Gynaecological Conditions Flashcards
What is an ectropion?
A benign condition of the cervix where the columnar epithelium which normally lines the inside surface of the cervix, protrudes outwards and can be seen on the vaginal surface of the cervix. Gives a ‘raw’ appearance to the cervix and can present with increased discharge.
What age-group of women are more commonly affected by functional ovarian cysts?
Young girls, adolescents, women of reproductive age
What is the treatment for a functional ovarian cyst?
If symptomatic, laparoscopic cystectomy. If no symptoms, observe by repeat ultrasound but doesn’t require immediate treatment.
Which type of ovarian cyst is associated with pregnancy?
Theca luteal cyst
List some medical management choices for increased menstrual bleeding
Mefanamic acid and NSAIDs Tranexamic acid Combined oral contraceptive pill Norethisterone Mirena coil GnRH agonist
Give 2 contraindications for using mefanamic acid and NSAIDs as treatment for heavy menstrual bleeding.
Severe asthma
Hx of duodenal ulcer
Why are GnRH agonists only used short-term (max. 6 months) for heavy menstrual bleeding?
They act on the pituitary to stop production of oestrogen. Long-term action predisposes to osteoporosis due to hypo-oestrogenic state.
Give 2 surgical options for management of heavy menstrual bleeding.
Endometrial ablation
Hysterectomy
What is meant by ‘dysmenorrhoea’?
Painful menstruation
List some management options for dysmenorrhoea
Lifestyle changes Heat NSAIDs e.g. ibuprofen, naproxen Oral contraceptives Mirena coil GnRH analogues
What is ‘dyspareunia’?
Pain on intercourse
What is the definition of urinary incontinence?
Involuntary leaking of urine that is objectively demonstrable and is a social and/or hygienic problem.
What are the 3 types of urinary incontinence?
Stress
Urge
Mixed
What is stress incontinence?
Involuntary leakage of urine during times of increased abdominal pressure e.g. coughing, laughing, exercise, etc.
Why does stress incontinence occur?
Physical changes to the pelvic floor e.g. after pregnancy/childbirth, atrophy resulting from menopause, pelvic floor weakening etc.
What is urge incontinence?
Overactivity of the detrusor muscle
What might cause the overactivity of the detrusor muscle seen in urge incontinence?
Loss of inhibitory mechanisms from the CNS, bladder irritation e.g. in UTI, bladder outlet obstruction e.g. in enlarged prostate
What is uroflowmetry?
Non-invasive procedure which allows observation of the rate of flow of urine. Patient will full bladder passes urine over a commode attached to a urodynamics machine. Allows objective measurement of amount of urine passed and the flow rate. Subsequent scan performed to observe any residual volume.
What age group of women are invited to have a cervical screening test?
25 - 64
How often do women aged 25 - 49 have a cervical smear test?
Every 3 years
How often do women ages 50 - 64 have a cervical smear test?
Every 5 years
What action is taken if a cervical smear test shows ‘low grade (borderline) dyskaryosis’?
It is tested for HPV…if positive for HPV patient is referred to colposcopy…if negative there is very little chance of development into abnormality so patient rejoins normal 3-5 year smear tests (depending on age).
What is pelvic inflammatory disease?
PID occurs when infection spreads from lower genital tract (vagina) through the cervix to the upper genital tract. Organisms causing PID are usually spread sexually although it may be that no organism is identified.
What might you find on internal examination of a patient with pelvic inflammatory disease?
Adnexal tenderness
Lower abdominal pain
Cervical excitation