firday 11th Flashcards
first line treatment o open angle glaucome
if <24 mmHg then 360 laser trebeculoplasty
what cancer can myelodysplastic syndrome progress into
AML
ix for SAH
non contrast CT
what hpv causes genital warts
6/11
first line treatment for syphilis and gonorrhoea
what is given in each case if needle phobic
SYPH- IM Benpen
2- doxcyclin
GON- IM cef
2- cefixime+azithromycin
a CD4+ count of what classes as AIDS
<200
when shoudl you test someone for HIV post exposure
4 weeks after exposre
multiple ring enhancing lesions on head scan in person with HIV
toxoplasmosis gondii
what is kaposis sarcoma caused by
human herpes virus 8
ziehls neelsen positive organism
mycobacterium and cryptosporidium
if someone has multidermotomal herpes zoster what should you screen for
HIV
when do you start HAART therapy in HIV
as soon as diagnosed
how long after HIV exposure can PEP be given and for how long
up to 72 hrs continue for 4 weeks
how long after last period should contraception be used
> 50 = 12 months
<50 = 24 months
when is menopause diagnosed in clinic
type of HRT given peri and post meno
12 months after last period
peri - cyclical
post- continuous
treatment of acute otitis media if needed
amoxicillen
treatment of pneumocystis jiroveci
co-trimoxazole
contraindications for HRT
current/past breast ca
OE sens cancer
undiagnosed vag/endo bleed
what type of HRT shoudl women with hysterectomy or mirena be given
oestrogen only
what type of HRT shoudl perimenopausal women without. amirena be given
cyclical HRT - daily oestrogen adn
what type of HRT increases risk of VTE
oral not the patch
what type of cancers does HRT increase risk of
ovarian and breast
how long post partum is cervical smear delayed
3months
most common type of cervical cancer
squamous cell carcinoma
risk factors for cervical cancer
HPV 16,18,33
smoking
HIV
early first intercourse, many sexual partners
high parity
lower socioeconomic status
COCP
Koilocytosis
HPV
CIN I, II, III
CIN I - basal third
CIN II - middle third
CIN III (carcinoma in situ ) - full thickness
halo cells
HPV
stagng system for cervical cancer
FIGO
CIN develops from what area of cervix
ectocervix
adeno- endocervix
causes of vulval intraepithelial neoplasi
lichen scelrosis and HPV
treatment of vulvular SCC
vulvectomy adn lymphaadenectomy
treatment of lichen scelrosis
steroids and emollients
causes of menorrhagia
dysfunctional uterine bleeding: eg . anovulatory cycles
uterine fibroids
hypothyroidism
intrauterine devices
pelvic inflammatory disease
bleeding disorders, e.g. von Willebrand disease
what is adenomyosis
endometrium breaks into myometrium
what is menorrhagia in the absense of roganic symtoms called
Dysfunctional uterine bleedign
first line treatment for heavy bleeding
IUS
investigation in fibroids
TVUS
mangement of primary dysmenorrhoea
NSAID - mefenamic acid
IUS
causes of secondary dysmneoorhoa
endometriosis
adenomyosis
pelvic inflammatory disease
intrauterine devices*
fibroids
how to distinguish pain in primary vs secondary dysmenorrhoea
primary few hours before period
seondary - few days before
treatment of endometrial hyperplasia
IUS
hysterectoy if atypical
what criteria is used for PCOS
rotterdam
LH and FSH levels in PCOS
increased LH
normla FSH
management of PCOS
optimise BMI
hormonal contraception
tx of PCOS if trying
clomifene
prolonged heavy periods
adenomyosisi
bulky uterus
adenomyosis
what age is primary amenorrhoea defined
age 16
what is a krukenberg tumour
a gastric cancer thats metastesised to ovary - signet cells mucin producing
what size are benign ovarian tumours
<5cm
benign epithelial ovarian tumours
serous cystadenoma
mucinous cystadenoma
four types of germ cells ovarian tumours - which are malignant
teratoma
dysgerminoma
yolk sac tumour
choriocarcinoma
all malignant except teratoma
what endometrial thickness makes malignancy unlikely
<4mm
what is endometrial hyperplasia histologically
increase in gland:stromal ratio
most common type of endometrial cancer
adenocarcinoma - endometroid type 1
microsatillite instability
lynch syndrome
most common ovarian cancer
serous adenocarcinoma
what tumour marker is increased in mucinous ovarian cancer
CEA
what do granulosa cell tumour produce
oestrogen
call-exner bodies
granulosa cell tumours
ovarian tumour increased AFP
yolk sac
varian tumour increased HCG
choriocarcinoma
what tumour markers would you do in ovarian cancer
Ca125
AFP
CEA
HCG
enlarged boggy uterus
adenomyosis
side effect of aromatase inhibitors -anastrozole
osteoporosis
