Gynae pass med Flashcards
N/V in pregnancy: ketonuria/ weight loss despite use of oral antiemetics? what to do?
Admit for IV fluids, electrolyte imbalance, anti-emetics, trial of bland diet
Management of hyperemesis gravidarum?
Antihistamine= oral cyclizine, promethazine 1STLINE
Odansetron/metoclopramide (cleft lip risk 1st trimester, extrapyramidal effects) 2NDLINE
Complication of hyperemesis gravidarum
Wernicke encephalopathy, mallory weiss tear, Small fetus, pre-term birth
Urinary incontinence 1st line treatments
Urge= bladder retrain
Stress= pelvic floor muscle training
Hyperemesis gravidarum triad
Dehydration
5% weight loss compared to pre-pregnancy
Electrolyte imbalance
What can you use to treat menopausal vasomotar symptoms e.g. hot flushes
lifestyle: weight loss, exercise, reduce stress
HRT
non-hrt: SSRI fluoxetine, citalopram, SNRI- velafaxine
Which medicine can cause endometrial hyperplasia
Tamoxifen- pro-oestrogenic on endometrium but anti-oestrogenic on breast. unopposed by progesterone= endometrial hyperplasia.
Teen with 1ry amenorrhoea, 2ry sexual characteristics present, regular painful cycles and bloating what is differential?
Imperforate hymen- block menses, buildup= pelvic pain/bloating
Smear positive, 12 months later cytology performed positive 12 months later performed again, if negative what happens? if positive what happens?
- return to normal recall
- colposcopy
If cervical smear sample inadequate?
repeat sample within 3 months, if 2 inadequate then colposcopy
What is the treatment of CIN?
LLETZ- in colposcopy
If patient has been treated for CIN, when should be invited for repeat cervical sample
6 months later
TOP: how long does urine pregnancy test remain positive for?
4 wks- any more than that= incomplete abortion or persistant trophoblast
Up to which week can medical management of pregnancy occur?
9 wks.
Large fibroid submurally, woman wants to have baby in the future how to remove?
Myomectomy- performed abdominally
