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Paediatrics and Reproductive Help > Gynae 1&2 > Flashcards

Gynae 1&2 Flashcards

1
Q

Endometriosis is Prostgesterone / Oestrogen dependent

A

Endometriosis is Oestrogen Dependent

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2
Q

What’re the symptoms of endometriosis?

A

Secondary Dyspareunia

Pelvic pain inbetween periods

Menstrual irregularity

Bladder and bowel symptoms

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3
Q

What does a balck gun metal appearance on laperscopy indicate?

A

Endometriosis

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4
Q

What’s the management of endometriosis?

A

NSAIDs for pain relief

Suppression of cyclical hormone production therefore menstruation (OCP)

Surgery

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5
Q

What is Adenomyosis?

A

Ectopic glandual tissue found in muscle

Hyperplasia and fibrous tissue

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6
Q

What’re the symptoms of Adenomyosis?

A

Worsening Heavy Periods

Secondary Dysmonorrhoea (period pain)

Gradually enlarging tender uterus

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7
Q

What is Adenomyosis difficult to differenterate from?

A

Fibroids and DUB (Dysfunctional Uterine Bleeding)

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8
Q

How do you treat Adenomyosis?

A

Hysterectomy with conservation of the ovaries

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9
Q
A

Endometriosis of the ovary

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10
Q
A

Endometriosis

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11
Q

What’s the definition of infertility?

A

Inibility to conceieve after 2 years, with regular inprotected sex

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12
Q

What’re the main causes of infertility?

A

Unexplained (30%)

Ovulatory (27%)

Male factor (19%)

Tubal (14%)

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13
Q

Indications for early referral?

A

>25

Amenorrhoea / Oligomenorrhoea

Previous abdo/ pelvic surgery

Previous PID

Abnormal pelvic examination

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14
Q

What’s the commonest cause of oligo/azoospermia?

A

Primary testicular failure

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15
Q

What’re the important factors in increasing female feritlity

A

Fertility declines with age

Decline in oocyte number

Increased rate in higher aneuploidy and mascarriage rates

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16
Q

What female assesments are done?

A

Day 2 - FSH, LH and oestrogen

Ovulation - regular menstrual cycles, ovulation kits

Mid luteal progesterone (>30 nmol/L) - evidence for ovulation

USS follicular tracking is more reliable but costly and labour intensives

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17
Q

How do you differentiate PCOS and Premature Ovarian Failure?

A

PCOS (high LH, lower FSH, high testosterone)

Premature ovarian failure (high FSH, Low LH)

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18
Q

How do you diagnose tubal patency?

A

Hysterosalpingogram

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19
Q

What’re some uterine abnormalities?

A

Adhesions, Polyps, Submucus Fibroids

20
Q

Cystocele

A

Bladder Herniates into the Vagina

Occurs after childbirth

21
Q

What is a Rectocele?

A

Rectal herniation into the vagina

22
Q

What’re the causes of prolapse?

A

Pregnancy and delivery

Menopause

Pressure - ovarian mass, straining

23
Q
A

Uterine Prolapse

24
Q
A

Valt Prolapse

25
Q

What’s the symptoms of prolapse?

A

Prolapse Symptoms (Lump down below, Bearing Down, Fullness / Heaviness)

Urinary Symptoms (urgency, voiding dysfunction, stress incontinence)

Bowel Symptoms (obstructed, incontinence)

Sexual Dysfunction

Pain (backache)

26
Q
A
27
Q

What’s the treament of Prolapse?

A

No symptoms don’t treat

Pessary

Surgery

28
Q

What’re the different types of pessary?

A

Ring

Gellhorn

Replace every 3-9 months

Pts who can’t have surgery

29
Q

The anterior repair is an operation to correct?

A

Cystocele

30
Q

Posterior vaginal wall prolapse

A

Rectocele

31
Q

Posterior repair is an operation to correct?

A

Rectocele

32
Q

Vaginal Hysterectomy treats?

A

Uterine Prolapse

33
Q

Sacrospinous Fixation treats?

A

Treats a vault prolapse due to previous hysterecomy

34
Q

Urinary Incontinence

A

Stress

Urgency

Overflow

Nocturnal Enuresis

35
Q

What causes of Stress Incontinence?

A

Pregnancy and child bearing

Menopause

Pressure - bearing, smoking, high BMI

36
Q

What’re the investigations for stress incontinence?

A

Urodynamics: Cystometry / Pas test / Residual volume

37
Q

What’s the conversative management of urinary incontinence?

A

Pelvic floor muscle training

Smoking cessation

Weight loss

HRT / Local Oestrogen

38
Q

What’s the surgical management of stress incontinence?

A

Mid-urethral tapes

Urethral bulking agents

Colposuspension

Autologous sling

39
Q

What’re the symptoms of an Overactive Bladder?

A

Nocturia

Urinary Incontinence

Frequency

40
Q

What’re the causes of an overactive bladder?

A

Menopause

Irritants (smoking / caddiene / alcohol)

Masses (pressure)

Neurogenic spinal cord / parkinsonism

41
Q

What does a bladder drill treat?

A

An overactive bladder

42
Q

What’s the conservative management of an overactive bladder?

A

Fluid advice

Bladder drill

Weight loss

HRT / Local oestrogen

Medication

43
Q

What medication is used to treat an overactive bladder?

A

Anticholinergics - Oxybutinin

B-3 agonist - Mirabegron

44
Q

What surgical intervation is used in an overactive bladder?

A

Botulinum toxin A bladder wall injection

Tibial nerve stimulation

Detrusor myotomy

45
Q

Topical vaginal oestrogen is a treatment of?

A

Overactive bladder

46
Q
A

Paediatrics and Reproductive Help (14 decks)

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