Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3- Reproduction > Gynaecology: Management > Flashcards

Gynaecology: Management Flashcards

1
Q

Adenomyosis

A

endometrial tissue inside the myometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Adenomyosis management

A

No contraception

  • tranexamic acid - reduce bleeding
  • mefenamic acid- reduce pain & bleeding

Contraception

  • Mirena coil (1st line)
  • COCP
  • POP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

androgen insensitivity syndrome

A

cells unable to respond to androgen hormones due to a lack of androgen receptors

X-linked recessive genetic condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Androgen insensitivy syndrome management

A

MDT

  • bilateral orchidectomy to avoid testicular tumours
  • oestrogen therapy
  • vaginal dilator/ surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Asherman’s syndrome

A

adhesions forming within the uterus. following damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Asherman’s syndrome management

A

dissect adhesions during hysteroscopy (gold stand investigation)

reoccurrence of adhesions after treatment is common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Atrophic vaginitis

A

dryness and atrophy of the vaginal mucosa related to a lack of oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

atrophic vaginitis management

A

vaginal lubricants for dryness
- Sylk, replens

topical oestrogen
- estriol cream, pessary, tablet, ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

contraindications of topical oestrogen

A

breast cancer, angina, venous thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bartholin’s Cyst & Abscess

A

Blockaage of Bartholin’s glands causing them to swell and become tender.

If cysts become infection they lead to an abscess
Most common cause: e.coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Bartholin’s Cyst Management

A

Good hygiene
Analgesia
Warm compresses

Possibly biopsy if vulval malignancy needs to be excluded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bartholin’s Abscess

A

Antibiotics

Surgical Interventions

  • Word catheter
  • Marsupilisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cervical ectropion

A

Columnar epithelium of the Endocervical has extended out to the ectocervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cervical ectropion management

A

Normally no management required

Problematic bleeding
- Cauterisation of ectropion using silver nitrate or cold coagulation during colposcopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

endometriosis

A

ectopic endometrial tissue outside of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

endometriosis management

A

Hormonal management options
- COCP, POP, Depot, implant, Mirena coil

Gold standard diagnosis: laparoscopic surgery
Laparoscopic surgery to excise/ablate endometrial tissue and remove adhesions

Hysterectomy (final surgical option)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

fibroids

A

benign tumours of smooth muscle of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

fibroids management

A

<3cm

  • Mirena coil (1st line)
  • Symptomatic management: NSAIDs & tranexamic acid

Smaller fibroids + heavy menstrual bleeding

  • endometrial ablation
  • resection of submucosal fibroids
  • hysteroscopy
>3cm 
[referral to gynaecologist - investigation & management)
-Symptomatic management
-Uterine artery embolisation 
-Myomectomy
-hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Red degeneration of fibroids

A

Ischaemia, infarction and necrosis of fibroid due to disrupted blood supply

20
Q

red degeneration of fibroids: management

A

Supportive: rest, fluids, analgesia

21
Q

heavy menstrual bleeding management

A

Try to identify and treat aetiology

No contraception

  • Tranexamic acid (reduce bleeding)
  • Mefenamic acid (reduce pain & bleeding)

Contraception

  • Mirena Coil
  • COCP
  • Cyclical Oral progestogens
22
Q

lichen sclerosus

A

chronic inflammatory skin condition that presents with patches of shiny, ‘porcelain-white’ skin

23
Q

Lichen sclerosus management

A

Potent topical steroids
- clobetasol propionate

Regular use of emollients

24
Q

Contraception methods- women approaching menopause

A

Barrier methods
Mirena/ copper coil
Progesterone Only Pill
Progesterone Implant

COCP can be used up to 50y/o if no other contraindications but is a UKMEC2

25
Q

Management of perimenopausal symptoms

A

HRT

Testosterone- treat reduced libido

Vaginal oestrogen- for vaginal dryness & atrophy
Vaginal moisturisers

26
Q

nabothian cysts

A

fluid-filled cysts on the surface of the cervix

27
Q

nabothian cysts management

A

No treatment required

If diagnosis uncertain
-refer for colposcopy

28
Q

types of ovarian cysts

A 
function cysts
serous cyst adenoma 
mutinous cyst adenoma 
endometrioma 
dermoid cysts/ germ cell tumours 
sex-cord stromal tumours
29
Q

Ovarian cyst management

A

Possible ovarian cancer

  • complex cysts or raised CA125
  • two week wait referral to gynae oncology specialist

Possible dermoid cyst
- referral to gynaecologist for further investigation & consideration of surgery

Simple ovarian cysts

  • <5cm: resolve within 3 cycles
  • 5-7cm: routine referral to gynae & yearly US
  • > 7cm- consider MRI/surgical evaluation

Cysts in postmenopausal women

  • Correlation with CA125 & referral to gynaecologist
  • Raised CA125’ two-week wait suspected cancer referral
  • Simple cysts ,5cm & normal CA125: US every 4-6mths

Persistent/ Enlarging cysts

  • Surgical evaluation
  • Removal of cyst (ovarian cystectomy)
30
Q

Meig’s Syndrome

A

benign ovarian tumour (ovarian fibroma) with pleural effusion and ascites

31
Q

meig’s Syndrome management

A

Removal of tumour

32
Q

ovarian torsion

A

ovary twists in relation to surrounding connective tissue, Fallopian tube and blood supply
-Gynae emergency

Cn be visualised as whirlpool sign on pelvic US

33
Q

ovarian torsion management

A

Definitive diagnosis: Laparoscopic surgery

Detorsion (un-twist ovary & fix it in place)

Oophorectomy (remove affected ovary)

34
Q

pelvic organ prolapse

A

descent of pelvic organs into the vagin

Uterine prolapse: uterus descends into vagina
Vault prolapse: top of vagina descends
Rectocele: rectum prolapses forward into vagina
Cystocele: bladder prolapse backward into vagina

35
Q

Pelvic organ prolapse management

A

Conservative

  • physio
  • weight loss
  • lifestyle changes
  • vaginal oestrogen cream

Vaginal Pessary

Surgery (definitive option)

36
Q

Polycystic Ovarian Syndrome

A

Common condition causing metabolic and reproductive problems in women

Characteristic features of multiple ovarian cysts, infertility, oligomenorrhoea, hyperandrogegism and insulin resistance

37
Q

PCOS management

A

weight loss

reducing risk of endometrial cancer

  • Mirena coil
  • Induce withdrawal bleed every 3-4 months (cyclical progestogens or COCP)

Manage infertility

  • Clomifene
  • Laparoscopic ovarian drillin
  • IVF

Managing hirsutism

  • weight loss
  • co-cyprindiol (COCP)
  • topical eflornithine

Management of acne

  • COCP -first line for acne in PCOS (co-cyprindiol)
  • Retinoid.
38
Q

Premature ovarian insufficiency

A

menopause before the age of 40 years.
Characterised by hypergonadotropin hypogonadism
[Raised LH and FSH. Low estradiol levels}

39
Q

Premature ovarian insufficiency management

A

HRT

  • traditional hormone replacement therapy
  • COCP

Contraception is still recommended as small risk of pregnancy

Increased risk of VTE with HRT in women <50.
Can be reduced by using transdermal methods (patches)

40
Q

premenstrual syndrome

A

psychological, emotional and physical symptoms that occur during luteal phase of menstrual cycle

41
Q

PMS management

A

healthy lifestyle changes

COCP
- recommended COCPs contain drosperidone (i.e Yasmin)

SSRI antidepressants
CBT

Cyclical breast pain
-danazole & tamoxifen

physical symptoms (breast. swelling, water retention, bloating) 
-Spironolactonw
42
Q

Primary amenorrhoea

A

Not starting menstruation

  • by 13 when there is no other evidence of puberty
  • by 15 when there is other signs of puberty
43
Q

primary amenorrhoea management

A

Establish and treat underling cause

Hypogonadotropic Hypogonadism
(Hypopituitarism or Kallman Syndrome)
- Pulsatile GnRH (induces fertility)
- COCP (induce regular menstruation

Ovarian Aetiology
(PCOS, damage/ absence of ovaries) 
-COCP
44
Q

Secondary amenorrhoea

A

no menstruation for .3months after previous regular menstrual periods

45
Q

Secondary amenorrhoea management

A

Establish and treat underlying cause

Possible causes 
-pregnancy
-Menopause & premature ovarian failure
-Hormonal Contraception 
-Hypothalamic or pituitary pathology
Ovarian causes (PCOS) 
-Uterine pathology (Ashermans Syndrome) 
-Thyroid pathology
- Hyperprolactinaemia
46
Q

Urinary incontinence

A

loss of control of urination

Types

  • Urge incontinence
  • stress incontinence
  • mixed incontinence
  • overflow incontinence
47
Q

urinary incontinence management

A 
Stress Incontinence
Avoid caffeine, diuretics, overfilling bladder
Restrict fluid intake 
Weight loss 
Pelvic floor exercises 
Surgery

urge Incontinence

  • bladder retraining
  • anticholinergics (oxybutynin, tolterodine)
  • Miragebron
  • Invasive procedures

Overactive Bladder Invasive management

  • botulinum type A injection
  • percutaneous sacral nerve stimulation
  • augmentation cystoplasty

3- Reproduction (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions