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CFPC exam KM > Gynecology > Flashcards

Gynecology Flashcards

1
Q

What are the absolute contra indications to hormonal contraception?

A

< 4 weeks postpartum (breastfeeding)
Smoker (>15 cigarettes/d) and >/35 y/o
Vascular dz
HTN
Acute VTE
Hx vte not on anticoagulants and high risk
Major surgery with prolonged immobilisation
Thrombophilia
CAD/CVA
Migraine with aura
Breast ca
Severe cirrhosis
Hepatocellular adenoma

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2
Q

What are the risks of hormonal contraception?

A

VTE, increased risk MI and CVA, breast cancer

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3
Q

What are the benefits of hormonal contraception?

A

Cycle regulation, decreased flow, decreased anaemia, increased bone mass density, decrease dysmenorrhoea, decreased perimenopausal, decreased PMS, decreased acne, decreased endometrial/ovarian/colorectal ca

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4
Q

Examination you need to do for people taking combined oral contraceptive?

A

Blood pressure

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5
Q

When is the copper IUD effective for emergency contraception

A

7 days post coitus

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6
Q

What are the hormonal options for emergency contraception

A

Ulipristal 30mg x 1 - start hormonal contraception 5 d later
Plan B 1.5mg x 1 - start hormonal contaception 1 d later

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7
Q

Investigations for menopause

A

FSH - increased >30, best done day 3 of cycle. Do order in on OCP.
LH - increases later than FSH
TSH
Prolactin
Estradiol - if <20 = menopause. If on OCP test 7d of pill free time, if low estrogen and high TSH then menopause

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7
Q

What supplement should women take pre-conception

A

Folic acid 0.4mg

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8
Q

Examples of estrogen only oral HRT

A

Premarin
Estrace

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9
Q

Examples of progesterone only oral HRT

A

Prometrium
Provera
Mirena IUD

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10
Q

Exampled of combined E and P oral HRT

A

Activelle
Angelique

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11
Q

Criteria for diagnosis of PCOS

A

Oligomenorrhoea 3-4 years post menarche plus either
Clinical/biochemical hyperandrogenism
or polycystic ovaries on US

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12
Q

Investigations for PCOS

A

Total testosterone (most sensitive) - raised - also raised DHEAS and androstenedione. Low SHBG.
LH:FSH > 2:1
TSH
Prolactin
FBG
OGTT/Hba1c
Ultrasound

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13
Q

What to screen for in PCOS

A

Lipids
BP
Diabetes
Eating disorder

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14
Q

Management of cycle control in PCOS

A
  1. Decrease peripheral estrogen - lower BMI, increase exercise
  2. COCP
  3. Cyclic provera
  4. Oral hyperglycemia - metformin
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15
Q

Management of hirsutism in PCOS

A
  1. COCP
  2. Diane 35 - anti androgenic
  3. Spironolactone 25mg up to 100mg
  4. Finasteride
  5. Flutamide
16
Q

Management of acne in PCOS

A
  1. Benzyl peroxide
  2. Topical retinoids
  3. Systemic antibiotics
  4. COCP
17
Q

Management of infertility in PCOS

A
  1. Medical induction of ovulation - clomiphene
  2. Metformin
  3. Ovarian drilling
  4. Bromocriptine if hyperprolactinemia

CFPC exam KM (16 decks)

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