CASE 12: OBS & GYNAE

Question 1

What is FSH and its role

Answer 1

Follicular stimulating hormone
development of follicles

Question 2

What is LH and its role

Answer 2

Luteinising hormone
Main role in causing ovulation

Question 3

What is oestrogen

Answer 3

steroid sex hormone, produced on ovaries

Question 4

what is progestrone

Answer 4

steroid sex hormone produces by corpus luteum after ovulation
In pregnancy its produced by the placenta.

Fucntion:

Question 5

what is menopause?

Answer 5

cessation of menstruation due to loss of ovarian follicular activity

Question 6

how do you diagnose menopause

Answer 6

12 months of amenorrhea, and FSH blood test

Question 7

what is the placenta

Answer 7

organ than connects maternal uterus to foetus and allows for gas exchange, elimation of waste, transfer nutrients and endocrine functions

Question 8

what is dysfunctional uterine bleeding?

Answer 8

irregularities in the menstrual cycle affecting the frequency, duration and regularity of the cycle length and volume of the menses

Question 9

name different types of DUB

Answer 9

• *Intermenstural bleeding (IMB) :** bleeding occurring between periods
• *Post-coital bleeding (PCB):** Bleeding after sexual intercourse unrelated to mensuration
• *Oligomenorrhoea**: infrequenct periods with cycle length >35 days
• *Post-menopausal bleeding**: vaginal bleeding occurring during menopause

Question 10

what is endometritis

Answer 10

infection or inflammation of the endometirum which can be post-partum

Question 11

abdo pain, fever, uterine tenderness on bimanual, offensive discharge

Answer 11

endometritis

Question 12

what is endometriosis

Answer 12

ectopic endometrial tissue outside the uterus with no underlying cause

Question 13

abdo/pelvic pain, deep dyspareunia, dysmenorrhoea, infertility, cyclical bleeding from other sites,

Chocolate cysts on ovaries

Answer 13

endometrosis

Question 14

management for endometriosis

Answer 14

1. Analgesia (NSAIDS + Paracetamol)
2. Hormonal: COCP, POP, progesterone injection, Mirena
3. Surgery: laparoscopic surgery to improve fertility

Question 15

what is adenomyosis

Answer 15

occurs when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus.

Question 16

Leiomyoma

Answer 16

Fibroids; benign tumours of uterine smooth muscles

Question 17

endometrial cancer

Answer 17

cancer of the endometrium where 80% are adenocarcinomas and is oestrogen dependent

Question 18

what is PCOS

Answer 18

Polycystic ovarian syndrome:

multiple ovarian cysts causing metabolic and reproductive problems in women including infertility, oligomenorrhea, hyperandrogenism and insulin reistance

Question 19

what is Rotterdam criteria

Answer 19

triad for PCOS diagnosis:

Anovulation, hyperandrgoensim, polycystic ovaries on USS

Question 20

what is ectopic pregnancy

Answer 20

pregnancy that occurs outside the uterus most commonly in the fallopian tubes

Question 21

what is pre-eclampsia

Answer 21

defined by a new onset on hypertension and proteinuria

Question 22

when does pre-eclampsia occur

Answer 22

occurs after 20 weeks gestation or up to 6 weeks following delivery

Question 23

what is eclampsia

Answer 23

is pre-clampsia and a seizure

Question 24

what causes pre-eclampsia

Answer 24

abnormal placenta → vasoconstriction and kidney retain more salt → HYPERTENSION

Question 25

What is the blood pressure in pre-eclampsia

Answer 25

>140/ >90

Question 26

what is blood pressure in severe pre-eclampsia

Answer 26

>160 / >110

Question 27

symptoms of pre-eclampsia

Answer 27

kidneys: oligouria and proteinuria

Eyes (retina): blurred vision, flashing lights, scotoma

Liver: injury & swelling, ⇑liver enzymes, stretches capsule around liver, causing epigastric pain (RUQ pain)

Question 28

treatment of eclampsia

Answer 28

delivery of fetus and placenta (can induce but depends on gestation age)

if preclampsia after labour, then manage symptoms (e.g- supplemntal oxygen)

Question 29

which hormone confirm ovulation

Answer 29

progesterone

Question 30

what are small powder burn lesions, and which condiiton is it related to

Answer 30

Pouch of Douglas

Endometorisis

Question 31

threatened miscarriage

Answer 31

vaginal bleeding

foetal heart seen

cervix os is closed

Question 32

missed miscarriage (delayed miscarriage)

Answer 32

dead foetus before 20 weeks without symptoms of expulsion

may/may not have vaginal bleeding

cervix os closed

Question 33

Inevitable miscarriage

Answer 33

Cervix os opened

bleeding

Question 34

Incomplete miscarriage

Answer 34

not all products of conception has been expelled (placenta, etc)

Question 35

complete miscarriage

Answer 35

everything has been expelled

Question 36

what antibiotics is given to preganant women with UTI

Answer 36

Cephalexin

Question 37

Discharge in Clyhamida

Answer 37

yellow and odourless, mucal purulent discharge

Question 38

discharge in gonorrhea

Answer 38

green colour

Question 39

trichomoniasis discharge

Answer 39

yellow/green, fishy

strawberry cervix

Question 40

bacterial vaginosis presentation

Answer 40

fishy, off white, thin discharge

Cause: excessive washing

Question 41

Vaginal candidasis

Answer 41

fungal, white/grey cottage cheese

Question 42

Tx for vaginal candidiasis

Answer 42

fluconazole

Question 43

Tx for bacterial vaginosis

Answer 43

Metronidazole, Clindamycin, Tinidazole

Question 44

Tx for bacterial vaginosis

Answer 44

Metronidazole, Clindamycin, Tinidazole

Question 45

what is hyperemesis gravidarum

Answer 45

severe vomiting and nausea aka morning sickness