GYNAE Flashcards
where do LHRH and FSHRH come from?
hypothalamus
where to LH and FSH come from ?
ant pituitary
which day do progesterone levels peak?
21
average amount of blood loss in period
30-40ml
management of abnormal uterine bleeding no pathology
- IUS
- TXA, mefanamic acid (during menses only) or COCP
- noresthisterone days 5-26 of cycle or implant/depot
- surgery - ablation, hysterectomy, myomectomy etc
management of dysmenorrhoea (primary)
NSAIDs eg ibuprofen, mefanamic acid, naproxen (+/- patacetomol) COCP for 3-6 trial hot water bottle TENS stop smoking
risk factors for endometrial cancer
PCOS, obesity, FHx (breast, ovary, colon), DM, nulliarity, late menopause/early menarche, unopposed oestrogen, pelvic irradiation hx, tamoxifen, HTN
definition of amenorrhoea
not started by 16 yrs
definition of oligomenorrhoea
occurs every 36 days-6 months
which criteria is used to diagnoise PCOS
rotterdam consensus criteria
imaging signs of PCOS (2)
> 12 follicles OR
increased ovarian volume
if 17-hydroxyprogesterone is raised what is this indicative of? (amenorrhoea)
congenital adrenal hyperplasia
diagnosis of menopause
12 months of amenorrhoea
mean age of menopause
51
4 things menopause increases risk of
CVD
stroke
osteoporosis
atrophic changes in vagina or bladder
when do you do an FSH blood test to diagnose menopause (3)
> 45yrs with atypical symptoms
40-45 with menopausal symptoms
<40 yrs if suspect premature menopause
age of premature ovarian insufficiency
<40yrs
how to diagnose premature menopause
menopausal symptoms + 2x elevated FSH taken 4-6 weeks apart
what is anti-mullerian hormone testing
see how many eggs have left
how long after menopause are you still fertile
2yrs after LMP if <50 and 1 yr if >50
3 common places for endometriosis in pelvis
uterosacral ligaments, pouch of douglas, on or behind ovaries
what are chocolate cysts
endometriosis
2 protective factors for endometriosis
muliparity, OCP
management of PID when low risk of gonorrhoea
ofloxacin + metro PO for 14 days
management of PID when high risk gonorrhoea or acutely unwell
IV cef + doxy THEN PO doxy + metro
threatened miscarriage
bleeding but foetus still alive. os closed. only 25% will miscarry. little/no pain
inevitable miscarriage
heavy bleeding + clots + pain, os open
incomplete miscarriage
os open. products of conception partially expelled
complete miscarriage
all foetal tissue has been passed form confirmed intrauterine pregnancy. cervical os closed
missed miscarriage
foetus is dead but retained.
uterus smaller than expected for dates and os closed
hx of threatened miscarriage
septic miscarriage
endometriosis
signs of ectopic
abdo pain and tenderness, cervical excitation. blood loss is less heavy and darker than miscarriage
ectopic: indications for methotrexate injection
no significant pain, unruptured ectopic with adnexal mass <35mm and no visible heartbeat, no IU preg seen on TVS, serum hcg <1500 IU
management of ectopic
ABCDE either medical (methotrexate) or sugical (laprascopic salpingectomy unless other infertility RFs)
what is a complete molar pregnancy?
all genetic material comes from father. no foetal tissue
what is a partial molar pregnancy?
1 oocyte fertilised by 2 sperm, triploid. foetal tissue or blood cells present
