Gynaecology Flashcards
differentials for primary amenorrhoea?
- hypogonadotropic hypogonadism
- hypergonadotropic hypogonadism
- imperforate hymen
differentials for secondary amenorrhoea?
- pregnancy (commonest)
- menopause
- physiological stress
- PCOS
- contraceptives
- premature ovarian insufficiency
- hormonal (thyroid dysfunction, prolactinoma, cushing’s syndrome)
physiological stressors which could cause amenorrhoea?
- over-exercising
- low body weight
- chronic disease
- psychosocial
differentials for abnormal uterine bleeding (AUB)?
- extremes of reproductive age
- PCOS
- physiological stress
- drugs
- hormonal imbalances
hormonal causes of amenorrhoea / AUB?
- thyroid dysfunction
- high prolactin
- cushing’s syndrome
differentials for intermenstrual bleeding (IMB)?
- red flag for cervical Ca !!!!
- cervical ectropion / polyps
- contraception
- STI
- endometrial polyps / Ca
- vaginal Ca
- pregnancy
- drugs
drug causes of AUB?
- contraception
- antidepressants
- antipsychotics
drug causes of IMB?
- SSRIs
- anticoagulants
causes of dysmenorrhoea?
- primary (no underlying cause)
- endometriosis
- adenomyosis
- fibroids
- PID
- copper coil
- cervical / ovarian Ca
causes of menorrhagia?
- dysfunctional uterine bleeding (no underlying cause)
- extremes of reproductive age
- fibroids
- endometriosis
- adenomyosis
- PID
- meds (copper coil, anticoagulants)
- bleeding disorders (e.g. von willebrand disease)
- endocrine
- connective tissue disease
- endometrial Ca
- PCOS
endocrine causes of menorrhagia?
- diabetes
- hypothyroidism
differentials for postcoital bleeding (PCB)?
- red flag for cervical Ca !!!!
- cervical ectropion
- infection
- trauma
- atrophic vaginitis
- polyps
- endometrial Ca
- vaginal Ca
causes of pelvic pain? hint: there’s a LOT
- UTI
- dysmenorrhoea
- IBS
- IBD
- ovarian cysts
- ovarian torsion
- endometriosis
- PID
- ectopic pregnancy
- appendicitis
- mittelschmerz pain
- pelvic adhesions
what is mittelschmerz pain?
cyclical pelvic pain during ovulation
causes for a change in vaginal discharge?
- infection
- foreign body
- cervical ectropion / polyps
- malignancy
- pregnancy
- ovulation
- contraceptives
examples of infection which could cause a change in vaginal discharge?
- BV
- candidiasis (thrush)
- chlamydia
- gonorrhoea
- trichomonas vaginalis
causes of vaginal / vulval itching (pruritus)?
- atrophic vaginitis
- infection
- eczema
- vulval Ca
- pregnancy
- urinary / faecal incontinence
- stress
examples of infections which could give vulval itching?
- thrush
- public lice
