Gynaecological Conditions Flashcards
What are risk factors of ectopic pregnancy?
Infection
Smoking
Surgery
Endometriosis
In which condition is Rosvig’s sign seen?
Appendicitis
When LIF palpated, it elicits pain in the RIF.
What tests should be carried out if suspicious of pelvic inflammatory disease?
FBC
CRP
LFTs
Genital swab
What is pelvic inflammatory disease?
Ascending infection of the endocervix.
What can cause pelvic inflammatory disease?
Chlamydia
Gonorrhoea
Gardenella
Anaerobes
How is PID treated?
14 day course of metronidazole and doxycycline.
Removal of coil (if present) - replace with alternative contraception.
What are non-menstrual causes of heavy bleeding?
Miscarriage
Cervical cancer
Endometrial cancer
Vaginal trauma
What are causes of heavy bleeding during menstruation?
Anovulation (in the very young and very old)
Fibroids
Anticoagulation
Von-Willebrand’s disease
What is a fibroid also known as?
Leiomyoma
What should be performed in a 40/50yo with heavy bleeding?
Endometrial biopsy
What is the function of tranexamic acid?
Prevents the body breaking down its own clots.
It is a fibrinolytic agent.
What type of medication is mefenamic acid?
NSAID
Acts to reduce bloodflow to the womb.
Which 2 medications, when given in combination, reduce bleeding by around 50%?
Tranexamic acid
Mefenamic acid
How should a Bartholin’s cyst be treated?
Drain abscess
Give broad spectrum antibiotics
What is lichen sclerosus?
An inflammatory, scarring dermatosis of the anogenital skin of unknown causation.
What symptoms are seen in lichen sclerosus?
Itch (worse at night)
Pain
Dyspareunia
How does lichen sclerosus appear?
Ivory white papules and plaques on the vulval skin.
Can affect anus, but NOT the vaginal mucosa.
What is the main differential to lichen sclerosus?
Lichen planus
This will affect the vaginal mucosa. Will also affect the mouth, nails and hair.
What is the main complication of lichen sclerosus?
Squamous cell carcinoma
How is lichen sclerosus managed?
Skin care
Emollients
Super potent steroids (e.g. clobetasol propionate)
What does genitourinary syndrome in menopause produce?
Narrowing of the vaginal opening Atrophy of the labia Loss of vaginal length Petechial haemorrhage Urinary symptoms
How is genitourinary syndrome in menopause treated?
Vaginal oestrogens in the form of a cream or ring.
Is there a risk of endometrial hyperplasia from vagina oestrogens?
No
What is vaginismus?
A condition developed secondary to pain, in that the body anticipates pain (during sex) and so muscles around the vagina tighten.
Makes intimacy more painful.
How can vaginismus be circumvented?
Perineal massage
Lubricants
Vibrators
Combination of these is most effective.
What is vulvodynia?
Vulval discomfort occurring in the absence of a relevant causation.
This is a diagnosis of exclusion.
How is vulvodynia treated?
Genital skin care
Emollients
Ointments
Physiotherapy
What is female genital mutilation?
Any procedure involving the partial/total removal of the external female genitalia for a non-medical reason.
Is female genital mutilation illegal?
Yes
What is the name of the surgical procedure performed to correct female genital mutilation?
De-infibulation
What is usually present in lichen sclerosus?
Another dermatological manifestation of an autoimmune condition.
What causes vulvovaginal atrophy?
A lack of oestrogen.
Occurs in those who are peri-menopausal, menopausal or post-menopausal.
