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Yr 3 - Reproduction > Paediatric and Adult Gynaecology > Flashcards

Paediatric and Adult Gynaecology Flashcards

1
Q

How is competency tested in children?

A

Gillick Competence test

Fraser guidelines

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2
Q

What are the hormonal changes seen in puberty?

A

Increase in pulsatile LH secretion, due to increased GnRH secretion at night
Increased estradiol levels

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3
Q

What physical changes are seen in puberty?

A

Tanner Stages

Breast size, pubic hair etc

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4
Q

What changes are seen during the adolescent stage?

A 
Hormonal changes
Behavioural changes
Independence
Peer acceptance
Decisions over future
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5
Q

What is precocious puberty?

A

Appearance of secondary sexual characteristics before 8 in girls and 9 in boys

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6
Q

What is delayed puberty?

A

No testicular descent in boys at 14

No breast budding by 13, periods not started by 15

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7
Q

What is Vulvovaginitis?

A

Persistant vulval irritation/discharge

Peaks at 3 and 7 years

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8
Q

How does Vulvovaginitis

A

Offensive discharge
Vaginal soreness
Itching
Red flush around vulva/anus

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9
Q

What causes vulvovaginitis?

A

Poor perineal hygiene
Lack of estrogen
Chemical irritation (baths, detergents)

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10
Q

How does Foreign body present?

A

Vaginal bleeding

Persistent foul smelling discharge

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11
Q

When is the incidence of labial adhesions highest?

A

First year of life

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12
Q

When is surgery indicated in labial adhesions?

A

Persistent urinary symptoms with failed estrogen therapy

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13
Q

What are labial adhesions?

A

Thin membranous line where tissues fused, leading to a pinhole urethral opening

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14
Q

What is Menorrhagia?

A

Overfrequent, heavy and irregular periods

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15
Q

When are irregular periods normal?

A

First two years of periods in women

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16
Q

What conditions should be excluded in women with severe menorrhagia?

A

von Willebrand disease

Immune thrombocytopenic purpura

17
Q

How is menorrhagia treated?

A

Combined oral contraceptive pill
Tranexamic acid
Mirena coil

18
Q

What is the cause of Dysmenorrhoea?

A

Higher levels of prostaglandins

19
Q

How is Dysmenorrhoea treated?

A

Anti-prostaglandin drugs (mefenamic acid)

Suppression of ovulation (combined pill)

20
Q

How is primary Amenorrhoea defined?

A

Failure to menstruate by 16 years in presence of normal secondary sexual characteristics (14 years in absence of other evidence of puberty)

21
Q

How is secondary amenorrhoea defined?

A

Absent periods for atleast 6 months in previously regular woman (12 months if oligomenorrhoeic woman)

22
Q

What should be investigated in amenorrhoeic women?

A 
FSH
LH
PRL
TSH
Test + estrogen
Pelvic USS
Progesterone withdrawal bleed
23
Q

How is puberty induced in women?

A

Gradual build up with estrogen

Add progesterone once maximum height potential is reached

24
Q

What can cause secondary amenorrhoea?

A

Weight
PCOS
Pregnancy
Fluctuating LH/estrogens

25
Q

Why is PCOS hard to diagnose in adolescents?

A

Variable presentation similar to hypothalamic issues

26
Q

How is PCOS diagnosed?

A

FSH:LH
USS
Anovulation
Hyperandrogenism

27
Q

How is PCOS managed?

A

Weight loss
Lifestyle changes
Oral contraceptive pill

28
Q

What is PCOS?

A

Ovarian dysfunction

Hyperandrogenism

29
Q

What else must be excluded in PCOS patients?

A

Other causes of Hyperandrogenism

30
Q

How should endometriosis be treated?

A

NSAIDs

Oral contraceptive pill

31
Q

What should be considered in girls with bleeding disorders?

A 
Anovulation
Sexual abuse/trauma
Pregnancy 
Bleeding disorders (von willebrands, platelet defects)
Leukaemia
32
Q

A ruptured ovarian cyst presents how?

A

Subacute Hx
Tender to one side of pelvis
May feel uterine mass

33
Q

What is the cause of a mucoid discharge in infants up to 2 weeks after birth?

A

Maternal estrogen

34
Q

What is the cause of a mucoid discharge prepubertal girls?

A

Increased estrogen production by maturing ovaries

35
Q

What can cause a pathological vaginal discharge?

A

E. coli, Proteus, Pseudomonas
Hemolytic streptococcal vaginitis
Monial vaginitis
Foregin body

36
Q

How is vaginal discharge managed?

A

Find causative organisms (culture)
Urinalysis (cystitis)
Review hygiene
Perianal examination (pinworms)

37
Q

How is persistent discharge managed?

A

Examination under anaesthesia to rule out foreign body

38
Q

What should be considered in adolescent transgender patients?

A

Sandyford clinics
Support for individual
Fertility preservation

39
Q

How is endometriosis diagnosed?

A

Laparoscopy

Yr 3 - Reproduction (37 decks)

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