Case 4 - LOs

Question 1

what is the anatomical position of the prostate gland in relation to the bladder?

Answer 1

inferior (prostate gland is located inferior to the urinary bladder)

Question 2

what is the anatomical position of the prostate gland in relation to the rectum?

Answer 2

anterior (prostate gland is located anterior to the rectum)

Question 3

what are the symptoms of benign prostatic hyperplasia?

Answer 3

difficulty starting to urinate (difficulty starting the stream, e.g dribbles)
urinary retention
dysuria
difficulty in emptying the bladder fully

Question 4

what is the name given to cancers that arise in glandular epithelia?

Answer 4

adenocarcinoma

Question 5

what terms should be used when referring to sex registered at birth

Answer 5

male and female

Question 6

what terms should be used in clinical communication when referring to gender?

Answer 6

men, women, non-binary people, trans men, trans women, trans people

Question 7

recurrent urinary tract infections are particularly common in who?

Answer 7

women, trans men and non-binary people with a female urinary system

Question 8

when do medical practitioners need to consider for Gillick competency?

Answer 8

patients under 16 who request sexual health advice or treatment without parental/carers’ consent or knowledge

Question 9

list three points that a medical practitioner must consider when assessing a child’s capacity to consent (Gillick competency)

Answer 9

if they can understand the reasons for treatment/issue, including the advantages and disadvantages
understand risks and complications of their choices
understand alternative options
if child has sufficient maturity
if child has mental capacity
how well they understand what you (the medical practitioner) have told them

Question 10

when should a medical practitioner suspect or consider sexual abuse of a child

Answer 10

when an adult has sex with someone under 16.
also, remember that a child under 13 cannot legally consent to any form of sexual contact

Question 11

is sexual activity between two teenagers under 16 years of age unlawful

Answer 11

yes, but it’s unlikely to involve a prosecution unless there’s abuse or exploitation

Question 12

with regard to Gillick competency, could a girl aged b/w 15 and 16 years of age make decisions about their sexual health and treatment

Answer 12

yes if she is Gillick competent

Question 13

explain why risk taking behaviour is higher in adolescents

Answer 13

self image within a social group
sense of excitement
exploring their limits
pleasure
identity development

Question 14

what is menarche

Answer 14

first menstrual cycle after puberty

Question 15

what is thelarche

Answer 15

onset of breast growth

Question 16

which hormone from the hypothalamus stimulates the release of follicle stimulating hormone and luteinizing hormone from the pituitary gland and is essential for puberty

Answer 16

GnRH - gonadotropin releasing hormone

Question 17

list three symptoms of early pregnancy

Answer 17

absence of period (amenorrhoea)
nausea
vomiting
breast enlargement
breast tenderness
increased frequency of micturition

Question 18

A 32 year old woman attends the gynaecology clinic because of difficulty conceiving. she has a regular 28 day menstrual cycle. As part of the initial investigations for ovulation, the doctor asks her to attend for a blood test on day 21 of her cycle.

list 3 methods for testing for ovulation

Answer 18

check for her basal (resting) body temperature
cervical mucus changes
day 21 progesterone measurements
LH peaks

Question 19

which hormone is produced by growing ovarian follicles?

Answer 19

oestrogen

Question 20

what is the predominant hormone released by the corpus luteum during the luteal phase

Answer 20

progesterone

Question 21

what hormone peaks prior to ovulation as a result of positive feedback of oestrogen at the anterior pituitary?

Answer 21

LH

Question 22

what hormone’s release is selectively inhibited by inhibin produced in the developing follicle

Answer 22

FSH

Question 23

in the maturation of a follicle, on day one of a normal menstrual cycle, is initiated by which hormone

Answer 23

FSH

Question 24

(in a normal menstrual cycle) which hormone surges around ovulation and causes the release of the egg from the follicle?

Answer 24

LH

Question 25

which cells in the testicle does luteinizing hormone from the anterior pituitary act on and what does this produce

Answer 25

Leydig cells, in the testicles, are located between the seminiferous tubules and are responsible for producing testosterone

Question 26

a 36 year old woman became pregnant two months after discontinuing the use of oral contraceptives containing progesterone and oestrogen. approximately 3 weeks later, she had an early spontaneous abortion. how do these hormones in birth control pills affect the ovulation and menstrual cycle?

Answer 26

estrogen and progesterone prevent ovulation by suppressing the release of LH and FSH. They also thicken cervical mucus and alter the uterine lining. After stopping the pill, fertility can return quickly, but it may take time for the menstrual cycle to fully normalize.

Question 27

is there a link b/w discontinuation of oral contraceptives and spontaneous abortion

Answer 27

yes, because of chromosomal abnormality. chromosomal abnormality are higher in women who discontinue use of the birth control pill

Question 28

a method of barrier contraception is the male condom. advantages of condoms

Answer 28

widely available protects from STIs non-hormonal so doesn't influence homeostasis not affected/compromised by current drug treatment

Question 29

disadvantages of combined oral contraceptives

Answer 29

risk of clots therefore contra-indicated in women with thromboembolism migraines doesn't protect against STIs

Question 30

disadvantages of condoms

Answer 30

(generally) less effective at preventing pregnancies than IUDs and hormonal contraceptives allergies to latex may break/split requires negotiation interrupts intimacy

Question 31

advantages of combined oral contraceptives

Answer 31

lighter periods more regular periods less painful periods more effective than condoms at preventing pregnancies reduced risk of ovarian and endometrial cancers (this remains also after decades after you stop taking this pill)

Question 32

advantages of progesterone-only pill

Answer 32

no oestrogen so it's good for women with higher BMI progesterone only so it can ve used when breastfeeding

Question 33

disadvantages of progesterone-only pill

Answer 33

must be taken every day

Question 34

advantages of progesterone only implant

Answer 34

protects from pregnancy for 3 years and it's very effective at this normal fertility when the implant is removed

Question 35

disadvantages of progesterone only implant

Answer 35

doesn't protect from STIs risk of bleeding and complications

Question 36

advantages of levonorgestrel intrauterine device

Answer 36

protective from pregnancy for 3-8 years periods become lighter and so can be used in women with heavy periods may reduce pain in endometriosis and amenorrhoea

Question 37

disadvantages of levonorgestrel intrauterine device

Answer 37

doesn't protect from STIs takes 7 days to start being effective trained healthcare professional is reuired to insert and remove the device inspection of the female anatomy to see if the device is suitable

Question 38

which nerve branch (from the pudendal nerve) gives a somatic nerve supply to the penis

Answer 38

dorsal nerve

Question 39

what is the duct that joins with the duct from the seminal vesicle to form the ejaculatory duct

Answer 39

vas deferens

Question 40

what is the name of the structure that produces pre-ejaculate

Answer 40

bulbourethral gland

Question 41

name the muscle that helps with urethral emptying and covers the bulb of the penis

Answer 41

bulbospngiosus

Question 42

list 2 barriers of healthcare experienced by a trans or non-binary person

Answer 42

difficulty in IT systems, e.g allows info put in to be male or female only stigma fear of confidentiality fear of clinician accepting their gender identity fear of being called by their birth name negative cultural and social beliefs by public and Dr

Question 43

which healthcare professionals can prescribe medications for sexual health without teh need for supervision

Answer 43

nurses with PGD in each STI Doctors Pharmacist independent prescriber dentists nurse independent prescriber

Question 44

list 4 physiological defense mechanisms of the genitourinary tract that prevents infection

Answer 44

innate immune system mucus secretion in female reproductive tract urine flow males have a longer urethra MALT - mucosal associated lymphatic tissue

Question 45

list one chemical defense mechanism and one antibody found in the genitourinary tract that prevents infection

Answer 45

discharge and vagina secretion (vaginal secretions maintains acidic environments) IgA IgG