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3 Women's Health EJR > Gynae > Flashcards

Gynae Flashcards

1
Q

definition of acute pelvic infection

A

STI affecting pelvic organs including uterus, fallopian tubes and ovaries

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2
Q

what causes PID

A

ascending infections from vagina and cervix sexually transmitted, or iatrogenically from resident bacteria through instrumentation and procedures

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3
Q

what is perihepatitis

A

infection/adhesions between uterus and liver, causing RUQ pain

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4
Q

clinical features of PID

A 
asymptomatic
bilateral lower abdominal pain
deep dyspareunia
vagina discharge
bleeding
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5
Q

examination findings of PID

A 
tachycardia in severe
pyrexia
lower abdominal peritonism
bilateral adnexal tenderness
cervix excitation
palpable abscess
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6
Q

differential diagnoses of PID

A 
appendicities
ovarian cyst accidents (unilateral pain)
ectopic pregnancy (+ve pregnancy test and unilateral pain)
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7
Q

how to investigate PID

A

endocervical swabs for chlamydia and gonorrhea

blood cultures

WBC, CRP

pelvic US to exclude abscess/cyst

laparoscopy with fimbrial biopsy is diagnostic

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8
Q

what is diagnostic for PID

A

laparoscopy with fimbrial biopsy is diagnostic

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9
Q

how to treat PID

A

analgesics

antibiotics

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10
Q

complications of PID on fertility

A

reduced fertility

increased ectopic risk

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11
Q

What is the definition of menopause

A

12 months after cessation of menstrual bleeding

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12
Q

What is the definition of perimenopausal

A

Someone with the symptoms of menopause but still bleeding, albeit intermittently

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13
Q

What is the median age for menopause

A

51

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14
Q

What is the definition for premature menopause

A

Before 40

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15
Q

What is the definition of postmenopausal bleeding

A

Any bleeding that occurs after menopause

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16
Q

What can cause PMB

A 
endometrial cancer
endometrial hyperplasia
cervical cancer
endometrial or cervical polyps
Withdrawal bleed during sequential HRT
Atrophic vaginitis
Cervicitis
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17
Q

How is atrophic vaginitis diagnosed

A

Diagnosis of exclusion after investigating for malignancy, masses, cysts, hyperplasia

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18
Q

How is PMB investigated (1st, 2nd, 3rd line)

A

Speculum, smear, bimanual

TVUS - endometrial thickness, masses

Hysteroscopy + biopsy

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19
Q

What does TVUS look for in PMB investigation

A

Thickness of endometrium and any masses, or cysts

20
Q

What thickness is abnormal in postmenopausal endometriums

A

> 4mm

21
Q

What can a mass seen during TVUS in PMB bleed be?

A

Fibroid, polyp, cyst

22
Q

When should hysteroscopy and biopsis be done in PMB investigation

A

If endometrial lining is >4mm

23
Q

What are some vasomotor symptoms of menopause

A

Hot flushes, night sweats

24
Q

What are some urogenital symptoms in menopause

A

Itchy, dry, burning, dyspareunia,

Frequency, urgency, nocturia, incontinence, recurrent UTIs

25
Q

What sexual problems occur in menopause

A

Loss of desire
Loss of arousal
Pain during sex
Loss of ability to achieve orgasms

26
Q

What are risk factors for osteoporosis

A 
Family hx
Low bmi
Smoking/alcohol
Early menopause
Low calcium intake
Sedantary lifestyle
Long term corticosteroid use
Other bone homeostasis disrupting diseases
27
Q

What blood markers are useful in investigating menopause

A

FSH, AMH

High FSH and low AMH is typical in menopause

28
Q

Biochemical markers in blood are not used for diagnosis osteoporosis - t or f

A

True

29
Q

What is the HRT regiment for someone without a uterus

A

Continuous oestrogen

30
Q

Why is progesterone required in HRT for women with uteruses

A

To prevent endometrial hyperplasia

31
Q

What happens in unopposed oestrogen therapy?

A

Increased endometrial cancer risk.

32
Q

What is the regime of HRT for perimenopausal women with uterus

A

Estrogen + progesterone either combined daily or sequentially.

33
Q

What is the regime for postmenopausal women with uterus

A

Combined estrogen and progesterone, can be given in IUS

34
Q

Benefits and risks of HRT

A

Benefits: reduces symptoms, reduces osteoporosis and colorectal cancer

Risks: increases breast cancer risk, VTE and gallbladder diseases.

35
Q

How long is HRT regime stayed on for

A

5 years for perimenopausal women and then review on needs

Postmenopausal for osteoporosis risk - life long

Premature menopausal women - till median menopause age and then reviewed on needs

36
Q

What non-hormonal medication can be given to reduce osteoporosis

A

Biphosphonates

37
Q

what are 5 ways of assisted conception

A 
IUI
IVF
ICSI
oocyte donation
surrogacy
38
Q

when is an ovarian cyst significant or insignificant

A

if premenopausal: >55mm is significant

if postmenopausal: any sized cyst is significant

39
Q

5 common types of ovarian cancer

A 
serous cystadenoma
endometroid carcinoma
mucinous cystadenoma
clear cell carcinoma
others
40
Q

is PID pain unilateral or bilateral?

A

bilateral

41
Q

what is color discharge is characteristic of vaginosis?

A

grey watery discharge

42
Q

what is purulent vaginal discharge suggestive of?

A

gonorrhea, PID

43
Q

what color discharge is chlamydia?

A

yellow or milky white

44
Q

what causes a chracteristic cottage cheese discharge?

A

candida

45
Q

symptoms of ovarian cancer

A

abdominal bloating and/or distension
urinary frequency
weight loss

46
Q

symptoms of endometrial cancer

A

post coital bleeding
post menopausal bleeding
pelvic pain

47
Q

most common cause of PMB?

A

vaginal atrophy

3 Women's Health EJR (6 decks)

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