Gynaecology

Question 1

which contraceptive is contraindicated in breastfeeding? til when?
heavy bleeding?
enzyme inducers?
obesity?

Answer 1

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Question 2

primary amenorrhoea causes

secondary amenorrhoea causes?

Answer 2

hypogonadatrophic hypogonadism, hypergonadotrophic hypogonadism

preg, menopause, phys stress, PCOS, meds, premature ovarian infuff, thyroid, PRL xs, cushings

Question 3

irregular bleeding causes

intermensrual bleeding causes

Answer 3

ireegular similar to secondary - extreme of age, PCOS, phys stress, meds, hormonal imblanace

inter menstrual bleeding is RED FLAGS - contraception, cervical ectropion, polyps, cancer, STI, endometrial polyps, vaginal patholigy, pregnancy, ovulation can cause spottinhg, meds SSRI, anticoag

Question 4

dysmenorrhoea

causes

Answer 4

primary - no patholigy

endom, fibr, PID, copper coil, cercical / ovarian Ca

Question 5

menorrhagia causes

Answer 5

dysfunctional uterine bleeding - no cause. extreme of age, fibroids, endo adeno, PID, contrac, anticoag, bleding disorders, endocrine, endometrial hyperplasia, PCOS

Question 6

postcoital bleeding causes

Answer 6

is a RED FLAG

cervical cancer, ectropion, infection / trauma, atrophic vaginitis, polyps, endometrial cancer, vaginal cancer

Question 7

pelvic pain causes

Answer 7

UTI, dysmenorrhoea, IBS, ovarian cycts, endometriosis, PID, ectopic, appendicitis, mittelschmerz, pelvic adhesions, IBD

Question 8

vaginal discharge causes

Answer 8

XS / foul smelling – bacterial vaginosis, foreign body, cervical ectropin, polyps, malignancy, ovulation, contracepton - hormaonal

Question 9

pruritus vulvae causes

Answer 9

itching of vulva and vagina – irritants, atrophic vaginitis, infections such as candidiasis, eczema, vulval malignany, pregnancy related vaginal discharge, incontinence, stress

Question 10

bacterial vaginosis 
Presentation
RF?
I?
M?

Answer 10

fishy smelling grey discharge. NOT itching or pain OR co-infection

M - vaginal swap for vaginal pH. alkaline - should be 3.5 - 4.5, but it’s above.
vaginal CHARCOAL swab for microscopy - CLUE cells. Gardnerella vaginalis

M - metronidazole targets anaerobic bacteria. oral / gel. Clindamycin 2nd. AVOID ALCOHOL - N+V, SHOCK.

incr STI risk and pregancy complications

Question 11

candidiasis

RF?

Answer 11

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Question 12

candidiasis

RF?

Answer 12

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