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Obstetric And Gynecology > GYNAECOLOGICAL PROBLEMS IN CHILDREN AND ADOLESCENT > Flashcards

GYNAECOLOGICAL PROBLEMS IN CHILDREN AND ADOLESCENT Flashcards

1
Q

What is the earliest point at which gynaecological care may begin for a girl child?

A

Gynaecological care may begin in the delivery room with detection of obvious pathology during routine newborn examination.

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2
Q

What handling considerations are crucial for the vulva in children and adolescents?

A

There should be minimal handling of the vulva except when absolutely indicated.

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3
Q

What are the four classifications of gynaecological disorders in children and adolescents?

A

Congenital anomalies, premenarcheal disorders, sexual maturation disorders, and disorders affecting sexuality.

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4
Q

List examples of congenital anomalies of the genital tract.

A

Labial anomalies, clitoral anomalies, imperforate hymen, vaginal anomalies, uterine anomalies, ovarian anomalies, and ambiguous genitalia.

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5
Q

What is an imperforate hymen?

A

A condition where the hymen completely covers the vaginal opening.

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6
Q

What are the common symptoms of urethral mucosal prolapse?

A

Increased urinary frequency, dysuria, urinary retention, bloody discharge, and painful vulva.

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7
Q

What is the management for urethral mucosal prolapse?

A

Management includes pain relief with warm sitz baths, applying oestrogen cream, and in severe cases, surgical intervention.

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8
Q

What is adhesive vulvitis, and what are its causes?

A

A condition where irritation of the labia(labia minor) induces scratching and ulcerations, leading to labial adhesion; associated with low oestrogen levels.

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9
Q

What are the clinical findings in adhesive vulvitis?

A

Dysuria, urinary retention, and recurrent vulval infections in symptomatic cases; asymptomatic cases often resolve spontaneously.

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10
Q

How is adhesive vulvitis treated?

A

Treatment involves applying oestrogen cream, digital separation, or surgical intervention if severe.

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11
Q

What are the major changes during puberty?

A

Major changes include development of secondary sexual characteristics, reproductive system maturation, and accelerated skeletal growth.

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12
Q

Define thelarche and its usual onset age range.

A

Thelarche is the development of breasts, typically starting between 8.5 and 13.5 years.

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13
Q

Describe Tanner staging for breast development.

A

Tanner staging ranges from Stage 1 (preadolescent) to Stage 5 (full adult breast size).

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14
Q

What is adrenarche, and which hormones are involved?

A

Adrenarche involves adrenal secretion of DHEA, DHEAS, and androstenedione, contributing to pubic and axillary hair growth.

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15
Q

Explain Tanner staging for hair development.

A

Tanner staging of hair development goes from no terminal hair (Stage 1) to adult distribution and quantity (Stage 5).

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16
Q

What is gonadarche, and how does it begin?

A

Gonadarche begins with pulsatile secretion of GnRH, leading to LH and FSH release and ovarian follicular development.

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17
Q

What changes occur during gonadarche?

A

Increases in oestradiol initiate breast development, vaginal and uterine growth, and skeletal growth, eventually leading to menarche.

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18
Q

Define menarche and its usual onset age range.

A

Menarche is the onset of menstruation, usually between ages 10 and 16.

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19
Q

Define precocious puberty.

A

Early appearance of secondary sexual characteristics, generally before age 8.

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20
Q

What are the classifications of precocious puberty?

A

Classified as gonadotrophin-dependent (true) or gonadotrophin-independent (pseudo), among others.

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21
Q

List possible causes of precocious puberty.

A

Causes include idiopathic factors, hypothalamic tumors, infections, and ovarian or adrenal lesions.

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22
Q

What investigations are carried out for precocious puberty?

A

Tests for hormones like FSH, LH, oestradiol, imaging studies, and thyroid function.

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23
Q

How is precocious puberty treated?

A

Treatment includes counseling and addressing the specific cause.

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24
Q

What is dysmenorrhoea, and what causes it?

A

Painful menstruation caused by elevated prostaglandin levels in the endometrium.

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25
Q

What is leukorrhoea, and how is it managed?

A

Vaginal discharge, physiological or pathological, managed with reassurance and counseling.

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26
Q

What are preventive measures against STDs?

A

Prevention involves counseling, barrier methods, and limiting sexual partners.

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27
Q

What are common causes of congenital genital anomalies?

A

Genetic mutations, developmental abnormalities, and maternal hormonal exposure.

28
Q

What is clitoromegaly, and what causes it?

A

Enlargement of the clitoris, often due to excessive androgen exposure.

29
Q

What are transverse vaginal septum and longitudinal vaginal septum?

A

Transverse vaginal septum: horizontal wall; Longitudinal vaginal septum: vertical partition.

30
Q

What is ambiguous genitalia?

A

a rare birth defect that occurs when a baby’s external genitals are not clearly male or female

31
Q

What is the usual treatment for imperforate hymen?

A

Surgical incision and drainage.

32
Q

What are signs of vulvovaginitis in children?

A

Itching, redness, and foul-smelling discharge.

33
Q

What are the common foreign bodies found in the genital tract of children?

A

Paper, toilet tissue, or small toys.

34
Q

How does urethral prolapse differ from urethral caruncle?

A

Urethral prolapse: circumferential eversion; caruncle: partial eversion of distal urethra.

35
Q

What age group is most commonly affected by urethral prolapse?

A

Typically affects children aged 3–11 years.

36
Q

What are the common benign tumours found in the genital area of children?

A

Hemangiomas, retention cysts, and condyloma acuminata.

37
Q

What is lichen sclerosus, and how is it managed?

A

Lichen sclerosus is a chronic inflammatory skin condition affecting the vulva; it is managed with topical corticosteroids and monitoring for potential complications.

38
Q

What are the stages of Tanner breast development?

A

Tanner stages for breast development range from Stage 1 (no breast development) to Stage 5 (full adult breast size and form).

39
Q

What are the stages of Tanner pubic hair development?

A

Tanner stages for pubic hair development range from Stage 1 (no terminal hair) to Stage 5 (adult quantity and distribution).

40
Q

What is the first measurable sign of puberty?

A

Pulsatile LH secretion during sleep is the first measurable sign of puberty.

41
Q

What is the role of oestradiol during puberty?

A

Oestradiol triggers breast development, fat distribution, vaginal and uterine growth, and rapid skeletal growth.

42
Q

What is the average age for menarche?

A

The average age for menarche is 13.5 years.

43
Q

How does societal influence affect adolescent health?

A

Societal influences such as peer pressure and social media can affect adolescent risk-taking behaviors and health outcomes.

44
Q

What is pseudo-precocious puberty, and how does it differ from true precocious puberty?

A

Pseudo-precocious puberty occurs without GnRH stimulation, often due to peripheral hormonal sources, unlike true precocious puberty.

45
Q

What is the significance of juvenile hypothyroidism in precocious puberty?

A

Juvenile hypothyroidism can cause isosexual precocious puberty due to excessive TSH production acting on FSH receptors.

46
Q

What imaging studies are used for investigating precocious puberty?

A

Imaging studies like pelvic ultrasound and MRI help investigate causes of precocious puberty.

47
Q

What are common management strategies for psychological problems in adolescents?

A

Psychological problems in adolescents are managed through counseling, behavioral therapy, and support groups.

48
Q

What is the pathogenesis of primary dysmenorrhoea?

A

Primary dysmenorrhoea results from elevated prostaglandin F2α levels, leading to uterine hypercontractility and cramping.

49
Q

What differentiates physiological from pathological leukorrhoea?

A

Physiological leukorrhoea is a normal discharge before menarche, while pathological leukorrhoea is associated with infections.

50
Q

What are the clinical signs of STDs in adolescents?

A

Clinical signs of STDs in adolescents include abnormal discharge, genital sores, and pelvic pain.

51
Q

What is the management approach for vulval injuries in children?

A

Management of vulval injuries in children includes wound cleaning, pain relief, and addressing underlying causes like trauma.

52
Q

What are the clinical features of labial adhesions?

A

Clinical features of labial adhesions include difficulty with urination, recurrent infections, and sometimes dysuria.

53
Q

How is labial adhesion treated?

A

Labial adhesion treatment involves oestrogen cream application, manual separation, or surgical correction if necessary.

54
Q

What is the role of GnRH in puberty?

A

GnRH initiates puberty by stimulating the pituitary to release LH and FSH, which promote gonadal activity.

55
Q

What are the effects of elevated LH and FSH during puberty?

A

Elevated LH and FSH stimulate ovarian follicle development and oestradiol production during puberty.

56
Q

What is the Tanner stage associated with menarche?

A

Menarche typically occurs during Tanner Stage 3 or 4 of breast development.

57
Q

What factors influence the timing of puberty?

A

Timing of puberty is influenced by genetics, nutrition, and environmental factors.

58
Q

What are the types of ovarian anomalies?

A

Types of ovarian anomalies include agenesis, hypoplasia, and cystic malformations.

59
Q

What are the common causes of delayed sexual maturation?

A

Common causes of delayed sexual maturation include constitutional delay, chronic illnesses, and hormonal imbalances.

60
Q

What is the typical treatment for delayed sexual maturation?

A

Delayed sexual maturation is treated with hormone therapy or addressing underlying medical conditions.

61
Q

What are the psychological impacts of delayed puberty?

A

Psychological impacts of delayed puberty include low self-esteem, anxiety, and social withdrawal.

62
Q

What are the social challenges faced by adolescents with gynaecological problems?

A

Adolescents with gynaecological problems face social challenges like stigma, lack of awareness, and limited access to care.

63
Q

What is the role of hormonal therapy in managing adolescent gynaecological problems?

A

Hormonal therapy manages conditions like delayed puberty, precocious puberty, or menstrual irregularities.

64
Q

What are the common causes of genital injuries in children?

A

Common causes of genital injuries in children include accidental trauma, sexual abuse, or foreign body insertion.

65
Q

How can gynaecological care improve outcomes for adolescent girls?

A

Gynaecological care improves outcomes by addressing physical, emotional, and reproductive health needs early.

Obstetric And Gynecology (12 decks)

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