OBG Flashcards
WHAT ARE THE TWO TYPES OF OVARIAN CYST
FOLLICULAR
LUTEAL
WHAT ARE FOLLICULAR CYSTS
FUNCTIONAL CYSTS THAT OCCUR WITH HORMONAL CHANGES
THEY ARE ALWAYS SMALLER THAN 6CM
WHY DO FOLLICULAR CYSTS OCCUR
WHEN OVULATION DOESNT OCCUR AND THE FOLLICLE KEEPS GROWING
WHAT ARE THE TYPES OF LUTEAL CYSTS
GRANULOSA
THECA
WHAT ARE GRANULOSA CYSTS
OF CORPUS LUTEUM
are luteal cysts that occur with hormonal changes
have 2 stages vascular and serous, in vascular they can haemorrage if there is rupture
WHAT ARE THECA CYSTS
BAD ONLY OCCUR WITH HIGH LEVELS OF HCG AND ARE OFTEN ASSOCIATED WITH A HYDRATIFORM MOLE
HOW WOULD YOU INVESTIGATE A CYST
US
LAPROSCOPY
WHAT ARE SYMPTOMS OF AN OVARIAN CYSTS
USUALLY ASYMPTOMATIC UNLESS THEE IS TORSION OR RUPTURE
WHY DO GRANULOSA CYSTS HAVE DIFFERENT PRESENTATIONS TO MOST OTHER OVARIAN CYSTS
BECAUSE THEY COME FROM CORPUS LUTEUM THEY SECRETE POGESTERONE MIMIKING AN ECTOPIC PREGNANCY
WHAT ARE UTERINE FIBROIDS
BENIGN GROWTH OF UTERINE MUSCLE
WHAT ARE THE TYPES OF UTERINE FIBROID
SUBMUCUS
INTRAMURAL
SUBSEROUS
PEDUNCULATED
INTERLIGAMENTAL
PARASITIC
WHICH FIBROIDS CAN CAUSE ENLARGEMENT OF THE UTERUS
INTERMURAL
WHICH FIBROIDS CAUSE PAIN AS THEY GROW
SUBMUCOUS
PEDUNCULATED CCAN CAUSE PAIN IF THEY GET TWISTED
WHICH FIBROID TYPE ARE USUALLY ASYMPTOMATIC
SUBSEROUS
WHAT IS THE PRESENTATION OF FIBROIDS
HEAVY MENSES
NON TREATABLE ANAEMIA
DISCOMFORT ON PRESSURE
PAIN
HOW ARE FIBROIDS TREATED
ONLY IF SYMPTOMATIC
TREATED SURGICALLY VIA MYECTOMY OR HYSTERECTOMY
HOW DO YOU DIAGNOSE FIBROIDS
BI MANUAL PELVIC EXAM
US
WHAT IS A CHRONIC PELVIC INFECTION
WHEN AN ACUTE INFECTION ISNT TREATED AND PROGRESSES TO DILATATION AND OBSTRUCTION OF TUBES FORMING ADHESIONS
WHAT ARE THE SIGNS AND SYMPTOMS OF CHRONIC PELVIC INFECTION
CHRONIC PELVIC PAIN
CHRONIC PURULENT VAGINAL DISCHARGE
EPIMENORRHOEA
DYSMENORRHOEA
INFERTILITY
RETROVERTED UTEROUS
HOW WOULD YOU DIAGNOSE CHRONIC PELVIC INFECTION
SWABS
- HIGH VAGINAL
- ENDOCERVICLE
TRANSVAGINAL US
WHAT ARE TREATEMENT OPTIONS FOR CHRONIC PELVIC INFECTIONS
IVF + TUBAL REMOVAL
HISTORECTOMY AND PELVIC ORGAN CLEARENCE
WHAT % OF PREGNANT WOMEN ARE AFFECTED BY PYLEONEPHRITIS
1%
WHAT IS THE PRESENTATION OF A UTI
LOIN/ABDO PAIN
SUPRAPUBIC PAIN (CYSTITIS)
OFFENSIVE SMELLING URINE
FREQUENCY
URGENCY
HAEMATURIA
DYSURIA
FEVER/RIGORS
WHAT IS THE PRESENTATION OF UTI IN PREGNANCY
USUALLY ASYMPTOMIATIC
WHAT IS THE MOST COMMON PATHOGEN CAUSING UTI
E COLI (G -VE)
HOW WOULD YOU DIAGNOSE A UTI
MSU
DIPSTICK
CULTURES
BLOODS: CRP, ESR, ECC
WHEN IS TRIMETHOPRIM USED TO TREAT UTI
CYSTITIS IN 3RD TRIMESTER OR NON PREGNANT
WHAT ANTIBIOTICS ARE USED FOR CYSTITIS IN PREGNANCY
CEFALEXIN ALL THROUGHOUT PREGANCY
NUROFERONTOIN 1ST TRIMESTER
TRIMETHOPRIM 3RD TRIMESTER
WHAT ANTIBIOTICS ARE USED FOR PYLEONEPHRITIS IN PREGNANCY
CEFALEXIN
WHAT IS PELVIC CONGESTION
VASCULAR CONJESTION OF PELVIC ORGANS DUE TO VESSEL DILATATION CAUSING STASIS OF BLOOD
WHAT ARE THE SYMPTOMS OF PELVIC CONGESTION
PELVIC PAIN
PAIN OFTEN STARTING DURING OR AFTER PREGNANCY
DYSPYRUNEA
SYMPTOMS WORSE DUING MENSES
TENDERNESS AT ILLIAC FOSSA
HOW WOULD YOU INVESTIGATE FOR PELVIC CONGESTION
US
LAPROSCOPY
VENOGRAPHY (VERY INVASIVE AND UNPLESENT)
WHAT ARE TREATEMENTS FOR PELVIC CONGESTION
PROSTAGLANDINS
OOPHORECTOMY
WHAT IS PID
PELVIC INFLAMMATORY DISEASE IS A POLYMYCROBIAL DISEASE
USUALLY CAUSED BY INFECTION WITH CHAMYDIA OR GHONNOREA (OR BOTH)
USUALLY WITH ONE OTHER AEROBIC BACTERIA
HOW WOULD YOU DIAGNOSE PID
HIGH VAGINAL AND ENDOCERVICLE SWABS
BLOODS FOR ACUTE PHASE REACTANTS
TRANSVAGINAL SCAN
WHAT IS THE MANAGEMENT OF PID
- FLUIDS
- ANTIBIOTICS
- NSAID
- IUD/IUS REMOVAL
- IMMOBILIZATION UNTIL PAIN IS BETTER
- ABSTINENCE UNTIL INFECTION IS CLEARED
WHAT IS THE ANTIBIOTICS USED FOR CHAMYDIA
AZYTHROMYCIN
OR
DOXYCYLINE
WHAT IS THE ANTIBIOTIC USED FOR GONNOREA
CEFTRIAXONE (IM)
+
DOXYCYCLINE/AZYTHROMYCIN
WHAT IS THE ANTIBIOTIC USED FOR TRICHOMONIASIS
METRANIDOZOLE
WHAT ARE URETERIC CALICULI
AN ACCUMULATION OF EITHER
- CALCIUM OXOLATE
- STRIVATE
- URIC ACID
- CYSTINE
- MIXURE OF ABOVE
IN THE BLADDER/URETER
WHY DOES DEHYDRATION PREDISPOSE YOU TO URETERIC CALICULI
LEADS TO SUPERSATURATION OF URINE
WHAT ARE THE THREE COMMON AREAS IN WHICH THE URETERIC CALICULI GET STUCK
PELVIC - URETERIC JUNCTION
PELVIC BRIM
VESICO URETERIC JUNCTION
WHAT IS THE PRESENTATION OF A URETERIC CALICULI
SUDDEN SEVERE URILATERAL PAIN GOING LOIN TO GROIN
RIGORS
DYSURIA
HAEMATURIA
RETENTION
N+V
HOW WOULD YOU DIAGNOSE URETERIC CALICULI
UINE DIPSTICK - HAEMATURIA
BLOODS - CALCIUM, PHOSPHATE, URATE
X RAY (US)
CT
A PATIENT IS SHOWN TO HAVE A STONE < 5MM WHAT IS THE MANAGEMENT?
WATCH AND WAIT
ENCOURAGE FLUIDS
SPONTANEOUS PASS
+ ANALGESIA (AND POTENTIALLY ABX)
A PATIENT IS SHOWN TO HAVE A STONE> 5MM WHAT IS THE MANAGEMENT?
TAMSULOSIN
SHOCKWAVE LITHOTRIPSY OR PERCUTANEOUS NEPHROLITHOMY
ANALGESIA
(POTENTIALLY ABX)
WHAT IS ADENOMYOSIS
ENTROMETRIAL CELLS GROWING INTO THE UTERINE WALLS
HOW DOES ADENOMYOSIS DIFFER FROM ENDOMETRIOSIS
ENDOMETRAL CELLS ONLY GROW INTO WALL
IN ENDOMETRIOSIS THEY GROW OUTSIDE UTERUS
WHAT ARE SYMPTOMS OF ADENOMYOSIS
HEAVY MENSES
ENLARGED UTERUS
HOW DO YOU DIAGNOSE ADENOMYOSIS
CLINICALLY AND US/MRI CAN GIVE AN IDEA BUT A HYSTERECTOMY AND MICROSCOPY OF TISSUE SAMPLE IS ONLY TRUE DIAGNOSIS
WHAT ARE TREATEMENTS FOR ADENOMYOSIS
COMBINED ORAL CONTRACEPTIVE
GnRH ANALOGUES
UTERINE ARTERY AMBOLIZATION
ENDOMETRIAL ABLASION
WHAT IS ENDOMETRIOSIS
PROLIFERATION OF THE ENDOMETRIUM IN SITES OTHER THAN UTERINE MUCOSA
WHAT ARE SYMPTOMS OF ENDOMETRIOSIS
PAIN
DYSPYRUNEA
DISMENNOREA
PAIN ON DEFICATION
WHAT SRE THE SIGNS OF ENDOMETRIOSIS
INFERTILITY
RETROVETRED UTERUS
ADENAXAL MASS
VAGINAL - RECTAL SEPTUM MASS
HOW WOULD YOU DIAGNOSE ENDOMETRIOSIS
BIMANUAL PELVIC EXAM + SIMULTANEOUS VAGINAL AND RECTAL EXAM
LAPROSCPY
COMBINED ORAL CONTRACEPTIVE CHALLENGE
WHAT ARE TREATEMENTS OF ENDOMETRIOSIS
COMBINED ORAL CONTRACEPTIVE
ANDROGENS (INCREASE PERIFERAL OESTROGEN CONVERSION)
GnRH ANALOGUES
SURGERY
WHAT ARE SIDE EFFECTS OF COC
BREAST TENDERNESS
FLUID RETENTION
WHAT ARE SIDE EFFECTS OF ANDROGENS
WEIGHT GAIN
XS HAIR
WHAT ARE SIDE EFFECTS OF GnRH ANALOGUES
MENOPAUSAL SYMPTOMS
WHAT IS INCONTENENCE
INVOLUNTARY LEAKAGE OF URINE AFFECTING SOCIAL LIFE AND HYGENE
WHAT ARE THE TWO TYPES OF INCONTENENCE
OVERACTIVE BLADDER
STRESS INCONTENANCE
DEFINE OVERACTIVE BLADDER
INVOLUNTARY AND FREQUENT BLADDER CONTRACTIONS
DEFINE STRESS INCONTENENCE
SPHINCTER WEAKNESS WHERE URINE IS PASSED ON INCREASED BLADDER PRESSURE
WHAT IS THE PRESENTATION OF INCONTENENCE
PASSING URINE WHEN SNEEZING OR COUGHING
SENSE OF URGENCY
NOCTURIA
KEY IN DOOR SYNDROME
HOW DO YOU DIAGNOSE INCONTENENCE
FREQUENCY VOLUME CHART
RESIDUAL URINE MEASUREMENT USING IN OUT CATHETER
E PAQ
CONTRAST CYSTOGRAM FOR STRESS INCONTENENCE
WHAT IS E PAQ
A QUESTIONAIRRE LOOKING AT URINARY, VAINAL, BOWEL AND SEXUAL SYMPTOMS
WHAT IS URODYNAMIC TESTING
ARTIFICIALLY FILLING BLADDER AND ASKING PATIENT TO COUGH TO MEASURE BLADDER PRESSURE
WHAT IS THE TREATEMENT FOR STRESS INCONTENENCE
LIFESTYLE
BLADDER TRAINING
SURGERY
WHAT ARE TREATEMENTS FOR OVERACTIVE BLADDER
LIFESTYLE
OXYBUTAMINE (ANTICHOLINERGIC)
BOTOX
CATHETERS
VAGINAL OESTROGEN
WHAT IS A FISTULA
AN ABNORMAL COMMUNICATION OF THE URETER AND VAGINA
WHAT CAN CAUSE A FISTULA
TRAUMA
C SECTION
NECROSIS
WHAT IS A UTEROVAGINAL PROLAPSE
WHEN THE UTERUS PARTIALLY OR COMPLETELY PROTRUDES FROM THE CERVIX INTO THE VAGINAL CANAL
DESCRIBE A PRIMARY UTEROAGINAL PROLAPSE
DESCENT OF CERVIX INTO THE VAGINA THROUGH OS
DECRIBE A SECONDARY VAGINAL PROLAPSE
DESCENT OF CERVIC TO THE INTEROITUS
DECRIBE A TERTIARY VAGINAL PROLAPSE
DECSENT OF CERVIX THROUGH INTEROITUS
DECRIBE A QUATERNARY/TOTAL VAGINAL PROLAPSE
MOST OF UTERUS OUTSIDE INTEROITUS
HOW WOULD YOU DIAGNOSE A UTEROVAGINAL PROLAPSE
SIMS SPECULUM
ULTRASOUND
POTENTIALLY MRI
WHAT IS THE TREATEMENT OF A UTEROVAGINAL PROLAPSE
REASURRANCE
TREAT SYMPTOMATICALLY
physio
RING / SELF PESSARY
SURGERY
WHAT IS A RETROCELE
A POSTERIOR VAGINAL WALL PROLAPSE WHERE THE RECTAL PASSAGE BULGES INTO THE VAGINAL CANAL
WHAT IS THE PRESENTATION OF A RETROCELE
DIFFICULT BOWEL MOVEMENTS
PRESSURE FELT ON RECTUM
FEELING OF INCOMPLETE VOIDING
WHAT IS THE TREATEMENT OF A RETROCELE
SURGERY
WHAT IS A CYSTOCELE
AN ANTERIOS VAGINAL WALL PROLAPSE WHERE BLADDER PRESSES ON ANTERIOR VAGINAL WALL
WHAT IS THE PRESENTATION OF A CYSTOCELE
HESITATION
FREQUENCY
RECURRANT UTI
INCOMPLETE VOIDING AND RETENTION
WHAT IS THE TREATEMENT FOR CYSTOCELE
PHYSIO
PRESSARY
TOPICAL VAGINAL OESTROGEN
SURGERY
HOW WOULD YOU DEFINE A MISCARRIGE
THE SPONTANEOUS DISCHARGE OF A GESTATIONAL SACK BEFORE THE FETUS IS VIABLE
WHAT PROPORTION OF PREGNANCIES END IN MISCARRIGE
50%
WHAT ARE THE TYPES OF MISCARRIGE
THREATNED
INEVITABLE SEPSIS
MISSED
SPONTANEOUS SECOND TRIMESTER
RECURRENT
WHAT IS A THREATNED MISCARRIGE
BLEEDING FROM GENITAL TRACT AT EARLIEST STAGES OF PREGNANCY BUT NO PRODUCTS OF CONCEPTION ARE DISCHARGED
CERVIX REMAINS CLOSED
WHAT IS AN INEVITABLE MISCARRIGE
THE CERVIX OPENS AND THE PRODUCTS OF CONCEPTION ARE DISCHARGED
CAN BE COMPLETE OR INCOMPLETE
WHAT ARE THE SIGNS OF AN INCOMPLETE MISCARRIGE
PROLONGED ABDOMINAL PAIN AND PV BLEEDING
WHAT IS A SEPSIS MISCARRIGE
INFECTION CAUSING EXPULSION OF PRODUCTS OF CONCEPTION
WHAT ARE THE SIGNS OF A SEPTIC MISCARRIGE
UTERINE TENDERNESS
PURULENT VAGINAL DISCHARGE
PYREXIA
ALSO OCCURS POST MISSCARRIGE
WHAT IS A MISSED MISSCARRIGE
AN EMPTY GESTATIONAL SAC BEING DISCHARGED
THERE WAS FAILURE TO DEVELOP AFTER 7 DAYS
OFTEN WOMEN DO NOT REALISE THEY MISCARRY - SIMILAR TO PERIOD
WHAT IS A SPONTANEOUS SECOND TRIMESTER LOSS
SPONTANEOUS MEMBRANE RUPTURE WITH CERVICALE DILATATION WILL CAUSE A MISSCARRIGE
WHAT ARE RECURRENT MISSCARRIGES
3 OR MORE
WHAT ARE COMMON CAUSES OF MISCARRIGE
GENETIC DISORDERS INCOMPATIBLE WITH LIFE
ENDOCRINE : DECREASED PROGESTERIONE FROM PLACENTA OR CORPUS LUTEUM
MATERNAL ILLNESS OR DRUG USE
CERVICLE INCOMPLETENCY
AUTO IMMUNE DISEASES
WHAT WOULD A SECOND TRIMESTER MISSCARRIGE BE LIKE
A RAPID DELIVARY WHICH IS OFTEN PAINLESS AND BLOODLESS
WHAT OFTEN CAUSES CERVIACLE INCOMPLETENCY
PRIOR TRAUMA TO CERVIX
HOW WOULD YOU INVESTIGATE A MISCARRIGE
VAGINAL EXAM TO CHECK DILATATION
VAGINAL SWABS
US - TRANSVAGINAL AND ABDOMINAL
WHAT IS THE MANAGEMENT OF A MISCARRIGE
GIVE PROSTAGLANDINS - MISOPRASTOL
WHAT DO PROSTAGLANDINS (MISOPRASTOL) DO
PROMOTE UTERINE CONTRACTION AND EXPULSION
WHAT IS THE MANAGEMENT OF A RHESUS NEGATIVE MISCARRIGE
GIVE MISOPROSTOL
GIVE ANTI D IMMUNOGLOBULINS WHEN FETAL GESTATION IS OVER 12W
WHEN WOULD YOU INTERVENE SURGICALLY IN MISCARRIGE
IF INCOMPLETE MISCARRIGE
OR ESPECIALLY PAINFUL
WHAT SHOULD YOU INVESTIGATE FOR IN RECURRANT MISCARRIGES
LUPUS
PCOS
KARYOTYPE TESTING
CERVICLE CLEARENCE
WHAT IS AN ECTOPIC PREGNANCY
WHEN A FERTILIZED EGG ATTACHES OUTSIDE OF UTERINE CAVITY
WHERE DO ECTOPIC PREGNANCYS OCCUR MOST OFTEN
FALLOPIAN TUBES
WHAT ARE THE RISK FACTORS FOR AN ECTOPIC PREGNANCY
IUD/IUS
PREV ECTOPIC PREGNANCY
SURGERY TO UTERINE TUBES
WHAT IS THE PRESENTATION OF AN ECTOPIC PREGNANCY
SUDDEN SEVERE UNILATERAL PAIN
SHOULDER TIP PAIN (DUE TO DIAPHRAGM IRRITATION)
HOW DO YOU DIAGNOSE AN ECTOPIC PREGNANCY
PREGNANCY TEST
SMALL UTERUS FOR GESTATION
US
LAPROSCOPY
HOW WOULD YOU TREAT AN ECTOPIC PREGNANCY
METHOTREXATE IF UNDER 3CM
LAPSROSCOIC REMOVAL
TUBAL REMOVAL
WHAT IS THE PROBLEM WITH USING METHOTREXATE IN MANAGING ECTOPIC PREGNANCIES
MAY BE UNSUCCESSFUL
MAY CAUSE RUPTURE
WHAT IS THE PATHOPHYSIOLOGY OF PCOS
INCREASED ANDROGEN
DECREASED FSH AND LH
ANDROGENS CONVERTED TO TESTOSTERONE PERIFERALLY
WHAT ARE THE CYST TYPE IF PCOS
COLLICULAR
HAULTED FOLLICULAR DEVELOPEMENT
WHAT INVESTIGATIONS ARE REQUIRED FOR PCOS
US
BLOODS:
- LH NORMAL OR DECREASED
- FHS NORMAL OR DECREASED
- HIGH PROLACTIN!!!!
- HIGH TESTOSTERONE
WHAT IS PCOS
THE PRESENCE OF MULTPILE CYSTS WITHIN THE OVARY ABD XS ANDROGEN PRODUCTON FROM OVARIES AND ADRENAL GLANDS
WHAT IS THE PRESENTATION OF PCOS
OVERWEIGHT AND DIFFICULTY LOOSING WEIGHT
HIRTUISM
INFERTILITY
ACNE
AMENORRHOE OR OLIGOMENNORHEA
HOW WOULD YOU TREAT PCOS
MENSES:
- COC / CYCLICAL OESTROGEN
- METFORMIN
FERTILITY
- METFORMIN
- CLOMIFENE
- PREDNISOLONE
- IVF
SPRIONOLACTONE
HAIR REMOVAL AND ACNE TREATEMENTS
HOW DOES SPIRONOLACTONE HELP IN PCOS
HAS ANTIANDROGEN PROPERTIES
HOW DOES METFORMIN HELP IN PCOS
HELS ASSOCIATED INSULIN RESISTANCE AND REGULATES MENSES BOTH ALSO AIDING FERTILITY
HOW DOES CLOMIFENE HELP IN PCOS
INDUCES OVARIES
WHY SHOULD YOU BE CAUTIOUS OF PROLONGED CLOMIFENE
INCREASES RISK OF OVERIAN CANCER
NO MORE THAN 6 CYCLES
HOW DOES PREDNISOLONE HELP IN PCOS
REVERSES CARCADIAM RYTHMN AND SUPPRESSES PITUITARY ACTH
WHAT IS ANDROGEN INSENSITIVITY SYNDROME
WHEN AN INDIVIDUAL HAS CELLS WITH LITTLE TO NO RESPONSE TO ANDROGENS
WHAT CAUSES OF ANDROGEN INSENSITVITY SYNDROME
A GENETIC FAULT CAUSING THE BODY TO NOT RESPOND TO TESTOSTERONE
WHAT IS THE PATHOPHYSIOLOGY OF ANDROGEN INSENSITIVITY SYNDROME
FETUS IS UNRESUPONSIVE TO TESTOSTERONE CAUSING A GENETICALLY MALE FETUS TO NOT BE ABLE TO DEVELOP THEIR MALE REPRODUCTIVE ORGANS PROPERLY AND SO WILL HAVE DISORDERS OF SECUAL DIFFERENTIATION
WHAT ARE THE TYPES OF ANDROGEN IINSENSITIVITY SYNDROME
MILD
PARTIAL
COMPLETE
DESCRIBE MILD ANDROGEN INSENSITIVITY SYNDROME
ABNORMAL MALE GENETALIA
DESCRIBE PARTIAL ANDROGEN INSENSITIVITY SYNDROME
ABNORMAL INTERNAL MALE REPRODUCTIVE ORGANS BUT EXTERNALLY ARE NORMAL
DESCRIBE COMPLETE ANDROGEN INSENSITIVITY SYNDROME
NORMAL EXTERNAL FEMALE GENETALIA
WHAT IS THE PRESENTATION OF ANDROGEN INSENSITIVITY SYNDROME
INFERTILITY
FROM SPERM DEFECTS TO FULL FEMALE GENETALIA
HOW WOULD YOU DIAGNOSE ANDROGEN INSENSITIVITY SYNDROME
KARYOTYPE
GENETIC TESTING FOR ANDROGEN RECEPTOR INSENSITIVITY MUTATIONS
HOW WOULD YOU MANAGE ANDROGEN INSENSITIVITY SYNDROME
SEX ASSIGNMENT
GENITOPLASTY
GONADECTOMY
HRT
COUNCELLING
WHAT IS AMENNORHEA
ABSENCE OF PERIODS
WHAT IS PRIMARY AMENNORHEA
ABSENCE OF MENSES BY 14-16
WITH NORMAL SECONDARY SEXUAL CHARACTERISTICS AND GROWTH
WHAT IS SECONDARY AMENNORHEA
PREVIOSULY HAVING MENSES
THEN ABSENCE OF MENSES FOR 6M OR OVER
WHAT ARE THE MAIN CAUSES OF PRIMARY AMENORHEA
TURNERS SYNDROME
VAGINAL AGENESIS
ANDROGEN INSENSITIVITY SYNDROME
WHAT ARE CAUSES OF SECONDARY AMENORRHEA
GONADOTROPHIN FAILURE CAUSED BY
- ANOREXIA
- KALLMANS
- HYPOTHALAMIC PITUITARY DISEASE
OVARIAN FAILURE
- PREM FAILURE OR RESISTENT OVARIAN FAILURE
ENDOCRINE
- HYPOTHYROIDISM
- CUSHINGS
ANDROGEN XS
- CAH
- GONADAL OR ADRENAL TUMOUR
WHAT INVESTIGATIONS ARE REQUIRED IN AMENNORHEA
BLOODS
- FSH, LH, OESTROGEN, PROLACTIN, T3/T4, TSH
PIUTITARY MRI
OVARIAN BIOPSY
GENETIC TESTING
YOU ARE TESTING A PATIENT WITH SECONDARY AMENORHEA WHOS BLOODS COME BACK AS
HIGH FSH AND LH
WHAT DOES THIS INDICATE
OVARIAN FAILURE
YOU ARE TESTING A PATIENT WITH SECONDARY AMENORHEA WHOS BLOOS COME BACK AS
HIGH PROLACTIN
WHAT DOES THIS INDICATE
LACTATION
HOW DO WE MANAGE AMENNORHEA
TREAT ANY MANAGABLE CAUSES
HRT UNLESS RESISTANT OVARIAN SYNDROME
WHAT IS ATROPHIC VAGINITIS
THINNING OF VAGINAL WALLS
VAGINA BECOMING DRY AND INFLAMMED
WHAT CAUSES ATROPHIC VAGINITIS
FALLING OESTROGEN LEVELS
WHATS IS THE PRESENTATION OF ATROPHIC VAGINITIS
VAGINAL DRYNESS
VAGINAL BLEEDING AND DISHCHARGE
DYSPURUNEA
RECURRANT UTI
HOW WOULD YOU DIAGNOSE ATROPHIC VAGINITIS
SWABS TO RULE OUT INFECTION
SPECULUM
HOW WOULD YOU TREAT ATROPHIC VAGNITIS
LUBRICANT
EMMOLIANT
TOPICAL OESTROGEN
HRT
WHAT IS SUPERFICIAL DYSPYRUNEA
PAIN SURING SEX AT VAGINAL ENTRANCE / CANAL
WHAT ARE CAUSES OF SUPERFICIAL DYSPYRUNEA
INFECTIONS
INTROITUS NARROWING
ATROPHIC VAGINITIS
LICHEN SCLEROSIS
WHAT IS DEEP DYSPYRUNEA
PAIN DURING INTERCOURSE UPON DEEP PENETRATION FELT IN ABDOMEN
WHAT ARE CAUSES OF DEEP DYSPYRUNEA
PID
RETROVERTED UTERUS
OVARIAN PROLAPSE INTO POUCH OF DOUGLAS
ENDOMETRIOSIS
NEOPLASTIC DISEASE
POST OP SCARRING DUE TO DECREATED UTERINE MOTILITY
HOW WOULD YOU DEFINE THE MENAUPAUSE
CESATION OF MENSES FOR 12 MONTHS
WHAT IS THE AVERAGE AGE FOR STARTING MENAUPAUSE
51Y
HOW WOULD YOU DESCRIBE PERIMENAUPAUSE
THE PERIOD LEADING UPTO MENAUPAUSE CHARACTERISED BY IRREGULAR PERIODS AND MENAUPAUSAL SYMPTOMS
WHAT ARE SYPTOMS OF MENAUPASE / PERIMENAUPAUSE
HOT FLUSHES
MOOD SWINGS
UROGENITAL ATROPHY
DECREASED LIBIDO
VAGINAL DRYNESS
DRY ITCHY SKIN
DECREASED CONFIDENCE
JOINT AND MUSCLE PAIN
DESCRIBE THE PHYSIOLOGY OF MENAUPAUSE
DEACREASED EGGS SO DECREASED OESTROGEN
DECREASED OESTROGEN MEANS LESS NEGATIVE FEEDBACK OF PITUITARY MEANING LESS GnRH
HIGHER FSH LH CAUSING IRREGULAR MENSES
WHAT IS THE MANAGEMENT OF MENAUPAUSE
HRT
CLONIDINE
WHAT ARE THE TYPES OF HRT AND WHEN ARE THEY GIVEN
COMBINED
- UTERUS
OESTROGEN ONLY
- HYSTERECTOMY
CYCLICAL
- ANY WOMAN STILL IN PERI MENAUPAUSE
WHY IS OESTROGEN ONLY HRT NOT GIVEN TO WOMEN WITH UTERUS
LACK OF PREOGESTERONE AND HIGH OESTROGEN WILL INCREASE ENDOMETRIAL PROLIFERATION INCREASING RISK OF CANCER
WHAT ARE CONS OF HRT
INCREASED RISK OF BREAST CANCER
INCREASED RISK OF CVD AND STROKE
INCREASED RISK OF VTE
WHAT ARE BREAST CANCER RISKS IN HRT
PROGESTERONE IS DRIVING FORCE
OESTROGEN ONLY IN BRACA
RISK REDUCES AFTER STOPPING
WHY IS TRANSDERMAL BETTER IN SOME GROUPS (AND WHICH)
HIGH VTE RISK GROUPS AS
PASSES FIRST PASS METABOLISM SO DOESNT AFFECT CLOTTING FACTORS
WHAT IS PREMATURE OVARIAN INSUFFICIENCY
PERI MENAUPAUSE UNDER 40 YEARS
HOW CAN YOU DIAGNOSE PREMATURE OVARIAN INSUFFICIENCY
TWO FSH TESTS 4 WEEKS APART
NO PERIOD IN 4 MONTHS
PREGNANCY TEST
PELVIC US
WHAT IS THE PRESENTATION OF PREMATURE OVARIAN INSUFFICIENCY
IRREGULAR AND MISSED PERIODS
MENAUPAUSAL SYMPTOMS
INFERTILITY
HOW DO YOU MANAGE PREMATURE OVARIAN INSUFFICIENCY
HRT
CALCIUM AND VIT D SUPPLIEMNTS
IVF