GUM + Contraception Flashcards by Humairaa Asmal

What is the mechanism of an IUD?

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

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How long can an IUD remain effective?

10 years

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When is the IUD contraindicated for use?

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

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What is the most effective emergency contraception?

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

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

IUD

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What is the mechanism of the IUS?

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

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How long can the IUS be used for?

5 years

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What are the common SE of using the IUS ?

Irregular bleeding, spotting, amenorrhoea, ovarian cysts

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When would the IUS be a useful contraceptive device?

useful for women who get heavy and painful periods

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When are IUS use CI?

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

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

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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SE of implants?

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

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

Contains oestrogen (inhibits ovulation) and progesterone

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What are the different ways the CHC can be administerd?

Oral
Transdermal
Intravaginal

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What are the different types of COCP?

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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List 5 CI of using CHC?

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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What are the 4 different regimens for taking CHC?

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

No, the suer will be protected form pregnancy immediately

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

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

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Give a name for oral progesterone only contraceptive?

Desogestrel

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

7 days

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

UKMEC

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

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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List 3 benefits of HRT?

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

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List 3 risks of using HRT?

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

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

Blood pressure

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

Total Iron Binding Capacity- HIGH Ferritin- LOW

Cases of Microcytic anaemia?

Thalassemia Anaemia of chronic disease IDA Lead poisoning Sideroblastic Anaemia

What is the immediate primary treatment for suspected meningial septicaemia?

IM Benzylpenicillin

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

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

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

Topical acetic acid (combined antibiotic/steroid drops)

What is a common side effect of IUDs?

Long and heavier periods

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

Weight gain

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

Combined oral contraceptive pill

Which virus can cause slapped cheek syndrome?

Parovirus b19

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

Rubella

What virus causes hand foot and mouth disease?

Cocksackievirus A16

Describe the rash associated with rosella infantum?

Macular erythemous rash on trunk following high fever and Coryzal illness

What is the spirometery measurements expected in obstructive lung disease?

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

What spirometry measurements would you expect in restrictive lung disease?

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

What is the first line treatment in diabetic neuropathy?

Amitryptiline, duloxetine, gabapentin, pregabalin

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

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

What is the causative agent in chlamydia?

Chlamydia trachomatis

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

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

What medications must be ceased in someone with AKI?

NSAIDS Aminoglycosides ACEI Diuretics Angiotensin II receptor antagonist

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

A) breast and cervical B) ovarian and endometrial

Which contraception is a associated with weight gain?

Depo provera

What is the most common side effect of the POP?

Irregular vaginal bleeding

What kind of organism causes a Trichomonasis infection?

Flagellated protozoan

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

Profuse yellow vaginal discharge Strawberry cervix Dysparenuia Itching Post coital bleeding

What is the management of Trichomonasis infection?

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

What is the synonymous finding in chancroid?

Painful lesion that bleeds on contact

What is the Sx of genital candidiasis and is management?

White cottage cheese discharge + itchiness + soreness Tx- topical Azoles, vaginal pessary

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

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

What is the causative organism if syphyllis?

Treponema palladium (bacteria)

What is the treatment of syphyllis?

IM benzathine benzylpenicillin

When should ellaone be cautioned for use?

In patients with asthma controlled with steroids

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

Small domed shaped flesh colour/pink papules with central indentation Tx- generally self resolves within 18 months Can have cryotherapy for aesthetics

Management of chlamydia?

Oral doxycycline BD 7 days

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

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

What is the causative organism of genital herpes?

HSV1 and HS2

What is Ix and tx of genial herpes?

Ix- NAAT/viral PCR IV acyclovir and analgesia

What is the causative organism in Chancroid?

Haemophillus Ducreyi

What is the tx of chancroid?

Ceftriaxone, Azithromycin and Ciprofloxacin

What is the causative organism in bacterial vaginosis?

Gardnella vaginitis

List the ix in bacterial vaginosis?

Positive whiff test clue cells on wet mount ph >4.5

Tx for bacterial vaginosis

Metronidazole

Tx for genital warts

Podophiltoxin ointmnet Inquuimod crema Trichloracetic acid Cryotheraphy

Odourless prulent discharge is indicative of what?

N. Gonorrhoea

What is the most common caustaive organism in PID?

Chlamydia