Gynae Conditions Flashcards
What are some differentials for acute pelvic pain?
Ectopic pregnancy UTI Appendicitis Pelvic inflammatory disease Ovarian torsion Miscarriage
What are the features of an ectopic pregnancy?
Female 6-8 weeks amenorrhoea
Lower abdo pain
Vaginal bleeding
What are the features of an UTI?
Dysuria and frequency are common but women may experience suprapubic burning secondary to cystitis
What are the features of appendicitis?
Central pain that moves to RIF Anorexia Tachycardia Low grade fever Rovsing's sign: more pain in RIF when palpating LIF
What are the features of pelvic inflammatory disease?
Pelvic pain Fever Deep dyspareunia Vaginal discharge Menstrual irregularities
What are the features of ovarian torsion?
Sudden onset unilateral lower abdo pain
Precipitated by exercise
N+V
Unilateral, tender adnexal mass
What are features of miscarriage?
Vaginal bleeding and crampy lower abdominal pain following a period of amenorrhoea
What are some differentials for chronic pelvic pain?
Endometriosis
IBS
Ovarian cyst
Urogential prolapse
What are the features of endometriosis?
Chronic pelvic pain
Dysmenorrhoea - pain often starts days before bleeding
Deep dyspareunia
Subfertility
What are the features of ovarian cysts?
Unilateral dull ache which may be intermittent or only occur during intercourse
Torsion or rupture may lead to severe abdominal pain
Large cysts may cause abdominal swelling or pressure effects on the bladder
What are the features of urogenital prolapse?
Seen in older women
Sensation of pressure, heaviness, ‘bearing-down’
Urinary symptoms: incontinence, frequency, urgency
What is atrophic vaginitis?
Post-menopausal women
Vaginal dryness
Dyspareunia
Occasional spotting
What is the treatment for atrophic vaginitis?
Vaginal lubricants and moisturisers
Topical oestrogen creams
What is primary amenorrhoea?
lack of menses by age 15 years in a patient with appropriate development of secondary sexual characteristics
What is secondary amenorrhoea?
lack of menses in a non-pregnant female for at least 3 cycles of her previous interval, or lack of menses for 6 months in a patient who was previously menstruating
