Adolescent Gynaecology Flashcards
what is gilick competence?
a child under 16 years can give or withhold consent if the doctor feels they fully understand what is involved in an intervention,
what is the presentation of labial adhesions?
> vulvovaginitis
vertical line of fusion
difficulty urinating
what is the management of labial adhesions?
> improve hygiene if symptomatic
lubrication with bland ointments
topical oestrogen
surgical separation rarely necessary
what can cause vaginal discharge?
> increase in oestrogen from maturing ovaries > monial vaginitis > vaginal yeast infection > cervical infection > foreign body
what is the management of vaginal discharge?
> examination under anaesthetic for foreign body if persistent
perianal examination with transparent tape (pinworms)
review hygiene
urinalysis
culture organisms
why do cysts drop to the lowest point in the pelvis?
gravity
what can happen to cysts when they drop down in the pelvis?
they can tort, turn gangrenous and rupture
how do cysts present?
> tender on side of the pelvis
> mass
how does primary amenorrhea present??
normal secondary characteristics or absent secondary sexual characteristics
what investigations are carried out in primary amenorrhoea?
> pregnancy test > pelvic ultrasound > hormones - FSH - TSH - PL - LH - oestrogen - testosterone
what is the management of primary amenorrhoea?
puberty induction. a gradual build up with oestrogen then add progesterone
what can cause secondary amenorrhea?
> weight
poly cystic ovarian syndrome
pregnancy
fluctuating hormones of oestrogen and LH
what is the management of menorrhagia?
> reassurance > transexamic acid > progesterone only pill > COC > mirena > metenamic acid
