Pain and Bleeding + Contraception Flashcards
Post menopausal, weight loss, bloating, urinary frequency, pelvic pain, adnexal mass
Ovarian cancer
40s, first trimester gestation, high beta-hCG, snow storm appearance
Hydatidform mole
excessive vaginal discharge, PCB, adolescent, COCP
Cervical ectropion
Amenorrhoea, hirsutism, acne, TVUS shows polycystic ovaries
PCOS
Primary amenorrhoea, TVUS shows no uterus, otherwise normal pubertal development
Mullerian agenesis
Primary amenorrhoea, TVUS shows no uterus, karyotype 46, XY
Complete androgen insensitivity syndrome
TVUS shows double uterus with two separate cervices
Uterus didelphys
Management of menorrhagia
- NSAIDs/ Tranaxemic acid OR progestins
- GnRH agonists
- Surgical
Management of ectopic pregnancy
- Expectant with serial serum beta-hCG
- Methotrexate
- Surgical
Management of Pelvic Inflammatory Disease
Stat: CTX 500mg IM+ Azithromycin 1g orally
14d - 12 hourly: Metronidazole 400mg orally + Doxycycline 100mg orally
Management of Endometriosis
- NSAIDs + progestin
- Laparoscopic resection
- GnRH agonists
- Hysterectomy
Management of hydatidiform mole
Dilation and Curettage with/out MTX
Monitor Serum b-hCG weekly for 3w then monthly for 6m
TFT check
PCOS symptoms control management
SNAP , COCP, hair removal (epilation)
PCOS increasing fertility management
- Metformin, 2. Clomiphene, then other fertility drugs
Choice of HRT: Post menopausal
Oestrogen + continuous progesterone
Choice of HRT: Peri menopausal
Oestrogen + cyclical progesterone
Choice of HRT: hysterectomy NOT due to endometriosis
Oestrogen alone
Choice of HRT: Predominantly hot flushes
- Venlafaxine
2. Other drugs, cool showers, decrease caffeine + ETOH + spicy foods
Choice of HRT: Predominantly atrophic vaginitis
Topical PV oestrogen
Contraceptive indicated for PCOS/acne. increased risk of VTE and breast cancer, preferably avoid in HT, migraines, breastfeeding
COCP
Contraceptive indicated as good alternative to COCP if VTE risk, HT, migraines, breastfeeding. Must be taken daily in 3h window
POP (LNG 30ug)
Contraceptive good for heavy menstrual bleeding - HMB and breastfeeding. Lasts for FIVE years. Can have persistent irregular bleeding/spotting for 6 months or more
Mirena
Contraceptive is good oral emergency contraceptive within 3d.
Morning after pill (LNG 1.5mg)
Contraceptive is good for emergency contraceptive within 5d, cheaper than Mirena outside of Australia, lasts 10 years. Causes HMB.
Copper IUD
