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Year 4 > Gynae > Flashcards

Gynae Flashcards

1
Q

Cervical ectropion is regarded as a normal variant and does not require treatment unless symptomatic. what is Tx is=f symptomatic

A

First-line treatment:
Stop COCP
columnar epithelium can be ablated, typically using cryotherapy or electrocautery

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2
Q

Mx vaginal atrophy

A

lubricants & moistorisors
topical oestrogen creams
HRT

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3
Q

PMS Mx

A 
explanation & education
regualr carbohydrate intake
reduce sat fats & caffine (improves mastalgia)
COCP
CBT
SSRI (contineously or in leuteal phase)
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4
Q

PCOS Mx

A 
BMI targets (PCOS at increased risk diabetes)
COCP, IUS or medroxyprogesterone  (protects endometrium by inducing bleeds)
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5
Q

fertility PCOS

A

clomifene

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6
Q

hirtuism PCOS

A

cyproterone, spironolactone or finasteride

Eflornithine is a topical cream that can also be used to help reduce the growth rate of facial hair.

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7
Q

lifestyle management menopause includes;

A

excercise
lighter clothing / sleeping in cooler room
reducing stress

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8
Q

for HRT what must you prescribe osetrogen in combination with for women with a uterus

A

progesterone

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9
Q

forms of HRT

A

tablet
patches
vaginal ring

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10
Q

woem suffereing from vasomotor symptoms in menopause can be given what

A

SSRI such as fluoxetine

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11
Q

what can be given to women in menopause with increased risk VTE

A

transdermal HRT

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12
Q

often fibroids can be left untreated. but if symptomatic / enlarging / impacting on fertility

A 
analgesia
TXA (for menorrhagia)
mefenamic acid (for dysmenorrhea)
mirena 
COCP
GnRH agonists (zolidex) - fibroid shrink
myometctomy
Ulipristal
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13
Q

ovarian cysts. In pre-menopausal women rescan in 6 wks time - if peristent or over 5cm consider

A

laproscopic cyctectomy

oophorectomy

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14
Q

What criteria used for PCOS

A

Rottersdam

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15
Q

Amenorrhagic women in PCOS important to induce at least 3 bleeds per year. This can be done by

A

Cocp
IUS
Dyhydrogesterone (progesterone analogue)

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16
Q

Fertility PCOS

A

Clomifene +/- metformin

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17
Q

Management of symptomatic fibroids

A 
1st line mirena coil
Cocp (dysmenorrhagia/menorrhagia)
Nsaids
TXA (for menorrhagia)
Mefenamic acid (for dysmenorrhagia)
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18
Q

Fibroids can also be managed by surgery called a

A

Myomecyomy

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19
Q

In premenopausal women with cyst re-scan the cyst in 6 wks time. If persistant or over 5cm do what

A

Laproscopic cystectomy or oophorevtomy

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20
Q

Infertility management- obstructive azoospermia Tx

A

Testicular fine needle aspiration

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21
Q

Infertility management - if stuggling with sexusl intercourse or donor sperm usef e.g same sex partners whst can be done?

A

Intrauterine insemination

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22
Q

Azoospermia, tubual occulsion, unexplained fertility

A

IVF (this is where the egg is retrieved abd fertilised outside the body)

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23
Q

Severe male infertility- a single sperm per egg is enough. Or previous fertilisation failure using conventional IVF. Issues with the oocyte (poor quality eggs may compromise sperm penetration into egg)

A

Intracytoplasmic injection

24
Q

For incontience always need to exclude what

A

Uti

25
Q

Stress incontience Tx

A

Lifestyle - weight loss & smoking cessation
Pelvic floor retraining
Surgery - tension free vaginal tape and other surgeries
Medical- duloxetine

26
Q

Urge incontinence treatment

A

Lifestyle changes - fluid intake, limiting caffine
Bladder retraining
Medical - anticholinergic e.g oxybutanin, tolterodone
Miranegron (preferred in elderly due to risk of falls of oxybutanin)
Surgery last line

27
Q

Treatment prolapse

A

Pessary

Anterior / posterior wall repair

28
Q

non malignant hyperplasia of the cervical endometrium can be treated with what

A

mirena IUS

suvelliance biopsies

29
Q

atypical endometrial cervical hyperplasia should be treated with what

A

total abdominal hysterectomy & bilateral salpingo-ooporotomy

30
Q

endometrial cancer - stage 1 treatment

A

total hysterectomy & bilateral salpingo-oopherectomy

31
Q

stage 2 endomedtrial cancer

A

radical hysterectomy & removal pelvic lymph nodes

32
Q

treatment stage 3 endometrial cancer

A

maximal de-bulking surgery & additional chemotheapy & radiotherapy

33
Q

stage 4 endometrial cancer

A

maximal de- bulking surgery & consider pallative approach

34
Q

For ovarian cancer - if raised CA125 then urgent USS of abdomen & pelvis - then what is management

A

2WW if findings abnormal

35
Q

Further investigation - CT for staging then Mx

A

TAH
bilateral salpingo-oopherectomy
omentectomy
chemo

36
Q

Vulval cancer Mx

A

urgent 2WW if seen in primary care
wide local excision
groin lymph node dissection to stage & clear cancerous nodes

37
Q

medical management of endometriosis

A

pain Mx - NSAIDs
supressing ovulation for 6-12 months can cause atrophy endometriosis lesions & therefire reduction in Sx - low dose COCP or mirena can be used
(secondary Tx - GnRH analogues, surgery)

38
Q

PID Mx

A

analegisa
admission for IV ABx in more severe disease
no sex until they & partners have completed treatment

39
Q

ABx used in PID

A 
ceftriaxone IM (gonorrhea)
doxycyline 
metroidazole
(partner doxycycline)
40
Q

pre abortion management

A 
confirm preganacy with a PT
information on different methods abortion 
VTE risk assess
STI & HIV screening
contracpetion
safeguarding
41
Q

Medical TOP

A

mifepristone (cervical ripening)

misoprostol (stimulates contractions)

42
Q

surgical termination of pregnancy

A

cervical dilation & suction of contents of uterus (up to 15 wks)
cervical dilation & evacuation using forceps (between 15 and 24 wks)

43
Q

treatment of BV (lue cells found under microscopy)

A

avoid vaginal douching - consider removing IUD

treatment indicated for - symptomatic women - Tx = metronidazole

44
Q

candidiasis treatment

A

avoid tight fitting clothing / local irritants
clotrimazole pessary
fluconazole PO

45
Q

trichomonas vaginalis Tx

A

metronidazole

46
Q

chlamydia treatment

A

avoid sex until after they & partner have completed Tx
doxycycline (CI in pregnancy)
azithromycin (used in pregnancy)

47
Q

gonorrhea Tx

A

single dose IM ceftriaxone

48
Q

gentital herpes Mx

A

aciclovir

avoid sex during an outbreak

49
Q

syphillis - Tx for primary, secondary & early latent

A

benzathine penicillin IM single dose

50
Q

symphillis - late latent & cardiovascular

A

benzathine penicillin IM weekly for 3 weeks

51
Q

if allergic to penicillin for syphillis treatment used

A

doxycycline

52
Q

genital warts Mx

A

treatments not always nesessary - may resovle overtime
solution / cream (note Tx may weaken latex condoms)
excision / cryotherapy

53
Q

Tx balanitis

A

hygiene (don’t use soap just warm water & dry genttly)

54
Q

Tx candidal balanitis

A

imidazole cream

oral fluconazole

55
Q

for bacterial balanitis

A

oral flucloxacillin

oral clarithromycin in allergic

56
Q

HIV Prevention / protection

A

condoms
PrEP (pre exposure prophylaxis)
PEP (post exposure prophylaxis)

Year 4 (5 decks)

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