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AB 4th Year O+G > Gynae - Early Pregnancy + Menstruation > Flashcards

Gynae - Early Pregnancy + Menstruation Flashcards

1
Q

what is premenstrual syndrome?

A

occurs in the luteal phase and resolves by menstruation

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2
Q

what causes premenstrual syndrome?

A

decreased progesterone

increased PRL/oestrogens

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3
Q

features of premenstrual syndrome?

A 
emotional lability
bloating 
wt gain
mastalgia
fatigue
headache
cravings
cyclical
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4
Q

features of a molar pregnancy?

A

missed period
vaginal bleeding
large for dates

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5
Q

what causes a molar pregnancy?

A

non viable fertilised egg implants into the uterus/fallopian tube

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6
Q

what is a partial mole?

A

egg fertilised by one/two sperm (triploidy)

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7
Q

what is a complete mole? what are these at risk of?

A

egg with no DNA fertilised by sperm (diploidy)

choriocarcinoma

more common (snowstorm etc..)

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8
Q

Ix for molar pregnancy?

A 
BhCG elevated
pelvic US (snowstorm)
CXR (metastatic disease)
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9
Q

Tx for molar pregnancy? how long should pregnancy be avoided?

A

D+removal / hysterectomy
anti D

avoid pregnancy for 1 year

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10
Q

what is the menopause?

A

amenorrhoea for 12 months

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11
Q

when is the menopause premature?

A

<45yrs

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12
Q

features of the menopause?

A 
hot flush
night sweats
joint pain
dry sin 
hair thin
vaginal dryness
osteoporosis
poor memory
loss of libido
labile mood/concentration
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13
Q

what happens to cause the menopause?

A

decline in follicles
reduced oestrogen (which is produced by these)
no negative feedback on LH/FSH production
anovulation occurs

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14
Q

what does lack of oestrogen increase risk of?

A

CVS
osteoporosis
incontinence
prolapse

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15
Q

Ix for menopause?

A

FSH (high)

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16
Q

how long should women use contraception for after the menopause?

A

<50 2 years after LMP

>50 1 year after LMP

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17
Q

benefits vs risks of HRT?

A 
decrease # risk
decrease CVD (<65yrs)

VTE
stroke/CVD
breast Ca
ovarian if >5yrs

18
Q

what do those with no uterus get for HRT?

A

oestrogen

19
Q

what do those with a uterus get for HRT?

A

combined (oestrogen everyday, prog for 12/14 days monthly)

cyclical if perimenopausal

20
Q

contraindications for HRT?

A 
undiagnosed PV bleed
liver disease
uncontrolled HT
Hx VTE
Hx CVD/Stroke
Hx of benign breast disease
21
Q

oestrogen side effects of HRT?

A 
breast enlargement
leg cramps
fluid retention
nausea
headache
22
Q

progesterone side effects of HRT?

A 
PMS
headache
acne
mood swings
depression
irritable
constipated
increased appetite
23
Q

what is amenorrhoea? what is primary?

A

absence of menstruation for at least 6 months

primary is failure by 16yrs

24
Q

causes of primary amenorrhoea?

A 
imperforate hymen 
premature ovarian failure
turners (XO)
Kallman's
hypothyroid
PCOS
CAH
prolactinoma
sarcoid
25
Q

causes of secondary amenorrhoea?

A 
wt loss
exercise
sheehan's
high PRL
thyroid
PCOS
ashermann's
pregnancy
breastfeeding
26
Q

Ix for amenorrhoea?

A 
BMI
PV
bHCG
FSH/LH (low hypogonad, high ovarian failure)
TFTs
genetic tests
imaging
27
Q

what is mittelschemerz? Tx?

A

mid cyclical pain

analgesia

28
Q

where do bartholin’s cysts occur? Tx?

A

5/7 oclock position at introitus

marsupulisation and Abx

29
Q

when is abortion legal up until?

A

24wks

30
Q

when is abortion legal past 24 wks?

A

life at danger

fetal anomoly

31
Q

what is given for a medical abortion?

A

mifepristone

48hrs later misoprostol (up to 5 doses)

32
Q

risks of medical abortion?

A

bleeding
incomplete procedure
pain
infection

33
Q

what happens after a medical abortion?

A

complete pregnancy test at home 2wks later

34
Q

when can a medical abortion be completed?

A

up to 24wks

35
Q

what surgical abortion is done up to 12+6 wks?

A

vacuum aspiration

36
Q

what surgical abortion is done after 14 wks?

A

D+evacuation (not done in scotland)
misoprotolol softens cervix
azithro + met given

37
Q

what Ix should be done pre abortion?

A 
rhesus
FBC
swabs
US
bHCG
38
Q

who gets anti D prophylaxis after an abortion?

A

rhesus -ve after 9+6 wks

ALL surgical

39
Q

Tx for DUB?

A

mirena coil
tranxemic (antifibrinolytic)
mefanamic acid (NSAID)

40
Q

surgical complications 0-24hrs?

A

haemorrhage

UTI

41
Q

surgical complications 24hrs - 5days?

A

infection
DVT/PE
bladder/bowel/ureter injury

42
Q

surgical complications 7-14 days?

A

infection
DVT/PE
AVN secondary to diathermy

AB 4th Year O+G (17 decks)

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