GUM + Contraception Flashcards

1
Q

What is the mechanism of an IUD?

A

contains copper which is toxic to the egg and sperm thus preventing implantation

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2
Q

How long can an IUD remain effective?

A

10 years

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3
Q

When is the IUD contraindicated for use?

A

Abnormal cervix
Unexplained bleeding
Repeated History of STIs
Currrent pelvic infection
Distorted uterus

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4
Q

What is the most effective emergency contraception?

A

IUD- can be used 120 hours after UPSI (5 days)

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5
Q

What is the only suitable contraceptive option for a patient w/ Hx of breast cancer?

A

IUD

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6
Q

What is the mechanism of the IUS?

A

releases progesterone thus interfering with ovulation as it thickens cervical mucus and thins the lining of the uterus

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7
Q

How long can the IUS be used for?

A

5 years

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8
Q

What are the common SE of using the IUS ?

A

Irregular bleeding, spotting, amenorrhoea, ovarian cysts

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9
Q

When would the IUS be a useful contraceptive device?

A

useful for women who get heavy and painful periods

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10
Q

When are IUS use CI?

A

Breast cancer, PID, Unexpalined bleeding, Abnormal uterus/cervix anatomy

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11
Q

What is the mechanism of the implant and how long can it be used for?

A

releases progesterone thus interfering with ovulation as it thickens cervical mucus and thins the lining of the uterus.

Can be used for 3 years

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12
Q

SE of implants?

A

periods may stop, become longer, or become irregular + ACNE

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13
Q

What is the mechanism of Combined Hormonal Contraception (CHC)?

A

Contains oestrogen (inhibits ovulation) and progesterone

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14
Q

What are the different ways the CHC can be administerd?

A

Oral
Transdermal
Intravaginal

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15
Q

What are the different types of COCP?

A

1) Monophasic- each pill contains the same doe of hormones

2) Phasic- pills contain differing amounts of hormones which must be taken in the correct order

3) Everyday pills- usually contains 21 hormone pills and 7 hormone free pills

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16
Q

List 5 CI of using CHC?

A

Less than 6wks postpartum and breastfeeding
RF of VTE
Previous VTE, IHD, Cerebrovascular incident, AFib
Current Breast Cancer
Being age 35+ and smoking >15 cigarettes
Migraine with aura
Liver cirrhosis, hepatocellular adenoma/carcinoma

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17
Q

What are the 4 different regimens for taking CHC?

A

TRADITIONAL- Takes one pill per day/one patch per week/one vaginal ring for 3 weeks followed by 7 day HFI

EXTENDED USE- Continuous use for 9 weeks followed by 7 day HFI

CONTINUOUS USE- continuos use w/o HFI

FLEXIBLE EXTENDED USE- user uses the method until bleeding and when bleeding occurs 4 day HFI

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18
Q

If the COCP is started on the 1st day of the natural period cycle, is extra contraception required to protect from pregnancy?

A

No, the suer will be protected form pregnancy immediately

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19
Q

If the COCP is started on anytime during cycle, is extra contraception required to protect from pregnancy?

A

Yes, user will need to use additional precautions (condoms) for 7 days

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20
Q

Give a name for oral progesterone only contraceptive?

A

Desogestrel

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21
Q

How long does the OCP need to be taken for in order to be effective?

A

7 days

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22
Q

What is the scoring metric used for the potential cautions and CI of COPC use?

A

UKMEC

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23
Q

What are the two ways in which HRT can be used?

A

1) CYCLICALLY- for perimenopausal women who still continue to have periods

2) CONTINUOUSLY- for postmenopausal women who do not have periods

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24
Q

List 3 benefits of HRT?

A

Relief of vasomotor sx
Relief of urogenital sx
Decreases risk of osteoporosis

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25
Q

List 3 risks of using HRT?

A

Increases risk of breast cancer
Increases risk of endometrial cancer
Increases risk ok VTE

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26
Q

What annual check is recommended to women who use the OCP?

A

Blood pressure

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27
Q

What haemantic tests are required in IDA and what would they show?

A

Total Iron Binding Capacity- HIGH
Ferritin- LOW

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28
Q

Cases of Microcytic anaemia?

A

Thalassemia
Anaemia of chronic disease
IDA
Lead poisoning
Sideroblastic Anaemia

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29
Q

What is the immediate primary treatment for suspected meningial septicaemia?

A

IM Benzylpenicillin

30
Q

What criteria is used in GP for dianosis of acute tonsillitis, and what are they?

A

ModifiedCENTOR Criteria (requires 3 out 4 to reach diagnosis of acute bacterial tonsillitis)
-Age 3-14
-History of fever
-Tonsillar exudates
-No cough
-Tender anterior cervical lymphadenopathy

31
Q

What is the treatment given to patients presenting with otitis externa?

A

Topical acetic acid (combined antibiotic/steroid drops)

32
Q

What is a common side effect of IUDs?

A

Long and heavier periods

33
Q

What is a side effect of the depopovera injections and the oral progesterone pills?

A

Weight gain

34
Q

Which contraceptive is well known for improving the regularity of period cycles and may improve acne?

A

Combined oral contraceptive pill

35
Q

Which virus can cause slapped cheek syndrome?

A

Parovirus b19

36
Q

What virus causes a rash in children which tends to start at the face, moves down to trunk and spares the limbs?

A

Rubella

37
Q

What virus causes hand foot and mouth disease?

A

Cocksackievirus A16

38
Q

Describe the rash associated with rosella infantum?

A

Macular erythemous rash on trunk following high fever and Coryzal illness

39
Q

What is the spirometery measurements expected in obstructive lung disease?

A

FEV1 - decreased
Normal FVC
FEV1/FVC ratio <70%
Increase in TLC and RV

40
Q

What spirometry measurements would you expect in restrictive lung disease?

A

FEV1- decrease
FVC- decrease
FEV1/FVC ratio normal or increase
Decrease in TLC and RV

41
Q

What is the first line treatment in diabetic neuropathy?

A

Amitryptiline, duloxetine, gabapentin, pregabalin

42
Q

What is the management of asthma in adults according to NICE guidelines?

A

1st- SABA
2nd- LD ICS
3rd- Add LTRA
4th- Add LABA
5th- MART therapy

43
Q

What is the causative agent in chlamydia?

A

Chlamydia trachomatis

44
Q

What is the PEFR in the BTS asthma classification of moderate, severe, and life threatening?

A

Moderate- PEFR 50-75%
Severe- PEFR 33-50%
Life threatening- PEFR <33%

45
Q

What medications must be ceased in someone with AKI?

A

NSAIDS
Aminoglycosides
ACEI
Diuretics
Angiotensin II receptor antagonist

46
Q

Which cancers is the COCP pill;
A) increases risk against
B) protective against

A

A) breast and cervical

B) ovarian and endometrial

47
Q

Which contraception is a associated with weight gain?

A

Depo provera

48
Q

What is the most common side effect of the POP?

A

Irregular vaginal bleeding

49
Q

What kind of organism causes a Trichomonasis infection?

A

Flagellated protozoan

50
Q

What Sx and signs can be found when a person has trichiomonaisis infection?

A

Profuse yellow vaginal discharge
Strawberry cervix
Dysparenuia
Itching
Post coital bleeding

51
Q

What is the management of Trichomonasis infection?

A

Oral metronidiazole
Abstain from sex for at least a week or until screening has been completed
Contact tracing

52
Q

What is the synonymous finding in chancroid?

A

Painful lesion that bleeds on contact

53
Q

What is the Sx of genital candidiasis and is management?

A

White cottage cheese discharge + itchiness + soreness

Tx- topical Azoles, vaginal pessary

54
Q

What are the signs and symptoms in the different stages of syphyllis infection?

A

Primary- single painless lesion/ulcer

Secondary-
Manifests 4-10 weeks after infection
Symmetrical maculopapular rash (soles, palms and feet)
Mucosal ulcers and lymphadenopathy
Malaise, fever, hepatitis, glomerulonephritis

Tertiary- occurs 20-40 years after primary infection

55
Q

What is the causative organism if syphyllis?

A

Treponema palladium (bacteria)

56
Q

What is the treatment of syphyllis?

A

IM benzathine benzylpenicillin

57
Q

When should ellaone be cautioned for use?

A

In patients with asthma controlled with steroids

58
Q

What is the description for mollascum contagiosum and what’s its management?

A

Small domed shaped flesh colour/pink papules with central indentation

Tx- generally self resolves within 18 months
Can have cryotherapy for aesthetics

59
Q

Management of chlamydia?

A

Oral doxycycline BD 7 days

60
Q

What is the causative organism in genital warts and list sx?

A

HPV 6 + 11
Painless flesh coloured bumps in genital area + itching + burning

61
Q

What is the causative organism of genital herpes?

A

HSV1 and HS2

62
Q

What is Ix and tx of genial herpes?

A

Ix- NAAT/viral PCR
IV acyclovir and analgesia

63
Q

What is the causative organism in Chancroid?

A

Haemophillus Ducreyi

64
Q

What is the tx of chancroid?

A

Ceftriaxone, Azithromycin and Ciprofloxacin

65
Q

What is the causative organism in bacterial vaginosis?

A

Gardnella vaginitis

66
Q

List the ix in bacterial vaginosis?

A

Positive whiff test
clue cells on wet mount
ph >4.5

67
Q

Tx for bacterial vaginosis

A

Metronidazole

68
Q

Tx for genital warts

A

Podophiltoxin ointmnet
Inquuimod crema
Trichloracetic acid
Cryotheraphy

69
Q

Odourless prulent discharge is indicative of what?

A

N. Gonorrhoea

70
Q

What is the most common caustaive organism in PID?

A

Chlamydia