Gynae

Question 1

Stage 1 of TOP?

Answer 1

Anti-progesterone : Mifepristone.

Take this then go home.

Question 2

Stage 2 of TOP?

Answer 2

Vaginal or oral prostaglandin: misoprostol

Begins contractions and opens cervical.

Can complete at home if < 9 weeks.

Question 3

What is classes as an early TOP?

Answer 3

< 9 weeks

Question 4

Late termination is what?

Answer 4

9-12 weeeks.

Question 5

When can you do a vacuum aspiration?

Answer 5

9-13 weeks.

Question 6

What oestrogen is produced by the ovaries?

Answer 6

E2

Question 7

At the menopause, what happens to oestrogen levels?

Answer 7

E2 down, E1 up.

Question 8

What FSH is Dx of the menopause?

Answer 8

Serum FSH > 430, x2, 6 weeks apart.

Question 9

When do you use oestrogen only HRT?

Answer 9

If a woman has had a full hysterectomy

Question 10

When do you use sequential HRT?

Answer 10

Giving oestrogen for 28days with progesterone in latter 14 days.

Use in perimeneopauysal women for maximum of 2 years.

Question 11

When do you use continuous HRT?

Answer 11

Post menopausal women with a uterus or perimenoapusal women who have used sequential for 2years.

Question 12

How is postmenopayusal defined?

Answer 12

Amenorrhoea for 1 year or >54.

Question 13

If perimenopausal and want a bleed free regime what do you give?

Answer 13

You give oestrogen only HRT with the mirena coil.

Question 14

Name 3 risks of going on HRT?

Answer 14

VTE
Stroke
Increased risk of breast, ivariuan and endometrial cancer.

Question 15

Name 3 benefits of HRT?

Answer 15

Symptoms control
Reduced risk of colorectal cancer
Prevention of osteoporossi.

Question 16

Discussion on HRT with patient.

Answer 16

Tell that you will use the lowest dose possible for the shorted amount fo time.

Discuss how other lifestyle factors can reduce risk such as obesity and smoking.

Question 17

How is premature ovarian failure defined?

Answer 17

Menopause before age 45.

Question 18

Management of inevitable miscarriage/.

Answer 18

Allow time for the uterus to evacuate itself.
Give some analgesia.

Allow for 7-14 days for this to happen.

If bleeding continues ayfter this or you do not feeel comfortable come back in and see us..

Also, take a pregnancy test 3 weeks afterwards to confirm that everything has passed.

Then medicsalk or surgical management can be used.

Question 19

Management of septic miscarriage?

Answer 19

Dilatation and currettage

Question 20

Unsure of diagnosis for ectopic, what do you do?

Answer 20

Serial HCG, levels should double. In ectopic they increase but do not double

Question 21

Molar pregnancy clinical scenario?

Answer 21

Serum bHCG > 10000
No Fetal heart, snowstorm appearance

Hyper Emesis is often the case.

Question 22

Management of molar pregnancy?

Answer 22

Evacuation of the uterus and follow up with serial hcg.

Question 23

Management of a cystocele / urethrocele?

Answer 23

anterior colporrhaghy

Question 24

Management of rectocele?

Answer 24

Posterior colporrhapghy

Question 25

Management or uterine / Vaginal vault prolapse?

Answer 25

Sacrospinous ligament fixation.

Question 26

How does cervical ectropion present?

Answer 26

Usually with post coital bleeding and a watery non smelly discharge.