Adult and Paediatric Gynaecology Flashcards
What is meant by Gillick’s Competence
A child under 16 can give/withhold consent if the doctors feel they fully understand what is involved in the intervention
Components of gynae Hx
-Age at menarche
-Cycle
-Pain
-Sexual (in absence of parents)
Sexual activity
Contraception
-Weight gain/loss
-Exercise
Components of gynae exam
- General
- Breast
- Gynaecological
What are tanner stages
The stages define physical measurements of development based on external primary and secondary sex characteristics (breast size, genitalia, pubic hair development)
Rated 1-5
Define primary amenorrhea
-Failure to menstruate by 16
When would you investigate primary amenorrhea
- Primary amenorrhea + normal secondary sexual characteristics = investigate at age 16
- Primary amenorrhea + absent secondary sexual characteristics = investigate at age 14
Investigations for primary amenorrhea
- FSH
- LH
- Prolactin (PRL)
- Testosterone and oestrogen
- Pelvic US
Patient has primary amenorrhea and DOES have secondary sexual characteristics
Next step in management
US of uterus
Patient has primary amenorrhea and NO have secondary sexual characteristics
Next step in management
Measure FSH and LH levels
Patient has primary amenorrhea and DOES have secondary sexual characteristics
US shows uterus absent or abnormal
Next step
Karyotype analysis
Patient has primary amenorrhea and DOES have secondary sexual characteristics
US shows uterus present and normal
Next step
Check for outflow obstruction
Define menorrhagia
Periods with abnormally heavy or prolonged bleeding
Menorrhagia treatment
-Progesterone only pill or Combined oral contraceptive -Tranexamic Acid (Antifibrinolytic)
Define vulvovaginitis
Inflammation or infection of the vulva and vagina
Management of vulvovaginitis
- Improved hygiene (may be curative)
- Treatment is indicated if there it is chronic or there’s difficulty urinating
- Lubrication of the labia with a bland ointment
- Topical oestrogen
- Surgical separation is rarely necessary
