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finals > gynae > Flashcards

gynae Flashcards

1
Q

stress incontinence mx

A
  1. pelvic floor exercises
  2. surgery
  3. duloxetine if surgery declined
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2
Q

urge incontinence mx

A
  1. bladder retraining, min of 6 weeks
  2. oxybutynin or tolterodine (antimuscarinics)
    nb avoid oxybutynin in frail elderly patients
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3
Q

adenomyosis imaging

A

transvaginal USS is gold standard

in preference to transabdo USS or MRI) (NICE

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4
Q

primary dysmenorrhoea mx

A
  1. NSAIDs, e.g. Mefenamic acid and Ibuprofen

2. COCP

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5
Q

secondary dysmenorrhoea mx

A

must refer to gynae for investigations

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6
Q

menorrhagia mx

A

does not require contraception - Tranexamic acid

requires contraception - IUS, COCP

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7
Q

closed cervical os - what miscarriages?

A

threatened
missed
complete

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8
Q

open cervical os - what miscarriages?

A

inevitable
incomplete
‘open your I’s’

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9
Q

medical mx of ectopic

A

Methotrexate

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10
Q

when is mifepristone used?

A

termination of uterine pregnancy, used along side misoprostol

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11
Q

when is misoprostol used?

A

medical management of miscarriage

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12
Q

endometriosis mx

A

analgesia - NSAIDs and/or paracetamol
if analgesia doesn’t help, hormonal treatments - COCP or progestogens, IUS
if neither of the above helps - GnRH analogues

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13
Q

cervical cancer aetiology

A

HPV 16 & 18

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14
Q

mx of thrush in pregnancy

A

clotrimazole pessary

oral fluconazole is CI

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15
Q

trichomonas vaginalis features and mx

A

offensive, yellow/green, frothy discharge
vulvovaginitis
strawberry cervix
metronidazole

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16
Q

PCOS mx

A
  1. weight loss
  2. COCP if contraception required (may help hirsutism)
  3. for infertility - Clomifene most effective
  4. Metformin is used for obese patients
17
Q

what is tranexamic acid used for?

A

menorrhagia

18
Q

how often are smears carried out in scotland?

A

every 5 years from 25-64 years of age

19
Q

indications for surgical mx of ectopic

A 
>35 mm in size
ruptured
pain
visible foetal heartbeat
b-hCG >1500
20
Q

investigations for menorrhagia

A

FBC

transvaginal USS if abnormal examination findings, pelvic pain or postcoital bleeding

21
Q

when to refer to fertility clinic

A

no pregnancy after regular sexual intercourse (every 2-3 days) for 12 months

22
Q

PMS mx

A

mild symptoms - lifestyle advice
moderate symptoms - new-gen COCP (e.g. Yasmin)
severe symptoms - SSRI (taken either continuously or only during luteal phase)

23
Q

which ovulation induction agent carries greatest risk of ovarian hyperstimulation syndrome

A

GnRH therapies

24
Q

what is invovled in surgical mx of ectopic

A

salpingectomy

25
Q

medical mx of fibroids

A

GnRH agonists, e.g. Leuprolide or Triptorelin, may shrink fibroid prior to surgery

26
Q

risk factors for ovarian cancer

A

early menarche, late menopause
nulliparity
FHx - BRCA1/2

27
Q

what does raised FSH and LH but low oestradiol suggest

A

premature ovarian failure

28
Q

long term complications of PCOS

A

subfertility
diabetes mellitus
stroke and TIA
endometrial cancer

29
Q

most common ovarian cyst in asymptomatic patient

A

follicular cyst

30
Q

most common ovarian cancer

A

serous carcinoma

31
Q

which conditions is cervical excitation a feature of

A

PID and ectopic pregnancy

32
Q

what is mefenamic acid used for

A

mx of primary dysmenorrhoea

33
Q

diagnostic criteria for PCOS

A

oligo- or amenorrhoea
hyperandrogegism (hirtuism and acne)
polycystic ovaries on USS

34
Q

Asherman’s syndrome

A

intrauterine adhesions
can occur following dilation and curettage
may prevent the endometrium responding normally to oestrogen causing secondary amenorrhoea

35
Q

when does HPV test of cure take place

A

six months after treatment to assess for any residual disease

36
Q

what is Fitz-Hugh-Curtis syndrome

A

perihepatitis

seen in PID, Chlamydia and Gonorrhoea

finals (25 decks)

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