GYNAE Flashcards
Non-surgical management of prolapse
lifestyle: weight loss, smoking cessation, treat chronic cough/constipation
topical oestrogen
vaginal pessary
What are some differentials for IMB?
hormonal contraception cervical ectropion STI polyps/fibroids endometrial or cervical cancer vaginal trauma peri-menopause
Investigate IMB
STI screen
TVUSS +/- endometrial biopsy
Manage a cervical polyp
small risk of malignant transformation so remove in clinic and send to histology
What are some differentials for menorrhagia?
endocrine: HPO axis dysfunction, thyroid disease, excess oestrogen (obesity/ liver disease)
structural: fibroids or polyps
clotting disorder
PID
endometrial cancer
Investigate menorrhagia
FBC, clotting screen, TFTs
US for fibroids/polyp
+/- endometrial biopsy
Medical management of menorrhagia
- tranexamic acid
- mirena coil
- add NSAID to tranexamic acid
- COCP
What are some non-gynae causes of pelvic mass?
bowel: constipation, abscess, tumour
urological: retention, pelvic kidney
What are some gynae causes of pelvic mass?
pregnancy uterus: fibroids, endometrial cancer (rare) cervical cancer (late) ovarian cyst ectopic pregnancy if acute ovarian cancer
How is ? ovarian cancer investigated?
Ca125
TVUSS
menopause status
biopsy not done as hard to obtain
may need further imaging with MRI
Which form of HRT is given to menopausal women?
continuous
Which form of HRT is given to perimenopausal women?
cyclical
Which form of HRT is given to a woman with a uterus?
combined
Which form of HRT is given to a woman without a uterus?
oestrogen only, continuous
Manage patient on LARC with dysmenorrhoea
mefanamic acid
Manage large fibroid which is affecting fertility
myomectomy
What is the definitive management of adenomyosis?
hysterectomy
What is the most common form of endometrial malignancy?
adenocarcinoma
Manage endometrial hyperplasia
if typical use progestogens
premenopause –> IUS
atypical needs hysterectomy
What is a leiomyoma?
fibroid
benign proliferation of myometrium
What is the most common type of ovarian tumour?
serous epithelial tumour
What is the most common type of cervical cancer?
Squamous cell carcinoma (CIN is precancer)
when can vaccum aspiration abortion be carried out until?
14 weeks
If one missed pop how long should barrier contraception be used?
48hrs