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Finals > Obstetrics, Gynaecology & Breast > Flashcards

Obstetrics, Gynaecology & Breast Flashcards

1
Q

In which days of the menstrual cycle is the highest chance of pregnancy?

A

Day 8-19

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2
Q

Name the forms of combined oral contraception

A
  • Pill
  • Patch
  • Ring
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3
Q

Name the non-contraceptive effects of combined contraceptives

A
  • Regulate/reduce bleeding
  • Stop ovulation (premenstrual syndrome)
  • Reduction in functional ovarian cysts
  • 50% reduction in ovarian and endometrial cysts
  • Improves acne/hirsutism
  • Reduction in benign breast disease, rheumatoid arthritis, colon cancer and osteoporosis
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4
Q

Name some of the side effects of the combine oral contraceptive

A
  • Breast tenderness
  • Nausea
  • Headache
  • Initial irregular bleeding
  • Mood changes
  • Weight gain
  • Increased VTE risk
  • Arterial thrombosis
  • Increased risk of cervical cancer and breast cancer
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5
Q

Name the contraindications for the progesterone only pill

A

Personal history of breast cancer or liver tumour

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6
Q

Name some of the side effects of the progesterone only pill

A
  • Appetite increase
  • Hair loss/gain
  • Mood change
  • Bloating or fluid retention
  • Headache
  • Acne
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7
Q

Name some of the side effects of the depo injection

A
  • Weight gain
  • Delayed return of fertility
  • Bone density
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8
Q

Name some of the side effects of the progesterone implant

A
  • 30% have prolonged/frequent bleeding

- Mood changes

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9
Q

Name some of the benefits of the IUS

A

-Reduces menstrual bleeding

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10
Q

Name some of the options for emergency contraception and when they need to be taken by

A
  • Copper IUD (within five days of UPSI or day 19)
  • Levonorgestrel pill (72 hours)
  • Ullipristal pill (within 5 days)
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11
Q

Name the drugs used for a medical termination of pregnancy

A
  • Mifepristone

- Misoprostol

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12
Q

Name the causes of pelvic inflammatory disease

A
  • STIs
  • Uterine instrumentation
  • Post-partum
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13
Q

How does pelvic inflammatory disease present?

A
  • Lower abdominal pain
  • Deep dyspareunia (painful intercourse)
  • Vaginal discharge
  • intermenstrual/post-coital bleeding
  • Dysmenorrhoea
  • Fever
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14
Q

What investigations should be done for pelvic inflammatory disease?

A
  • Swabs for chlamydia and gonorrhoea
  • FBC, CRP & cultures if unwell
  • TVS
  • Laparoscopy
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15
Q

Name the complications of pelvic inflammatory disease

A
  • Tubo-ovarian abscess
  • Fitz-Hugh-Curtis syndrome (liver capsule inflammation)
  • Recurrent PID
  • Ectopic pregnancy
  • Subfertility
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16
Q

How can pelvic inflammatory disease be managed?

A
  • Ceftriaxone
  • Doxycycline
  • Metronidazole
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17
Q

How does gonorrhoea infection present?

A
  • Asymptomatic
  • PID
  • Epididymitis
  • Discharge
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18
Q

How is gonorrhoea managed?

A

Ceftriaxone

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19
Q

How does chlamydia present?

A
  • Discharge
  • Dysuria
  • Intermenstrual/post-coital bleeding
  • Conjunctivitis
  • Epididymitis
  • PID
  • Reactive arthritis
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20
Q

How is chlamydia managed?

A
  • Doxycycline

- Azithromycin if pregnant

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21
Q

How does trichomonas vaginalis present?

A
  • Asymptomatic

- Vaginal discharge

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22
Q

What are the complications of trichomonas vaginalis?

A
  • Miscarriage

- Preterm labour

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23
Q

How can trichomonas vaginalis be managed?

A

Metronidazole

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24
Q

How can anogenital warts be treated?

A
  • Podophyllotoxin
  • Imiquimod
  • Cryotherapy
  • Diathermy
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25
Q

How does syphilis present?

A
  • Local ulcer

- Rash, mucosal ulceration, neuro symptoms, alopecia

26
Q

How can syphilis be treated?

A
  • Benzathine penicillin

- Doxycycline

27
Q

How can urinary incontinence be assessed?

A
  • 3 day urinary diary
  • Urine dipstick
  • Bladder scan
  • Urodynamics
28
Q

Name the non-pharmacological managment options for incontinence

A
  • Pelvic floor muscle training
  • Smoking cessation
  • Weight loss
  • Diet changes
  • NO alcohol or caffeine
  • Physiotherapy
  • Surgery
29
Q

Name the medical treatment for stress incontinence

A

Duloxetine

30
Q

How can urge incontinence be managed?

A
  • Anti-muscarinic (oxybutinin etc.)
  • Beta-3 adrenoceptor agonists (mirabegron)
  • Alpha-blockers (tamsulosin etc.)
  • Anti-androgen drugs (male only - finasteride etc.)
31
Q

How can a missed miscarriage be managed?

A
  • Prostaglandins (misoprostol)

- Surgical management of miscarriage

32
Q

How can an ectopic pregnancy be managed?

A
  • Methotrexate
  • Salpingectomy
  • Conservative
33
Q

How does placenta praevia present?

A
  • Painless PV bleeding
  • Malpresentation of the fetus
  • Incidental
34
Q

How can placenta praevia be managed?

A

C-section

35
Q

How can PPH be managed

A
  • Medical: oxytocin, ergometrine, carbaprost and TXA
  • Balloon tamponade
  • Surgical: B lynch suture, ligation of vessels and hysterectomy
36
Q

How does placental abruption present?

A
  • Pain
  • Vaginal bleeding
  • Increased uterine activity
37
Q

How can preterm delivery be managed?

A
  • Steroids
  • Transfer to unit with NICU facilities
  • Aim for vaginal delivery
38
Q

Name the neonatal morbidities resulting from prematurity

A
  • RDS
  • Intraventricular haemorrhage
  • Cerebral palsy
  • Nutrition
  • Temperature
  • Jaundice
  • Infections
  • Visual impairment
  • Hearing loss
39
Q

What is HELLP syndrome?

A
  • Haemolysis
  • Elevated liver enzymes
  • Low platelets
40
Q

How can pre-eclampsia be managed?

A
  • Labetolol, methyldopa or nifedipine
  • Steroids if gestation <36 weeks
  • Aspirin in subsequent pregnancies
41
Q

How can eclampsia be managed?

A
  • IV magnesium sulphate
  • IV labetolol or hydrallazine
  • Avoid fluid overload
42
Q

How should VTEs be managed in pregnancy?

A

LMWH e.g. dalteparin

43
Q

How should women with epilepsy be managed during pregnancy?

A
  • High dose folic acid

- Lamotrigine or levetiracetam

44
Q

Name the presentation of hyperemesis gravidarum

A
  • Severe nausea and vomiting
  • Dehydration
  • Electrolyte imbalance
  • Ketonuria
  • Weight loss > 5%
45
Q

How can hyperemesis gravidarum be managed?

A
  • Self care advice
  • Adequate fluid intake
  • Oral anti-emetics
  • Consider hospital admission
46
Q

How can atrophic vaginitis be managed?

A
  • Topical HRT
  • Modified release vaginal tablet
  • Vaginal ring
47
Q

How does a fibroadenoma of the breast present?

A
  • Well circumscribed
  • Freely mobile
  • Non-painful
48
Q

How does endometriosis present?

A
  • Dysmenorrhoea
  • Dyspareunia
  • Cyclical or chronic pelvic pain
  • Subfertility
  • Bloating/lethargy/constipation
  • Menorrhagia
  • Adnexal tenderness
  • Chocolate cysts
49
Q

How can endometriosis be investigated?

A
  • Laparoscopy
  • Transvaginal USS
  • MRI
50
Q

How can endometriosis be managed?

A
  • COC pill
  • Medroxyprogesterone acetate
  • GnRH agonist
  • Levonorgestrel intrauterine system
  • Surgery (lesion removal, ovarian cystectomy and bilateral oophrectomy)
  • Pain relief: NSAIDs, paracetamol and COC
51
Q

How do fibroids present?

A
  • Asymptomatic
  • Excessive or prolonged heavy periods
  • Lethargy and pallor
  • Iron deficiency anaemia
  • Pelvic pain
  • Recurrent miscarriage or infertility
52
Q

How can fibroids be investigated?

A
  • Pregnancy test
  • FBC
  • Pelvic USS
  • TVUS
  • MRI
  • Endometrial histology
  • Hysteroscopy
53
Q

How can fibroids be managed?

A
  • NSAIDs
  • TXA
  • Mirena coil
  • GnRH agonists
  • Surgery (myomectomy, ablation and hysterectomy)
54
Q

What blood results would be expected for someone going through the menopause?

A
  • Low oestrogen and progesterone levels

- Increased LH and FSH

55
Q

How does PCOS present?

A
  • Oligomenorrhoea
  • Infertility or subfertility
  • Acne
  • Hirsutism
  • Alopecia
  • Obesity
  • Mood swings, depression and anxiety
  • Sleep apnoea
  • Normal to slightly raised testosterone
  • Elevated LH and normal FSH
  • USS scan showing characteristic ovaries
56
Q

How can PCOS be managed?

A
  • Lifestyle interventions (weight loss etc.)
  • COC pill
  • Metformin
  • Clomifene
57
Q

Name some of the causes of secondary amenorrhoea?

A
  • PCOS
  • Early menopause
  • Thyroid disease
  • Prolactinoma
  • Androgen secreting tumour
  • Pituitary failure
58
Q

How does cervical cancer present?

A
  • Abnormal vaginal bleeding
  • Vaginal discharge
  • Vaginal discomfort
  • Painless haematuria and rectal bleeding
59
Q

How does endometrial cancer present?

A
  • Post-menopausal bleeding
  • HNPCC
  • PCOS
  • Tamoxifen use
60
Q

How does ovarian cancer present?

A
  • Abdominal discomfort and bloating
  • Urinary frequency
  • Fatigue, weight loss, anorexia and depression
  • Pelvic or abdominal mass
  • PV bleeding
  • Ascites
  • CA 125
61
Q

Name the drugs used for a medical termination of pregnancy

A
  • Mifepristone

- Misoprostol

Finals (18 decks)

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