Oxford clinical specialties I Flashcards
Describe ovarian pain.
Ovarian pain tends to be felt in the iliac fossa and radiates down front of the thigh to the knee.
Describe uterine pain.
Uterine pain is often colicky and felt in the sacrum and groins.
When is day 1 of the menstrual cycle?
Day 1 of the menstrual cycle is the first day of menstruation.
What medication is given to postpone menstruation?
Norethisterone
Dysmenorrhoea can occur together with which other symptoms?
Nausea and vomiting
What is raised in Polycystic Ovarian syndrome?
Serum free androgen index is often raised
What will cause an increase in the levels of prolactin?
Prolactin levels are increased with stress, hypothyroidism and drugs like phenothiazines, domperidone and metoclopramide.
What tests or investigations are done for amenorrhoea?
- beta-HCG human chorionic gonadotropin level: to exclude pregnancy
- Prolactin: Raised in hypothyroidism, stress, and drugs like phenothiazines, metoclopramide and domperidone
- Serum free androgen index: raised in polycystic ovary syndrome
- FSH/LH: low if hypothalamic pituitary cause but normal if there is excessive exercise or weight loss
- TFT: abnormal thyroid function can lead to amenorrhoea
- testosterone: level >5nmol/L may indicate androgen secreting tumour or late onset congenital adrenal hyperplasia
Polycystic Ovarian syndrome features?
Acne, male pattern baldness, hirsutism.
Acanthosis nigricans on the neck and skin flexures may reflect hyperinsulinaemia
Which type of women are more at risk of PCOS? Why?
Obese women are more at risk of PCOS due to the increased likelihood of insulin resistance.
How is the diagnosis of PCOS made?
When patients present with secondary amenorrhoea or oligomenorrhoea and adequate oestrogen levels.
What is menorrhagia and how much blood loss is there?
Menorrhagia is increased menstrual blood loss of more than 80mL/cycle.
What medical conditions are considered for those presenting with menorrhagia?
Hypothyroidism, endometriosis, adenomyosis, fibroids, IUCD, polyps.
Endometrial carcinoma is considered in perimenopausal women.
When does symptoms of the Premenstrual syndrome be at its worse?
When will the symptoms become better?
PMS symptoms are worst before periods and are relieved by menstruation.
How can the medication - Pyridoxine, help for patients with PMS?
Pyridoxine 10MG OD PO can help provide symptomatic relief, if given continuously, may help low mood and headache.
