Gyn Flashcards
Menorrhagia 1st line
Mirena
Unopposed oestrogen increases risk of what?
Endometrial ca
COCP and endometrial ca?
COCP is protective against endometrial ca
Contraception and the menopause:
12 months after the last period in women > 50 years
24 months after the last period in women < 50 years
1st line medical Rx of stress incontinence ?
Duloxetine
If have coil in and needing HRT…
Can have single agent estradiol (IUS licenced for 4 years as progesterone component)
What is the most common inherited bleeding disorder?
Von Willebrands
Blood results in VW?
Prolonged bleeding time
Prolonged APTT
Factor VIII levels may be reduced
USUALLY behaves like a platelet disorder
Premature ovarian insufficiency Rx?
COCP or Combined HRT until age 51
What hormone do you measure at day 21 to check if ovulating?
Progresterone
Whirlpool sign on USS?
Ovarian torsion
1st line Rx of urinary incontinence?
Urge = Bladder re-training
Stress = Pelvic floor
Ovarian cancer risk factors?
Risk factors
family history: mutations of the BRCA1 or the BRCA2 gene
many ovulations*: early menarche, late menopause, nulliparity
Primary amenhorroa with elevated testosterone?
Androgren insensitivity
Ovarian cyst Rx?
If under 50 and <5cm likely benign - conservative management likely using repeat USS 8-12 weeks
If post menopausal then refer everyone
Risk factors for ectopic pregnancy?
damage to tubes (pelvic inflammatory disease, surgery)
previous ectopic
endometriosis
IUCD
progesterone only pill
IVF (3% of pregnancies are ectopic)
When do progesterone levels peak?
Luteal phase
1st line Rx of primary dysmenorrhoea?
NSAIDs e.g. mefanamic acid
Gonadal dysgensis
Turners syndrome
Raised LH/FSH and 1* amenorrhoea
Kallmans syndrome Dx?
Low FSH and Low LH
No smell
Management of 2* dysmenorrhoea?
Insert coil / COCP and refer gyn
Most important blood test to diagnose primary ovarian failure (early menopause)
FSH
Ovarian pathology Association with Meigs syndrome?
Fibroma (benign)
Most common benign ovarian tumour in people under 25?
Dermoid cyst (teratoma)
