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Obs and Gynae Flashcards

1
Q

What is an ovarian cyst

A

A fluid filled sac in the ovary, may be benign or malignant

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2
Q

What are the risk factors for ovarian cyst

A
  • Family Hx
  • Obesity
  • Smoking
  • Early menarche/late menopause
  • BRCA 1/2
  • Nulliparity
  • HRT- oestrogen only
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3
Q

What are protective factors for ovarian cyst

A
  • Multiparity
  • Breastfeeding
  • Combined oral contraceptive
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4
Q

How you calculate risk of malignant ovarian cyst

A
  • RMI (Risk of malignancy index) score
  • 1 for pre-menopause, 3 for post-menopause
    x
  • 0 for 0 features on USS, 1 for 1 and 3 for 2+
    x
  • CA125 score
    RM| 250+ NEEDS REFERRAL TO GYNAE
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5
Q

How might ovarian cysts present

A
  • Chronic pelvic pain
  • Deep dyspareunia
  • Vaginal bleeding
  • Frequency/constipation (cyst pressing on bladder/bowel)
  • Weight loss/ malaise/ sweats
  • Acute sudden onset severe pain in torsion/rupture
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6
Q

What investigations might you perform for ovarian cysts

A
  • USS
  • Bloods
  • Biopsy
  • CA125
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7
Q

How would you treat ovarian cysts

A 
BENIGN
- Watchful waiting
- Cystectomy 
MALIGNANT
- Hysterectomy + bilateral salpingo-oophorectomy + lymph nodes
- Chemo/radiotherapy
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8
Q

What is polycystic ovarian syndrome (PCOS)

A
  • PCOS is characterised by excessive androgen production and presence of multiple cysts on the ovaries
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9
Q

Describe the pathophysiology of PCOS

A
  • Excess LH production causes excess ovarian production of androgens (testosterone)
  • Insulin resistance also occurs
  • Despite the increased levels of LH the raised androgens stop an LH surge occurring so ovulation is not triggered meaning follicles remain as cysts in the ovaries
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10
Q

How might PCOS present

A
  • Excess weight gain
  • Male pattern hair (alopecia + facial/chest/back hair)
  • Amenorrhoea/oligomenorrhoea
  • Chronic pelvic pain
  • Acne/oily skin
  • Infertility
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11
Q

What investigations might you do in PCOS

A
  • USS of ovaries
  • Bloods (testosterone and LH raised), TFTs to rule out thyroid
  • ?cortisol
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12
Q

What is the diagnostic criteria for PCOS

A
  • Rotterdam criteria (2 of 3)
    1) Polycystic ovaries on USS
    2) Clinical or biochemical signs of hyperandrogenism
    3) Oligo/anovulation
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13
Q

How would you manage PCOS

A

Tailored to individual symptoms
Oligo/amenorrhoea (trigger ovulation to dec. cancer risk)
- Combined oral contraceptive or progesterone analogue
Obesity
- Lifestyle advice
- Orlistat / off licence metformin
Infertility (for people wanting to conceive)
- Clomifene +/- metformin
Hirsutism
- Anti-androgen medication

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14
Q

What are fibroids

A
  • Benign tumour of the uterine smooth muscle
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15
Q

What are the risk factors for fibroids

A
  • Prev. fibroids/ family Hx
  • Early menarche/ late menopause (growth thought to be stimulated by oestrogen)
  • Inc. age
  • African-American
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16
Q

How might fibroids present

A
  • Most are asymptomatic
  • Heavy periods
  • Pelvic pain/ deep dyspareunia
  • Constipation/ frequency/ Abdo. distention
  • Subfertility
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17
Q

What investigation might you do for fibroids

A
  • USS

- Bloods

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18
Q

How might you manage fibroids

A
  • Watch and wait
  • Tranexamic acid
  • GnRH analogues goserelin (not a long term option due to demineralisation of bone)
  • Hysterectomy/ myomectomy/ Hysteroscopy + removal of fibroids
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19
Q

What is endometriosis

A
  • Endometrial tissue growth in areas outside uterine cavity. Common areas include ovaries, peritoneum, bladder and pouch of Douglas.
  • Most common in 25-40
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20
Q

What are the risk factors for endometriosis

A
  • Early menarche
  • Family Hx
  • Heavy periods/ short cycles
  • Uterine defects
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21
Q

How might endometriosis present

A
  • Cyclical pelvic pain (may be constant)
  • Heavy, painful periods (dysmenorrhoea)
  • Subfertility
  • Painful bowels
  • Deep dyspareunia
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22
Q

What investigations might you do for endometriosis

A
  • USS

- Laproscopy (gold standard)

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23
Q

How might you manage endometriosis

A
  • Pain - Analgesic ladder
  • Periods - COCP or merina coil
  • Surgical excision
  • Hysterectomy + bilateral salpingo-oophorectomy
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24
Q

What is Pelvic inflammatory disease (PID)

A
  • An infection of the female upper genital tract

- Mostly caused by STIs (chlamydia/gonorrhoea)

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25
Q

What are the risk factors for PID

A
  • Sexually active
  • IUD/pelvic surgery
  • Prev. PID/STI
  • Unprotected sex
  • Recent partner change
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26
Q

How might PID present

A
  • Pelvic/lower abdo. pain
  • Deep dyspareunia
  • Post- coital bleeding
  • Abnormal offensive discharge
  • Menstrual abnormalities
  • Dysuria
  • Fever/ N+V/ severe abdo pain (advanced)
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27
Q

What investigations might you do for PID

A
  • Endocervical swab
  • STI screen
  • Urine dip (rule out UTI)
  • Pregnancy test (rule out ectopic)
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28
Q

How might you manage PID

A
  • Broad spectrum antibiotics
  • Analgesia
  • Avoid sex
  • Contact tracing
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29
Q

What complications can arise from PID

A
  • Ectopic pregnancy (scarring of fallopian tubes)
  • Infertility
  • Chronic pelvic pain
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30
Q

What is a Bartholin’s cyst

A
  • A fluid filled sac within one of the Bartholin’s glands in the vagina
  • They secrete mucus to help lubricate vagina, can get blocked leading to a cyst or abscess
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31
Q

What are the risk factors for Bartholin’s cyst

A
  • Vulvar surgery
  • Previous cyst
  • STIs can cause cysts/ abscess
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32
Q

How might Bartholin’s cyst present

A
  • Mostly asymptomatic
  • Cyst- Soft, non-tender vulval lump
  • Abscess - Hard, painful, vulval lump (may be cellulitis)
  • Superficial dyspareunia
  • Vulvar Pain
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33
Q

What investigations might you do for Bartholin’s cyst

A
  • Clinical diagnosis
  • Biopsy in suspicious/ over 40
  • STI screen if indicated
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34
Q

What is the management of Bartholin’s cyst

A
  • Watch + wait
  • Drainage with word catheter
  • Antibiotics if systemically unwell
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35
Q

What is bacterial vaginosis

A
  • An infection of the lower genital tract, occurring due to disturbance of the normal vaginal flora causing an increase in pH
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36
Q

What are the risk factors for bacterial vaginosis

A
  • Sexually active
  • Douching/ overwashing vagina
  • Antibiotics
  • IUD
  • Black
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37
Q

How might bacterial vaginosis present

A
  • White thin, fishy smelling discharge

- Usually no pain or itchiness

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38
Q

What investigations might you do for bacterial vaginosis

A
  • Clinical diagnosis

- High vaginal smear

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39
Q

How might you manage bacterial vaginosis

A
  • Metronidazole oral or vaginal gel
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40
Q

What is vulvovaginal candidiasis

A
  • A fungal infection of the lower genital tract (aka. thrush/yeast infection)
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41
Q

What are the risk factors for vulvovaginal candidiasis

A
  • Pregnancy
  • Diabetes
  • Antibiotics
  • Steroids/immunosuppression
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42
Q

How might vulvovaginal candidiasis present

A
  • Itchiness/ pain
  • White curd like discharge usually inoffensive
  • Satellite lesions/ redness
  • Dysuria
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43
Q

What investigations might you do for vulvovaginal candidiasis

A
  • Usually clinical diagnosis
  • Urine dip to rule out UTI
  • Smear in recurrent/ complicated
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44
Q

How might you manage vulvovaginal candidiasis

A
  • Vaginal clotrimazole

- Oral fluconazole

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45
Q

What is urinary incontinence

A
  • The involuntary leakage of urine
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46
Q

What are the two main types of urinary incontinence

A

1) Stress
- Involuntary leakage of urine due to increases in intra-abdominal pressure
2) Urge
- Aka. over-active bladder syndrome. Presence of urgency without UTI or other obvious pathology

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47
Q

How might stress incontinence present

A 
- Leakage of urine on exertion eg.
Laughing
Coughing
Sneezing
Exercise
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48
Q

How might urge incontinence present

A
  • Patient will complain of urgency resulting in leakage

- May also be frequency and nocturia

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49
Q

What investigations might you do for urinary incontinence

A
  • Urine dip to exclude UTI
  • Frequency volume chart
  • In stress is normal, in urge frequency is raised
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50
Q

How do you manage stress incontinence

A
  • Lifestyle changes
  • Pelvic floor exercises/ physio
  • Surgery- tension free vaginal tape
  • Duloxetine (if surgery fails/contra-indicated)
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51
Q

How do you manage urge incontinence

A
  • Lifestyle changes
  • Bladder re-training
  • Anti-cholinergics- oxybutynin
  • botulinum toxin A (botox)
  • Surgery
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52
Q

What is the menopause

A
  • Cessation of menstruation

- Average age is 51

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53
Q

When can menopause be diagnosed

A
  • After 12 months amenorrhoea

- If hysterectomy diagnosed at onset of menopausal symptoms

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54
Q

What is the perimenopause

A
  • Period leading up to menopause

- Characterised by irregular periods, hot flushes, mood swings and urogenital atrophy

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55
Q

What are the symptoms of the menopause

A
  • Hot flushes
  • Mood swings/ irritability
  • Decreased sex drive
  • Aches/pains
  • Dry vagina
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56
Q

What are the long term consequences of the menopause

A
  • Stroke/ CVD
  • Dementia
  • Osteoporosis
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57
Q

What does HRT cause increased risk of

A
  • Stroke
  • Breast cancer
  • Venous thromboembolism
  • Must weigh up risks vs benefits and be wary when giving to patients at inc. risk of these conditions
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58
Q

What are the types of HRT

A
  • Combined sequential (oestrogen + progesterone 12-14 days per 28 - causes a bleed)
  • Combined continuous (Oestrogen + progesterone daily - bleed free)
  • Mirena coil
  • Tibolone (synthetic Oestrogen + progesterone, equivalent to combined cont.)
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59
Q

What is premature ovarian insufficiency

A
  • Menopause at less than 40 years old
  • Can be natural or iatrogenic causes
  • Mostly idiopathic
60
Q

How do you manage premature ovarian insufficiency

A
  • Hormone replacement
  • Dec. symptoms and risk of oestrogen deficiency
  • Continue until at least 51 yrs
61
Q

What is the aetiology of cervical cancer

A
  • 3rd most common in world, 12th in uk
  • Primarily of younger people - peak at 25-29
  • Strong association with HPV, hence vaccination scheme in schools
62
Q

What are the risk factors for cervical cancer

A
  • HPV!!!!! IMPORTANT
  • Smoking
  • Family Hx
  • Oral contraceptive pill long term
  • STIs
63
Q

How might cervical cancer present

A
  • Abnormal vaginal bleeding
  • Dyspareunia
  • Pelvic pain
  • Vaginal discharge
  • B- symptoms
  • Often are picked up on cervical cancer screen
64
Q

What investigations might you do for cervical cancer

A
  • If pre-menopausal then do a chlamydia screen, if negative then colposcopy + biopsy
  • If post-menopausal then colposcopy + biopsy
  • CT/MRI
65
Q

How might you manage cervical cancer

A
  • Surgical - may preserve fertility, or hysterectomy - Hysterectomy + bilateral salpingo-oopherectomy (full pelvic clearance)
  • Chemo/radiotherapy
66
Q

What are the risk factors for endometrial cancer

A
  • Early menarche/ late menopause (inc. proliferation)
  • Low parity
  • HRT (only oestrogen)
  • Tamoxifen
  • Inc. age
  • PCOS
  • Obesity
67
Q

How might endometrial cancer present

A
  • Post menopausal bleeding (most common)
  • Vaginal discharge
  • B-symptoms
68
Q

What investigations might you do for endometrial cancer

A
  • Transvaginal USS
  • Biopsy/ hysteroscopy + biopsy
  • CT/MRI for staging
69
Q

How do you stage endometrial cancer

A

FIGO staging
Stage I – Carcinoma confined to within uterine body.
Stage II – Carcinoma may extend to cervix but is not beyond the uterus.
Stage III – Carcinoma extends beyond uterus but is confined to the pelvis.
Stage IV – Carcinoma involves bladder or bowel, or has metastasised to distant sites.

70
Q

How might you manage endometrial cancer

A
  • Hysterectomy + bilateral salpingo-oopherectomy

- Chemo/radiotherapy

71
Q

What is an ectopic pregnancy

A
  • Any pregnancy which has implanted outside the uterine cavity
  • Common sites include fallopian tubes (most common), ovaries, cervix and peritoneum
72
Q

What are the risk factors for ectopic pregnancy

A
  • PID
  • Past ectopic
  • Endometriosis
  • Pelvic surgery
  • IUD
  • IVF
73
Q

How might an ectopic pregnancy present

A
  • Recent onset lower abdo./ pelvic pain
  • Vaginal bleeding
  • Shoulder tip pain
  • Vaginal discharge
74
Q

What investigations might you do for ectopic pregnancy

A
  • Urine B-HCG
  • USS
  • If no pregnancy seen on USS and urine B-HCG >1500 then offer laparoscopy for diagnosis
  • Blood B-HCG
75
Q

How might you manage ectopic pregnancy

A

1) Expectant (rare)
- Monitor blood B-HCG
2) Medical
- IM methotrexate
- Monitor bloods, if not falling then repeat dose
3) Surgical
- Salpingectomy
- Salpingotomy if need to preserve fertility

76
Q

What is a miscarriage

A
  • A loss of a pregnancy at less than 24 weeks gestation

- More common less than 12 weeks than 12-24 weeks

77
Q

What are the risk factors for miscarriage

A
  • Previous miscarriage
  • Maternal age >30-35
  • Uterine abnormalities/surgery
  • Obesity
  • Smoking
78
Q

How might a miscarriage present

A
  • Vaginal bleeding

- Crampy pain (like period pains)

79
Q

What investigation might you do for miscarriage

A
  • Transvaginal USS

- Serum B-HCG

80
Q

How might you manage miscarriage

A

1) Expectant
- Allow POC to pass naturally
2) Medical
- Give mifepristone followed by vaginal misoprostol (prostaglandin analogue) 24-48 hours later
3) Surgical
- Removal via. vacuum or excavation

81
Q

Describe a threatened miscarriage

A 
CLINICAL
- Small bleed +/- pain, cervix is closed
TV USS
- Viable pregnancy
MANAGEMENT
- Reassure/ treat bleeding if required
82
Q

Describe an inevitable miscarriage

A 
CLINICAL
- Heavy bleed/ clots, pain, cervix open
TV USS
- Viable or non-viable pregnancy
MANAGEMENT
- Medical/ surgical/ expectant
83
Q

Describe a missed miscarriage

A 
CLINICAL
- Usually asymptomatic
TV USS
- No foetal heartbeat
MANAGEMENT
- Medical/ surgical/ expectant
84
Q

Describe an incomplete miscarriage

A 
CLINICAL
- Bleed/ clots, pain,
TV USS
- Partially expelled POC
MANAGEMENT
- Medical/ surgical/ expectant
85
Q

Describe a complete miscarriage

A 
CLINICAL
- Hx bleed/ clots, pain
TV USS
- No POC
MANAGEMENT
- Refer to GP
86
Q

What are the moderate risk factors for pre-eclampsia

A
  • Nulliparity
  • BMI >35
  • Multiple pregnancy (twins+)
  • Family Hx pre-eclampsia
  • Maternal age 40+
  • Pregnancy interval 10+ years apart
87
Q

What are the high risk factors for pre-eclampsia

A
  • Prev. pre-eclampsia
  • Autoimmune disease
  • CKD
  • Diabetes
  • Hypertension
    If 2+ moderate or 1+ high then give 75mg aspirin
88
Q

How might pre-eclampsia present

A
  • Headache
  • Oedema
  • Visual changes
  • Epigastric pain
  • Hyper-reflexia
89
Q

What is the diagnostic criteria for pre-eclampsia

A
  • B.P >140/90
  • Proteinuria
  • > 20 wks. gestation
90
Q

What investigations might you do for pre-eclampsia

A
  • B.P

- Bloods - FBC, LFT, U&E

91
Q

How might you manage pre-eclampsia

A
  • Inc. monitoring
  • Anti-hypertensives - 1st line labetalol, 2nd line nifedipine
  • Delivery
92
Q

What is Eclampsia

A
  • Occurrence of one or more convulsions in a pre-ecplamptic woman
93
Q

How might eclampsia present

A
  • Seizure/ convulsions
  • Jaundice
  • Headache
  • Oedema
  • Visual changes
  • N+V
94
Q

How might you manage eclampsia

A

1) Stop seizure
- Magnesium sulphate
2) IV Anti-hypertensives
- Labetalol
3) Deliver baby when mother is stable via. C-section

95
Q

What are the definitions for small for gestational age (SGA) and foetal growth restriction (FGR)

A
  • <10th centile of estimated foetal weight or <10th centile of abdominal circumference
  • A pathological process in which the foetus’ growth is restricted, commonly by genetic abnormalities or placental insufficiency
96
Q

What investigations might you do for FGR

A
  • USS - plot growth on growth chart
  • Uterine artery doppler (absent/reversed end-diastolic flow)
  • Karyotyping
97
Q

How would you manage FGR

A

1) Surveillance
- UAD every 14 days
- Change modifiable risk factors
2) Delivery
- Absent/reversed EDF on UAD = urgent C-section

98
Q

What are some of the complications of FGR

A
  • Still birth
  • Cancer
  • Hypothermia
  • Obesity
  • Birth asphyxia
99
Q

What is an Antepartum haemorrhage (APH)

A
  • > 50mls of bleeding at >24 weeks before birth
100
Q

What are the common and important causes of APH

A 
Common 
- Cervical ectropion
- Unexplained
Important
- Placental abruption 
- Placenta previa
101
Q

What is placental abruption

A
  • Premature separation of the placenta from the uterine wall
102
Q

What are the risk factors for placental abruption

A
  • Previous abruption
  • Pre-eclampsia
  • Polyhydramnios
  • Smoking/drug use
  • Multiple pregnancy
103
Q

How might placental abruption present

A
  • Painful vaginal bleeding

- Woody uterus

104
Q

What investigations might you do for placental abruption

A
  • FBC/clotting
  • Foetal CTG
  • USS
105
Q

How do you manage placental abruption

A
  • Maternal resuscitation

- C-section

106
Q

What is placenta previa

A
  • Where the placenta is partially or fully attached to the lower part of the uterus
    Minor - Not covering the cervical Os
    Major - Covering cervical Os
107
Q

What are the risk factors for placenta previa

A
  • Previous placenta previa
  • Maternal age >40 yrs
  • Multiple pregnancy (eg. twins)
  • High parity
108
Q

What investigations might you do for placenta previa

A
  • FBC/Clotting
  • Foetal CTG
  • USS
109
Q

How do you mange placenta previa

A
  • Maternal resuscitation

- C-section

110
Q

What is primary PPH

A
  • A loss of >500mls of blood within 24hrs of delivery
  • Minor = 500-1000mls
  • Major >1000mls
111
Q

What are the 4 Ts for causing PPH

A

Tone - Uterine atony (most common)
- Failure of uterus to contract following delivery
Tissue - retained placental tissue
Tears - episiotomy, instrumental delivery, C-section all inc. risk
Thrombin - Clotting abormalities

112
Q

How might you manage PPH

A
  • Fluids/blood/resuscitation
  • Bimanual compression to stimulate uterine contractions
  • Drugs to stimulate uterine contractions eg. syntocinon
  • Repair trauma/manually evacuate tissue
113
Q

What is cord prolapse

A
  • When the umbilical cord descends through the cervix alongside or before the presenting part of the foetus
  • This causes foetal hypoxia due to compression of the cord and arterial vasospasm when exposed to cold atmosphere
114
Q

What are the risk factors for cord prolapse

A
  • Prematurity
  • Breech presentation
  • Abnormal/unstable lie
  • AROM
115
Q

Why might you suspect cord prolapse

A
  • Always considered in non-reassuring foetal heart and absent membranes
116
Q

How might you manage cord prolapse

A
  • AVOID HANDLING THE CORD
  • Elevate foetus pressing on cord
  • Encourage into left lateral position
  • Emergency C-section
117
Q

What are the stages of labour

A 
Stage 1
- Latent/active
Stage 2
- Passive/active
Stage 3
- Delivery of placenta
118
Q

Describe stage 1 of labour

A 
Latent
- Cervix <4cm dilated
- Contractions every 5-20 mins
- Do not encourage pushing
Active
- Cervix dilated 4-9cm
- Contractions every 2-10 mins
- Do not encourage pushing
Management
- V.E every 4 hrs
- If failing to progress (should progress 1cm every two hours) then AROM/oxytocin/membrane sweep
119
Q

Describe stage 2 of labour

A 
Passive
- not pushing
Active
- Encourage pushing
- Cervix 9cm+/ fully dilated
- Contractions every 2-5 mins
Management
- May need episiotomy/ forceps/ ventouse
120
Q

Describe stage 3 of labour

A
  • Delivery of placenta
  • Cord clamp
  • May need traction/ oxytocin
121
Q

What are the 4 Ps for successful labour

A 
Power
- Adequate contractions
Passage
- Pelvic abnormalities
Passenger
- Lie/position
- Size of baby
Psychology
- Support
122
Q

How might chlamydia present

A 
50% of men and 70% of men are asymptomatic
- Dysuria
- Abnormal discharge
Women
- Deep dyspareunia
- Lower abdo pain
Men
- Testicular pain
123
Q

What investigations might you do for chlamydia

A 
- Full STI screen
Women
- First catch urine, vulvo-vaginal or endocervical swab
Men
- First catch urine or urethral swab
124
Q

How do you treat chlamydia

A
  • Doxycycline 100mg 2x daily
  • IM azathioprine 1g single dose
  • Sexual abstinence/contact tracing
125
Q

How might gonorrhoea present

A
  • Abnormal discharge
  • Dysuria
  • Dyspareunia
  • Lower abdo pain
126
Q

What investigations might you do for gonorrhoea

A
  • Endocervical/vaginal swab

- First catch urine sample

127
Q

How do you treat gonorrhoea

A
  • IM ceftriaxone 1g
128
Q

What are the potential complications of gonorrhoea and chlamydia

A 
Women
- PID - Ectopic/infertility
Men
- Epididymo-orchitis - Infertility
Chlamydia can cause reactive arthritis
129
Q

How might primary syphilis present

A
  • Papule on genitals which develops into a painless ulcer (chancre)
  • Usually a singular painless, non itchy and hard ulcer
130
Q

How might secondary (if left untreated) syphilis present

A
  • Skin rash (on hands and soles of feet)
  • Fever
  • Malaise/arthralgia
  • Weight loss
  • Painless lymphadenopathy
  • Elevated plaque like lesions on moist skin (axilla, inner thighs, genitalia)
131
Q

How do you investigate syphilis

A
  • Swab from and active lesion

- Serology

132
Q

How do you treat syphilis

A 
Early
- Penicillin IM x1 dose
Late
- Penicillin IM weekly for 3 weeks
Contact tracing/sexual abstinence
133
Q

How might Trichomonas vaginalis present

A
  • Many cases asymptomatic
  • Offensive vaginal odour
  • Abnormal discharge
  • Itchy vulva/foreskin
  • Dysuria
  • Dyspareunia
  • Strawberry cervix
134
Q

How might you investigate Trichomonas vaginalis

A
  • High vaginal swab

- First void urine sample/urethral swab

135
Q

How might you treat Trichomonas vaginalis

A
  • Metronidazole 2g x1

- Sexual abstinence/contact tracing

136
Q

What is hyperemesis gravidarum

A
  • Persistent vomiting in pregnancy that causes weight loss in excess of 5% of pre-pregnancy weight and ketosis
137
Q

How might hyperemesis gravidarum present

A
  • Can’t keep food/fluids down
  • Weight loss
  • Malnutrition
  • Dehydration
  • Tachycardia
138
Q

What investigations might you do in hyperemesis gravidarum

A
  • Urine dip to check for UTI and ketones

- U&Es to check electrolyte levels

139
Q

How might you manage hyperemesis gravidarum

A
  • Hospital admission for fluid resuscitation and electrolyte balancing
  • Anti-emetics
140
Q

What are the types of FGM

A

Type 1
- Partial or full removal of the clitoris
Type 2
- Partial or full removal of clitoris and labia
Type 3
- Narrowing of vagina via cutting/stitching of labia, with or without removal of clitoris
Type 4
- Any other non-medical procedures that harm female genitalia

141
Q

What is primary amenorrhoea

A
  • Failure to start periods, need investigation at 16, or 14 if no breast development
142
Q

What is secondary amenorrhoea

A
  • Stopping of periods for >6 months, other than for pregnancy
143
Q

What is menorrhagia

A
  • Excessive bleeding during periods
144
Q

What is primary dysmenorrhoea

A
  • Painful periods with no underlying pathological cause
145
Q

What is secondary dysmenorrhoea

A
  • Painful periods caused by pathology

Finals (11 decks)

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