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J Repro > Conditions summary > Flashcards

Conditions summary Flashcards

1
Q

medical induction of TOP

A

mifepristone and vaginal prostaglandins

metronidazole prophylactic antibiotic

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2
Q

surgical induction of TOP

A

vaginal prostaglandins
+ vacuum aspiration
metronidazole prophylactic antibiotic

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3
Q

pregnant lady
hypertension
proteinuria
oedema

A

pre-eclampsia

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4
Q

<24w pregnant lady
bleeding and period like cramps
cervical os closed on speculum examination

A

threatened miscarriage (threatened bc cervical os still closed)

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5
Q

<24w pregnant lady
bleeding and period like cramps
can see fetus in vagina with cervical os open on speculum examination

A

complete miscarriage

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6
Q

eclampsia treatment

A

delivery of baby asap
IV labetalol
IV magnesium sulfate (to stop seizures)

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7
Q

v bad morning sickness
decreased QoL
electrolyte imbalance
emotional instability

A

hyperemesis gravidarum

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8
Q

hyperemesis gravidarum treatment

A

IV fluids
electrolyte replacement
steroids if recurrent

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9
Q

recurrent miscarriages

anti cardiolipin antibody positive

A

antiphospholipid syndrome

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10
Q 
PMH chlamydia 
shoulder tip pain 
pain>bleeding 
hCG positive 
US - empty uterus
A

ectopic pregnancy

chlamydia = PID = narrows tubes

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11
Q

treatment of ectopic pregnancy (if stable, stable but far along and unstable)

A

stable - methotrexate
stable but far along - laparoscopy
unstable eg sepsis - laparotomy (remove tube and ectopic)

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12
Q

treatment of ectopic pregnancy (if stable, stable but far along and unstable)

A

stable - methotrexate
stable but far along - laparoscopy
unstable eg sepsis - laparotomy (remove tube and ectopic)

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13
Q

hyperemesis
vaginal bleeding with tissue discharge
hCG v v high
US snowstorm appearance

A

molar pregnancy

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14
Q

molar pregnancy treatment

A

surgical removal of mole

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15
Q

molar pregnancy treatment

A

surgical removal of mole

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16
Q

pregnant >24w

painless bleeding

A

placenta praevia until proven otherwise

need to do US (NOT speculum/vaginal exam)

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17
Q

placenta praevia treatment (2)

A

c section unless >2cm of cervical os , not emergency

fluid resus if blood loss

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18
Q 
pregnant >24w 
painful bleeding 
tender/woody abdo 
antiphospholipid syndrome 
hCG v high
A

placental abruption

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19
Q

treatment of placental abruption

A

emergency c section

fluid resus mum

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20
Q

sudden bleeding and fetal tachycardia

A

vasa praevia

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21
Q

vasa praevia management

A

emergency c section

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22
Q

fetus in distress
full cervical dilatation 10cm
2/5 engagement

what type of delivery

A

operative vaginal delivery - forceps or ventouse

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23
Q

fetus in distress
cervical dilatation 9cm
3/5 engagement

what type of delivery

A

c section

bc not fully dilated and not 2/5 engagement

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24
Q

vaginal bleeding >500ml <24h after birth

A

primary post partum haemorrhage (PPH)

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25
Q

vaginal bleeding >500ml 48 hours after birth

fever

A

secondary post partum haemorrhage (PPH) caused by infection

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26
Q

management of primary PPH (4)

A

uterine massage
syntocin (synthetic oxytocin)
surgery
fluid resus

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27
Q

management of secondary PPH (2)

A

antibiotics - bc infectious cause

fluid resus

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28
Q

PPH after birth of last child

now infertile

A

sheehans syndrome

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29
Q

puerperium

red hot swollen leg

A

DVT

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30
Q

DVT treatment

A

LMWH

mobility

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31
Q

low mood 3-10 days after birth of baby

A

baby blues

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32
Q

baby blues treatment

A

reassurance

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33
Q

low mood 2 weeks after birth of baby

PMH depression

A

post natal depression

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34
Q

post natal depression management

A

mild - counselling
moderate - CBT and antidepressants
severe - admission to mother baby unit

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35
Q 
PMH bipolar 
perinatal death 
acute onset confusion 2 weeks after birth 
decreased sleep 
hallucinations and irrational ideas
A

puerperal psychosis

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36
Q

puerperal psychosis management

A

admission to mother baby unit

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37
Q

excess amniotic fluid

shiny tense abdo during pregnancy

A

polyhydramnios

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38
Q

treatment of female infertility from pituitary/hypothalamus problem

A

HRT - GnRH if hypothalamus problem, LH and FSH if pituitary problem

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39
Q 
50yo 
mood swings 
hot flushes 
night sweats 
menorrhagia
A

menopause

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40
Q

menopause treatment

A

vasomotor symptoms - HRT (COCP or oestrogen only pill), clonidine
menorrhagia - mefenamic acid and tranexamic acid, or mirena coil
vaginal dryness - oestrogen cream
mood swings - SSRI
increase Ca in diet

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41
Q

menorrhagia
US normal
pregnancy test negative

A

dysfunctional uterine bleeding (no pathological cause)

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42
Q

dysfunctional uterine bleeding treatment

A

first line - mirena coil
second line - mefenamic acid + tranexamic acid
third line - COCP

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43
Q

> 16yo never had a period

A

primary amenorrhoea eg kallmans, turners

44
Q

cessation of periods for >6 months in someone previously with a period

A

secondary amenorrhoea eg anorexia, POF, PCOS, hyperprolactinaemia, hypopituitarism

45
Q

dragging sensation and back pain

A

uterine prolapse

46
Q

dragging sensation

urinary/bowel incontinence

A

prolapse (dk what kind until investigations)

47
Q

management of prolapse

A

conservative - pelvic floor exercises, lose weight
pessaries
surgery

48
Q

koilocytosis on cytology after cervical smear
unusual discharge, painful sex
irregular bleeding

what investigation do you do to confirm

A

cervical cancer

biopsy - to see if squamous cell carcinoma or adenocarcinoma (glandular)

49
Q

CIN 1 management

A

conservative

50
Q

CIN 2/3/CGIN management

A

loop excision

51
Q

squamous cell carcinoma of cervix, or adenocarcinoma of cervix management

A

loop excision
cervical excision
hysterectomy
chemo

52
Q

lump in uterus with glands and stroma
presents with bleeding
do US

A

endocervical polyp

53
Q

lump in uterus with smooth muscle
presents with bleeding and pelvic mass
do US

A

fibroid (leiomyoma)

54
Q 
abnormal bleeding 
bloating 
weight loss 
fatigue 
Fx bowel cancer
A

endometrial cancer associated with lynch syndrome

55
Q

endometrial cancer management

A

hysterectomy and salphinoectomy

56
Q 
amenorrhoea 
infertility 
overweight 
acne, hirsutism 
diabetes PMH 
pearl necklace on laparoscopy
A

PCOS

57
Q

PCOS management

A

1 - weight loss and clomifene citrate

2 - metformin, gonadotrophin therapy, COCP, laparoscopic ovarian diathermy (drilling)

58
Q

amenorrhoea <40yo
prev cancer treated with chemo
infertility
osteoporosis

A

POF

59
Q

POF management

A

HRT (COCP)

vit D and Ca and bisphosphonates - for osteoporosis

60
Q

menorrhagia
chronic pelvic pain
infertility
chocolate cysts on laparoscopy

A

endometriosis

61
Q

endometriosis management

A

NSAIDs for pain
COCP - will probs do!
ablation/excision/hysterectomy

62
Q

ovarian cancer
secondary mets

where is most likely primary cancer

A

stomach

63
Q

ovarian cancer

psammoma bodies

A

serous ovarian tumour (type of epithelial)

64
Q

ovarian cancer

epithelium looks like bladder

A

brenner ovarian tumour (aka transitional cell carcinoma)

type of epithelial ovarian tumour

65
Q

ovarian cancer with teeth, skin and hair inside it

A

dermoid cyst (aka teratoma)

type of germ cell ovarian tumour

66
Q

ovarian cancer

secretes AFP

A

yolk sac tumour

type of germ cell ovarian tumour

67
Q

ovarian cancer
secretes hCG
prev molar pregnancy

A

choriocarcinoma

type of germ cell ovarian tumour

68
Q

ovarian benign tumour
ascites
pulmonary oedema

A

meigs syndrome
associated with fibroma

type of sex cord/stromal ovarian tumour

69
Q

ovarian tumour

presents with precocious puberty <9yo

A

granulosa-theca cell tumour
type of sex cord/stromal ovarian tumour

secretes oestrogen = precocious puberty or abnormal bleeding

70
Q

ovarian tumour

presents with hirsutism and acne

A

Leydig-Sertoli cell tumour
type of sex cord/stromal ovarian tumour

secretes androgens = hirsutism

71
Q

management of ovarian tumours

A

chemo and surgery

72
Q

watery urethral discharge
most common STI
dysuria

A

chlamydia

73
Q

chlamydia treatment

A

first line - doxycycline BD 7 days

second line - azithromycin PO once

74
Q

chlamydia in past

now infertile

A

PID

75
Q

pus urethral discharge
dysuria
irritation

A

gonorrhea

76
Q

gonorrhea treatment

A

ceftriaxone IM, test of cute 5w later

77
Q

painless penile ulcer

A

primary syphilis

78
Q

syphilis treatment

A

long acting penicillin IM

79
Q

painful penile ulcer

recurrent

A

genital herpes (caused by HSV)

80
Q

strawberry vagina

recurrent

A

genital herpes (caused by HSV)

81
Q

genital herpes treatment

A

acyclovir

symptomatic - topical lidocaine cream, saline bath

82
Q

painless cauliflower warts

A

genital warts (caused by HPV 6+11)

83
Q

genital warts treatment

A

nothing

84
Q

intense vaginal itch
white vaginal discharge
uncontrolled diabetes

A

vaginal thrush (caused by candidia albicans)

85
Q

vaginal thrush treatment

A

topical clotrimazole cream OTC (anti fungal)

86
Q

fishy discharge
frothy bubbles
no pain
‘clue cells’ on microscopy

A

bacterial vaginalis

87
Q

bacterial vaginalis treatment

A

Po metronidazole 7 days

88
Q 
fishy discharge 
frothy bubbles 
painful 
red 
'strawberry cervix'
A

trichomonas vaginalis

89
Q

trichomonas vaginalis treatment

A

Po metronidazole 7 days

90
Q

MSM
presents with viral symptoms
what should you suspect

A

HIV!

91
Q

HIV treatment

A

HAART - 3 drugs from 2 classes
until undetectable viral load
PrEP/PEP for partner

92
Q

emergency contraception (3)

A

levonorgestrel (LNG-EC) - <3 days
EllaOne (UPA-EC) - <5 days
copper coil (IUD) <5days

93
Q

painless lump in breast 25yo

A

probs fibroadenoma

94
Q

bloody nipple discharge

‘cauliflower’ like extension of duct

A

papilloma of breast

95
Q

minor car accident 3 weeks ago

lump in upper outer quadrant of breast

A

fat necrosis

96
Q 
smoker 
green nipple discharge
sub areolar (under areola) lump
A

duct ectasia

97
Q

red inflamed breasts when breast feeding

not painful

A

mastitis

98
Q

painful swelling of breasts when breast feeding

A

engorgement

99
Q

scaly eczematous nipple

discharge

A

pagets disease of nipple - type of DCIS

100
Q

most common type of breast cancer

A

invasive ductal carcinoma

101
Q

dimpled skin
lump in breast
nipple change and discharge

A

breast cancer

102
Q

management of breast cancer

A 
wide local excision + radiotherapy 
OR mastectomy (entire breast removal)
103
Q

adjuvant therapy for oestrogen receptor pos breast cancer

A

tamoxifen (anti oestrogen)

104
Q

adjuvant therapy for triple negative breast cancer

A

chemo

105
Q

adjuvant therapy for HER2 receptor pos breast cancer

A

trastuzumab (Herceptin)

106
Q

prev radiotherapy on breast

new lump on same breast

A

breast angiosarcoma

J Repro (28 decks)

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