Gynae Flashcards
Stage 1 of TOP?
Anti-progesterone : Mifepristone.
Take this then go home.
Stage 2 of TOP?
Vaginal or oral prostaglandin: misoprostol
Begins contractions and opens cervical.
Can complete at home if < 9 weeks.
What is classes as an early TOP?
< 9 weeks
Late termination is what?
9-12 weeeks.
When can you do a vacuum aspiration?
9-13 weeks.
What oestrogen is produced by the ovaries?
E2
At the menopause, what happens to oestrogen levels?
E2 down, E1 up.
What FSH is Dx of the menopause?
Serum FSH > 430, x2, 6 weeks apart.
When do you use oestrogen only HRT?
If a woman has had a full hysterectomy
When do you use sequential HRT?
Giving oestrogen for 28days with progesterone in latter 14 days.
Use in perimeneopauysal women for maximum of 2 years.
When do you use continuous HRT?
Post menopausal women with a uterus or perimenoapusal women who have used sequential for 2years.
How is postmenopayusal defined?
Amenorrhoea for 1 year or >54.
If perimenopausal and want a bleed free regime what do you give?
You give oestrogen only HRT with the mirena coil.
Name 3 risks of going on HRT?
VTE
Stroke
Increased risk of breast, ivariuan and endometrial cancer.
Name 3 benefits of HRT?
Symptoms control
Reduced risk of colorectal cancer
Prevention of osteoporossi.
Discussion on HRT with patient.
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.
How is premature ovarian failure defined?
Menopause before age 45.
Management of inevitable miscarriage/.
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.
Management of septic miscarriage?
Dilatation and currettage
Unsure of diagnosis for ectopic, what do you do?
Serial HCG, levels should double. In ectopic they increase but do not double
Molar pregnancy clinical scenario?
Serum bHCG > 10000
No Fetal heart, snowstorm appearance
Hyper Emesis is often the case.
Management of molar pregnancy?
Evacuation of the uterus and follow up with serial hcg.
Management of a cystocele / urethrocele?
anterior colporrhaghy
Management of rectocele?
Posterior colporrhapghy
Management or uterine / Vaginal vault prolapse?
Sacrospinous ligament fixation.
How does cervical ectropion present?
Usually with post coital bleeding and a watery non smelly discharge.
