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GOSH > GYNAE > Flashcards

GYNAE Flashcards

1
Q

where do LHRH and FSHRH come from?

A

hypothalamus

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2
Q

where to LH and FSH come from ?

A

ant pituitary

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3
Q

which day do progesterone levels peak?

A

21

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4
Q

average amount of blood loss in period

A

30-40ml

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5
Q

management of abnormal uterine bleeding no pathology

A
  1. IUS
  2. TXA, mefanamic acid (during menses only) or COCP
  3. noresthisterone days 5-26 of cycle or implant/depot
  4. surgery - ablation, hysterectomy, myomectomy etc
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6
Q

management of dysmenorrhoea (primary)

A 
NSAIDs eg ibuprofen, mefanamic acid, naproxen (+/- patacetomol)
COCP for 3-6 trial
hot water bottle
TENS
stop smoking
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7
Q

risk factors for endometrial cancer

A

PCOS, obesity, FHx (breast, ovary, colon), DM, nulliarity, late menopause/early menarche, unopposed oestrogen, pelvic irradiation hx, tamoxifen, HTN

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8
Q

definition of amenorrhoea

A

not started by 16 yrs

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9
Q

definition of oligomenorrhoea

A

occurs every 36 days-6 months

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10
Q

which criteria is used to diagnoise PCOS

A

rotterdam consensus criteria

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11
Q

imaging signs of PCOS (2)

A

> 12 follicles OR

increased ovarian volume

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12
Q

if 17-hydroxyprogesterone is raised what is this indicative of? (amenorrhoea)

A

congenital adrenal hyperplasia

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13
Q

diagnosis of menopause

A

12 months of amenorrhoea

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14
Q

mean age of menopause

A

51

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15
Q

4 things menopause increases risk of

A

CVD
stroke
osteoporosis
atrophic changes in vagina or bladder

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16
Q

when do you do an FSH blood test to diagnose menopause (3)

A

> 45yrs with atypical symptoms
40-45 with menopausal symptoms
<40 yrs if suspect premature menopause

17
Q

age of premature ovarian insufficiency

A

<40yrs

18
Q

how to diagnose premature menopause

A

menopausal symptoms + 2x elevated FSH taken 4-6 weeks apart

19
Q

what is anti-mullerian hormone testing

A

see how many eggs have left

20
Q

how long after menopause are you still fertile

A

2yrs after LMP if <50 and 1 yr if >50

21
Q

3 common places for endometriosis in pelvis

A

uterosacral ligaments, pouch of douglas, on or behind ovaries

22
Q

what are chocolate cysts

A

endometriosis

23
Q

2 protective factors for endometriosis

A

muliparity, OCP

24
Q

management of PID when low risk of gonorrhoea

A

ofloxacin + metro PO for 14 days

25
Q

management of PID when high risk gonorrhoea or acutely unwell

A

IV cef + doxy THEN PO doxy + metro

26
Q

threatened miscarriage

A

bleeding but foetus still alive. os closed. only 25% will miscarry. little/no pain

27
Q

inevitable miscarriage

A

heavy bleeding + clots + pain, os open

28
Q

incomplete miscarriage

A

os open. products of conception partially expelled

29
Q

complete miscarriage

A

all foetal tissue has been passed form confirmed intrauterine pregnancy. cervical os closed

30
Q

missed miscarriage

A

foetus is dead but retained.
uterus smaller than expected for dates and os closed
hx of threatened miscarriage

31
Q

septic miscarriage

A

endometriosis

32
Q

signs of ectopic

A

abdo pain and tenderness, cervical excitation. blood loss is less heavy and darker than miscarriage

33
Q

ectopic: indications for methotrexate injection

A

no significant pain, unruptured ectopic with adnexal mass <35mm and no visible heartbeat, no IU preg seen on TVS, serum hcg <1500 IU

34
Q

management of ectopic

A 
ABCDE
either medical (methotrexate) or sugical (laprascopic salpingectomy unless other infertility RFs)
35
Q

what is a complete molar pregnancy?

A

all genetic material comes from father. no foetal tissue

36
Q

what is a partial molar pregnancy?

A

1 oocyte fertilised by 2 sperm, triploid. foetal tissue or blood cells present

GOSH (2 decks)

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