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OBSGYN Y4 > Pain and Bleeding + Contraception > Flashcards

Pain and Bleeding + Contraception Flashcards

1
Q

Post menopausal, weight loss, bloating, urinary frequency, pelvic pain, adnexal mass

A

Ovarian cancer

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2
Q

40s, first trimester gestation, high beta-hCG, snow storm appearance

A

Hydatidform mole

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3
Q

excessive vaginal discharge, PCB, adolescent, COCP

A

Cervical ectropion

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4
Q

Amenorrhoea, hirsutism, acne, TVUS shows polycystic ovaries

A

PCOS

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5
Q

Primary amenorrhoea, TVUS shows no uterus, otherwise normal pubertal development

A

Mullerian agenesis

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6
Q

Primary amenorrhoea, TVUS shows no uterus, karyotype 46, XY

A

Complete androgen insensitivity syndrome

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7
Q

TVUS shows double uterus with two separate cervices

A

Uterus didelphys

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8
Q

Management of menorrhagia

A
  1. NSAIDs/ Tranaxemic acid OR progestins
  2. GnRH agonists
  3. Surgical
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9
Q

Management of ectopic pregnancy

A
  1. Expectant with serial serum beta-hCG
  2. Methotrexate
  3. Surgical
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10
Q

Management of Pelvic Inflammatory Disease

A

Stat: CTX 500mg IM+ Azithromycin 1g orally

14d - 12 hourly: Metronidazole 400mg orally + Doxycycline 100mg orally

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11
Q

Management of Endometriosis

A
  1. NSAIDs + progestin
  2. Laparoscopic resection
  3. GnRH agonists
  4. Hysterectomy
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12
Q

Management of hydatidiform mole

A

Dilation and Curettage with/out MTX
Monitor Serum b-hCG weekly for 3w then monthly for 6m
TFT check

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13
Q

PCOS symptoms control management

A

SNAP , COCP, hair removal (epilation)

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14
Q

PCOS increasing fertility management

A
  1. Metformin, 2. Clomiphene, then other fertility drugs
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15
Q

Choice of HRT: Post menopausal

A

Oestrogen + continuous progesterone

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16
Q

Choice of HRT: Peri menopausal

A

Oestrogen + cyclical progesterone

17
Q

Choice of HRT: hysterectomy NOT due to endometriosis

A

Oestrogen alone

18
Q

Choice of HRT: Predominantly hot flushes

A
  1. Venlafaxine

2. Other drugs, cool showers, decrease caffeine + ETOH + spicy foods

19
Q

Choice of HRT: Predominantly atrophic vaginitis

A

Topical PV oestrogen

20
Q

Contraceptive indicated for PCOS/acne. increased risk of VTE and breast cancer, preferably avoid in HT, migraines, breastfeeding

A

COCP

21
Q

Contraceptive indicated as good alternative to COCP if VTE risk, HT, migraines, breastfeeding. Must be taken daily in 3h window

A

POP (LNG 30ug)

22
Q

Contraceptive good for heavy menstrual bleeding - HMB and breastfeeding. Lasts for FIVE years. Can have persistent irregular bleeding/spotting for 6 months or more

A

Mirena

23
Q

Contraceptive is good oral emergency contraceptive within 3d.

A

Morning after pill (LNG 1.5mg)

24
Q

Contraceptive is good for emergency contraceptive within 5d, cheaper than Mirena outside of Australia, lasts 10 years. Causes HMB.

A

Copper IUD

25
Q

Contraceptive good for young, breastfeeding, fertility quickly restore upon removal, lasts 3 years. Can cause irregular periods

A

Implanon

26
Q

Contraceptive used 3 monthly. Fertility not immediately restored, increased risk osteoporosis and weight gain.

A

Depo injection

27
Q

Victorian Law Abortion protocol

A

Legal upon request up to W24

28
Q

Medical abortion protocol

A

(D1) 200mg oral mifepristone, (D3) 800ug PV misoprostol + diclofenac. If no bleeding within 3h, give further 400ug misoprostol (max 4 doses)

29
Q

Surgical abortion protocol

A

3h before 400ug PV misoprostol, 30m before diclofenac, GA, mechanical dilatation (Hegar dilator), vacuum aspiration of foetus. Give doxycycline prior in Australia.

30
Q

IMB, premenopausal, benign uterine growth

A

endometrial polyp

31
Q

HMB, premenopausal, benign uterine mass

A

Fibroid

32
Q

PMB, post menopausal, increased endometrial thickness

A

endometrial cancer

33
Q

young adolescent, first few months after menarche, irregular bleeding

A

anovulatory bleeding

34
Q

20s lower abdominal pain, vaginal bleeding, +ve bHCG

A

Ectopic pregnancy

35
Q

20s lower abdominal pain, fever, cervical/adnexal motion tenderness

A

PID

36
Q

dysmenorrhoea starting just before menses, infertility, pelvic mass

A

endometriosis

37
Q

dysmenorrhoea starting at menses, other PMS symptoms

A

primary dysmenorrhea

38
Q

dysmenorrhoea, HMB, enlarged boggy uterus

A

adenomyosis

OBSGYN Y4 (5 decks)

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