GYN conditions Flashcards
MCC of postmenopausal bleeding
Atrophic vaginitis
Sx of Atrophic vaginitis
bleeding, pruritus, burning, swelling, watery discharge, dyspareunia
Dx of Atrophic vaginitis
Speculum exam + pH if positive for discharge
Tx of Atrophic vaginitis
vaginal estrogen cream (premarin or Estrace) or vaginal estrogen ring (Estring)
Which types of patients are more prone to develop candida vulvovaginitis?
Immunosuppressed, diabetics, and alcoholics
Dx of candida vaginitis
pH of discharge, microscopy
Tx of candida vaginitis
Topical azole * 7 days = oral azole (fluconazole * 1 time)
5 possibility of that bulging mass from VJ
- Cystocele
- Uterine prolapse
- Rectocele
- Enterocele
- Vaginal cuff prolapse s/p hysterectomy
RF of pelvic organ prolapse
- post-menopausal
- obesity
- multiparity
- chronic cough
- constipation
- Heavy lifting
Tx of pelvic organ prolapse
- Kegel
- Pessary
- Surgery
HRT for vesomotor sx during menopause - which hormone to use?
- If no uterus, use estrogen
- If + uterus, add progestin
What dose to use HRT?
Lowest effective dose for shortest duration possible
What are some non-hormone alternatives?
SSRI
SNRI
Clonidine
Gabapentin
What are the risk a/w HRT?
- Thromboembolic disease!!
- Breast Ca!!
Which patients are CI in using HRT?
- Breast Ca
- Vaginal bleeding & Endometrial Ca
- Thromboembolism
- Prior stroke/TIA
