Gynaecology

Question 1

Treatment Algorithm for Menorrhagia

1st/2nd line

Answer 1

1) Mirena Coil (C/I if active infection)

2) Mefenamic/Tranexamic acid

Question 2

Mechanism and side effects of Finasteride

Answer 2

Inhibitor of 5 alpha-reductase - increases metabolism of testosterone to dihydrotestosterone leading to gynaecomastia, impotence, decreased libido

Question 3

Indications of Finasteride

Answer 3

BPH

Male-pattern baldness

Question 4

Medical termination of pregnancy

Answer 4

200mg Mifepristone PO

after 36-48 hours 400mcg PV Misoprostol

Doses vary depending on gestation

Offer prophylactic antibiotics for Clamydia Trachomatis (arithromycin/metronidazole or doxycyclin plus metronidazole)

If >21 weeks - inject KCl into cardiac ventricle to induce feticide (unable to experience pain due to cortical development)

Consider Rhesus status of mother