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YR 3 MED > OBS & GYNAE WK 2 > Flashcards

OBS & GYNAE WK 2 Flashcards

1
Q

mechanism of action of contraception

A

suppressing FSH and LH by negative feedback
prevention of ovulation

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2
Q

LARC

A

Long acting reversible contraception
-IUD
-permanent methods

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3
Q

permanent contraception methods

A

tubal ligation - female
tie off tubes
vasectomy - male, no scalpel technique
early and late failure rate

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4
Q

LNG releasing IUD

A

Levonorgestrel-releasing
more effective than copper IUD
MIRENA
irregular spotting / bleeding is common

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5
Q

COPPER COILS VS COPPER IUD - PROS AND CONS

A

coils - hormonal
long lasting 3-10 yrs
very effective
quick

uncomfortable, pain
invasive
small risk of perforation

IUD
Can last up to 10 yrs
non-hormonal

heavier periods and longer

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6
Q

SDI

A

subdermal contraceptive implant
-delivery of a steroid progestin from polymer capsules or rods placed under the skin

most effective of all conceptive methods
lasts 3 yrs
progesterone only

bleeding

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7
Q

UK MEC criteria

A

4 categories
1 = no restriction for use, always useable
2 = broadly useable
3 = caution
4 = DO NOT use

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8
Q

combined hormonal contraception, what are the 3 types - CHC

A

pill
patch
ring
combined pill = take daily, then a break

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9
Q

what factors may affect effectiveness of CHC??

A

impaired absorption
increased metabolism

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10
Q

pros and the risks of CHC

Combined hormonal contraception

A

-reduction in ovarian and endometrial cancers
-beneficial effect on acne
-fewer functional ovarian cysts

-VENOUS THROMBOEMBOLISM
-ARTERIAL DISEASE, MI
-ADVERSE EFFECTS ON SOME CANCERS, breast and cervical cancer risk

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11
Q

POP

A

progestogen only pill
taken daily
eg. cerelle

inhibits ovulation
usually taken day 1-5

v small increased risk of breast cancer, so contraindicated in ppl w breast cancer

nausea, spots, bleeding, headache

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12
Q

depo provera / sayana press

A

injection into buttocks
or thigh, by professional, every 13 wks.
injection into thigh by yourself

weight gain
nausea
spots
stop depo after 50 yrs due to bone health

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13
Q

diaphragm

A

cup shaped w removal dome, made of silicon

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14
Q

emergency contraception - 3

A

levonorgestrel aka levonelle
72hrs after sex

ulipristal acitate aka ellaone
120hrs after sex

IUD - 5 days after

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15
Q

most common non-specific urethritis ?

A

chlamydia

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16
Q

cystitis vs urethritis vs dermatitis

A

c - bladder inflammation, wider symptoms (gut bacteria)
u - systemically well, dysuria and discharge (chlamydia, gonorrhoea)
d - rash, ulcers (candida)

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17
Q

investigations for urethritis

A

clinical exam
urethral swab for gram stain and microscopy
urethral swab for gonorrhoea culture
throat and rectal swabs for chlamydia and gonorrhoea NAAT (if they r having anal)
blood for syphilis and HIV

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18
Q

diagnosis of urethritis

A

> 5 polymorphs under microscope

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19
Q

gonococcal urethritis vs non-gonococcal urethritis

A

gonococcal - shorter incubation period, yellow/green, more urinary symptoms

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20
Q

chlamydia vs gonorrhoea

A

chlamydia - milky discharge, irregular bleeding, abdo pain, dysuria

gonorrhoea - more between younger ppl, men and men, greenish discharge

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21
Q

1st and 2nd line for gonorrhoea

A
  1. ceftriaxone usually
    or ciprofloxacin (only where antimicrobial sensitivities are known)
  2. cefixime
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22
Q

complications of gonorrhoea

A

tysonitis
bartholinitis
pretty rare

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23
Q

dyspareunia

A

pain associated with sexual intercourse

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24
Q

cervical excitation

A

cervical motion is tender on bimanual exam, sign of PID

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25
Q

symptomatic sampling for vaginal discharge

A

cervical microscopy
vaginal microscopy
urinalysis
VVS
HVS
amies swab

26
Q

PID

A

lower abdo pain, discharge
tenderness on bimanual vaginal exam
under 25
not using barriers
chlamydia most likely causing this

use ceftriaxone, doxy

27
Q

complications of Chlamydia Trachomatis

A

PID -> ectopic pregnancy
conjunctivitis
reactive arthritis

28
Q

CT treatment

A

doxycycline
or
azithromycin if they can’t take doxy

29
Q

MG - mycoplasma genitalium

A

asymptomatic
association w non-gonococcal urethritis and PID
NAAT test
high levels of macrolide resistance

30
Q

bacterial vaginosis - why does this happen and what to use to treat it

A

white, frothy, milky discharge, smelly, fishy like cottage cheese

pH increases as there is no lactobacillus (due to entry of semen, blood, or douching)

use metronidazole
topical clindamycin

31
Q

what cells are present in bacterial vaginosis under microscopy

A

clue cells

32
Q

candidiasis

A

Not sexually transmitted
fungal infection
white, clumpy discharge

genital skin care advice
any azole - eg. fluconazole

33
Q

trichomonas - most common non viral STI IN WORLD

TX

A

grey frothy discharge
red
smell
itch
strawberry cervix

METRONIDAZOLE
PARTNER NOTIFICATION

34
Q

causes of genital ulceration

A

SEXUALLY TRANSMITTED
herpes
syphilis
HIV
monkeypox

NOT SEXUALLY TRANSMITTED
varicella zoster
crohn’s
trauma (chemical)
behcet’s

35
Q

genital herpes - caused by what?

A

HSV
transmission - close contact thru mouth, anogenital tract
pain, dysuria, discharge, flu, fatigue, erythema

36
Q

primary vs recurrent herpes

A

primary - first time, few days incubation period
recurrent - reactivation of latent virus, tingling, itching (prodrome)

37
Q

mx of primary genital herpes simplex

A

swab lesion PCR
FULL STI SCREEN
aciclovir
supportive

38
Q

HSV 1 vs HSV 2

A

over 50% of genital herpes are type 1
type 2 is associated w less stigma than type 1

39
Q

neonatal herpes

A

most dangerous when mother has it during 6 months before delivery

40
Q

syphilis

A

chancre - painless ulcer usually
incubation 10-90 days
primary is usually on mouth
primary -> secondary (whole body, swollen glands, fever, RASH) -> early latent -> late latent

41
Q

secondary syphilis complications

A

meningitis
hepatiis
iritis
uveitis
pregnancy complications

42
Q

syphilis ix and mx

A

swab lesion - PCR
bloods

antibodies - IgG and IgM, not very specific

benzathene penicillin - IM

43
Q

genital lumps causes

A

SEXUALLY TRANSMITTED
warts
scabies
molluscum contagiosum
monkeypox
cyst
NOT SEXUALLY TRANSMITTED
folliculitis
lichen planus
skin tags
cancer

44
Q

genital warts transmission - complications

A

skin-to-skin contact, in areas most susceptible to trauma eg. vulva posterior
NO LINK BETWEEN WARTS (HPV) AND HERPES (HSV)
HPV will be cleared but HSV is lifelong
COMPLICATION = intra-epithelial neoplasia

45
Q

TX for genital warts

A

cryotherapy
imiquimod

46
Q

molluscum contagiosum

A

pearly white spots

47
Q

HIV is what type of virus, and how many types??

A

RNA retrovirus
HIV 1 and 2
HIV-1 group M -> global epidemic

48
Q

HIV viral replication

A

v quick in early and late infection

49
Q

mechanism of HIV

A
  1. binding - receptors
  2. fusion
  3. reverse transcriptase
  4. integration
  5. transcription
  6. translation
  7. budding - new variant to infect other cells
50
Q

what receptors are target site for HIV and what type of protein are they

A

CD4+ T cells
glycoprotein

51
Q

effect of HIV Infection on immune response??

A

REDUCED circulation of CD4+ cells
reduced proliferation of CD4+ cells
Reduced CD8+ cytotoxic T cell activation
susceptible to fungal, viral infections and some cancers

52
Q

how long does HIV take from exposure to establish itself as an infection

A

72 hrs

53
Q

PCP

A

pneumocystis pneumonia

dry cough, SOB
<200 CD4+ cells
interstitial infiltration

54
Q

dx and tx of PCP

A

BAL
immunofluorescence
high dose co-trimoxazole

55
Q

cerebral toxoplasmosis

A

from cats
<150 CD4+
reactivation fo latent infection, multiple cerebral abscess
headache, fever, seizures, raised ICP

56
Q

CMV

A

CD4 <50
retinitis, colitis
floaters, abdo pain

57
Q

AIDS related cancers - Kaposi’s sarcoma

A

HHV 8
Tx - anti retrovirals

58
Q

non-hodgkins lymphoma

A

EBV

59
Q

HIV - modes of transmission

A

sexual - 90% of cases
parenteral transmission - injection drug use
vertical transmission - mother to child

60
Q

rapid HIV tests

A

POCT
fingerpick blood specimen or saliva
results within 20-30mins

61
Q

PrEP

A

pre-exposure prophylaxis

62
Q

prevention of vertical transmission

A

HAART during pregnancy
c-section if detected viral load, safe if not for vaginal delivery
exclusive formula feeding

YR 3 MED (23 decks)

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