Normal Gyn Symptoms Flashcards

1
Q

discharge - c / I

A

can be normal (sex, puberty, the pill) // infection (STI/thrush) , CA , local cause (retained tampon, fistula)

I - do speculum exam

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2
Q

itch - c / DD / I

A

c - infection (bact/viral/fungal) atrophic vaginitis, eczema/lichen sclerosis, vulva CA

DD - always consider dermo condition

I - if unsure, biopsy and smear + test for DM

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3
Q

hyperemesis - C / I / T

A

uti/ketones

I - take hx and examine / MSSU / Bloods (TFT’s and U+E) / USS (multiple preg?)

T - fluids, anti-emetic, thromboproph, vit replacement, refer to dietician?

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4
Q

prolapse - ? / forms / severity scale

A

when weakness of supporting pelvic musc to allow pelvic organs to sag within vagina

takes form of:
CYSTocele (bladder comes through to upper ant wall of vag) –> freq and dysuria
URETHRocele ( lower an vag wall bulge) –> stress incont
RECTocele (rectum bulging through middle posterior wall) –> asymp, may need reduced before poo though

Uterine prolapse also occurs with severity = 1 - 3rd degree (3rd being procidentia)

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5
Q

CF / I / RF / T of uterine prolapse

A

CF - dragging sensation, freq up, stress incont, defecation issues
I - use a SIM’s speculum and ask pt to bear down

RF - childbirth is most common, menopausal atrophy, pelvic floor muscles weak

T - lose weight, stop smoking, stop straining
physiotherapy for pelvic floor + topical oestrogen cream
SURG - pesseries, repair or hysterectomy

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6
Q

incontinence - 2 main forms / c / I / T of each

A

split into urge and stress (normal bladder control is via external sphincter in urethra as well as pelvic floor muscles)

URGE
CF - need to go now!
c - preg/ pelvic mass/ prolapse/ uti/ diuretics
I - input/output chart to monitor
T - avoid any bladder stimulants + behavioural therapy (retraining) +/- anti-cholinergic meds

STRESS
CF - invol loss of urine during increased abdo pressure (sneeze, cough etc)
RF/c - parous women, prolapse
I - urodynamic study
T - pelvic floor exercises (PT) +/- duloxetine +/- SURG (colposuspecsion/ slings)

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7
Q

dysparenunia - ?/ CF/ DD / T

A

pain during sex, either described as superficial or deep

hx - pain // o/e = determine cause. ?discharge? Dry? post partum? narrow intra-oitus?

DD superfical - infection, decrease sexual stim, scar
DD Deep - endometriosis, pelvic sepsis, PID, cerv CA

T - fix cause if possible, otherwise topical creams

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8
Q

dysmenorhea - ? / c

A

pain during period

either normal or pathological (endometriosis, PID, fibroids)

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9
Q

Acute abdo
general pain causes
localised pain causes

A

PID, STI, UTI, endometriosis

ectopic/ CA/ STI/ abscess/ wound

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10
Q

ovarian CA - what kind/ C/RF / genetic testing criteria/ CF/ I /T / staging

A

80% cystadenoma
c - genetic (BRCA 1+2), nulliparity, unsuccessful IVF, +ve FHx, no use of OCP, increased age, HRT use

test for BRCA if FHx = 1 ov CA + 2 Breast CA // 2 ov CA

CF - often asymp (reason why so deadly) 4 NICE criteria pain, bloating, appetite, freq up (+ other CA CF’s)

I - pelvic US (solid mass) / CT scan (staging/mets) / Ca125 / biopsy
T - depends on tumor type : most common is surgical excision + chemo

staged 1-4
1-ovaries
2-capsule invaded but confinied
3-peritoneum 
4-mets
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