16 if

  • mature enough to understand advice and implications of treatment
  • likely to begin/continue having sex with or without treatment
  • girl’s health would suffer without treatment/advice
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3
Q

What is important in an adolescent gynaecologist history?

A 
Age of menarche
Cycle
PAin
Sexual activity
Contraception
Wight changes
Exercise
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4
Q

When is primary amenorrhoea investigated?

A

Normal secondary sexual characteristics= age 16

Absent secondary sexual characteristics= age 14

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5
Q

What are the causes of secondary amenorrhoea?

A

Weight
PCOS
Pregnancy
Fluctuating LH/oestrogen

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6
Q

How is PCOS diagnosed in adolescents?

A

US

Androgens

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7
Q

What is the treatment of PCOS in adolescents?

A

Weight reduction and lifestyle changes

OCP

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8
Q

What investigations are done with gynaecologist problems in adolescents?

A

FSH, LH, prolactin, TSH, testosterone, oestrogen
Pelvic US
Progesterone withdrawal bleed

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9
Q

How is puberty induced?

A

Gradual build up with oestrogen

Add progesterone once maximum height potential is reached

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10
Q

What are the common causes of bleeding disorders in adolescents?

A

Anovulation
Pregnancy complications
Leukaemia
Sexual abuse, bullying, trauma

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11
Q

What is the management of menorrhagia?

A

Reassure
Progesterone only pill, combined pill, Mirena
Tranexemic acid
Mefenamic acid

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12
Q

What is labial agglutination?

A

Adhesions of labia minor in midline

Can lead to retention of urine and vaginal secretions, can cause vulvovaginosis or UTI

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13
Q

What is the management of labial agglutination?

A

Improve hygiene
Lubrication of labia
Topical oestrogen
Surgical seperation- rare

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14
Q

When is physiological vaginal discharge common?

A

Infants up to 2 weeks due to maternal oestrogen

Pre-pubescent girls due to oestrogen from maturing ovaries

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15
Q

What are the causes of pathological discharge?

A

Infection
Haemolytic streptococcal vaginitis
Candidiasis
Foreign body

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16
Q

What are the investigations pathological discharge?

A

Culture
urinalysis
Review hygiene
Perianal exam for pinworms

Repro AM (27 decks)

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