Gynaecology Flashcards
Ix for endometriosis
Laparoscopy
Ectopic pregnancy sx
1st trimester bleeding (relatively light) +/- abdo pain
Contraceptions affected by CYP40 inducers: (e.g. antiepileptics - carbamazepine, phenytoin, phenobarbital)
reduces effectiveness of Combined pill, Patch, vaginal ring. Progestogen only pills,
Progestogen implant.
Contraception if on inducing drugs
Cu IUD, LNG IUS, Depot medroxyprogesterone acetate,
Sterilisation.
Most common abnormality associated with male infertility
Varicocoele (40% of males with primary infertility, 60-80% with secondary infertility).
Progesterone only implant side effects
Infrequent bleeding, can treat with mefenamic acid, ethinylestradiol or mifepristone.
acne
Progesterone implant mechanism
Etonorgestrel : Inhibits ovulation, supplemented by mucus secretion + endometrium thickening.
insert between d1-5 of cycle. or anytime + additional contraception for 7 days after insertion.
effective for 3 years
Special indications mittelscmerz, ectopic preg.Can reduce dysmenorrhea.
Emergency contraception post ovulation
Cu IUD up to 5 days.
always f.u 3-4w post treatment
Which emergency contraception can only be used between 0-96h post UPSI
Levonorgestrel only post coital contraception
Which EC can be used upto 120h after UPSI
Ulipristal acetate
Subfertility ix for female
Mid luteal phase serum progesterone (confirm ovulation) - take 7 days before expected period.
Combined hormonal contraception start date
Any day of cycle, if day 6 or later need additional contraception for first 7 days.
enzyme inducer + levonorgestrel as EC
Give 3mg as double dose needed due to inducers.
how long needed for rpt sperm count if <15 million/ml
3months (cycle of sperm formation to be completed) if zero or severe then rpt ASAP
Vitamin D def risk factors
Pregnant
Pigmented/covered skin,
Obese,
Malabsorption
wt loss surgery
