gynae Flashcards
drug causes for amenorrhoea
chlorpromazine, metoclopramide, domperidone
old atypical antipsychotics (apart from olanzapine and quetiapine)
Cervical screening
Between ages 25-64
25-49 3 yrly Screening
50-64 5 yrly screening
Delay 3 months post partum
Fgm
Female genital mutilation in under 18 - report to police
Oral glucose tolerance test
Fasting >5.6 if more than 7 start insulin straight away
Random >7.6
Intrahepatic dholestasis
Intrahepatic cholestasis of pregnancy increases the risk of stillbirth; therefore induction of labour is generally offered at 37-38 weeks gestation
COCP
reduces the risk of bowel, endometrial and ovarian cancer
increases the risk of breast and cervical cancers.
Stop at age 50
first trimester miscarriage
fetal chromosomal abnormalities
second trimester miscarrige
cervical incompentence
uterine abnormalities
Menopause vasomotors sx only
if HRT contraindicated
CBT is 1st line
SSRI (fluoxetine citalopram) SNRI (venlafaxine) and clonidine 2nd line
Stess incontinence
1st line pelvic floor
2nd refer for surgical rx of decline to trial duloxetine
Urgency incontinence
Bladder retraining
Oxybutynin(avoid in old frail women)/tolteridone/darifenacin if does not work mirabegron
Pregnancy hyperthyroid
First trimester propylthiouracil
2nd trimester switch to carbimazole
Pregnant hypothyroid
Double dose or inc by 50-100
Mastitis
If effective removal of milk has not improved the symptoms of lactational mastitis after 12-24 hours flucloxacillin is the 1st line empirical treatment
Contraception insertion
If insert iud or ius in first week of cycle then immediately effective but outside this useful 7 days barrier
Post partum either insert first 48hrs if not wait 4wks post partum
pregnant 8 weeks initial booking bloods
Pregnant women are offered testing for HIV, syphilis and hepatitis B at their booking appointment (ideally before 10 weeks of pregnancy). Tests for sickle cell disease and thalassemia are also offered at this stage.
breast screening
Breast cancer screening is available to women aged 50- 70 years and is done every 3 years in the UK. There are plans to extend this to women aged 47-73 years by the end of 2016. Women aged 40-50 who have a high risk of breast cancer may be offered 2 yearly screening.
gonorrhoea
first line IM ceftriaxone
2nd oral cefixime + oral azithromycin
