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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

25
Stress incontience Tx
Lifestyle - weight loss & smoking cessation Pelvic floor retraining Surgery - tension free vaginal tape and other surgeries Medical- duloxetine
26
Urge incontinence treatment
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
Treatment prolapse
Pessary | Anterior / posterior wall repair
28
non malignant hyperplasia of the cervical endometrium can be treated with what
mirena IUS | suvelliance biopsies
29
atypical endometrial cervical hyperplasia should be treated with what
total abdominal hysterectomy & bilateral salpingo-ooporotomy
30
endometrial cancer - stage 1 treatment
total hysterectomy & bilateral salpingo-oopherectomy
31
stage 2 endomedtrial cancer
radical hysterectomy & removal pelvic lymph nodes
32
treatment stage 3 endometrial cancer
maximal de-bulking surgery & additional chemotheapy & radiotherapy
33
stage 4 endometrial cancer
maximal de- bulking surgery & consider pallative approach
34
For ovarian cancer - if raised CA125 then urgent USS of abdomen & pelvis - then what is management
2WW if findings abnormal
35
Further investigation - CT for staging then Mx
TAH bilateral salpingo-oopherectomy omentectomy chemo
36
Vulval cancer Mx
urgent 2WW if seen in primary care wide local excision groin lymph node dissection to stage & clear cancerous nodes
37
medical management of endometriosis
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
PID Mx
analegisa admission for IV ABx in more severe disease no sex until they & partners have completed treatment
39
ABx used in PID
``` ceftriaxone IM (gonorrhea) doxycyline metroidazole (partner doxycycline) ```
40
pre abortion management
``` confirm preganacy with a PT information on different methods abortion VTE risk assess STI & HIV screening contracpetion safeguarding ```
41
Medical TOP
mifepristone (cervical ripening) | misoprostol (stimulates contractions)
42
surgical termination of pregnancy
cervical dilation & suction of contents of uterus (up to 15 wks) cervical dilation & evacuation using forceps (between 15 and 24 wks)
43
treatment of BV (lue cells found under microscopy)
avoid vaginal douching - consider removing IUD | treatment indicated for - symptomatic women - Tx = metronidazole
44
candidiasis treatment
avoid tight fitting clothing / local irritants clotrimazole pessary fluconazole PO
45
trichomonas vaginalis Tx
metronidazole
46
chlamydia treatment
avoid sex until after they & partner have completed Tx doxycycline (CI in pregnancy) azithromycin (used in pregnancy)
47
gonorrhea Tx
single dose IM ceftriaxone
48
gentital herpes Mx
aciclovir | avoid sex during an outbreak
49
syphillis - Tx for primary, secondary & early latent
benzathine penicillin IM single dose
50
symphillis - late latent & cardiovascular
benzathine penicillin IM weekly for 3 weeks
51
if allergic to penicillin for syphillis treatment used
doxycycline
52
genital warts Mx
treatments not always nesessary - may resovle overtime solution / cream (note Tx may weaken latex condoms) excision / cryotherapy
53
Tx balanitis
hygiene (don't use soap just warm water & dry genttly)
54
Tx candidal balanitis
imidazole cream | oral fluconazole
55
for bacterial balanitis
oral flucloxacillin | oral clarithromycin in allergic
56
HIV Prevention / protection
condoms PrEP (pre exposure prophylaxis) PEP (post exposure prophylaxis)

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